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May 25, 2023 7 min read

As a vital hormone replacement therapy for individuals with hypothyroidism, levothyroxine often proves to be life-changing by restoring balance to the body's metabolic functions. However, with any medical treatment comes the potential for side effects, and levothyroxine is no exception. Of these side effects, one that has perplexed both patients and medical professionals alike is hyperactivity, which seemingly contradicts the usual symptoms of hypothyroidism.

Below, we'll discuss the connection between levothyroxine and hyperactivity, as well as what you can do to combat it and improve your thyroid function.

Understanding hypothyroidism and its treatments

Before diving deeper into the connections between levothyroxine and hyperactivity, it's necessary to understand the complexity of hypothyroidism and its available treatment options.

The thyroid gland, situated at the base of the neck, plays a pivotal role in regulating various functions of the body, including metabolism, energy production, and the nervous system's growth. It secretes two essential hormones: thyroxine (T4) and triiodothyronine (T3), which help maintain optimal body temperature, heart rate, and muscle strength.

When the thyroid gland fails to produce enough thyroid hormones, hypothyroidism arises. This thyroid disease can lead to symptoms like fatigue, constipation, unexplained weight gain, dry skin, and hair loss. The reasons for this thyroid dysfunction can include an autoimmune disease called Hashimoto's thyroiditis, certain medications, thyroid surgery, radiation therapy, or iodine deficiency.

Levothyroxine, a synthetic form of thyroxine (T4), is the standard treatment prescribed by physicians for people with thyroid disorders like hypothyroidism. It works by replacing the insufficient hormone levels in the body. While some patients might need additional T3 therapy, most people respond well to levothyroxine alone, as T4 is converted to T3 within your body.

What's the connection between hyperactivity and levothyroxine?

Typically, treatment with levothyroxine is aimed at finding the appropriate dosage to maintain a healthy balance of thyroid hormones. When you've reached the appropriate dosage, your thyroid symptoms should subside. However, finding the correct dosage may take some time and adjustments, often informed by blood tests measuring thyroid-stimulating hormone (TSH) levels of the pituitary gland. In some cases, patients may receive an excessive amount of levothyroxine than needed. This leads to various side effects, including hyperactivity.

Hyperactivity may manifest as a sudden increase in energy levels, an inability to sit still, constant agitation, restlessness, impulsiveness, and difficulty concentrating or completing tasks. In some cases, the signs might be confused with attention deficit hyperactivity disorder (ADHD) symptoms. These symptoms might make it difficult for individuals to perform optimally in their daily lives and may negatively impact their mental well-being. There are a few reasons why levothyroxine causes hyperactivity. Some of them include:

Excess thyroid hormone

The reason behind the development of hyperactivity as a result of levothyroxine use is the excess of thyroid hormones in the bloodstream. This excess induces a state called hyperthyroidism (overactive thyroid). As opposed to the sluggishness and fatigue associated with hypothyroidism, hyperthyroidism is a thyroid disorder that accelerates the body's processes, creating increased heart rate, body temperature, metabolism, and also, hyperactivity.

Impaired T4 to T3 conversion

Hyperactivity as a side effect of levothyroxine could be related to an issue with the body's conversion of T4 to T3, although it is not the most common cause. Levothyroxine is a synthetic form of thyroxine (T4), and the body typically converts T4 to the more active form of thyroid hormone, triiodothyronine (T3), as needed. In some cases, individuals with thyroid abnormalities might have impaired conversion of T4 to T3 due to various factors such as nutrient deficiencies, high stress, certain medications, or medical conditions.

When the body struggles to convert T4 to T3 efficiently, it could result in an accumulation of unconverted T4, leading to a relative increase in thyroid hormone levels in the bloodstream. In some instances, this may cause symptoms similar to hyperthyroidism, including hyperactivity. However, most cases of hyperactivity related to levothyroxine stem from an inappropriate dosage leading to excessive thyroid hormone levels.

If you suspect that impaired T4 to T3 conversion might be contributing to hyperactivity or other symptoms, it is essential to consult with your healthcare provider. They can assess your specific situation, conduct appropriate tests, and provide guidance on potential adjustments to your treatment plan, such as considering combination therapy with both T4 and T3 medications or addressing any underlying factors that may be affecting the conversion process.

What's the prevalence of hyperactivity among levothyroxine users?

Levothyroxine-induced hyperactivity is prevalent among those who have been prescribed too high a dosage or patients who are sensitive to the effects of thyroid hormones.

It's crucial to note that certain demographics may be at an elevated risk of experiencing hyperactivity as a side effect of levothyroxine. These include children, adolescents, and patients with pre-existing mental health disorders. More specifically, children and adolescents with attention deficit hyperactivity disorder (ADHD) may experience an exacerbation of their symptoms when treated with levothyroxine, warranting extra caution and monitoring from healthcare providers.

