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Levothyroxine is typically used to treat hypothyroidism, [12] and is the treatment of choice for people with hypothyroidism [13] who often require lifelong thyroid hormone therapy. [14] It may also be used to treat goiter via its ability to lower thyroid-stimulating hormone (TSH), which is considered goiter-inducing.
Myxedema (British English: myxoedema) is a term used synonymously with severe hypothyroidism.However, the term is also used to describe a dermatological change that can occur in hypothyroidism and (rare) paradoxical cases of hyperthyroidism.
[8] [50] Subclinical hypothyroidism is estimated to affect approximately 2% of children; in adults, subclinical hypothyroidism is more common in the elderly, and in White people. [49] There is a much higher rate of thyroid disorders, the most common of which is hypothyroidism, in individuals with Down syndrome [30] [62] and Turner syndrome. [30]
It is most commonly used to treat hypothyroidism and myxedema coma. [2] It can be taken by mouth or by injection into a vein. [2] Side effects may occur from excessive doses. [2] This may include weight loss, fever, headache, anxiety, trouble sleeping, arrhythmias, and heart failure. [2] Use in pregnancy and breastfeeding is generally safe. [3] [2]
If the medication is mixed with formulas containing iron or soya products, larger doses may be required, as these substances may alter the absorption of thyroid hormone from the gut. [16] Monitoring TSH blood levels every 2–3 weeks during the first months of life is recommended to ensure that affected infants are at the high end of normal range.
Many children diagnosed with Hashimoto's disease will experience the same progressive course of the disease that adults do. [114] However, of children who develop anti-thyroid antibodies and hypothyroidism, up to 50% are later observed to have normal antibodies and thyroid hormone levels. [5]
Certain medications can have the unintended side effect of affecting thyroid function. While some medications can lead to significant hypothyroidism or hyperthyroidism and those at risk will need to be carefully monitored, some medications may affect thyroid hormone lab tests without causing any symptoms or clinical changes, and may not require treatment.
In Graves' disease, treatment with antithyroid medications must be given for six months to two years, in order to be effective. Even then, upon cessation of the drugs, the hyperthyroid state may recur. Side effects of the antithyroid medications include a potentially fatal reduction in the level of white blood cells.