Treatment of hypothyroidism with drugs. Drugs and folk remedies for hypothyroidism of the thyroid gland Replacement therapy with thyroid hormones

Good day, dear readers!

In today's article, we will look at hypothyroidism, as well as its symptoms, causes, types, diagnosis, treatment and prevention. So...

What is hypothyroidism?

Hypothyroidism- a pathological condition of the body due to a chronic lack of thyroid hormones (thyroid hormones) in it.

The cause of hypothyroidism lies mainly (in 99% of cases) in hypofunction (insufficient production) of thyroid hormones - triiodothyronine, thyroxine and calcitonin, this is in the case of primary hypothyroidism. The cause of hypofunction itself is usually thyroiditis - an inflammatory disease of the thyroid gland. Another cause of hypothyroidism, but the most rare, is a malfunction of the hypothalamus or pituitary gland, which are involved in regulating the production of thyroid hormones. There are other factors / diseases of the thyroid gland that contribute to the lack of hormones, but we will talk about this later in the article.

Hypothyroidism is a serious disease of the endocrine system, so its consequences are very complex. For example, the extreme degree of hypofunction of the thyroid gland in adults is myxedema (mucous edema of the skin), and in children - cretinism. In addition, metabolic processes are disturbed in the body - energy, protein and mineral metabolism, the synthesis of sex hormones, normal development, structure and functioning of the brain, cardiovascular, digestive and musculoskeletal systems. When the required dose of the missing hormones enters the body, the symptoms usually disappear, however, this must be done on time.

Disease statistics

Hypothyroidism in women, especially after 60 years, usually occurs most often - 19 women out of 1000, while among men, this figure is only 1 out of 1000. These thyroid problems are also seen in people living in regions remote from the sea. If we talk about global statistics, then doctors note that the total population who have a lack of thyroid hormones is about 2%.

The insidiousness of the pathology lies in the difficulty of self-diagnosing it. So, the onset of the disease can proceed with a simple manifestation of chronic fatigue.

For the first time, the disease hypothyroidism was discussed and described in 1873.

Hypothyroidism - ICD

ICD-10: E03.9;
ICD-9: 244.9.

Symptoms of hypothyroidism

The first signs of hypothyroidism are:

  • General weakness, increased fatigue;
  • The appearance of dense swelling of soft tissues on the skin;
  • , after which ;
  • (decrease in heart rate below 59 bpm);
  • Violation of mental activity;
  • Sexual dysfunction.

The main symptoms of hypothyroidism:

  • , lethargy, fatigue, drowsiness or;
  • Edema on the skin, sometimes mucous membranes of the nasopharynx and middle ear;
  • Oppression of mental activity, deterioration of memory and attentiveness;
  • Disorders of the gastrointestinal tract -, lack of appetite;
  • A set of extra pounds,;
  • Menstrual irregularities in women, up to complete absence;
  • Sexual dysfunction and decreased sexual desire in men;
  • with slight yellowness,;
  • Increased hair loss, as well as their dryness and brittleness;
  • Thinning of the nail plate, delamination and increased fragility of nails;
  • Severe tolerance of heat and cold;
  • Muscle pain, sometimes accompanied by cramps;
  • Stiffness of movements, some numbness of the limbs;
  • , bradycardia, cardiomegaly, arterial hypotension;
  • Violation of the functioning of the adrenal glands;
  • Decrease in the level of hemoglobin in the blood;
  • , B12-deficient, macrocytic and megaloblastic anemia;
  • Decreased protective properties of the body (immune system).

Specific symptoms:

  • yellowing of the scalp;
  • Oppression of auditory function;
  • Oppression of visual function;
  • Oppression of the vocal function, as if the tongue were tangled, hoarse voice;
  • Galactorrhea;
  • carpal tunnel syndrome;
  • Development of biliary dyskinesia;

Complication of hypothyroidism

Complications of hypothyroidism include:

  • Growth of the thyroid gland in volume;
  • thyroid cancer;
  • Formation of a secondary adenoma;
  • Formation of an "empty" Turkish saddle;
  • Changes in the structure of the mammary glands, constant galactorrhea;
  • Due to ovarian dysfunction - infertility;
  • The birth of a child with a disorder in the development and functioning of the nervous system;
  • Loss of consciousness;
  • Hypothyroid (myxedematous) coma, mortality in which is up to 80%;
  • Fatal outcome.

The most common cause of hypothyroidism is the presence of chronic autoimmune thyroiditis, which is an inflammatory disease of the thyroid gland, against the background of impaired functioning of the immune system.

Other causes of hypothyroidism include:

  • hereditary predisposition;
  • Congenital anomaly of the thyroid gland - its increase or decrease in size;
  • Postponed surgical treatment of the thyroid gland;
  • Acute deficiency in the body for a long period;
  • Treatment of goiter with the use of radioactive iodine (iodine-131);
  • Ionizing radiation of the thyroid gland;
  • The presence of tumors;
  • Pathological effects on the body of certain drugs (Levodopa, Parlodel, serotonin preparations and others);
  • The presence of infection in the body - actinomycosis and others;
  • Injury to the pituitary gland or hypothalamus;
  • hemorrhages;
  • Necrosis;
  • Violations of the functions of the kidneys and liver for the conversion of enzymes;

Types of hypothyroidism

The classification of hypothyroidism includes the following types ...

By etiology:

Primary (thyroid) hypothyroidism. The determining factor that leads to a lack of thyroid hormones in the body is a malfunction of the thyroid gland. Consider its subspecies:

  • Congenital hypothyroidism, caused mainly by a violation of the development of the thyroid gland, as well as the transformation of enzymes involved in the production of hormones by the gland.
  • Acquired hypothyroidism, due to many factors due to which the thyroid gland malfunctioned - these are operations, and radiation, and injuries, various tumors, the presence of infectious diseases, autoimmune processes, an acute persistent lack of iodine in the body, removal of the gland, and others.
  • Idiopathic hypothyroidism - the exact cause of hypothyroidism cannot be determined.

Secondary (pituitary) hypothyroidism. The disease is caused by a malfunction in the production of thyroid hormones due to disturbances in the functioning of the pituitary gland (a gland located in the brain). The factors that lead to this are usually - ischemic damage and inflammatory diseases in the brain, autoimmune processes, tumors, as well as the poisoning effect on the pituitary gland of certain drugs. If we talk about the clinical picture of secondary hypothyroidism, then unlike primary, it is more difficult, because. it is accompanied by damage to other organs, in particular, the ovaries, adrenal glands, cardiovascular and other systems.

Tertiary (hypothalamic) hypothyroidism. The failure is associated with malfunctions of the hypothalamus, which in turn is usually due to factors such as trauma, tumors, ischemic processes and inflammatory infectious diseases (meningoencephalitis, etc.) in the brain area, as well as the effects on the body of certain drugs, such as serotonin .

Tissue (transport, peripheral) hypothyroidism. Violations are usually associated with the transformation of hormones and their distribution throughout the body. This is often facilitated by factors such as autoimmune processes, disturbances in the structure of receptors in body tissues, metabolic disorders, as well as liver and kidney fermentopathy, which are involved in the conversion of thyroxine to triiodothyronine.

