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July 03, 2023 11 min read

Levoxyl is often a go-to for many people suffering from hypothyroidism, a condition that occurs when the thyroid gland does not produce enough thyroid hormones to meet the body's needs. This guide aims to provide you full information about Levoxyl: from its uses and potential side effects to other essential things that you need to know.

What is Levoxyl?

For patients diagnosed with hypothyroidism, Levoxyl offers a comprehensive solution that addresses their hormonal deficit. Levoxyl, levothyroxine sodium, in the brand name version, is a synthetic form of the thyroxine (T4) thyroid hormone, which steps in when your thyroid gland under-produces hormones.

The role of Levoxyl is multifaceted. Its primary function is to replace or supplement thyroid hormones, including Levoxyl, aiding the thyroid hormone metabolism process. In conditions like primary, secondary, or tertiary hypothyroidism, where the hormonal deficit can be traced back to issues in the thyroid gland, pituitary gland, or hypothalamus, Levoxyl provides the hormone that your body lacks.

Levoxyl's services are called upon not just for hypothyroidism but also for managing an enlarged thyroid gland, known as a goiter. The continued supply of thyroid hormones by Levoxyl helps reduce the size of the goiter and relieves the thyroid gland from the strain caused by overactive hormone production. Moreover, Levoxyl is also used for benign thyroid nodules.

Interestingly, Levoxyl finds use in managing certain types of thyroid cancers as well, particularly well-differentiated thyroid cancer (WDTC). Post-operative care for patients who have undergone thyroidectomy, the surgical removal of the cancerous thyroid gland, entails Levoxyl administration to maintain suppressed thyroid-stimulating hormone (TSH) levels. By providing a stable supply of levothyroxine sodium, Levoxyl ensures pituitary TSH suppression, effectively reducing the risk of cancer recurrence.

However, while a disorder like hypothyroidism can often lead to weight gain, it's important to note that Levoxyl should not be used for obesity or for weight loss, especially if you don't have hypothyroidism. Levoxyl works to regulate your thyroid hormone, but it does not directly cause weight loss.

Pfizer, a New York-based leading pharmaceutical company, produces Levoxyl. This FDA-approved medication is offered in multiple dosages, such as Levoxyl dp 25, Levoxyl dp 50, Levoxyl dp 88, and Levoxyl dp 300, allowing for customized treatment based on a patient's condition and overall health status. The specific dosage of levothyroxine sodium each patient receives will be determined by their healthcare professional after careful consideration.

What are the ingredients of Levoxyl?

The active ingredient in Levoxyl is levothyroxine sodium, which is a synthetic form of T4. Levothyroxine sodium is chemically designated as L-3,3',5,5'-tetraiodothyronine sodium salt.

The inactive ingredients in Levoxyl may vary depending on the specific formulation and strength of the medication. However, common inactive ingredients in Levoxyl tablets include:

  • Microcrystalline cellulose

  • Croscarmellose sodium

  • Calcium stearate

  • Sodium lauryl sulfate

  • Colloidal silicon dioxide

  • Lactose monohydrate

It is important to note that Levoxyl tablets may contain trace amounts of gluten. Some formulations of Levoxyl may also contain FD&C Yellow No. 6 or other dyes, which may cause allergic reactions. It is always important to read the label and check with your doctor or pharmacist if there are any concerns about the ingredients in a medication.

The active ingredient in Levoxyl may interact with concomitant medications, including blood thinners, antidepressants, and cholesterol-lowering medications. Some examples of these interactions are:

  • Blood thinners (such as warfarin): Levothyroxine may increase the effects of blood thinners, increasing the risk of bleeding. Blood clotting tests may need to be monitored more frequently in individuals taking both medications.

  • Antidepressants (such as selective serotonin reuptake inhibitors, or SSRIs): Levothyroxine is a drug that may decrease the effectiveness of antidepressants, and the antidepressants may increase the levels of thyroid hormones in the body. Dose adjustments or medication changes may be necessary.

  • Cholesterol-lowering medications (such as cholestyramine or colestipol): These medications may decrease the absorption of levothyroxine from the gastrointestinal tract, reducing its effectiveness. Levothyroxine should be taken at least 4 hours before or after these medications.

Other drugs that may interact with levothyroxine include antacids, iron supplements, calcium supplements, and some medications used to treat diabetes.

How to use Levoxyl?

