Hashimoto Thyroiditis Medication

  • Author: Stephanie L Lee, MD, PhD; Chief Editor: George T Griffing, MD   more...
 
Updated: Nov 11, 2011
 

Medication Summary

As previously discussed, the treatment of choice for Hashimoto thyroiditis (or hypothyroidism from any cause) is thyroid hormone replacement. The drug of choice is orally administered levothyroxine sodium, usually for life.

Tailor and titrate the dose of levothyroxine sodium to meet the individual patient's requirements. The goal of therapy is to restore a clinically and biochemically euthyroid state.

The following medications interfere with the absorption of levothyroxine from the gastrointestinal tract, and patients should be advised to separate ingestion of these compounds from ingestion of levothyroxine by at least 4 hours:

  • Cholestyramine
  • Ferrous sulfate
  • Sucralfate
  • Calcium carbonate
  • Aluminium hydroxide and other antacids
  • Iron-containing multivitamins

Medications that enhance the metabolism and clearance of levothyroxine may necessitate an increase in the replacement dose. These medications include phenytoin, carbamazepine, and rifampin.

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Thyroid Products

Class Summary

These are used as thyroid hormone replacements.

View full drug information

Levothyroxine sodium (Levoxyl, Synthroid, Levothroid)

 

This is a synthetic thyroid hormone (T4). It is available in 12 strengths for easy dose adjustment. Absorption of levothyroxine sodium is 48-79% when it is administered orally; absorption is higher in persons in a fasting state. Normal T4 levels are achieved within 24 hours and normal T3 levels are reached within a few days. Thyroid hormone is involved in normal metabolism, growth, and development.

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Contributor Information and Disclosures
Author

Stephanie L Lee, MD, PhD  Associate Professor, Department of Medicine, Boston University School of Medicine; Director of Thyroid Health Center, Associate Chief, Section of Endocrinology, Diabetes and Nutrition, Boston Medical Center; Fellow, Association of Clinical Endocrinology

Stephanie L Lee, MD, PhD is a member of the following medical societies: American College of Endocrinology, American Thyroid Association, and Endocrine Society

Disclosure: Nothing to disclose.

Coauthor(s)

Sylvester Odeke, MD, FACE  Clinical Assistant Professor of Medicine, Division of Endocrinology and Metabolism, The Brody School of Medicine at East Carolina University

Sylvester Odeke, MD, FACE is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Endocrinology, and North Carolina Medical Society

Disclosure: Nothing to disclose.

Steven B Nagelberg, MD  Clinical Professor, Department of Medicine, Division of Endocrinology and Metabolism, Drexel University College of Medicine

Steven B Nagelberg, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Clinical Endocrinologists, American College of Physicians, American Diabetes Association, American Medical Association, Endocrine Society, and Pennsylvania Medical Society

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD  Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

Additional Contributors

Don S Schalch, MD Professor Emeritus, Department of Internal Medicine, Division of Endocrinology, University of Wisconsin Hospitals and Clinics

Don S Schalch, MD is a member of the following medical societies: American Diabetes Association, American Federation for Medical Research, Central Society for Clinical Research, and Endocrine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References

  1. Fava A, Oliverio R, Giuliano S, et al. Clinical evolution of autoimmune thyroiditis in children and adolescents. Thyroid. Feb 18 2009;[Medline].

  2. Hadj-Kacem H, Rebuffat S, Mnif-Feki M, et al. Autoimmune thyroid diseases: genetic susceptibility of thyroid-specific genes and thyroid autoantigens contributions. Int J Immunogenet. Apr 2009;36(2):85-96. [Medline].

  3. Duntas LH. Environmental factors and autoimmune thyroiditis. Nat Clin Pract Endocrinol Metab. Aug 2008;4(8):454-60. [Medline].

  4. Tomer Y, Huber A. The etiology of autoimmune thyroid disease: a story of genes and environment. J Autoimmun. Mar 21 2009;[Medline].

  5. Jørgensen KT, Rostgaard K, Bache I, et al. Autoimmune diseases in women with Turner's Syndrome. Arthritis Rheum. Feb 25 2010;62(3):658-666. [Medline].

  6. Wiebolt J, Achterbergh R, den Boer A, et al. Clustering of additional autoimmunity behaves differently in Hashimoto's patients compared with Graves' patients. Eur J Endocrinol. May 2011;164(5):789-94. [Medline].

  7. [Best Evidence] Vestgaard M, Nielsen LR, Rasmussen AK, et al. Thyroid peroxidase antibodies in pregnant women with type 1 diabetes: impact on thyroid function, metabolic control and pregnancy outcome. Acta Obstet Gynecol Scand. 2008;87(12):1336-42. [Medline].

  8. Tagami T, Tamanaha T, Shimazu S, et al. Lipid Profiles in the Untreated Patients with Hashimoto Thyroiditis and the Effects of Thyroxine Treatment on Subclinical Hypothyroidism with Hashimoto Thyroiditis. Endocr J. Dec 22 2009;[Medline]. [Full Text].

  9. Vanderpump MP, French JM, Appleton D. The prevalence of hyperprolactinaemia and association with markers of autoimmune thyroid disease in survivors of the Whickham Survey cohort. Clin Endocrinol (Oxf). Jan 1998;48(1):39-44. [Medline].

  10. Vanderpump MP, Tunbridge WM, French JM. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf). Jul 1995;43(1):55-68. [Medline].

  11. Kim KW, Park YJ, Kim EH, et al. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto's thyroiditis. Head Neck. May 2011;33(5):691-5. [Medline].

  12. Huber A, Menconi F, Corathers S, et al. Joint genetic susceptibility to type 1 diabetes and autoimmune thyroiditis: from epidemiology to mechanisms. Endocr Rev. Oct 2008;29(6):697-725. [Medline].

  13. Baloch ZW, LiVolsi VA. Fine-needle aspiration of the thyroid: today and tomorrow. Best Pract Res Clin Endocrinol Metab. Dec 2008;22(6):929-39. [Medline].

  14. Escobar-Morreale HF, Botella-Carretero JI, Escobar del Rey F, et al. REVIEW: Treatment of hypothyroidism with combinations of levothyroxine plus liothyronine. J Clin Endocrinol Metab. Aug 2005;90(8):4946-54. [Medline]. [Full Text].

  15. z. Interferon alpha treatment and thyroid dysfunction. Endocrinol Metab Clin North Am. Dec 2007;36(4):1051-66; x-xi. [Medline]. [Full Text].

 
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