Primary hypothyroidism is also classified according to severity:

Latent (subclinical) hypothyroidism- is characterized by an increased level of thyroid-stimulating hormones (TSH) against the background of a normal level of thyroxine (T 4).

manifest- characterized by an increased level of thyroid-stimulating hormones (TSH) against the background of a reduced level of thyroxine (T 4), with obvious clinical manifestations (symptoms). May be:

  • Compensated;
  • Decompensated.

Complicated hypothyroidism (severe course)- accompanies such complications as - cretinism, disorders of the heart, secondary pituitary adenoma and others, up to myxedematous coma and death.

Diagnosis of hypothyroidism

Diagnosis of hypothyroidism includes the following examination methods:

  • Visual examination of the patient, anamnesis (including family history);
  • for thyroxine, triiodothyronine and thyroid-stimulating hormone (TSH);

Additionally, it can be assigned:

  • Thyroid scintigraphy;
  • Puncture fine needle biopsy.

The diagnosis of "hypothyroidism" can only be established.

Treatment for hypothyroidism usually includes, depending on the diagnosis, the following items:

1. Etiotropic therapy;
2. Replacement therapy;
3. Symptomatic treatment;
4. Diet.

Important! Medicines and their dosages are selected by the endocrinologist, based on the type of disease, its severity, clinical manifestations, concomitant diseases and the age of the patient.

1. Etiotropic therapy

Etiotropic therapy implies the treatment of primary and concomitant diseases that led to hypothyroidism. This may be thyroiditis, which in most cases is the cause of hypothyroidism, endemic goiter and other inflammatory diseases of the thyroid gland, pituitary gland or hypothalamus.

If the cause of hypothyroidism lies in an insufficient amount of iodine in the body, the patient is prescribed drugs based on iodine - Betadine, Iodide.

Additionally, iodized salt, seaweed can be prescribed.

2. Replacement therapy

Replacement therapy involves taking hormonal drugs that are substitutes for natural thyroid hormones. Usually these drugs are well tolerated, but their use can be lifelong in some cases.

Hormone replacement drugs include:"Bagotiroks", "Levothyroxine" (L-T4), "Eutiroks".

3. Symptomatic treatment

To improve the course of the disease and the quality of life of the patient, symptomatic treatment is prescribed, which is aimed at stopping the symptoms of hypothyroidism, as well as maintaining the normal functioning of other organs, the activity of which can be inhibited in this disease.

Symptomatic treatment of hypothyroidism may include the use of the following drugs:

Cardioprotectors- aimed at normalizing the heart rhythm, and other areas that improve the functioning of the cardiovascular system: ATP, Mildronate, Preductal, Trimetazidine.

cardiac glycosides- are used for heart failure: "Digoxin", "Korglikon", "Strophanthin"

Nootropics and Neuroprotectors- are prescribed to normalize metabolic processes in the nervous system, brain:

Drugs based on female sex hormones- aimed at normalizing the course of menstruation and ovulation.

Vitamin and mineral complexes, which contribute to the improvement of the activity of all organs and systems: "Aevit", "Milgama", multivitamin complexes ("Geksavit", "Undevit").

The diet for hypothyroidism is based on the exclusion from the diet of foods rich in cholesterol and saturated fatty acids. In addition, it is necessary to reduce to a minimum the use of "fast" carbohydrates, which are difficult to digest and increase the secretion in the stomach of products.

It is best to cook dishes for a couple, such food will be easy on the stomach, as well as with minimal loss. Products can also be baked. The amount of protein food should be increased.

With constipation, you need to increase the amount of fiber in food.

As salt, it is better to use the iodized version.

The use of butter or sunflower oil in cooking is best excluded, or at least minimized.

The amount of water per day should be limited to 1.5 liters, otherwise swelling may increase. As a drink, the use of mineral water, especially enriched with iodine, has a beneficial effect on the body.

What can you eat with hypothyroidism?

Meat and fish: beef, veal, chicken, sea fish (salmon, herring, mackerel), cod liver, eggs.

Kashi: buckwheat, millet.

Dairy products: milk, cottage cheese, cheese, kefir, natural yogurt.

Vegetable products: seaweed, cabbage, beets, potatoes, carrots, tomatoes, cucumbers, eggplants, zucchini, bell peppers, spinach, onions, as well as apples, currants, cherries, grapes, persimmons, tangerines, kiwi, bananas, and dates.

It is advisable to do 1 day a week, in which to focus on eating fresh vegetables and fruits.

What can not be eaten with hypothyroidism?

Nutrition for hypothyroidism excludes foods such as spicy, fatty, fried, smoked meats, fast food (fast food), pickles, sauces and marinades, pastries, sugary juices, polished rice, alcoholic beverages, wheat and corn flour.

Hypothyroidism is a disease that occurs when the thyroid gland is unable to produce hormones in the amount required by the body. Hypothyroidism is usually asymptomatic in its early stages, but if left untreated, it can lead to serious health problems. Hypothyroidism is usually treated with synthetic thyroid hormones, which is a fairly safe and effective treatment. If you have hypothyroidism, you should see your doctor. He will select the method of treatment that will be most effective and safe in your case.

Steps

Medical Treatment for Hypothyroidism

    Contact your doctor. Be sure to see your doctor if you have any symptoms of hypothyroidism, if you have had radiation therapy to the head, neck, upper chest, or if you have been treated with radioactive iodine or antithyroid drugs. Symptoms of hypothyroidism usually appear very slowly, over many years. At first, you may not even notice them or associate them with other factors. Symptoms of hypothyroidism may include:

    • Weight gain
    • Unreasonable feeling of tiredness
    • Dry skin
    • Pale and/or puffy face
    • constipation
    • Hoarse voice
    • After examining the symptoms, the doctor should order a blood test to find out the level of thyroid-stimulating hormone (TSH) and the level of thyroxine (thyroid hormone).

  1. Discuss with your doctor the interactions of the medicines prescribed by him with other medicines and nutritional supplements that you take. Before starting thyroid treatment, you should ask your doctor which foods, supplements, or medications you need to avoid. In addition, you should tell your doctor about any supplements or medications you are taking and make sure they will not interact with any therapy your doctor is planning to prescribe. Many drugs interact with levothyroxine, which is the most commonly used thyroid medication. Be sure to tell your doctor if you are taking any of the following medications:

    • amphetamines
    • Anticoagulants
    • Tricyclic antidepressants
    • Sedatives
    • Arthritis medications
    • Aspirin
    • Beta blockers
    • Insulin
    • Oral contraceptives
    • Digoxin
    • Anticonvulsants
    • Some drugs used to treat cancer
    • Iron replacement therapy
    • Calcium carbonate
    • aluminum hydroxide
    • Rifampicin

  2. Take your prescribed thyroid medicines. Hypothyroidism is almost always treated with levothyroxine (T4), a synthetic thyroid hormone. The drug is taken orally. It restores thyroid hormone levels to normal and relieves symptoms of hypothyroidism.

