Your doctor will do regular blood tests to check the levels of thyroid hormones in your body before and after starting Unithroid.
These will allow your doctor to adjust the dose to suit you.
At the start of treatment you can expect to have blood tests often. Once your hormone levels are stable, you'll usually have a blood test after 4 to 6 months, and after that once a year.
You may need blood tests more often if you:
- are pregnant
- start or stop a medicine that can interfere with Unithroid
- have any symptoms that could mean your dose is not quite right
You shouldn't take more Unithroid than your doctor prescribes.
If you take too much of the drug, you may develop symptoms of overactive thyroid, including fatigue, sensitivity to heat, increased appetite, and sweating.
Symptoms of a Unithroid overdose may also include:
- Confusion and disorientation
If you or someone else has symptoms of an overdose, call a poison control center at 800-222-1222. If someone collapses or isn't breathing, call 911.
What is the most important information I should know about Unithroid?
You may not be able to take Unithroid if you have certain medical conditions. Tell your doctor if you have an untreated or uncontrolled adrenal gland disorder, a thyroid disorder called thyrotoxicosis, or if you have any recent or current symptoms of a heart attack.
Unithroid should not be used to treat obesity or weight problems.
#2. Follow Your labs (Including Free Thyroid Hormones)
While the TSH may not be the most valuable lab test to evaluate your thyroid that doesn't mean that other lab tests don't have value.
In fact, it is just the opposite.
When you are treating your thyroid with medication you should periodically evaluate your free thyroid hormone levels.
These lab tests provide a window into your body and can help you determine if your dose is sufficient.
The hallmark of hypothyroidism is a reduction in Free T4 and an elevation in TSH (typically, but not always the case).
As you take Unithroid your Free T4 should increase.
Because Unithroid contains the same thyroid hormone that your body produces naturally.
If you are taking thyroid medication and you only see a drop in your TSH without a simultaneous rise in your free T4, then your medication dose may not be sufficient .
It's critical that your body has sufficient Free T4 levels because it uses T4 to create T3 through the conversion process.
Low levels of T4 may result in decreased T3 and further issues down the road.
It may seem obvious to you that it's necessary to look at the free hormone concentration in your body, but it's not always obvious to Doctors.
But it should be, especially if you think about it.
Hypothyroidism is the only hormonal condition in which we evaluate the pituitary marker instead of the free thyroid hormone.
Take for instance testosterone:
If you have low testosterone and you take testosterone medication, doesn't it make sense to check your testosterone levels to see if they have improved?
It makes perfect sense and that's exactly what your Doctor should be doing.
Q: I have recently been prescribed Unithroid 25 mcg. Someone told me I shouldn't eat walnuts or spinach. Is this true? Are there other foods I should avoid? I normally don't eat these until afternoon or at supper -- I take my pill on an empty stomach about 45 to 60 minutes before breakfast.
A: There are various foods that can cause your body to absorb less Unithroid, potentially alter your thyroid hormone levels and possibly require your doctor to adjust your dose. Examples of these foods do include walnuts and high-fiber foods. It is important to contact your doctor for instructions regarding treatment with Unithroid and proper diet. For additional information on Unithroid or thyroid conditions you may want to visit our Web site: //www.everydayhealth.com/drugs/Unithroid and //www.everydayhealth.com/thyroid-conditions/evaluating-your-thyroid-disease-risk.aspx.
Oral: Administer Unithroid on an empty stomach (acidity increases absorption), at least 30 to 60 minutes before breakfast or 3 to 4 hours after dinner. Do not administer Unithroid within 4 hours of administration of products that may contain iron or calcium. Do not administer Unithroid in conjunction with antacids or proton pump inhibitors.
Capsule: Swallow whole; Do not crush or cut.
Tablet: May crush into 5 to 10 mL of water and drank immediately. If swallowing tablet whole, administer with a full glass of water to prevent dysphagia.
Solution: Give either undiluted (directly squeeze contents into mouth) or diluted in water only (squeeze contents into water, stir, and drink immediately).
Intravenous Unithroid is exclusively for use in the hospital setting in which vital signs can undergo close monitoring.
In cases where the patient can not tolerate anything by mouth due to an underlying problem, the Unithroid capsules are usable as a suppository and are well absorbed.
For the treatment of hypothyroidism (oral): Adults who are healthy and who have a diagnosis of hypothyroidism for a few months should receive an initial dose of 1.6 mcg/kg/day with a 12.5 to 25 mcg/day dose adjustment every 6 to 8 weeks as needed. Adults with cardiac disease or elderly over 65 years old and hypothyroidism should receive an initial dose of 25 mcg/day with dose adjustment of 12.5 to 25 mcg every 4 to 6 weeks as needed. Pregnant patients with newly diagnosed hypothyroidism should receive initial treatment at 1.8 mcg/kg/day. Adjust dose every 4 weeks as needed. If a patient has a diagnosis of hypothyroidism prior to pregnancy, adjust the dose of Unithroid as needed. After pregnancy, the dose of Unithroid should decrease to 1.6 mcg/kg/day.
For the treatment of myxedema coma (IV) or severe hypothyroidism: 200 to 400 mcg initial IV loading dose followed by a daily dose of 1.2 mcg/kg/day with consideration to use lower doses in patients with a history of cardiac disease, arrhythmia, or older patients. Switch to oral therapy (8mcg/kg/day) when symptoms resolve. The equivalence between intravenous to oral is 2 to 1 (for example 200 mcg IV of Unithroid is equal to 100 mcg of oral Unithroid )
For organ recovery from a cadaver (IV):20mcg IV bolus to the donor, followed by 10 mcg/hour continuous infusion. Given with methylprednisolone, dextrose, and insulin.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to Unithroid.
