Levothyroxine is a thyroid hormone used to treat low thyroid hormone levels (hypothyroidism) in people of all ages. It's also approved to help treat thyroid cancer along with radioactive iodine and surgery. The medication is available in tablet and liquid forms and is taken once daily, usually on an empty stomach in the morning. Regular blood tests are needed to keep your dose in the right range. Common side effects happen when the dose is too high and can include fast heartbeat, anxiety, and weight loss.
Levothyroxine is a lab-made version of thyroxine (T4), a natural hormone made by your thyroid. It works by replacing or adding to the T4 your body isn’t making. This helps keep your metabolism, energy, heart rate, and body temperature working properly.
In people with thyroid cancer, levothyroxine is used to keep thyroid-stimulating hormone (TSH) levels low. Lowering TSH might help prevent cancer from coming back after treatment.
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Signs of having too much thyroid hormones in the body, such as:
Contact your healthcare provider immediately if you experience any of the following.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Less common
Chest pain or discomfort
decreased urine output
difficult or labored breathing
difficulty with swallowing
dilated neck veins
extreme fatigue
fainting
fast, slow, irregular, pounding, or racing heartbeat or pulse
heat intolerance
hives or welts, skin itching, rash, or redness
irregular breathing
irritability
menstrual changes
pain or discomfort in the arms, jaw, back, or neck
sweating
swelling of the eyes, face, lips, throat, or tongue
tightness in the chest
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Change in consciousness
cold, clammy skin
confusion
disorientation
fast or weak pulse
lightheadedness
loss of consciousness
sudden headache
sudden loss of coordination
sudden slurring of speech
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Abdominal or stomach cramps
change in appetite
crying
false or unusual sense of well-being
fear or nervousness
feeling not well or unhappy
feeling of discomfort
feeling of warmth
feeling things are not real
feelings of suspicion and distrust
headache
increased appetite
mental depression
muscle weakness
quick to react or overreact emotionally
rapidly changing moods
redness of the face, neck, arms, and occasionally, upper chest
restlessness
trouble getting pregnant
trouble sitting still
unusual tiredness or weakness
vomiting
weight gain or loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Tips for the liquid solutions:
Levothyroxine isn't known to cause weight gain as a side effect. But it’s still possible for you to gain weight while taking it. In most cases, this happens because your dose might be too low. This means your thyroid hormone levels haven't reached the target range. If you notice unexpected or concerning weight gain, talk to your prescriber. They might check your hormone levels and adjust your dose if needed.
It can take about 4 to 6 weeks after starting levothyroxine to feel the full benefits of the medication. Some people might notice their symptoms begin to improve sooner, but results can vary. In the beginning, it might take several weeks to find the dose that works best for you. Your prescriber will check your thyroid hormone levels from time to time. They might also raise your dose slowly to help avoid side effects like headache and nausea. If you’re not sure whether the medication is working, ask your prescriber for guidance.
Levothyroxine is usually taken in the morning, at least 30 minutes before breakfast. This helps your body absorb the medication better because your stomach is empty. But some research shows that taking it at night can work just as well, as long as you separate it from food and other medications.
You might need to take levothyroxine and your other medications at different times to avoid interactions. How long you should wait depends on the medication. For example, take antacids like Tums, wait at least 4 hours before or after taking levothyroxine. Some medications can lessen how much levothyroxine gets absorbed into the body, making it work less well. Others might increase how much levothyroxine stays in your body, which can lead to symptoms of hyperthyroidism. Ask your pharmacist or prescriber if you need to separate your medications.
You might experience some hair loss during the first few months of starting levothyroxine. This side effect is usually temporary and tends to get better with time. Talk to your prescriber if you're concerned about hair loss or if it doesn't improve.
Make sure to take levothyroxine at least 4 hours after your last meal. Eating too soon after taking your dose can affect how well your body can absorb the medication. Foods that are high in fiber, soy products, and walnuts can reduce how much of the medication your body takes in. That’s why it’s generally recommended to take levothyroxine 30 minutes to 1 hour before food, on an empty stomach.
