Can You Stop Taking Levothyroxine or Other Thyroid Medications?

If you have a low level of thyroid hormones in your body, you might have hypothyroidism. Hypothyroidism is a medical condition that can occur when your thyroid gland is underactive or doesn’t work as well as it should.

If you’ve been diagnosed with hypothyroidism, your primary care provider might prescribe medication. This medication will help replace your missing thyroid hormones. The most common medication used to treat hypothyroidism is levothyroxine (Synthroid, Levoxyl, Tirosint). In fact, levothyroxine is one of the most commonly prescribed medications in the U.S. 

It’s important to take levothyroxine, and other thyroid medications, exactly as prescribed. These medications help your body function properly. Stopping them suddenly can lead to symptoms of hypothyroidism. And this can lead to some serious health problems. So, make sure to talk with your healthcare team before stopping your thyroid medication.

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What is levothyroxine used for, and how does it work?

Levothyroxine is a synthetic thyroid hormone. It’s the most common medication used to treat hypothyroidism. Thyroid hormones help regulate many of your bodily functions, including metabolism, weight, and body temperature. If you don’t have enough of this hormone, you can develop a range of symptoms including:

• Fatigue

• Weight gain

• Depression 

Levothyroxine replaces the hormone thyroxine (T4), which converts to the active form of thyroid hormone, triiodothyronine (T3).Taking levothyroxine to replace your missing hormone will bring your thyroid hormones into balance. And it can help relieve these types of symptoms. 

What are the different types of thyroid hormones?

There are a few important thyroid hormones to be aware of:

• Thyroid-stimulating hormone (TSH): This is the hormone most frequently checked to monitor your thyroid function and response to medication. TSH tells the thyroid how much thyroid hormone to make.

• Triiodothyronine (T3): T3 is the active form of thyroid hormone that binds to thyroid receptors.

• Thyroxine (T4): T4 is the inactive form of thyroid hormone that’s converted to the active form, or T3.

What are the different types of thyroid medications?

Here are the main categories of medications for hypothyroidism:

• Synthetic T4 medication: Levothyroxine is the most common synthetic thyroid medication. It’s a lab-made version of the T4 hormone. Levothyroxine has several brand-name products available, including Synthroid, Levoxyl, and Tirosint. 

• Synthetic T3 medication: A synthetic version of the active T3 hormone is also available. It’s called liothyronine (Cytomel). T3 does not last as long in the body, needs to be taken more often, and can cause more side effects.

• Natural T3 and T4 thyroid products: These include desiccated thyroid products. They come from dried animal thyroid glands (usually pigs). These products — including Armour Thyroid and NP Thyroid — naturally contain T3 and T4 hormones. They aren’t approved by the FDA, but they’re still available by prescription only. There aren’t as many studies on these products as there are for levothyroxine. They may also cause more side effects.

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Levothyroxine is the first-choice medication to treat hypothyroidism for most people, according to the American Thyroid Association.

What happens when you stop taking thyroid medication?

If you stop your thyroid medication all of a sudden, symptoms of hypothyroidism will likely return. 

If hypothyroidism is left untreated, it can lead to serious health problems. You may experience mood swings, irritability, and slowed thoughts. In fact, hypothyroidism is one of the reversible causes of dementia. 

Hypothyroidism can also damage your nerves, raise your risk of heart problems, and affect your fertility. And hypothyroidism is especially dangerous if you’re pregnant. It can cause risks to both the pregnant mother and fetus. 

Severe hypothyroidism can be life-threatening. In rare cases, your body could slow down so much that you enter a coma. This can even lead to death. 

Is it possible to stop taking thyroid medication in a safe way?

Yes, there can be a safe way to stop taking thyroid medication. Whether or not you’re able to safely stop taking thyroid medication may depend on the reason you are taking it. But you should always check with your healthcare team first.

Research shows that some people can safely stop taking thyroid medications. In this review of over 17 individual studies, up to 1 in 3 people were able to stop their thyroid medication. But this was mostly in people with “borderline” hypothyroidism, also called subclinical hypothyroidism. In subclinical hypothyroidism, T4 levels are normal. People with this condition sometimes don’t need thyroid medications at all. 

What happens if you stop taking Levothyroxine? 

Those who have clearer hypothyroidism may not be able to stop taking levothyroxine. Stopping levothyroxine usually leads to the return of hypothyroidism symptoms. In the review mentioned above, only about 1 in 10 people with overt hypothyroidism were able to stop their thyroid medications successfully.

If you’ve had your thyroid completely removed, you’ll need thyroid medications for life. These medications will help your body function normally. If your thyroid was removed due to cancer, treatment may also lower the risk of your cancer coming back.

Talk with your healthcare team before making changes to your thyroid medication. They can help make sure that you’re making the best decision for your health.

What happens if you miss a dose of thyroid medication?

If you miss a dose of thyroid medication, take it as soon as you remember. It’s possible to experience symptoms of hypothyroidism (like fatigue) after a missed dose. If you experience any symptoms, call your primary care provider.

If you miss a dose and it’s almost time for your next dose, skip the missed dose. Take your next dose at your regularly scheduled time. It’s usually not advised to take 2 doses of thyroid medication at the same time. Too much thyroid medication can cause symptoms of hyperthyroidism including shakiness, sweating, and fast heartbeat.

But if you forget to take your medication for several days, let your primary care provider know. They may want to adjust your dose for a few days.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a special interest in chronic care management, women’s health, mental health, and preventive care. She has over 10 years of experience in primary care research, innovation, and practice.

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