PATIENT GUIDELINES FOR THYROID HORMONE THERAPY

Your physician has prescribed thyroid hormone (thyroxine) to treat your thyroid condition. This medication will supplement or replace you own thyroid gland function. For the best results it is important that you take the correct dose faithfully and follow a few guidelines. Take your medication consistently at the same time, ideally in the morning on an empty stomach. If a dose is missed you can make it up at a later time or the next day. Separate your thyroid hormone by 4 hours from iron containing multi-vitamins, iron tablets, calcium supplements, antacids, and soy products. Thyroid medication doses vary from 0.025 mg to 0.3 mg tablets. Your medication dose is embossed on the color-coded tablet. Your doctor will select a dose appropriate for your situation. Take the same brand of thyroxine regularly, since all preparations are not the same. Generic forms of thyroxine are not recommended. If you switch to another preparation, a blood test should be done in 4-6 weeks to confirm the adequacy of your new medication. Sometimes it is necessary to "fine tune" a dosing schedule by adding or subtracting a weekly tablet. There are other medications that may affect your requirements for thyroid hormone. Notify your doctor if you start or stop the following medications: estrogen replacement (HRT), oral contraceptives, cholestyramine (Questran®) , cholestipol (Colestid®) , aluminum hydroxide gel (Amphogel®), sucralfate (Carafate®), phenytoin (Dilantin®), carbemazapine (Tegretol®), phenobarbital, valproic acid (Depakene®), rifampin (Rifadin®), raloxafene (Evista®), sertraline (Zoloft®), amiodarone (Cordarone®). Thyroid hormone is safe to take during pregnancy. If you become pregnant while taking thyroid hormone, notify your doctor immediately. It is important to monitor your bloodwork frequently during pregnancy since the dose may need to be increased. A TSH (thyroid stimulating hormone) blood test will confirm if you are on the correct dose of medication. It is usually done 4-6 weeks after thyroxine is begun or after your dose of medication is changed. You do not have to be fasting for this test and it maybe done anytime of the day. You should take your medication the day of this testing. Side effects of thyroid hormone are usually related to an incorrect dose. Your doctor has selected this strength based on your weight, diagnosis, and goal of treatment. Frequent dose adjustments are not regularly required. Possible symptoms of thyroid hormone excess (too high a dose of medication) include: Palpitations (rapid heart beat) Heat intolerance Hand tremors Anxiety Insomnia Fatigue Difficulty concentrating Frequent stools, diarrhea Unexplained weight loss Possible symptoms of thyroid hormone deficiency (too low a dose of medication) include: Fatigue Cold intolerance Constipation Dry skin Weight gain Coarse skin Impaired memory Depression Developed by Endocrine Nurses Society - Thyroid Task Force With an unrestricted educational grant from Jones and Monarch Pharmaceuticals, Wholly owned subsidiaries of King Pharmaceuticals, Inc.