If you stop taking levothyroxine, your low thyroid symptoms will likely return and might even get worse over time. This happens because your body is no longer getting the thyroid hormones it needs to function properly. Don't stop taking levothyroxine without first speaking with your prescriber.
Yes, you can crush levothyroxine tablets. This might be helpful for infants or anyone who has trouble swallowing pills. After crushing the tablet, mix the powder with 1 to 2 teaspoonfuls of water, then give the mixture with a spoon or dropper.
Levothyroxine can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Levothyroxine shouldn't be used for weight loss. It’s not recommended, safe, or effective for that purpose. Taking high doses of levothyroxine can cause serious or even life-threatening effects, especially if taken with other medications for weight loss.
Taking too much levothyroxine can cause heart problems, especially if you have heart disease or are an older adult. If you develop new heart symptoms or your current ones get worse, your prescriber might lower your dose or pause treatment for a week before restarting it at a lower dose. Always tell your prescriber if you feel chest pain, a racing heartbeat, or other heart-related symptoms.
If you have adrenal insufficiency (a condition where your adrenal glands don’t make enough hormones), starting levothyroxine too soon can lead to a serious condition called adrenal crisis. This can happen because thyroid hormone speeds up how your body breaks down steroid hormones, which help you manage stress. To help prevent this, your prescriber will likely treat you with replacement steroids before beginning levothyroxine. If you feel very tired, have stomach pain, feel dizzy or weak, or start vomiting while taking this medication, get medical help right away.
If you have diabetes, starting levothyroxine can make it harder to keep your blood sugar levels under control. You might need to adjust your diabetes medications or insulin after starting, stopping, or changing your dose of levothyroxine. Your prescriber will likely monitor your blood sugar more closely during this time to keep you safe and avoid complications. Let them know if you notice changes in your blood sugar readings or symptoms like increased thirst, frequent urination, or tiredness.
Taking levothyroxine can weaken your bones over time, especially if your dose is too high. The risk is greater for women after menopause. This happens because high thyroid hormone levels can make your body break down bone faster than it can rebuild it.
To lower this risk, your prescriber will give you the lowest dose possible that still keeps your thyroid levels in a healthy range. Be sure to attend all follow-up appointments and get regular lab tests to check your hormone levels and bone health.
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30 tablets of 25mcg | 1 package | $6.85 | $6.85 |
| 30 tablets of 50mcg | 1 package | $7.19 | $7.19 |
| 30 tablets of 75mcg | 3 packages | $8.45 | $2.82 |
| 30 tablets of 88mcg | 1 package | $7.44 | $7.44 |
| 30 tablets of 100mcg | 3 packages | $16.25 | $5.42 |
| 30 tablets of 112mcg | 1 package | $8.04 | $8.04 |
| 30 tablets of 125mcg | 3 packages | $16.93 | $5.64 |
| 30 tablets of 137mcg | 1 package | $7.71 | $7.71 |
| 30 tablets of 150mcg | 3 packages | $17.11 | $5.70 |
| 30 tablets of 175mcg | 3 packages | $10.13 | $3.38 |
| 30 tablets of 200mcg | 1 package | $11.63 | $11.63 |
| 90 tablets of 25mcg | 1 package | $15.23 | $15.23 |
| 90 tablets of 50mcg | 1 package | $16.23 | $16.23 |
| 90 tablets of 75mcg | 1 package | $8.48 | $8.48 |
| 90 tablets of 88mcg | 1 package | $16.47 | $16.47 |
| 90 tablets of 100mcg | 1 package | $16.62 | $16.62 |
| 90 tablets of 112mcg | 1 package | $16.99 | $16.99 |
| 90 tablets of 125mcg | 1 package | $17.29 | $17.29 |
| 90 tablets of 137mcg | 1 package | $16.63 | $16.63 |
| 90 tablets of 150mcg | 1 package | $16.94 | $16.94 |
| 90 tablets of 175mcg | 1 package | $18.66 | $18.66 |
| 90 tablets of 200mcg | 1 package | $18.28 | $18.28 |
Hypothyroidism:
Thyroid cancer:
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Levothyroxine will not be safe for you to take.