Have you been on thyroid medication for years? Wanting to wean off? Unsure of whether or not you can just, stop cold turkey? Well hopefully, we can provide you with some insight so you can discuss your options with your Physician.
Some patients want to come off thyroid medicine for a variety of reasons. Depending on the thyroid medication someone is on, there may be some long-term adverse side effects. For example, some research shows that long-term use of high-dose Synthroid or levothyroxine (T4) could increase the risk of fracture incidence and osteoporosis.
Some people find it daunting to have to take medicine for the rest of their lives. Patients may have other reasons for wanting to stop taking thyroid medication; however, it must always be done as a wean and never discontinued cold turkey. Discontinuing your thyroid medicine cold turkey could lead to undesirable side effects, including changes in blood pressure and heart rate and significant fatigue.
Suddenly stopping your thyroid medicine may cause rapid weight gain, delayed reflexes, hair loss, dry skin and brittle nails. Sudden discontinuation of thyroid medicine could also cause a shock to the thyroid, making it more challenging for your thyroid to work efficiently on its own and produce thyroid hormone.
Depending on the dose and type of medication you are on, you may discuss options to wean off your thyroid medicine with your Physician. Your Physician will have to closely monitor your thyroid levels if you wean off your medication to ensure your thyroid is still efficiently producing thyroid hormone. Your Physician can do this by assessing your Thyroid Stimulating Hormone (TSH), Free T3, and Free T4.
Each physician will have a unique way of weaning your thyroid medicine, but with any medication wean, the slower, the better, in our opinion. The slower the wean, the more support your thyroid has to start functioning independently and producing hormones.
So let’s say, for example, you’re taking Levothyroxine (T4) 50 mcg. Depending on your thyroid blood tests (TSH, FT3, and FT4), we might consider reducing your thyroid medicine to alternating 50 mcg with 25 mcg for 4 weeks. After those 4 weeks or so, it would be prudent to re-check your thyroid blood tests.
If your physician thinks your thyroid levels are within the normal range, then you may further reduce your medicine to 25 mcg for another 4 weeks. The process would proceed slowly while rechecking your thyroid labs are you decrease your medicine.
Given that there are some hidden causes of hypothyroidism, like certain infections and nutrient deficiencies that may cause sluggish thyroid function, you may want to ask your physician to assess these other etiologies so that you can support your thyroid on all fronts.
Some common places to look may be assessed for an infection, like Helicobacter pylori or Epstein Barr Virus. Even more recently, there have been links correlating COVID-19 infection with thyroid function.
You can also ask your physician to look at nutrient status, including iron (you can check iron, but also be sure to check ferritin). Ferritin is how much iron you’re able to store. You also want to ask your Physician to check your zinc levels, selenium, vitamin C, and urinary iodine.
By testing your nutrient status and for possible infections, you’re able to address potential root causes of your thyroid dysfunction. Even if you can’t fully discontinue thyroid medicine, addressing potential etiologies that may be impacting your thyroid could allow you to decrease the amount of thyroid medication you are on.
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