    • If the dosage is chosen correctly, you should feel a decrease in signs of fatigue within the first or second week.
    • The drug should also help lower cholesterol levels, which may have risen due to hypothyroidism, as well as regulate weight, which may have changed due to illness.
    • Note that most patients need treatment for the rest of their lives. In hypothyroidism, it is necessary to regularly check the level of thyroid hormones to determine the correct dosage of the drug.

  3. See your doctor regularly to find the right dosage. In a few months, the doctor will be able to choose the right dosage. Your doctor will likely send you for a blood test to check your thyroid-stimulating hormone (TSH) levels before setting your starting dose. Six to eight weeks after starting treatment, your doctor will ask you to repeat this test to determine if the prescribed dosage is correct.

    Watch for signs of deterioration. Even if you check your thyroid levels annually, there is a chance that your hormone levels may drop before you go for your annual checkup. That is why it is important to pay attention to any signs of hypothyroidism: slowness, constipation, confusion, frequent feeling of cold, and so on. See your doctor again if you think the prescribed medicine is not working.

    • If you are also being treated for a bowel disease or are taking medications that affect the gastrointestinal tract, the thyroid medication may not be absorbed properly. You will need to either treat the comorbid condition first or increase the dosage of the thyroid medication.
    • Similarly, your doctor may increase the dosage of your thyroid medication if you are taking estrogen or phenytoin.
    • You also need to make sure you don't take too much thyroid medication. Over time, its excess can lead to arrhythmias and osteoporosis.

  4. Try not to take medicines with certain foods. Some foods may interact with thyroid medications. You can still consume these foods, but try to do so within a few hours of taking your medications. Such products are walnuts, soy flour, cottonseed meal and dietary fiber in large quantities. .

    Pay attention to any side effects. Levothyroxine is a safe drug and side effects are extremely rare when used in the correct dosage. In rare cases, side effects such as chest pain or discomfort, increased urination, difficulty swallowing or breathing, fever, increased blood pressure, arrhythmias, menstrual changes, skin irritation, sweating, mood changes, muscle weakness, increased appetite, abdominal pain and diarrhea. Contact your doctor as soon as possible if you notice any of these side effects.

    Ask your doctor about the possibility of using natural extracts. Prior to the development of synthetic levothyroxine, physicians used drugs derived from animal thyroid glands (such as Armor or Nature-Throid). Since the compatibility and efficacy of these drugs has not been fully studied, such extracts are used quite rarely today, but you all You can also choose them if you prefer to use natural remedies.

    Natural remedies for treating hypothyroidism

    1. Remember that there is no specific diet to treat hypothyroidism. You can find a lot of information about diets that help treat hypothyroidism. However, at the moment there is no evidence that any diet can improve thyroid function. In general, with hypothyroidism, it is recommended to eat right and monitor your health.

      Consider alternative treatments. If you are interested in alternative medicine methods for treating hypothyroidism, consider consulting a naturopathic doctor or a doctor who practices complementary and alternative medicine. Be sure to let your doctor know what alternative medicine methods the naturopath has recommended for you. Even if your regular doctor does not support the naturopath's recommended treatments, you should continue to see your doctor and report any changes to alternative treatments, as medications can interact and cause side effects.

      Avoid foods that contain iodine. High iodine intake can exacerbate hypothyroidism. Many doctors recommend that patients with hypothyroidism avoid certain foods. Iodine is found in fish, dairy products and algae. It is not recommended to consume more than 600 micrograms of iodine daily.

      • Discuss with your doctor how much iodine is enough for you.
      • Organic dairy products contain less iodine than non-organic ones.

    2. Try to avoid soy products. At the moment, it is not entirely clear whether people with hypothyroidism should avoid soy products or not. Soy can interfere with the body's ability to absorb synthetic thyroid medications. Today, there are no specific guidelines for people with hypothyroidism to avoid soy products or not, however, if you eat soy, it is very important to ensure that you are getting the right amount of iodine. The diet contains different amounts of iodine in different regions, so we recommend that you ask your doctor if you need to take additional iodine or not.

      • If you have any questions or doubts about the use of soy, we recommend that you consult a doctor.

    3. Limit your intake of goitrogenic foods. Goitrogenic foods affect the functioning of the thyroid gland, which can aggravate the condition of a person with hypothyroidism. Vegetables such as broccoli, Beijing, cabbage, Brussels sprouts, cauliflower, collard, kale (curly cabbage), mustard greens, turnips, radishes and watercress have a goitogenic effect. If you like such foods, then it is better to cook them, and do not eat them raw.

      Take essential fatty acid and vitamin B supplements. If hypothyroidism is caused by an autoimmune reaction in the body, then taking fatty acids can reduce inflammation in the body. High doses of fish oil can effectively reduce inflammation. Your doctor will help you determine the correct dosage. It is extremely important to visit a doctor regularly, as too high doses of fish oil can affect blood clotting. Vitamin B12 supplements help relieve symptoms of hypothyroidism and provide more energy.

    4. Try supplementing with L-tyrosine. L-Tyrosine is a nutritional supplement that can help treat hypothyroidism. Tyrosine helps the thyroid produce TSH. The recommended dosage is 500 mg 2-3 times a day. This dietary supplement is not recommended if you have high blood pressure or if you have symptoms of mania (such as racing thoughts, irritability, excessive energy and excessive good mood).

      • Check with your doctor before taking L-Tyrosine, especially if you are taking their thyroid medications.

In the past, before I discovered that it was my life's calling to help people with thyroid disease get back to their health, I worked as a consultant pharmacist and focused on optimizing drug therapy for people with disabilities and the elderly. Although my official job title was consultant pharmacist, I really felt that the most important part of my job was supporting people who couldn't come forward with their health problems. I took the necessary steps to ensure that they get the maximum benefit from their medications, that they are not over-medicated, that they have access to medications that could potentially help them, and that they receive the proper care they deserve. I want to do the same for you.

There are quite a few thyroid treatment options for hypothyroidism. However, most people are only familiar with synthetic thyroid medications containing T4.

Some people report feeling better when they take T4/T3 combination medications (such as Armour®, custom T4/T3 medications, or Nature-Throid®). Others may feel better taking synthetic T4 medications (such as Synthroid®, Tirosint®, or Levoxyl® (analogues of these drugs in Russia - Euthyrox andL), while some patients may benefit from synthetic T3 (eg Cytomel®). Also, someone feels better when taking T4 preparations made without excipients to which there is a sensitivity.

Of the readers I interviewed, up to 59 percent felt better on T4/T3 combinations, while up to 43 percent felt better on synthetic T4s. . While lab results seem to improve dramatically with Synthroid® (69 percent), mood and overall energy seem to improve with switching to a combination drug such as Nature-Throid® ( 63 percent).

Changing your hypothyroid medication can help you absorb thyroid hormones better, which can in turn lead to less symptoms and more mood and energy!

Today I would like to help you explore the different options, so I will cover the following topics:

  • Do all patients get a positive result from taking levothyroxine?
  • What are preparations containing T3?
  • Potential Benefits of T4/T3 Combination Therapy Options
  • Demystifying Natural Desiccated Thyroid (NDT) Myths
  • What are T4/T3 prescription medications?

