Thyroid hormone replacement medications treat hypothyroidism. The common drugs include levothyroxine (Synthroid, Levoxyl, Tirosint), liothyronine (Cytomel, compounded time-released T3), and natural desiccated thyroid (Nature-throid, Thyroid WP, Armour Thyroid.)
If you are on thyroid hormone replacement medication, you will want to avoid making common mistakes that can interfere with the effectiveness of your treatment. We asked thyroid patients to share some of their own thyroid medication mistakes. Read and learn from their good advice!
Mistake #1: You fail to check your prescription carefully when you receive it from the pharmacy.
When you pick up or receive your thyroid medication, you should:
- Check to make sure it’s the correct medication, at the correct dosage.
- Count the pills or capsules to make sure you received your full prescription.
- Ensure that a generic has not been substituted for your brand-name medication.
Marilyn was lucky that she routinely double-checked her prescriptions. She says: “I went to my pharmacy to pick up my thyroid prescription. They switched my name brand to a generic, and I caught it before I left their counter.”
Linda had a similar experience, getting a generic instead of the brand-name medication she usually took. In her case, it wasn’t the pharmacy’s fault. “It was the insurance company that made the switch,” says Linda.
Mistake #2: You forget to take your thyroid medication
One of the most common mistakes is to forget to take your thyroid medication. Angie takes Synthroid.
“I forget to take it … a lot! That is my biggest mistake. I tried writing myself a note, setting a reminder, getting a daily pill box, and leaving it out on the counter so I see it. I will be great for like two months, then forget two or three days in a row and wonder: ‘Why do I feel like crap?’”
Even a few days of forgetfulness can have an impact on your health. It is also particularly important to remember your thyroid medication if you are on a suppressive dose to prevent a recurrence of thyroid cancer.
Mistake #3: You double-dose your thyroid medication
Even if you remember to take your medication, you may forget you’ve taken it, and take it again!
Kate says: “I keep forgetting I have already taken it and then take it another time. Then I end up so wired and energetic that I can’t sleep!” Tina reports that she sometimes takes her medication twice because she forgets she already took it. “Racing heart, much?!”
To avoid double-dosing, some patients turn the bottle upside down or move it from one location to another after it’s been taken. A pill box with individual slots for each day, or even for morning and evening medications, can also help you remember whether you’ve taken your medication, and help you prevent accidental double-dosing.
Mistake #4: You don’t take your medication correctly
Thyroid medication should generally be taken in the morning, an hour before eating any food, drinking coffee, or drinking milk, and at least three hours apart from taking any calcium or iron supplements or calcium-fortified drinks. If you take it in the evening, you should wait at least three to four hours after eating.
Some thyroid medications, however, have specialized instructions. Levoxyl brand levothyroxine, for example, needs to be taken with a full glass of water, according to prescribing instructions from the manufacturer. According to Anne: “One of my worst thyroid medication mistakes was taking Levoxyl without plenty of water. Once I started drinking a full glass of water after taking the pill, I started losing weight and my pill worked effectively.”
Mistake #5: You don’t store your medication properly
If you don’t store your medication properly, it can lose potency quickly and become less effective. Ideally, you should store your thyroid medication in a dry place, away from humidity and light. (This means the bathroom, or near the kitchen window, are not good places for your thyroid drugs.)
It’s also important that your thyroid medication is not exposed to temperature extremes. Store your thyroid medication at no more than 80 degrees Fahrenheit. Be careful about leaving your thyroid drugs in a hot car or mailbox, or in areas without air conditioning when temperatures exceed 80 degrees.
Mistake #6: You mix up pills
Many pills look the same. If you take multiple prescriptions, or there are many medications in your home for family members or roommates, it’s important to double check the labels. Donna’s experience explains why this advice is so crucial:
“My Synthroid pills and my 15-year-old son’s Focalin (for attention deficit hyperactivity disorder - ADHD) are a similar size and color. The pharmacy’s printer ink was nearly out, so the bottles came with very lightly printed labels. We happened to get them filled at the same time. So, for three days, I accidentally took his ADHD medication, and he took my Synthroid. (I did get so much accomplished in those three days!)”
