Synthroid Uses, Dosage & Side Effects

A levothyroxine product that is not therapeutically equivalent with SYNTHROID might not have the exact same effect on the patient’s TSH as SYNTHROID. In the elderly and in patients with cardiovascular disease, SYNTHROID should be initiated at lower doses than those recommended in younger individuals or in patients without cardiac disease. Patients with coronary artery disease who are receiving SYNTHROID should be closely monitored for cardiac arrhythmias during surgical procedures.

AbbVie is dedicated to ensuring that all SYNTHROID products are manufactured at the highest standards. One is, I indicate to them that there are certain SYNTHROID programs where the patient can receive additional educational resources that can help them with savings and tips and tools to how to make sure they get the most of their SYNTHROID treatment. I can write the prescription for SYNTHROID and also drop down to the pharmacy and type in SYNTHROID as well, and guarantee that the prescription is sent out to the SYNTHROID pharmacy and know that the patient will be prescribed and dispensed brand-name SYNTHROID only. Some key points that I discuss with the patients during appointments are, one, is that this is an open conversation.

• Patients on high dosages of levothyroxine (greater than 200 mcg per day) with persistently elevated TSH levels may be nonadherent or have absorption issues attributed to meal timing or other medications1,5,20 (Table 5 and Table 820).
• A search of the literature was conducted using the PubMed and CENTRAL (Cochrane) databases.
• In pregnancy, results of ongoing and future clinical trials are awaited to inform whether all pregnant women should be screened and treated for subclinical hypothyroidism.

SYNTHROID has been committed to treating hypothyroidism for 65 years.3

Optimal treatment of hypothyroidism requires a partnership between patient and physician. The physician is tasked with vigilant appraisal of the patient’s status based on a thorough clinical and laboratory assessment and appropriate adjustment of their levothyroxine therapy. The patient in turn is tasked with medication adherence and reporting of symptomatology and any changes in their medical situation. The goal is consistent maintenance of euthyroidism, without the patient experiencing the adverse events and negative health consequences of under- or overtreatment. Clinical hypothyroidism affects one in 300 people in the United States, with a higher prevalence among female and older patients. Symptoms range from minimal to life-threatening (myxedema coma); more common symptoms include cold intolerance, fatigue, weight gain, dry skin, constipation, and voice changes.

Diagnosis

Since thyroid hormone occurs naturally in the body, almost anyone can take levothyroxine. However, you may not be able to take this medicine if you have certain medical conditions. And to adjust the dose based on periodic assessment of the patient's clinical response and their laboratory values. The second is that Synthroid has a history, as physicians have been treating patients with hypothyroidism with Synthroid for over 65 years.

Firstly, a number of them have a TSH outside the normal range, suggesting a suboptimal dosage of levothyroxine. Secondly, given that both hypothyroidism and dysphoria are common diagnoses, there will be a clinical overlap and thus symptoms attributed to hypothyroidism may not improve with treatment. Moreover, patients feeling unwell are more likely to seek medical advice and thus get their thyroid function tested. Furthermore, in thyroidectomized rats, tissue euthyroidism could be achieved by infusion of both levothyroxine and triiodothyronine and not by levothyroxine alone.49 These observations led to the hypothesis that a triiodothyronine-levothyroxine combination is necessary to restore tissue euthyroidism in patients with hypothyroidism. It remains uncertain as to why a minority of hypothyroid patients on levothyroxine continue to have residual symptoms despite apparently adequate replacement, and it is hoped that future studies will clarify this enigma.

Moreover, despite several randomized controlled trials showing a lack of benefit of combining triiodothyronine with levothyroxine in such patients,51 it is possible that triiodothyronine formulated to mimic the normal physiological profile may have a better outcome. Indeed, a proof of concept study has demonstrated the biochemical efficacy of a combination of long-acting triiodothyronine and levothyroxine on the T4/T3 ratio and TSH over levothyroxine monotherapy.101 Further studies are required to see whether this biochemical advantage translates into clinical benefit. Finally, recent genetic studies have shown associations between common genetic variations and thyroid hormone levels,23–26,55,102 wellbeing in levothyroxine- treated patients,55 and response to triiodothyronine-levothyroxine combination synthroid anorexia treatment,55 opening the door to the possibility of pharmacogenomics. Future genetic studies may help in identifying the subgroup of patients who would benefit from combination therapy. Prolonged untreated hypothyroidism can lead to persistent bradycardia, an adverse atherogenic lipid profile, and deterioration in myocardial function. Thyroid hormones, including SYNTHROID, either alone or with other therapeutic agents, should not be used for the treatment of obesity or for weight loss.