Traditional drug treatment of the thyroid gland: T4 hormonal preparations

The standard of care for Hashimoto's thyroiditis (autoimmune thyroiditis) is replacement therapy with synthetic thyroid hormones. Levothyroxine, commonly sold as Synthroid® or under other brand names such as Levoxyl®, Tirosint®, Euthyrox® (in the EU), Eltroxin® (in Canada) and Oroxine® or Eutroxsig® (in Australia), is a synthetic T4 hormone (Analogues of these drugs in Russia - Euthyrox and L-Thyroxine - translator's note). It is the most commonly prescribed drug in Hashimoto's, and in advanced forms of hypothyroidism, it is used as a replacement or adjuvant therapy in cases where our own thyroid gland cannot produce enough hormones.

Many people begin to feel good on T4-containing drugs, as soon as they correctly select the dosage and stabilize on it. However, while these drugs may be helpful in managing symptoms in many people, levothyroxine does not address the underlying causes of the disease.

It is also common for doctors to prescribe the wrong dosages of synthetic thyroid medications, patients to take medications incorrectly, and such medications are not fully utilized by our bodies. This is due to the fact that levothyroxine contains a less active, but longer acting T4 hormone. The T4 molecule is considered a prohormone because it is less physiologically active than T3 and needs to be converted in our bodies to T3, the more active thyroid hormone. T3 is sometimes referred to as our "trigger" hormone because it tells our body to speed up metabolism, grow hair, and create more energy. The conversion of T4 to T3 can be difficult due to numerous factors, including stress, and abnormal liver function and.

However, not everyone converts the T4 hormone to T3 properly. This is why many people continue to struggle with symptoms of hypothyroidism, such as hair loss, confusion, weight gain, depression, and fatigue, even after starting medication.

In addition, some people may be sensitive to some of the excipients in their Levothyroxine preparations. Some common fillers found in T4-only formulations include lactose, cornstarch, and even gluten!

As I mention in my books: "The Root Cause of Hashimoto" and "The Hashimoto Protocol" and also on my blog, corn and gluten are some of the most common food allergens in people with Hashimoto’s; and ingestion of even small portions of these foods can exacerbate symptoms and prevent healing in some cases. Eliminating these can, however, reverse the autoimmune attack on the thyroid in some cases! You can ask your doctor about Tirosint®, which is a hypoallergenic T4 formulation for those who have many food intolerances.

Of the readers I interviewed, those who switched to Tirosint® had 68 percent improved test scores, 50 percent improved mood, 62 percent more energy, and 32 percent reduced hair loss.

T3 drugs and combined T4/T3 drugs

Some people opt for another type of medication to treat hypothyroidism: T3 medications. They contain liothyronine and include the brand name Cytomel® and T3 custom formulations. They provide the body with T3 thyroid hormone, which is more active, although it has a short duration of action. (You can read more about)

These medications are generally not recommended as the sole therapy for hypothyroidism, as their short half-life can make a person feel like their thyroid is on a roller coaster. However, they can be used as an adjunct to T4-only preparations. T4/T3 combination products provide the body with the two major thyroid hormones in the same proportion as they are present in our own bodies.

In 2014, Dr. Wilmar Wiersinga, a Dutch endocrinologist and leading thyroid researcher, stated that: to normal TSH levels. Such ailments can hypothetically be associated with an increase in the concentration of free T4 and a decrease in the concentration of free T3 in the blood serum, as a result of which an incorrect ratio of free T4 to free T3 is observed in 30% of patients on levothyroxine. It is becoming increasingly clear that levothyroxine (T4) monotherapy cannot provide a euthyroid state in all tissues simultaneously, and normal serum TSH values ​​in patients receiving levothyroxine reflect euthyroidism only from the pituitary gland. In other words, this study suggests that T4 monotherapy may not be sufficient to resolve symptoms in patients with hypothyroidism, especially those related to mental health.

Dr. Wiersinga suggests that people with specific genetic polymorphisms (certain gene mutations) that affect thyroid hormone transport may benefit from T4/T3 combination therapy, and that people who continue to have symptoms of hypothyroidism despite having normal TSH levels, may get a positive result if they try to give T3 in addition to the T4 drug.

Further research is needed to answer questions about whether T4 alone is sufficient. To date, studies do not allow for a definitive conclusion, however, the number of hypothyroid patients interested in T4/T3 combination therapy has increased over the past decade.

It is interesting to note that a new 2014 follow-up study by Dr. Wiersinga, published in 2017, states that T3 therapy has not yet been proven effective, but many patients are now asking their doctors to switch them to T4/T3 combination medications, as many people have reported a reduction in symptoms of hypothyroidism when T3 is added to their regimen.

Differences in views on T3 drugs

Doctors may be worried about using T3 drugs or increasing the dose of drugs for hypothyroidism because of the potential heart problems and increased risk of osteoporosis that can occur in a person with excessive thyroid hormone levels.

According to Carter Black, who has been a practicing pharmacist since the 1970s, the 80s gave T3 drugs a bad rap…

Weight loss clinics have begun prescribing Cytomel® along with amphetamine and liquid diets for people without thyroid disease. As you might guess, this combination, taken by an overweight person with normal thyroid function, often created a dangerous situation. Patients were admitted to emergency departments with life-threatening symptoms: high fever, palpitations, difficulty breathing, dehydration, delirium, nausea, vomiting, and even coma. Such a clinical situation is very difficult to help the patient, and it can end in death. People exposed to this cocktail were at risk for future thyroid problems (alternating hypothyroidism and hyperthyroidism), heart problems, and severe depressive disorders.

Of course, as a pharmacist, I would like to draw your attention to the fact that it is absolutely unacceptable to use drugs for the treatment of hypothyroidism to reduce weight in people without thyroid disease.

Essentially, doctors were inducing hyperthyroidism in people in order to lose weight. Since then, the FDA has issued a "special black box warning" (the strongest warning that can be placed on a prescription drug label when there is reasonable evidence of serious risks associated with that drug) on all drugs for the treatment of hypothyroidism, noting that they should not be used for the treatment of obesity and weight loss in people with normal thyroid function, and that higher doses may cause life-threatening toxic effects, especially when sympathomimetic drugs are prescribed.

Many of today's practicing endocrinologists have seen firsthand the effects of using T3 to induce weight loss, as young interns and medical students have studied it. Of course, one can understand the physicians' dislike of T3 or T4/T3 combination therapy due to their history of off-label use in the past.

Most doctors really care about your safety and want to do the best for their patients. However, due to their efforts to reduce the potential side effects caused by overdose, many people continue to experience symptoms of hypothyroidism due to undertreatment. Still, it is important to understand why T3-containing drugs may be beneficial for some patients.

Why T4/T3 Combinations Can Help

There are also other factors that can interfere with the conversion of T4 to T3, including and which are common underlying causes of Hashimoto's. You can see other possible factors below.

