Synthroid Medication| How Does Levothyroxine treat Hypothyroidism


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Evidence Based - Facts Checked

This content is medically reviewed by Dr. Sharwari Dabhade Dua (MD-Internal Medicine) and written by Puneet Utreja

Last Medical Review Date - 2nd October 2020


Table of ConteNT



Hypothyroidism is a prevalent disease, globally. Around 5% of individuals suffer from hypothyroidism, and another 5%1Chiovato, L., Magri, F., & Carlé, A. (2019, September) 'Hypothyroidism in Context: Where We've Been and Where We're Going'  Source of the population goes undiagnosedLevothyroxine (Brand Name - Synthroid), is the most commonly prescribed medicine to treat hypothyroidism2Wass et al, Oxford Handbook of  Clinical Endocrinology and Diabetes, 3rd Edit.. Before we proceed to understand how Synthroid / Levothyroxine helps treat hypothyroidism, lets try to understand what is hypothyroidism.

What is Hypothyroidism?

When the thyroid glands are not able to produce required levels of thyroid hormone in the human body, the condition is known as Hypothyroidism.

Thyroid hormone helps in regulating heart rate and myocardial contraction as well as relaxation, helps promote normal fetal and childhood growth along with central nervous system development, affects gastrointestinal motility and renal water clearance, regulate human body's energy, weight, heat generation as well as lipid metabolism3David G Gardner, et al. Greenspan’s Basic and Clinical Endocrinology, 10th Edit.

Decrease in the levels of thyroid hormone leads to problems like poor brain development in children, cardiac diseases, infertility, fatigue, unexplained changes in the body weight, deterioration in the quality of life, etc.4Chiovato, L., Magri, F., & Carlé, A. (2019, September) 'Hypothyroidism in Context: Where We've Been and Where We're Going'  Source 

What Causes Hypothyroidism?

In under-developed countries, iodine deficiency is the primary cause of hypothyroidism, whereas Hashimoto’s thyroiditis (an autoimmune disorder) is the main cause of hypothyroidism in the developed countries5Kostoglou-Athanassiou, I., & Ntalles, K. (2010, April). 'Hypothyroidism - new aspects of an old disease'  Source


Now since we know what is Hypothyroidism and how is it caused, lets focus on how does Synthroid / Levothyroxine help in treating hypothyroidism.

What is Synthroid / Levothyroxine Sodium? 

Synthroid is a prescription medication and is a brand name for levothyroxine sodium. It is mainly used to treat hypothyroidism. It helps in restoring the thyroid hormone balance and is available in the form of oral tablets, capsules and injection for emergency purposes. 

Synthroid is also used in the treatment of goiter, which could be due to thyroid disorders like Grave’s disease, Hashimoto’s thyroiditis , thyroid carcinoma of various types, exposure to radiation or radiotherapy, family history of thyroid illness6Wass et al, Oxford Handbook of  Clinical Endocrinology and Diabetes, 3rd Edit.. It is important to note here that not all goiters are treated by Synthroid / Levothyroxine.

How does Synthroid / Levothyroxine Sodium work in the human body?

Synthroid / Levothyroxine Sodium is a synthetic formulation for the hormone – thyroxine (produced naturally by the human body). Consuming Synthroid / Levothyroxine Sodium supplements the shortage of thyroxine hormone and thereby restores the normal levels in the body. As a result,  the metabolic rate of all tissue cells in the body resumes back to normal and helps maintain body temperature, absorption of food, and brain functions7Eghtedari, B. (2020, September 18). 'Levothyroxine'  Source

What your Physician should know Before you take Synthroid / Levothyroxine Sodium?

Synthroid has a black box warning attached to it and therefore should only be taken as a prescription drug. The physician must be aware of the below-mentioned conditions while he/she prescribes Synthroid / Levothyroxine Sodium:-

1. Heart Problems

You should let your physicians know if you have a history of heart problems or are currently suffering from it. This will help your physician decide the dose accordingly.8Eghtedari, B. (2020, September 18). 'Levothyroxine'  Source

2. Diabetes

If you are a diabetic patient, then you should let your physician know about it. Your doctor may needs to monitor your blood sugar level while prescribing you for Synthroid / levothyroxine sodium and adjust your diabetes drugs accordingly9'Synthroid Indications Side Effects Warnings'  Source

3. Osteoporosis

Your doctor should know if you have the problem of Osteoporosis. Longtime consumption of Synthroid can cause a decrease in your bone mineral density. It can also lead to a higher risk of bone fractures 10Ko, Y., Kim, J. Y., Lee, J., Song, H., Kim, J., Choi, N., & Park, B. (2014, January). 'Levothyroxine dose and fracture risk according to the osteoporosis status in elderly women' Source. The medication leaflet does mention about this however the control studies have not been very conclusive.