Hypothyroid medications require precise dosing and careful

If there is a suspicion for levothyroxine treatment having been prescribed unnecessarily, this can be investigated via a test period incorporating 6- to 8-week therapy discontinuation, followed by TSH testing. Euthyrox (levothyroxine) is used to treat hypothyroidism and to treat or prevent goiter. Armour Thyroid is used for hashimoto's disease, hypothyroidism, after thyroid removal, thyroid ... Synthroid can be given to infants and children who cannot swallow whole tablets by crushing the tablet and mixing the freshly crushed tablet in a small amount (5 to 10 mL or 1 to 2 teaspoonfuls) of water and immediately giving the misture by spoon or dropper.

• Initial dosing of levothyroxine can vary greatly and may be based on the amount of residual thyroid function retained by the patient, the body weight or lean body mass of the patient, and thyroid-stimulating hormone levels.
• There are also certain vitamins and supplements that can interfere with the absorption of SYNTHROID.
• 19 Thyroid function should be checked as soon as the pregnancy is confirmed to adjust the dose of levothyroxine further.
• This is important as 32% of patients who think they are on SYNTHROID are actually not given this because substitutions are made at the pharmacy.
• Some patients may experience persistent symptoms despite adequate dosing of levothyroxine to a normal TSH level; therefore, other etiologies should be considered and evaluated accordingly (Table 41,2).

Avoidance of Over- and Under-Dosing with Levothyroxine

Dangerous side effects or death can occur from the misuse of levothyroxine, especially if you are taking any other weight-loss medications or appetite suppressants. You may not be able to take Synthroid if you have certain medical conditions. Tell your doctor if you have an untreated or uncontrolled adrenal gland disorder, a thyroid disorder called thyrotoxicosis, or if you have any recent or current symptoms of a heart attack. Synthroid is also used in patients who need surgery and radioiodine therapy to manage a type of thyroid cancer called well-differentiated thyroid cancer.

• An example of the dose requirement in those with Hashimoto’s thyroiditis without residual function and post-surgical hypothyroidism is approximately 1.6 μg/kg 8.
• An alternative approach is to advise the woman to increase the dose of levothyroxine by 30%–50%77 or by two tablets per week81 as soon as pregnancy is confirmed to avoid any delay in dose increment.
• Failure of the serum T4 to increase into the upper half of the normal range within 2 weeks of initiation of SYNTHROID therapy and/or of the serum TSH to decrease below 20 mIU per liter within 4 weeks may indicate the patient is not receiving adequate therapy.
• However, a recent study suggests that this decreased requirement may be mediated by the changes in weight that may accompany ageing 26.

Please see the additional Important Safety Information at the end of this video, including the BOXED WARNING regarding inappropriate treatment for obesity or for weight loss. Primary hypothyroidism is basically diagnosed off of a screening TSH, or thyroid stimulating hormone. Administer SYNTHROID to pediatric patients who cannot swallow intact tablets by crushing the tablet, suspending the freshly crushed tablet in a small amount (5 to 10 mL) of water and immediately administering the suspension by spoon or dropper. Do not administer in foods that decrease absorption of SYNTHROID, such as soybean-based infant formula. In summary, it is necessary in all cases to periodically verify the need for dose adjustment and/or continuation of treatment.

DISCUSS THE FOLLOWING WITH PATIENTS WHEN PRESCRIBING SYNTHROID

Potential articles of interest were identified by title and abstract, and citation lists of articles of interest were used to identify additional literature. This article is based on previously conducted studies and does not contain any studies with animals performed by any of the authors. Some of the studies cited include analyses, or studies with human participants, performed by the authors and completed prior to the initiation of this manuscript. Signs and symptoms are nonspecific and can vary in individual presentations (Table 2 and Table 31,3,10). TSH may not normalize in some patients due to in utero hypothyroidism causing a resetting of pituitary-thyroid feedback. Failure of the serum T4 to increase into the upper half of the normal range within 2 weeks of initiation of SYNTHROID therapy and/or of the serum TSH to decrease below 20 mIU per liter within 4 weeks may indicate the patient is not receiving adequate therapy.