Stress is another common cause of low T4 to T3 conversion. In stressful situations, T4 is converted to reverse (reverse) T3 instead of T3. Reverse T3 is an inactive T3-bound molecule, but without any physiological activity (essentially, it just takes up space!). When a large amount of reverse T3 is being produced, taking a combination product that contains T3 ensures that the right hormone gets to the right receptors.

Dried Thyroid Natural Products (NDT)

One option for T4/T3 therapy is natural desiccated thyroid preparations (NDTs, sometimes referred to as desiccated thyroid extracts or DTEs). These drugs are obtained from the thyroid glands of pigs. NDTs are considered bioidentical hormones; they are identical in molecular structure and action to the hormones produced by the human thyroid gland.

NDT preparations also contain T1 and T2 thyroid hormones, which may also have some physiological activity.

Many patients who did not feel well with traditional treatment reported feeling better after switching to NDT medications such as Armour®, Nature-Throid® or WP Thyroid®. (Note: While Armor does not contain any gluten ingredients, it is not tested for gluten and is therefore not "Certified Gluten Free")

In a survey of my readers, I found that 59% felt better after switching to Armour®, 57% felt better with Nature-Throid®, and 32% reported improvement with WP Thyroid®.

Divergence of views

Conventional treatment protocols state that there is no benefit from taking T4/T3 combination drugs and that T4 drugs have more benefits. However, most of these claims are based on research funded by pharmaceutical companies that are interested in promoting the use of their products.

When NDT hormones were first isolated in pure form from the thyroid glands of animals, manufacturers assessed the activity of the hormones by measuring the iodine content within the substance. Of course, iodine levels will differ from one animal to another, so this method has proven to be inaccurate for measuring hormone levels.

It was later discovered that different batches of NDT may have different levels of thyroid hormones.

However, over the past two decades, the technology used to produce NDT has improved significantly. Manufacturers of natural desiccated thyroid products now use special chemical testing methods to determine the exact amount of thyroid hormones in their product, ensuring an accurate and consistent dose.

Nowadays, it seems you can really trust the dosage of T4 and T3 in NDT, whereas 30 years ago things were different. Physicians who have been in practice for quite some time and are not proponents of integrative medicine may still be against the use of NDT, as they remember the problems associated with product instability early on.

The National Institutes of Health (a US government agency not funded by pharmaceutical companies) conducted clinical trial to find out if treatment with desiccated thyroid drugs is more effective than T4 monotherapy. The authors of the study concluded: “DTE (dried thyroid extract) therapy did not lead to a significant improvement in quality of life; however, DTE therapy resulted in modest weight loss, and almost half (48.6%) of the patients in the study preferred DTE over l-T4 (Levothyroxine). DTE therapy may be relevant for some patients with hypothyroidism.”

A physician who is familiar with clinical studies that have shown that T3 and NDT can be safe and effective when used appropriately is more likely to feel confident prescribing these medications. However, your doctor may not be aware of this study, and it is sometimes worth keeping your doctor up to date with the latest news in thyroid care.

Other Controversial Issues About Natural Desiccated Thyroid Products

Some proponents of natural remedies for hypothyroidism, including Dr. Alan Christianson (author of the book "Healing Hashimoto's") report that desiccated animal thyroids may be a better option, as they also have low amounts of T1 and T2, which may have unexplored biological functions.

Conversely, Dr. Alexander Haskell (author of "Hope for Hashimoto's") and Dr. Mark Starr (author of "Hypothyroidism Type II") report that natural animal thyroid preparations such as Armour® may perpetuate an autoimmune attack in some patients due to the fact that such preparations contain thyroglobulin and thyroid peroxidase, and they recommend only synthetic thyroid preparations for people with Hashimoto's and prescription drugs. However, some people report that desiccated thyroid medications decrease thyroid antibodies, especially when suppressing TSH. The supraphysiological dose essentially puts our own thyroid into hibernation, and all the necessary hormones are obtained from the drug.

In addition, some patients may have ethical objections to the use of natural dried animal products.

T4/T3 preparations made according to an individual prescription

If NDT products are not right for you, custom made T4/T3 products offer another alternative. The advantage of these preparations is that they are made without any excipients (such as gluten or lactose) to which people may be sensitive. Such excipients may be present in some conventional hypothyroidism medications and cause problems for patients. In addition, individually manufactured drugs do not increase the autoimmune response.

However, such T4/T3 preparations must be prepared by specially trained pharmacists. These formulations are usually much more expensive and may need to be stored in a cool place to maintain their properties.

Individual prescription thyroid preparations are usually made in the same physiological proportion as found in NDT preparations. However, doctors may decide to change the amount of T3 and T4, in which case pharmacists will have to make the drugs from scratch. This can be a huge plus for patients who have not been doing well with conventional or natural treatments for desiccated thyroids.

Most custom made T4/T3 and NDT preparations are in immediate release dosage form, which means that they are designed to release the active substance as soon as the drug is taken orally. At the same time, pharmacists can also make slow-release drugs. Some experts recommend slow-release formulations so that the hormone is released continuously throughout the day. Yet these types of drugs may not be absorbed properly by people with Hashimoto’s and . That's why a lot of people say, "I've tried prescription drugs and they didn't work for me."

I have seen quite a few examples of people with optimal TSH levels (between 1 and 3 µIU/mL) starting on custom-made delayed or slow release formulations and suddenly their TSH jumped to 8, 10 or even 20 µIU/mL!

This is why many people with Hashimoto's avoid slow release formulations such as methylcellulose (Methocel) and instead opt for microcrystalline cellulose (Avicel), an immediate release formulation that is better absorbed by their body.

If you are considering trying T4/T3 formulations, please note that it takes specially trained pharmacists to make T4/T3 formulations for individual prescriptions and it will take time to make the medications. In addition, not all prescription pharmacies are the same, and a specific workflow is required to obtain an accurate dose of custom-made thyroid medications. Thus, patients may have to make an effort to find the right pharmacy with a prescription department.

Because I myself am a pharmacist specializing in thyroid diseases, I have created a catalog recommended pharmacies with a prescription and production department to help you find local pharmacies near you. (Here is a link to pharmacies in the United States. There are also pharmacies with a prescription department in Russia or in another country where you live, look for such pharmacies near you - translator's note)

Questions to ask your personal care pharmacist:

  • What types of fillers are used?
  • What is the source of materials?
  • Is the dosage form slow release or immediate release?

Main conclusion and next steps

The bottom line is that there are many options for hormone therapy for hypothyroidism, and you should work with your healthcare provider to find the one that works best for you.

Brands of drugs for hypothyroidism, available by category:

  • T4: Levothyroxine (and generics), Tirosint, Synthroid, Levothroid, Levoxyl, Thyro-Tabs, Unithroid (in Russia - Euthyrox andL-Thyroxin - approx. translator)
  • T3 (for use in combination with T4 preparations): Liothyronine (and generics), Cytomel
  • Natural preparations for desiccated thyroid glands (T4/T3): Armor Thyroid, Nature-Throid, WP Thyroid, NP Thyroid
  • Preparations T4 / T3 according to an individual prescription: Manufactured by pharmacists (choose an immediate release dosage form)

Please note that sometimes medicines may not be available. If this happens to you, here are some resources to see what's available. You can try any of the online pharmacies listed on their website: .