Learn the brand name and generic name of your medication. Do not switch brands without talking to your doctor or pharmacist, as each brand of Unithroid contains a slightly different amount of medication.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Q: I was considering a joint supplement that was referred to me called Super Cissus RX. The ingredient is Cissus quadrangularis. Would it interact with Unithroid?
A: Cissus quadrangularis is an herbal supplement marketed for a variety of uses, including obesity, diabetes, high cholesterol, and osteoporosis. Unfortunately, not enough information is known about this herbal supplement to know if it is safe to take with thyroid medications. Nutritional and herbal supplements are not regulated by the U.S. Food and Drug Administration (FDA) in the same way that prescription and over-the-counter medications are. Supplements are regulated as foods and not drugs. Because herbs and supplements are not strictly regulated by the FDA, these products are not required to be tested for safety, purity, or even effectiveness. Therefore, their manufacturers aren't required by law to prove they work, even if they make dramatic claims. Because supplements have not been thoroughly studied in a clinical setting, possible side effects and interactions with other drugs are often not known. There are also no regulated manufacturing standards in place and some supplements have been found to be contaminated with toxic metals and other drugs. Supplements should be purchased from a reliable source to minimize the risk of contamination. When choosing a supplement, look for the stamps, USP (United States Pharmacopeia) or DSVP (Dietary Supplement Verification Program), on the label. These organizations assure that the content claims on the label are true. The National Institutes of Health (NIH) also has a website that reviews products, so you can check them out before you purchase anything. Always read and follow the complete directions and warnings on over-the-counter products and discuss their use with your doctor before taking them. In general, supplements should be taken only under the supervision of your doctor. For more specific information, consult with your doctor or local pharmacist for guidance based on your health status and current medications, particularly before taking any action. Sarah Lewis, PharmD
What should I avoid while taking Unithroid?
Avoid the following food products, which can make your body absorb less Unithroid: grapefruit juice, infant soy formula, soybean flour, cotton seed meal, walnuts, and high-fiber foods.
Adverse reactions associated with Unithroid therapy are primarily those of hyperthyroidism due to therapeutic overdosage. They include the following:
General: fatigue, increased appetite, weight loss, heat intolerance, fever, excessive sweating;
Central nervous system: headache, hyperactivity, nervousness, anxiety, irritability, emotional lability, insomnia;
Musculoskeletal: tremors, muscle weakness;
GI: diarrhea, vomiting, abdominal cramps;
Dermatologic: hair loss, flushing;
Reproductive: menstrual irregularities, impaired fertility.
Pseudotumor cerebri and slipped capital femoral epiphysis have been reported in children receiving Unithroid therapy. Overtreatment may result in craniosynostosis in infants and premature closure of the epiphyses in children with resultant compromised adult height.
Seizures have been reported rarely with the institution of Unithroid therapy.
Inadequate Unithroid dosage will produce or fail to ameliorate the signs and symptoms of hypothyroidism.
Hypersensitivity reactions to inactive ingredients have occurred in patients treated with thyroid hormone products. These include urticaria, pruritus, skin rash, flushing, angioedema, various GI symptoms (abdominal pain, nausea, vomiting and diarrhea), fever, arthralgia, serum sickness and wheezing. Hypersensitivity to Unithroid itself is not known to occur.
In addition to the above events, the following have been reported, predominately when Levoxyl tablets were not taken with water: choking, gagging, tablet stuck in throat and dysphagia (see PATIENT INFORMATION).
Read the entire FDA prescribing information for Levoxyl (Unithroid Sodium)
8. Cautions with other medicines
Some medicines can interfere with thyroid hormones, so the dose of Unithroid may need to be changed. They include:
- medicines for seizures, carbamazepine and phenytoin
- oestrogens - such as in combined contraceptive pills or hormone replacement therapy (HRT)
Unithroid can change how other medicines work, so their doses may need to be altered. These medicines include:
- medicines for diabetes - either insulin or tablets
- the blood thinning medicine, warfarin
Some medicines shouldn't be taken at the same time of day as Unithroid as they can reduce the amount of Unithroid your body takes in, including:
- calcium salts
- iron salts
- orlistat, a medicine used for weight loss
- sucralfate, a medicine used to treat stomach ulcers
- some cholesterol-lowering medicines such as colestyramine, colestipol or colesevelem
Read the information leaflet supplied with these medicines or speak to your pharmacist for advice on how much time to leave between taking these medicines and taking Unithroid.
What are some things I need to know or do while I take Unithroid Tablets?
For all patients taking this medicine (Unithroid tablets):
- Tell all of your health care providers that you take this medicine (Unithroid tablets). This includes your doctors, nurses, pharmacists, and dentists.
- Do not run out of this medicine (Unithroid tablets).
- It may take several weeks to see the full effects.
- If you have high blood sugar (diabetes), this medicine (Unithroid tablets) may sometimes raise blood sugar. Talk with your doctor about how to keep your blood sugar under control.
- Check your blood sugar as you have been told by your doctor.
- Have blood work checked as you have been told by the doctor. Talk with the doctor.
- This medicine may cause weak bones (osteoporosis) with doses that are too high. The risk may be higher in women who have been through menopause. Talk with your doctor to see if you have a higher risk of weak bones or if you have any questions.
- This medicine may affect fertility. Fertility problems may lead to not being able to get pregnant or father a child. Talk with the doctor.
- If you are 65 or older, use this medicine (Unithroid tablets) with care. You could have more side effects.
- Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.
- If giving this medicine (Unithroid tablets) to your child and your child's weight changes, talk with the doctor. The dose of this medicine (Unithroid tablets) may need to be changed.
- This medicine may affect growth in children and teens in some cases. They may need regular growth checks. Talk with the doctor.