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Levothyroxine has a half-life of 7.5 days when taken daily, so about six weeks is required for it to reach a steady level in the blood. [5] Side effects from excessive doses include weight loss, trouble tolerating heat, sweating, anxiety, trouble sleeping, tremor, and fast heart rate. [5]
When pregnant, a woman with a low-functioning thyroid will also need to increase her dosage of thyroid hormone. [16] One exception is that thyroid hormones may aggravate heart conditions, especially in older patients; therefore, doctors may start these patients on a lower dose and work up to a larger one to avoid risk of heart attack. [17]
It has been shown that the prevalence of positive tests for thyroid antibodies increases with age, "with a frequency as high as 33 percent in women 70 years old or older." [ 27 ] Hashimoto's thyroiditis can occur at any age, including children, [ 119 ] but more commonly appears in middle age , particularly for men. [ 123 ]
In starvation or severe somatic stress, deiodinase type 1 is inhibited which lowers circulating levels of T 3 (due to it being the main source of peripherally converted T 3 from T 4 in the plasma), causing a decrease in the metabolic rate. [3]
Blood free thyroxine and TSH levels are monitored to help determine whether the dose is adequate. This is done 4–8 weeks after the start of treatment or a change in levothyroxine dose. Once the adequate replacement dose has been established, the tests can be repeated after 6 and then 12 months, unless there is a change in symptoms. [8]
Euthyroid sick syndrome (ESS) is a state of adaptation or dysregulation of thyrotropic feedback control [1] wherein the levels of T3 and/or T4 are abnormal, but the thyroid gland does not appear to be dysfunctional.