Hormone therapy for hypothyroidism should be selected individually for the patient. You must work with a progressive doctor to find the drug that is best for you.

You may find that, depending on your body and the type of drug you are using, you may need to increase or decrease the dose of the drug based on your body's response to the dosage. Your task is not only to find the right drug and live on. After you start taking your thyroid medications, you will need to to find out your hormone levels and see if you need to adjust your dosage.

I always recommend having a blood test for thyroid antibodies before and after you start taking new drugs to treat hypothyroidism. For example, if someone begins to feel worse after starting NDT, or if there is an increase in thyroid peroxidase antibodies after starting NDT, it may be wise to switch to prescription T4/T3 products.

Ready to start? Download my free eBook "Optimization of drug therapy in hypothyroidism" . It contains key information, strategies, and resources to help you get the most out of your thyroid medications, including a chart to help you switch medication doses when switching from one type of medication to another. (Book in English - translator's note)

Content

According to official medical statistics, the most common disease of the endocrine system is hypothyroidism. Especially often such a diagnosis is made to women over 65 years of age and people living far from the sea, which is the cause of iodine deficiency in the body. The disease can be acquired and congenital in nature, in the initial stages it does not make itself felt, and as it develops, it will require a long and difficult treatment. What is the danger of the disease and is it necessary to take hormonal drugs to eliminate it?

What is hypothyroidism

The name of the disease is formed from the Latin word "thyreoidea", meaning "thyroid gland", with the Greek prefix "hypo" added to it, which speaks of not reaching the norm or limit. In official medicine, “hypothyroidism” is understood as a condition that is caused by a persistent and prolonged deficiency of thyroid hormones, which is common to people of all ages. The disease has 2 extreme clinical forms:

  • myxedema (in adults) - characterized by tissue edema against the background of a violation of protein metabolism;
  • cretinism (in children) - characterized by a delay in mental and physical development, since thyroid hormones affect the growth and formation of the body.

The disease was first described in 1873; a severe (extreme) form under a specific diagnosis was discussed 5 years later. The specific state of the body, which is hypothyroidism, completely disappears after compensation for hormonal deficiency. In Russia, the disease is diagnosed in 19 out of 1000 women and in 21 out of 1000 men, but it is not detected at an early stage, since the primary symptoms are erased, and the forms of the development of the disease are nonspecific. The clinic of hypothyroidism (manifestations) includes several syndromes:

  • Metabolic-hypothermic: chilliness, yellowing of the skin (against the background of carotene accumulation), hypothermia (a strong drop in body temperature), overweight, cold intolerance.
  • Anemic: development of anemia.
  • Myxedematous: puffiness of the face and extremities, swelling of the tongue with the appearance of imprints of teeth along the lateral (lateral) edges, difficulty in nasal breathing, hearing impairment, coarsening of the voice.
  • Hyperprolactinemic gonadism: disorders of the ovaries (amenorrhea - delayed menstruation for several cycles, infertility, menorrhagia - large blood loss during menstruation), galactorrhea (excessive secretion of milk or colostrum, not related to childbirth or lactation) in women, erectile dysfunction (decreased potency) in men.
  • Ectodermal disorders: dullness, brittle hair, loss, slow growth (hair on the eyebrows and body is also affected), dry skin, thinning and delamination of nails.
  • Damage to the central nervous system (central nervous system): inhibition of actions and thinking, drowsiness (especially daytime, a person can sleep up to 12 hours at night), depression, decreased tendon reflexes, muscle pain, impaired attention, intelligence, memory.
  • Damage to the cardiovascular system: bradycardia (violation of sinus rhythm), hypotension (low blood pressure), hypertension (increased pressure, an atypical symptom), signs of pericarditis (inflammation of the pericardium with the appearance of effusion - fluid - in its cavity), slow heartbeat (below 60 bpm).
  • Lesions of the musculoskeletal system: joint edema, pain during movement, muscle weakness.
  • Lesions of the digestive system: hepatomegaly (enlarged liver), biliary tract or colon dyskinesia, frequent constipation, loss of appetite, nausea, weight loss, vomiting.

At the initial stage, the clinical picture is non-specific: most people experience only weakness, decreased performance, memory impairment, complain of dry skin, chilliness, hair loss. They may have swelling of the limbs or face, coarsen the voice, increase body weight. The severity of symptoms depends on the cause of hypothyroidism, the level of hormone deficiency and the individual characteristics of the body. According to the severity of the disease is divided into the following types:

  • Subclinical (latent) - an increase in thyroid-stimulating hormone (TSH) with a normal level of thyroxine (T4), symptoms are almost absent.
  • Manifest (clinical) - an increase in TSH against the background of a fall in T4, the clinical picture is pronounced.
  • Complicated - supplemented by cardiac disorders, secondary pituitary adenoma, can lead to myxedematous coma and death.

Causes

The main prerequisite for the spontaneous development of primary hypothyroidism, doctors call the presence of chronic autoimmune thyroiditis: inflammation of the thyroid gland, in which the body perceives its own cells as "enemies" and stimulates the synthesis of antibodies against them. Primary hypothyroidism is based on pathologies that reduce the mass of glandular tissue and inhibit the production of thyroxine and triiodothyronine, which is facilitated by:

  • nutritional features in which the body lacks iodine or selenium, an excess of thiocyanates, lithium ions, calcium (these substances block the uptake of iodine);
  • irradiation of the thyroid gland, removal of its part, taking medications;
  • congenital anomaly of the thyroid gland (hypoplasia - underdeveloped tissues, aplasia - the absence of individual sections, agenesis - the complete absence of tissue);
  • congenital disorder of the synthesis of thyroid hormones;
  • thyroiditis (inflammatory diseases of the thyroid gland);
  • hereditary predisposition to the disease (genetically transmitted defects in the biosynthesis of hormones T3 and T4);
  • exogenous (internal) effects in the prenatal period (the baby will experience skeletal development disorders, mental retardation).

Separately, doctors mention idiopathic hypothyroidism, the causes of which have not been identified. In addition to the direct damage to the tissues of the thyroid gland, doctors in the classification of hypothyroidism distinguish dysregulation of its functions in case of problems with the hypothalamus (the center of the autonomic nervous system, brain area) and the pituitary gland (lower cerebral appendage). Secondary hypothyroidism is called hypothalamus or pituitary (depending on the type of disorder) and among the causes is:

  • craniocerebral injuries, among the complications of which are brain hematomas, necrosis;
  • pituitary tumors;
  • ischemic brain damage;
  • lesions of the pituitary gland in autoimmune diseases;
  • meningoencephalitis;
  • long-term therapy with serotonin drugs.

Some specialists also classify hypothyroidism as tissue or peripheral, in which the functioning of the thyroid hormones present is disrupted. They can initially be produced defective, or receptors for them are damaged in the body, there are defects in transport proteins that transport hormones into cells. Less commonly, there is a problem with the functioning of the structures of the enzyme system of the kidneys or liver, due to which the conversion of T4 to T3 is disrupted.

