Levothyroxine After Diagnosis of Hypo- and Hyperthyroidism?

[Vaibhav]

Hi, my sister Arya is a 24-year-old woman, she is staying in US. She comes into the pharmacy with a new prescription for levothyroxine. She tells the pharmacist she was recently diagnosed with hypothyroidism due to Hashimoto’s disease. She says that her friend’s mother was diagnosed with a hyperactive thyroid and also takes levothyroxine. Arya is worried that this is the wrong prescription, and she does not want to take something that will make her go more “hypo,” as she is a student and really needs to have energy for her busy life. Please suggest if anyone is aware of this.

[Ted]

@vaibhav It is important that the pharmacist assure your sister that levothyroxine is the correct medication for her; in fact, it is the first-line treatment for her condition, because it will increase her thyroid hormone levels back to normal. Arya should be counseled that it may take a few weeks for her to notice a difference, and that her doctor may need to adjust her dose gradually to get her thyroid hormone levels where they need to be. It will also be important to clarify with Arya that sometimes levothyroxine is used in patients with a hyperactive thyroid (Graves’ disease), but only after their thyroid is removed through surgery or by destroying all or part of it through treatment with radioactive iodine. After such procedures, patients may become permanently hypothyroid and need to take levothyroxine daily, just like her.