Commencement of Treatment on Thyroid Replacement Therapy
By Diana Holmes
Once you are on thyroid replacement therapy, you will probably be taking the medication for the rest of your life. Only in rare cases is medication ceased. Thyroxine comes in strengths of 25 micrograms, 50 micrograms and 100 micrograms.
Medication is best taken first thing in the morning with a drink of water on an empty stomach. Don’t eat for at least ½ an hour to an hour if you can and don’t take iron supplements or antacids within two hours of your medication as these affect absorption. Calcium can also interfere with the absorption of thyroid drugs. You should take calcium at least two to three hours apart from your thyroid medication. Don’t forget some fruit juices are calcium fortified.
A high fibre diet can also affect absorption. If you have always had a high fibre diet, carry on as usual. If you are on thyroid replacement and you decide to try a high fibre diet, then your absorption may be affected and you need to have another test done about 6-8 weeks into your new regime, to check to see if your levels change. You need to be consistent. Don’t do high fibre for a couple of weeks and then change as your levels may change with it!
Don’t forget to take your medication. If you do, DO NOT take two day’s medication together, just carry on as normal. You may find if you have missed more than one day that you notice a recurrence of some of the symptoms you had before.
When starting medication, it is sensible to monitor yourself. This can be done by taking your pulse. The pulse should be taken before arising in the morning counting the beats for one full minute. Normal resting pulses are between 60 and 75 beats per minute.
To take the pulse, look to the base of the thumb. Follow the line down the outer edge of the wrist for 2 inches, then take the index finger and the middle finger of the right hand and ½ an inch in from the outer edge depress those two fingers (it’s in the soft part). There you should feel your pulse.
If a fast pulse is apparent and other symptoms such as lots of palpitations, headaches, agitation, excitability and anginal pain (pain over the heart area) occur, you most probably have gone into a slight overdose. Their adverse reactions normally disappear after dosage reduction or temporary withdrawal of treatment.
You may feel the need to pass water more often. DO NOT WORRY, as this is quite normal.
DO remember that once on thyroid replacement therapy, you body is under a massive repair so be gentle with yourself and DON’T try to do too much too soon. If you do, you may regress.
Don’t expect to be well over night. It just won’t happen. Some symptoms can take as long as 12 -18 months to subside. Do be patient.
It will be helpful to the doctor if you make a note of any changes that occur once on treatment. Keep a diary and make a note of any improvements. Also keep a note of how much thyroxine you are taking and any decreases or increases so that you know when you felt well and what amount of thyroxine you were taking at that stage.
Copyright © 1997, Diana Holmes.
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