Treatment

To prescribe a competent therapeutic regimen, a differential diagnosis of hypothyroidism is required, which helps to separate it from other endocrinopathies and requires control of the level of thyroid hormones for some time. Additionally, the patient is prescribed magnetic resonance imaging, ultrasound of the neck, radiography, computed tomography, thyroid puncture. Treatment is complex and involves:

  • etiotropic therapy (elimination of primary and concomitant diseases);
  • symptomatic effect;
  • hormone replacement therapy;
  • diet (nutrition correction to increase the level of iodine and selenium in the body).

Drug therapy is not prescribed in the subclinical form, when the TSH level is below 4.2 μIU / ml, and in the peripheral form, if the symptoms are erased. Here, often the replenishment of the level of thyroid hormones is based on the correction of the diet. The exact treatment regimen is compiled exclusively by an endocrinologist: this is especially true for the dosages of hormonal drugs.

Medications for hypothyroidism

Most doctors advise starting the treatment of thyroid hormone deficiency with etiotropic therapy: it affects the cause of this disease. Here it is often necessary to take iodine preparations (Betadine, Iodide, Endonorm), to fight thyroiditis and other inflammatory diseases of the thyroid gland. At the same time, the patient is prescribed symptomatic treatment, which involves taking:

  • cardiac glycosides (Korglikon, Digoxin, Strofantin), if heart failure is present;
  • cardioprotectors (Preductal, Riboxin, Mildronate, Trimetazidine) to protect the heart muscle;
  • drugs that improve brain activity (Piracetam);
  • vitamins and multivitamin complexes (Milgama, Neurobeks).

Treatment of hypothyroidism necessarily involves replacement therapy with synthetic analogues of thyroid hormones: the rest of the drugs are auxiliary. In hypothyroid coma, T3 is administered intravenously to the patient, but in other cases, thyroxine preparations (T4) are prescribed - Levothyroxine, Euthyrox, Bagothyrox. Their lifetime reception is not excluded. The most effective hormonal drugs for hypothyroidism of the thyroid gland:

  • L-thyroxine - tablets contain 25-200 mcg of levothyroxine sodium, activate the functions of the nervous system, blood vessels, heart, accelerate metabolic processes, are prescribed for primary and secondary forms of the disease. The clinical manifestation of treatment is observed on the 5th day. The drug is prohibited in thyrotoxicosis, myocardial infarction, inflammation of the heart muscle, it is used with caution in patients with diseases of the cardiovascular system. There are no side effects during treatment under medical supervision. Dosages are selected individually, tablets are drunk on an empty stomach, half an hour before meals. The duration of treatment is determined by a specialist.
  • Eutiroks - inexpensive tablets of levothyroxine sodium at a dosage of 25-150 mcg, which affect the growth and development of tissues, metabolic processes. The therapeutic effect of the treatment appears after a week (at low dosages - after 12 days) and the same amount persists after the drug is discontinued. General indications, contraindications and recommendations for taking are similar to those presented for L-thyroxine, drugs can replace each other.

Treatment in women

If hypothyroidism was detected in a pregnant woman, it is mandatory to prescribe drugs for substitution treatment and monthly monitoring of the level of thyroid hormones: this minimizes the risk of the disease to the fetus. Patients over 50 years of age are also recommended to take a full course of thyroxine and triiodothyronine preparations (non-lifelong prescription is allowed). Treatment for hypothyroidism in women includes:

  • normalization of the activity of the reproductive system and correction of the menstrual cycle with hormonal drugs (selected by a doctor);
  • replenishment of iodine deficiency (Endonorm, Iodomarin).

Medicines on thyroid hormones can be combined (Thyreocomb, Thyreoidin), or based only on thyroxine (L-thyroxine, Bagotiroks). The initial dosage is always minimal (25 mcg), increasing gradually every 2 weeks. The most prescribed drugs:

  • Thyroxine - tablets of levothyroxine sodium 50/100 mcg, a synthetic thyroid hormone, in large doses affecting the work of the pituitary gland and hypothalamus. It is allowed during pregnancy, does not require dose adjustment, and does not adversely affect the fetus. It is forbidden for exacerbations of heart disease, adrenal insufficiency, thyrotoxicosis, diabetes mellitus. Take the tablets in the morning on an empty stomach with water. Treatment is often lifelong, the dosage is determined by the doctor.
  • Thyreoidin - a combined agent on the hormones T3 and T4, inhibits the thyroid-stimulating function of the pituitary gland and leads to protein breakdown in large doses. It is prescribed for persons who do not tolerate treatment with single thyroxin, who have a severe form of hypothyroidism (myxedema, cretinism), cerebro-pituitary diseases. Reception is carried out after meals in the morning, the dosage is set individually. The effect of the treatment is visible after 2-3 days. Contraindications - heart disease, diabetes mellitus, thyrotoxicosis.

How to cure hypothyroidism without hormones

Due to the large number of side effects from thyroxine and triiodothyronine preparations at the initial stage of hypothyroidism, some doctors suggest trying to do without hormonal treatment. Homeopathy (Spongia, Ignatia), nutrition correction, herbal medicine, traditional medicine recipes, vitamin complexes, acupuncture (acupuncture) used in combination become an alternative. You can do without hormones when it comes to:

  • subclinical form of the disease with mild symptoms;
  • peripheral hypothyroidism;
  • slight hormonal imbalance;
  • iodine deficiency as the main cause of hypothyroidism.

In children

If the disease is congenital, it is necessary to start treatment already 1-2 weeks after the baby is born: this will help prevent severe disorders of psychosomatic development. If the form of hypothyroidism is not subclinical, the child is prescribed synthetic hormone replacement therapy for life, for which Levothyroxine sodium is used (initial daily dose is 10-15 mcg / kg). With the development of cretinism, the violations are irreversible, but the drug has a positive effect on the course of the disease. Additionally, the treatment regimen includes:

  • vitamins A, B12;
  • nootropic drugs (Hopantenic acid, Piracetam) - improve brain activity;
  • massage (courses);
  • therapeutic exercises under the supervision of a specialist.

How to treat hypothyroidism at home

Drug therapy is carried out on an outpatient basis (at home) - the patient only needs to visit the hospital for regular examinations and tests to check hormone levels. In rare cases, in addition, the doctor prescribes physiotherapy (electrophoresis with iodine, massage, decimeter microwaves), and the rest of the treatment is carried out at home and involves:

  • correction of the diet (first of all, remove foods that suppress the production of T3 and T4);
  • herbal medicine (the use of medicinal preparations with a diuretic effect, sedative, normalizing the menstrual cycle);
  • local exposure to iodine (well absorbed from the skin, better tolerated than when taken orally).

Diet

Treatment for hypothyroidism of the thyroid gland necessarily involves a correction of nutrition: cholesterol-rich foods and sources of saturated fatty acids, fast carbohydrates, and hard-to-digest foods are removed from the menu. It is desirable to cook for a couple, or boil, do not use oil. If constipation is present, the amount of fiber consumed increases. It is advisable to take salt iodized, reduce the volume of water to 1.5 liters. To treat a lack of thyroid hormones, they are introduced into the diet:

  • sea ​​fish, cod liver, seafood;
  • beef, chicken;
  • eggs (without yolk);
  • milk, cheese, yogurt, cottage cheese;
  • cucumbers, zucchini, bell peppers, tomatoes, carrots, apples, grapes, cherries, currants, kiwi, dates, bananas;
  • buckwheat, millet;
  • walnuts;
  • dried fruits.