How can you manage hyperactivity due to levothyroxine?

If you are experiencing hyperactivity as a side effect of levothyroxine, it is essential to communicate with your healthcare provider. They may recommend various approaches to mitigate this side effect, which may include:

1. Dosage adjustment

Your healthcare provider may discuss adjusting your levothyroxine dosage to find the optimal level that alleviates your hypothyroidism symptoms without causing hyperactivity. This adjustment process may require periodic blood tests to monitor TSH levels, ensuring a proper balance of the thyroid hormone in your body.

2. Medication timing

It is crucial to take levothyroxine consistently and at the same time every day to maintain stable hormone levels. Your healthcare provider may recommend taking your medication in the morning on an empty stomach, about 30 minutes to an hour before breakfast. This allows for optimal absorption and minimizes fluctuations that can increase the risk of side effects.

3. Avoiding drug interactions

Some medications, supplements, and even certain foods can interfere with the absorption and effectiveness of levothyroxine. Discuss any other medications and supplements you are taking with your healthcare provider to ensure they do not interact negatively with your levothyroxine therapy.

4. Adding T3 to your treatment regimen

For some patients experiencing hyperactivity due to thyroid hormone supplementation, incorporating a combination therapy that targets thyroid hormone production might be beneficial. This approach, which includes both T4 (levothyroxine) and T3 (liothyronine), can help ease the hyperactivity side effect while still effectively managing hypothyroidism and supporting optimal thyroid function.

A promising alternative for those who encounter hyperactivity and other adverse effects of levothyroxine is natural desiccated thyroid (NDT). It's made of dried pig thyroid glands. Unlike levothyroxine, which solely comprises the T4 thyroid hormone, NDT contains a comprehensive blend of thyroid hormones, including T4, T3, T2, T1, and Calcitonin. This more holistic approach to thyroid hormone supplementation can be found in medications such as Armour Thyroid and NP Thyroid. Moreover, it's also available in supplement form like VitaliThy, a natural desiccated thyroid you can buy online.

5. Coping techniques

While medical intervention is crucial in addressing hyperactivity resulting from levothyroxine, you may also benefit from incorporating coping techniques to manage the symptoms in your daily life. These can include engaging in regular physical activity to expend excess energy, practicing mindfulness and relaxation techniques to promote focus and calmness, or seeking support from mental health professionals.

6. Monitoring

Your healthcare provider will monitor your thyroid hormone levels and overall health regularly to ensure your medication is effective and free from adverse side effects of levothyroxine. Do not hesitate to reach out to them if you experience any new or worsening symptoms while on levothyroxine therapy.

Can hyperactivity be caused by hypothyroidism instead of levothyroxine?

The connection between hyperactivity and hypothyroidism, rather than levothyroxine as a contributing factor, is an area of interest given the links between ADHD and thyroid disease. The symptoms of ADHD and thyroid disease can be similar. Plus, the two conditions often occur together.

Thyroid hormones hold the key to healthy brain development, powering essential processes like nerve cell growth and myelination, which supercharge the brain's ability to transmit information. These hormones work their magic throughout our lives, shaping the regulation of motor, affective, and cognitive functions.

When disruptions in brain function occur, they can toy with one's cognition and behavior, possibly manifesting ADHD-like symptoms in typically developing kids or exacerbating symptoms in those already diagnosed. A thyroid hormone deficiency can wreak serious havoc on a child's brain both in the womb and post-birth, leading to intellectual challenges and neurological impairments.

One 2020 study discovered that mothers with hypothyroidism had an increased risk of having a child diagnosed with ADHD, particularly in preterm Hispanic boys. Interestingly, even exposure to mildly low thyroid levels in early pregnancy led to more ADHD symptoms than those with typical thyroid levels.

Another 2020 study found a compelling link between fT3 (levels of free T3 hormone not bound to specific proteins) and the presence of ADHD symptoms in youngsters. So, it's clear that a delicate dance between thyroid hormones and brain function plays an important role in ADHD symptoms!

Conclusion: There are ways to combat hyperactivity due to levothyroxine

Hypothyroidism requires ongoing management to maintain a healthy lifestyle, and thyroid hormone replacement therapy like levothyroxine is a vital component in achieving that balance for numerous patients. While the side effects of hyperactivity may be concerning and disruptive, open communication with your healthcare provider and following prescribed guidance can help mitigate this side effect while optimizing your treatment and overall health.

If you've adjusted your dose several times and you still don't experience any improvements, trying natural desiccated thyroid (NDT) can be a great idea. And for those who want to get started on it, you can buy desiccated thyroid online without a prescription like VitaliThy. This NDT supplement contains both T4 and T3 thyroid hormones. Plus, it's free from lactose, gluten, eggs, shellfish, and fish, as well as artificial coloring and flavoring.

Wojciech Majda
Wojciech Majda

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