Treatment options for Hypothyroidism

By  , Expert Content
Mar 19, 2012

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  • Patients with hypothyroidism can control their condition by making lifestyle changes.
  • Obese or overweight hypothyroidism patients need a higher dose of medication.
  • People with certain medical conditions may find it hard to absorb the medicines.
  • Medicines like birth control pills can influence effectiveness of thyroid medicines.

Hypothyroidism is a medical condition in which the thyroid gland, also referred to as the butterfly gland fails to produce sufficient amount of the thyroid hormones for the functioning of the body. Hypothyroidism cannot be cured i.e. there is no medication, which can make the thyroid gland start to work normally again, but medications can completely control the symptoms in almost every patient.  Hence, most people with hypothyroidism need life-long medications.

thyroid gland

L-thyroxine or levothyroxine

Hypothyroidism is treated by synthetic thyroxine pills called L-thyroxine or levothyroxine. It is given at a dose to replace the amount of hormone that your own thyroid can no longer make so that your T4 and TSH normalise. Therefore, even if your thyroid gland cannot make enough thyroid hormone, medication for T4 replacement can restore the thyroid hormone levels and your body’s function. The synthetic thyroxine pills that are used contain hormone exactly like the T4 that the thyroid gland makes. Treatment for hypothyroidism is very successful as each dose of synthetic thyroxine keeps working in your blood for a very long time (about 7 days). Therefore, the level of T4 in your blood remains steady and this gives a constant supply of T4 to your body’s cells. Thyroxine remains for in your body for a long time (it takes about 4 weeks to clear completely from the body after stopping the medication). Most patients with hypothyroidism (except those with severe hypothyroidism) can be managed as outpatients and don’t need to be admitted in a hospital.

Dose of Thyroxine

The average dose of T4 in adults is 1.6 micrograms per kilogram per day. In most patients, this translates to approximately 100 to 150 micrograms per day. After diagnosing hypothyroidism, your doctor will decide on the starting dose of thyroxine based certain on factors such as:

  • Weight: People, who are obese/overweight need higher dose (that is the heavier you are the higher the dose may be)
  • Age:  In older people, the medication is started at a lower dose and is increased slowly to give their body time to adjust. Children usually need larger doses.
  • Cause of hypothyroidism: People, who have their thyroid gland removed surgically, need higher dose as all the T4 must be replaced.  If you have hypothyroidism, but your gland is still making hormone, you will need a lower dose.
  • Other associated conditions: Other diseases that you have also influence the dose of thyroxine such as people with celiac disease or Crohn’s disease may have trouble absorbing thyroxine and hence may need a higher dose; if you have heart disease, the doctor will start with a very low dose and increase it slowly.
  • Other medicines: Many medications interfere with the function of thyroxine such as if you are on birth control pills, hormone replacement therapy or epilepsy medications such as carbamazepine and valproate, you may need a higher dose.


Hypothyroidism can be controlled by making certain lifestyle changes as well as taking medications as instructed by the doctor. Do not dwell into alternative treatment options before consulting your doctor about the same.


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