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Levothyroxine is a commonly used prescription drug used to treat hypothyroidism, which is when the thyroid gland cannot produce enough thyroid hormone. Because it takes a long time to take effect, it is easy for patients to tolerate and the dosage is easy to control. It is currently an alternative treatment for hypothyroidism. Its advantages are low price and easy to take. The disadvantages are that it needs to be taken for a long time or even for life, and exogenous hormones are used to supplement the insufficient secretion of the thyroid gland. Some people have certain side effects, and hypothyroidism cannot be completely cured. Discontinuation of the drug is prone to relapse.

Without thyroid hormone, your body cannot function properly, which may result in poor growth, slow speech, lack of energy, excessive tiredness, constipation, weight gain, hair loss, dry, thick skin, increased sensitivity to cold, joint and muscle pain, heavy or irregular menstrual periods, and depression. When taken correctly, levothyroxine reverses these symptoms.

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Potential Long-Term Side Effects

Though Levothyroxine is considered safe for long-term use, there are some potential side effects that may arise with extended treatment. Overuse or incorrect dosing can lead to symptoms of hyperthyroidism, such as rapid heart rate, anxiety, and unintended weight loss. Chronic use might also impact bone density, potentially increasing the risk of osteoporosis, and can influence cardiovascular health, possibly exacerbating heart conditions.

How should this medicine be used?

Levothyroxine comes as a tablet and a capsule to take by mouth. It usually is taken once a day on an empty stomach, 30 minutes to 1 hour before breakfast. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take levothyroxine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow capsules whole; do not chew or crush them. Do not remove the capsule from the package until you are ready to take it.

Take the tablets with a full glass of water as they may get stuck in your throat or cause choking or gagging.

If you are giving levothyroxine to an infant, child, or adult who cannot swallow the tablet, crush and mix it in 1 to 2 teaspoons (5 to 10 mL) of water. Only mix the crushed tablets with water; do not mix it with food or soybean infant formula. Give this mixture by spoon or dropper right away. Do not store it for later use.

Your doctor will probably start you on a low dose of levothyroxine and gradually increase your dose.

Levothyroxine controls hypothyroidism but does not cure it. It may take several weeks before you notice a change in your symptoms. Continue to take levothyroxine even if you feel well. Do not stop taking levothyroxine without talking to your doctor.

Impact on Bone Health

One notable concern with long-term Levothyroxine use is its impact on bone health. Studies suggest that excessive thyroid hormone levels, whether from medication or thyroid overactivity, can accelerate bone loss. This is particularly significant for postmenopausal women and older adults, who are already at higher risk for osteoporosis. Regular monitoring of bone density and appropriate medication adjustments can help mitigate this risk.

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Monitoring and Managing Risks

To manage the potential long-term effects of Levothyroxine, regular monitoring by healthcare professionals is crucial. Blood tests to check thyroid hormone levels and routine assessments of bone density and cardiovascular health can help catch any issues early. Patients should work closely with their healthcare providers to ensure their medication dose is properly adjusted and to address any emerging symptoms.

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What side effects can this medication cause?

Levothyroxine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• weight gain or loss
• headache
• vomiting
• diarrhea
• changes in appetite
• fever
• changes in menstrual cycle
• sensitivity to heat
• hair loss
• joint pain
• leg cramps

Some side effects can be serious. If you experience either of the following symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment:

• shortness of breath, wheezing, hives, itching, rash, flushing, stomach pain, nausea, or swelling of hands, feet, ankles, or lower legs

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