Hashimoto Thyroiditis Medication
- Author: Stephanie L Lee, MD, PhD; Chief Editor: George T Griffing, MD more...
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:
Aluminium hydroxide and other antacids
Medications that enhance the metabolism and clearance of levothyroxine may necessitate an increase in the replacement dose. These medications include phenytoin, carbamazepine, and rifampin.
These are used as thyroid hormone replacements.
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.
Baloch ZW, LiVolsi VA. Fine-needle aspiration of the thyroid: today and tomorrow. Best Pract Res Clin Endocrinol Metab. 2008 Dec. 22(6):929-39. [Medline].
Fava A, Oliverio R, Giuliano S, et al. Clinical evolution of autoimmune thyroiditis in children and adolescents. Thyroid. 2009 Feb 18. [Medline].
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. 2009 Apr. 36(2):85-96. [Medline].
Duntas LH. Environmental factors and autoimmune thyroiditis. Nat Clin Pract Endocrinol Metab. 2008 Aug. 4(8):454-60. [Medline].
Tomer Y, Huber A. The etiology of autoimmune thyroid disease: a story of genes and environment. J Autoimmun. 2009 Mar 21. [Medline].
Jørgensen KT, Rostgaard K, Bache I, et al. Autoimmune diseases in women with Turner's Syndrome. Arthritis Rheum. 2010 Feb 25. 62(3):658-666. [Medline].
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. 2011 May. 164(5):789-94. [Medline].
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].
Mazokopakis EE, Papadomanolaki MG, Tsekouras KC, et al. Is vitamin D related to pathogenesis and treatment of Hashimoto's thyroiditis?. Hell J Nucl Med. 2015 Sep-Dec. 18(3):222-7. [Medline].
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. 2009 Dec 22. [Medline]. [Full Text].
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). 1998 Jan. 48(1):39-44. [Medline].
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). 1995 Jul. 43(1):55-68. [Medline].
Kim KW, Park YJ, Kim EH, et al. Elevated risk of papillary thyroid cancer in Korean patients with Hashimoto's thyroiditis. Head Neck. 2011 May. 33(5):691-5. [Medline].
Kahaly GJ, Diana T, Glang J, et al. Thyroid Stimulating Antibodies Are Highly Prevalent in Hashimoto's Thyroiditis and Associated Orbitopathy. J Clin Endocrinol Metab. 2016 May. 101(5):1998-2004. [Medline].
Huber A, Menconi F, Corathers S, et al. Joint genetic susceptibility to type 1 diabetes and autoimmune thyroiditis: from epidemiology to mechanisms. Endocr Rev. 2008 Oct. 29(6):697-725. [Medline]. [Full Text].
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. 2005 Aug. 90(8):4946-54. [Medline]. [Full Text].
Bozkurt NC, Karbek B, Ucan B, Sahin M, Cakal E, Ozbek M, et al. The Association Between Severity of Vitamin D Deficiency and Hashimoto's Thyroiditis. Endocr Pract. 2013 Jan 21. 1-14. [Medline].
Tomer Y, Blackard JT, Akeno N. Interferon alpha treatment and thyroid dysfunction. Endocrinol Metab Clin North Am. 2007 Dec. 36 (4):1051-66; x-xi. [Medline]. [Full Text].
Dorr HG, Bettendorf M, Binder G, Karges B, Kneppo C, Schmidt H, et al. Levothyroxine Treatment of Euthyroid Children with Autoimmune Hashimoto Thyroiditis: Results of a Multicenter, Randomized, Controlled Trial. Horm Res Paediatr. 2015 Aug 7. [Medline].
Pyzik A, Grywalska E, Matyjaszek-Matuszek B, Rolinski J. Immune disorders in Hashimoto's thyroiditis: what do we know so far?. J Immunol Res. 2015. 2015:979167. [Medline].
Caturegli P, De Remigis A, Rose NR. Hashimoto thyroiditis: clinical and diagnostic criteria. Autoimmun Rev. 2014 Apr-May. 13 (4-5):391-7. [Medline].