HYPOTHYROIDISM - DRUGS FOR THE TREATMENT OF HYPOTHYROIDISM

Causes

In addition to its congenital origin (absence of the thyroid gland from birth), hypothyroidism can be caused by multiple etiological elements: surgical removal of the thyroid gland, intake of antithyroid drugs, intake of radioactive iodine (used for example for the treatment of hyperthyroidism) , iodine deficiency in the diet, pituitary and hypothalamic diseases, autoimmune thyroid diseases (Hashimoto's disease), administration of particular pharmacological specialties (eg lithium: transient form of hypothyroidism).

Symptoms

In the case of fetal hypothyroidism, the symptoms are very severe and weigh on the brain and structural development of the unborn child. If hypothyroidism is a consequence of pathologies, drugs or thyroidectomy, the symptoms can be many: altered menstrual regularity, mood alteration, anemia, asthenia, bradycardia, decreased sexual desire, brittle hair, thinning hair, muscle cramps , bone and muscle pain, goiter, weight gain, hypertension, somnolence, cutaneous xerosis.

Medicines

In case of ascertained hypothyroidism it is a good rule to follow an immediate therapeutic path; even in the event of a presumed pathology, it is advisable to request a medical consultation, to prevent the symptoms from worsening over time. Hypothyroidism, compared to the opposite pathology (hyperthyroidism) is much easier to treat and control, thanks to the aid of appropriate synthetic drugs, the dosage of which must always be established by the doctor, and possibly modulated during the course of the disease.
It is also useful to treat secondary symptoms derived from hypothyroidism, such as anemia.
Correction of eating habits is not only useful to better deal with therapy, but it is necessary to avoid constipation, which often accompanies those suffering from hypothyroidism.
In the event of neonatal hypothyroidism, it is necessary to intervene promptly to induce physiological development; the administration of hormones T3 and T4 already from the earliest stages of embryo development seems decisive. The future baby will have to take thyroid hormones for life, also paying particular attention to food. From here it is understood that replacement therapy is essential in pregnant women suffering from hypothyroidism.

The following are the classes of drugs most used in the therapy against hypothyroidism, and some examples of pharmacological specialties; it is up to the doctor to choose the active ingredient and the dosage most suitable for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:

Levothyroxine sodium (eg Eutirox, Syntroxine, Tiracrin, Tirosint): this drug is widely used in therapy for hypothyroidism, as well as being the drug of choice for the treatment of Hashimoto's thyroiditis. The dosage, always carefully established by the attending physician, can be changed from patient to patient, based on the levels of thyroid hormones in the blood, the level of TSH and the patient's response to therapy. Indicatively, the drug must be administered by mouth at a dosage of 12.5-50 mcg / day. It is possible to increase the dose up to 12.5-50 mcg per day, every 1-2 weeks, in full compliance with the established indications. in children and the elderly, the dose is usually changed after a longer interval (every 3-6 weeks). Do not exceed 200 mcg. If a parenteral (other than oral) intake is required, the dose of the drug drops by 50-75% compared to the oral administration of the drug. Some drugs / foods can heavily affect the absorption of this substance: sucralfate, calcium supplements (eg Calcium Carbonate), iron supplements, CCColestyramine (eg Questran), aluminum hydroxide.

Liothyronine sodium (eg. Liotir, Titre): it is a drug very similar to the previous one, from the therapeutic point of view, but the molecule tends to be metabolized faster by the body: the therapeutic effect, therefore, occurs after a few hours but disappears within 1-2 days from the end of the treatment. It is recommended to start administering the drug at a dosage of 25 mcg, to be taken orally once every 24 hours. The dose can be increased by 25 micrograms every 7-14 days, under the supervision of the physician. The maintenance dose generally ranges from 25 to 75 mcg per day. Do not interrupt therapy, even in the absence of the typical symptoms of hypothyroidism.

Notes: practical dietary advice to better address the therapy to treat hypothyroidism:

Prefer foods rich in iodine: marine fish, shellfish, brown algae, cow's milk, eggs

Season foods with iodized salt

Follow a balanced diet in fiber, useful for counteracting the constipation that often accompanies hypothyroidism

The intake of broccoli, cauliflower, flax seeds, turnips and radishes seems to increase the need for iodine, therefore the consumption of these foods, in the context of known or suspected hypothyroidism, must be moderate.