4. Adrenal Gland Insufficiency

You ought to let your physicians know if you have adrenal gland disorders as the use of Synthroid / levothyroxine sodium may lead to changes in your thyroid hormone level and could make your adrenal problems worse 11'Levothyroxine'  Source

5. Blood Thinners

If you are already taking blood thinner medications, then let your physician know about it. The clotting status may need to be monitored regularly while consuming Synthroid / levothyroxine12'Levothyroxine'  Source

6. Pregnancy

Synthroid is categorized as an A-class pregnancy drug. It would be best if your physician knows about the pregnancy so that the dose of  Synthroid / levothyroxine can be adjusted accordingly13Maraka, S., Singh Ospina, N. M., O'Keeffe, D. T., Rodriguez-Gutierrez, R., Espinosa De Ycaza, A. E., Wi, C., . . . Montori, V. M. (2017, January). 'Effects of increasing levothyroxine on pregnancy outcomes in women with uncontrolled hypothyroidism'  Source

7. Senior Citizens and Children

Please share your correct age with the physicians as Synthroid / levothyroxine especially if you are over less than 5 or more than 65, as your physician will prescribe the initial dose, accordingly.14Eghtedari, B. (2020, September 18). 'Levothyroxine'  Source

Dosage of Synthroid / Levothyroxine15Eghtedari, B. (2020, September 18). 'Levothyroxine'  Source

- The dosage of Synthroid generally depends on the age group, the condition being treated, medical history, other current medical problems and the reaction of the patient to the first dose. An adult dose (ages 18-49 years) starts with an initial dose of 1.6 micrograms per kg per day. The dose is adjusted every six to eight weeks.

- The initial dose in pregnant women is 1.8 micrograms per kg per day.  

- It is advised to take medicine, at least 30-60 minutes before breakfast in the morning

What are the Alternative Brand Names of Levothyroxine (With Cost) Available in the Market if Synthroid is not Available?

Cost of Levothyroxine In the United States as of 26th September 2020

Alternative Brand Name for Levothyroxine

Manufacturer

Cost

Levothroid

Mylan

$16 - $34.41 for 100 tablets16Source

Levoxyl

Mylan

$82.18 - $143.82 for 100 tablets17Source

Tirosint

IBSA

$ 148.56 for 30 tablets18Source

Unithroid

Jerome Stevens Pharm

$7.5 - $331.84 for 100 tablets19Source

Cost of Levothyroxine In India as of 26th September 2020

Alternative Brand Name for Levothyroxine

Manufacturer

Cost

Lethyrox

Intas

Rs 25 – Rs 34 for Pack of 3020Source

Thyronorm

ABBOTT

Rs 79 – Rs 161 for Pack of 10021Source

Roxin

CADILA

Rs 18 for Pack of  10022Source

Thyrox

MACLEODS

Rs. 13.5 – Rs. 24.3 for Pack of 3023Source

Eltroxin

GSK Pharma

Rs. 24.73 for Pack of 60 – 50mcg24Source

Rs. 74.00 for Pack of 100 – 100mcg25Source

References

  1. 1
    Chiovato, L., Magri, F., & Carlé, A. (2019, September).
    Hypothyroidism in Context: Where We've Been and Where We're Going.
    Retrieved September 28, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822815/
  2. 2
    Kostoglou-Athanassiou, I., & Ntalles, K. (2010, April).
    Hypothyroidism - new aspects of an old disease.
    Retrieved September 28, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895281
  3. 3
    Eghtedari, B. (2020, September 18).
    Levothyroxine 
    Retrieved September 29, 2020, from https://www.ncbi.nlm.nih.gov/books/NBK539808/
  4. 4
    Synthroid  Indications, Side Effects, Warnings. (n.d.).
    Retrieved September 29, 2020, from https://www.drugs.com/cdi/synthroid.html
  5. 5
    Ko, Y., Kim, J. Y., Lee, J., Song, H., Kim, J., Choi, N., & Park, B. (2014, January).
    Levothyroxine dose and fracture risk according to the osteoporosis status in elderly women.
    Retrieved September 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3930806/
  6. 6
    Levothyroxine. (n.d.).
    Retrieved September 29, 2020, from https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=5ada7c99-cb63-4b68-8dd2-e0f4fafdf4f6&type=display
  7. 7
    Maraka, S., Singh Ospina, N. M., O'Keeffe, D. T., Rodriguez-Gutierrez, R., Espinosa De Ycaza, A. E., Wi, C., . . . Montori, V. M. (2017, January).
    Effects of increasing levothyroxine on pregnancy outcomes in women with uncontrolled hypothyroidism.
    Retrieved September 29, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5161643/


This content is only for educational purpose and should not be considered as a substitute for your Physician's/Doctor's clinical judgement

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