(Note: Donna did contact her healthcare provider and confirmed that there was no danger to her son from the mix-up.)
Andrea also had a snafu.
“I mixed up Cytomel (small, white, round, and flat) pills with someone else’s blood pressure medication (a small, white, round, flat pill) for three or four days. I was incredibly calm and subdued but could barely move. I already have naturally low blood pressure, and being off thyroid meds for four days? Whoa!”
Mistake #7: You fail to check ingredients if you have allergies
Various thyroid medications contain ingredients, used as fillers and binders, that can trigger your allergies or sensitivities. These ingredients include gluten, soy, acacia (from tree bark), and lactose. Teresa recommends that you talk to the pharmacist and “ask to see an ingredient list.”
Note that if you have a pork allergy, you are not a good candidate for natural desiccated thyroid - also known as porcine thyroid - which is manufactured from the dried thyroid gland of pigs.
Mistake #8: You think all compounding pharmacies are the same
Some compounding pharmacies have a bad track record when producing compounded, time-released T3 medications. Research and choose carefully, ensuring that your pharmacy has a good reputation for high-quality production of compounded thyroid medication.
Corey made this mistake.
“I moved my time-released T3 prescription from one pharmacy to a local one. After taking just one pill from the new pharmacy in the morning as usual, that afternoon I felt like I had electricity running up and down my arms! I switched back to the old pharmacy, and it all calmed down.”
Mistake #9: You don’t separate coffee, milk, and your thyroid medication
Drinking coffee (including decaf coffee), milk, or milk products too close to taking your thyroid medication can reduce your absorption of thyroid hormone medication and make it less effective. Says Susan: “I used to take my Synthroid with a cup of coffee with cream and sugar. I had no idea I had to wait!”
Experts recommend waiting at least an hour after you take your thyroid medication before drinking coffee or milk products.
Mistake #10: You stop taking your medication while pregnant or breastfeeding
Most women are very careful about prescription and over-the-counter medications during and after pregnancy. But it’s important to realize that for a healthy pregnancy and baby, not only must you continue to take your thyroid hormone replacement medication, you will probably require a dosage increase. Unfortunately, not all doctors know this, as Joyce learned. She says: “I stopped talking Synthroid while pregnant on my doctor’s advice.”
You should also continue to take your thyroid hormone replacement medication while breastfeeding. If you are on the proper dosage, very little medication reaches your baby via breast milk.
Mistake #11: You don’t recognize the symptoms of overmedication
If you end up accidentally overmedicated on thyroid hormone replacement, you can experience many symptoms you may not realize are related to your thyroid medication.
Caroline spent two years in this situation.
“I had rushes of adrenaline, a thumping heartbeat, racing heart rate, sweating, feelings of extreme hunger, and high blood pressure. They put all these symptoms down to anxiety. After my prescription was accidentally lowered by 25 percent, all my symptoms have subsided!”
Some other symptoms of overmedication include diarrhea, weight loss, and insomnia. If you have any of these symptoms while on thyroid medication, be sure to consult your healthcare provider.
Make sure that you read through the informational materials provided by your pharmacist with your prescription. For additional information, read, “How to Effectively Take Thyroid Medication.”
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Mary Shomon is a thyroid disease, hormonal and autoimmune health writer, and patient advocate. For two decades, Mary has been a leading force advocating for more effective, patient-centered thyroid and hormonal health care. Mary is the New York Times bestselling author of “The Thyroid Diet Revolution,” “Your Healthy Pregnancy with Thyroid Disease,” “Living Well With Hypothyroidism,” and 10 other books on thyroid disease and integrative health. She co-stars in two PBS health specials, “Healthy Hormones,” and “Vibrant for Life.” Follow her on Twitter at @thyroidmary or at her Facebook communities: ThyroidSupport and ThyroidDiet.