The restriction is imposed on products containing soy, strong coffee and tea. Spicy, fatty, fried, smoked, fast food, alcohol are completely excluded. It is advisable to forget about products made from corn and wheat flour, polished rice, onions, beans, garlic, avoid using sauces, marinades, and do not add salt to dishes. To avoid obesity, the amount of confectionery products is reduced to 100 g / day, and once a week it is recommended to spend a fasting day on fresh plant foods.


Folk remedies

In the subclinical form, or as an addition to the main treatment regimen, traditional medicine recipes can be used, but the feasibility of each of them should be discussed with the doctor. The following remedies work well for hypothyroidism:

  • Seaweed - no more than 100 g per day of a fresh product. The powder is diluted in an amount of 1/2 tsp. in 200 ml of warm water, let it swell and take 2-3 rubles / day after meals. With tuberculosis, kidney disease, pregnancy is prohibited.
  • Application of iodine mesh on the neck area - 3 vertical lines and 3 horizontal lines with a cotton swab, area 7 * 7 cm. The procedure is carried out once a day.
  • Dissolve 5% iodine solution (1 drop for weight up to 65 kg, 2 drops for over 65 kg) and apple cider vinegar (1 tsp) in warm water (200 ml). Divide into 3 doses, drink with meals. This tool is used with an interval of 3 days.

Video

Occurs due to insufficient production of thyroid hormones. This condition develops and progresses for several years, gradually manifesting itself as a decrease in working capacity, deterioration in mood, and obesity. Unfortunately, today this disease cannot be cured, and this is a proven fact.

  • increased activity, irritability, insomnia develops;
  • heart rhythm is disturbed, sweating increases;
  • body weight decreases rapidly with a constant daily caloric intake;
  • there is a tremor of the limbs and head.

If these signs occur while taking substitution drugs, it is urgent to visit an endocrinologist. Depending on the severity of the symptoms, the doctor may recommend reducing the dose of the drug or prescribing beta-blockers. After the disappearance of adverse reactions, therapy should be continued, choosing a lower dose.

Recommendations for taking drugs for hypothyroidism

To make therapy more effective, you should follow simple rules:

  • Tell your doctor about all medications you take during treatment, as some of them can adversely affect hormonal drugs.
  • Most interactive medications need to be taken four hours before thyroid medications.
  • Medicines are recommended to be washed down with a small amount of water at room temperature. The tablets should not be taken with tea, coffee or milk as these liquids may interfere with the absorption of the drugs.
  • In the process of treatment, it is necessary to follow a diet, since some products affect the absorption and effectiveness of hormonal drugs. It will be better to take replacement drugs on an empty stomach.
  • If for any reason it was not possible to take the medicine, you should not take a double dose to make up for the missed dose.
  • During pregnancy planning or childbearing, the use of replacement drugs is considered safe.

Contraindications

Replacement therapy for hypothyroidism should be carried out with great caution in pathologies of the cardiovascular system, persistent increase in blood pressure, diabetes mellitus, and progressive adrenal insufficiency.

The presence in the anamnesis of a patient with hypothyroidism of any of these ailments requires dose adjustment and constant monitoring by a physician. With the development of individual intolerance to a particular drug, it should be replaced by another.

Symptomatic therapy for hypothyroidism

To improve well-being and improve the quality of life, the patient, in addition to hormonal drugs, is prescribed maintenance therapy. It helps to reduce the manifestations of the disease and maintain the performance of those organs that suffer from hypothyroidism of the thyroid gland.

Symptomatic treatment includes taking the following groups of drugs:

  • funds aimed at correcting the functional state of the myocardium: Mildronate, ATP-Long, Asparkam, Mexicor (Mexidol), Niacin, Riboflavin;
  • medicines that have a cardiotonic and antiarrhythmic effect used to treat heart failure: Digitoxin, Digoxin, Celanide, Strofantin K, Korglikon, infusion of Adonis herb;
  • nootropics and neuroprotectors;
  • preparations of female hormones: Premarin, Estroferm, Pregnin, Norkolut, Postinor, Ovidon, Pregestrol;
  • vitamin-mineral complexes and immunostimulants.

Taking these drugs will help support the body and restore lost performance. There is no need to use them all the time. It is enough to undergo 3-4 courses of treatment per year strictly according to the doctor's prescription. and immunostimulants can be taken continuously.

The role of iodine preparations in the treatment of hypothyroidism

The fight against hypothyroidism always begins with etiotropic therapy, which eliminates not itself, but the root cause of the disease state.

Often, hypothyroidism develops against the background of iodine deficiency pathologies - and colloid nodes. In this case, there is a chance to do without hormonal treatment and restore the functionality of the thyroid gland with the help of iodine-containing drugs.

For optimal hormone production, the daily dose of iodine should be 150 mcg. For pregnant women, this figure increases to 230–250 mcg per day.

In the treatment of hypothyroidism, you can take such iodine preparations:

  • IodineActive;

All these drugs contain not only the daily dose of iodine, but also various vitamin and mineral supplements.

However, taking even such drugs, which in most cases are dietary supplements, must be agreed with the doctor. Excessive dosage can lead to problems - the development of iodism. In this case, the following symptoms appear:

  • lacrimation and runny nose;
  • profuse salivation;
  • itching of the skin.

If these signs appear, it is necessary to reduce the dosage or stop the drug.

Therapy for hypothyroid coma

Mexidematous coma in medical practice is rare. It develops rather slowly, so it is difficult not to notice it.

Therapy of patients in a state of coma is complicated not only by the severity of the pathology, but also sometimes by the elderly age of patients, for whom it is very difficult to quickly compensate for the lack of thyroids.

Treatment of a critical condition with hypothyroidism of the thyroid gland is carried out in the intensive care unit. In this case, T3 drugs are most often used, since they act much faster than T4.

To remove the patient from a coma, glucocorticoids and drugs are used to restore water-salt metabolism.

Diet for hypothyroidism

Therapy for hypothyroidism of the thyroid gland without fail requires proper nutrition. In order for the correction of the hormonal background to be more successful, it is necessary to adhere to the following recommendations:

  • exclude from the diet all fatty, spicy, pickled and pickled dishes, sausages and smoked meats;
  • reduce to a minimum the consumption of sugar, muffins, confectionery and replace them with honey;
  • include in the diet, protein, complex carbohydrates and;
  • limit fluid intake, as there is a risk of swelling with hypothyroidism;
  • remove tea, coffee, cocoa, sweet carbonated water, alcohol from the diet and replace them with clean liquid, freshly squeezed juices, fruit drinks and compotes.

If the diet is supplemented with daily exercises or regular visits to the gym, hypothyroidism will quickly recede. Excess weight, bad mood and fatigue will remain in the past.

Similar posts