Levoxyl is best taken in the morning, on an empty stomach, approximately half an hour before any food is consumed. This habit is crucial, considering that some food items can interfere with Levoxyl's absorption. Further, it's advised that Levoxyl should be administered at least 4 hours apart from medications known to disrupt its absorption, ensuring its full efficacy and avoiding drug interactions.

Why should you take the medication on an empty stomach? Well, it's because Levoxyl's absorption can be impacted by malabsorption syndromes and certain foods, such as soybean infant formula. Dietary fiber decreases the bioavailability of T4, the thyroid hormone, and this absorption can decrease with age. Furthermore, various drugs and foods can influence T4 absorption and should be taken into account when administrating Levoxyl.

When it comes to the capsule form of Levoxyl, it's crucial not to split, crush, or chew it. Swallowing it whole is the best practice. If that proves to be a challenge, switching to the tablet form is a potential solution. For infants or children, the tablet can be crushed and mixed into 1 to 2 teaspoons (i.e., 5 to 10 milliliters) of water. From here, it should be administered immediately, using either a spoon or dropper.

While taking Levoxyl, hydration is key. It is recommended to consume Levoxyl with water, which helps facilitate not only its ingestion but also its absorption into your system. Consistency is important with this medication—taking it simultaneously each day as prescribed by your doctor is advised to maximize its effectiveness. Failing to do so can affect your treatment, as skipped doses can impede its efficacy.

One significant aspect to consider about Levoxyl is its long half-life. Because of the time it takes for the body to metabolize the medication, it usually requires about 4 to 6 weeks to experience the peak therapeutic effects of a given dose of levothyroxine sodium.

Given the potent effects of Levoxyl and its role in managing thyroid hormone levels, certain precautions are necessary. Patients with pre-existing cardiovascular disease, the elderly, and those diagnosed with concomitant adrenal insufficiency should be closely monitored while consuming Levoxyl. Their underlying conditions mean their body might react differently to the drug.

What is the recommended dose of Levoxyl?

The preferred dose of Levoxyl, levothyroxine sodium tablets, recommended for patients varies significantly based on factors like age, weight, and the severity of the thyroid function disorder. Typically, the inaugural dose ranges between 25 and 50 mcg per day, which may be tweaked over time, contingent upon individual responses.

Newborns, particularly those susceptible to cardiac failure, necessitate a lower initial dosage. This dose is then progressively escalated every 4-6 weeks, with adjustments made based on both the clinical response and laboratory results indicating thyroid function.

When considering pediatric patients, the dosage is typically calibrated based on their age and weight. Initial doses generally fall within the bracket of 25-50 mcg per day.

Elderly patients or those with pre-existing heart diseases often require lower initial doses. Levoxyl dose for these patients should be attentively observed and adjusted under the watch of a healthcare provider. Patients with underlying cardiovascular disease usually start on a lower dose, which is then gradually escalated, all the while maintaining constant monitoring of their heart function. Due to their conditions, these patients may require lower doses of Levoxyl compared to those without cardiovascular disease.

For infants grappling with congenital hypothyroidism, the initial dose is generally in the neighborhood of 10-15 mcg/kg/day per kg body weight. This dosage can be escalated over time, reaching about 100-150 mcg/day by the time the infant is three months old.

Interestingly, there is distinct dosing advice for patients with congenital versus acquired hypothyroidism. Pediatric patients and adolescents with acquired hypothyroidism usually start on a dose of 12.5-50 mcg/day. This dosage can be gradually increased to the ballpark of 100-150 mcg/day or higher, depending on the severity of hypothyroidism and the patient's response to treatment.

For adults contending with acquired hypothyroidism, the initial recommended dosage generally falls between 25-50 mcg/day. This dosage can then be slowly bumped up, with an increase of 25-50 mcg applied every 4-6 weeks until the target serum TSH level is achieved.

What are the possible side effects of Levoxyl?

Starting treatment with Levoxyl might bring along some common side effects, especially during the first few months. These could include hair loss, headaches, insomnia, tremors, and excessive sweating. These symptoms are often a sign of the body attempting to adjust to the medication.

However, there are also potential significant side effects to be aware of. These could be problems related to the heart, worsening diabetic control, and weak or brittle bones. If such issues arise, it's crucial to immediately get in touch with your healthcare provider. Chances are, they might adjust the Levoxyl dosage or suggest a temporary pause in the treatment.

Rarely, some patients might experience allergic reactions to Levoxyl. Be alert to symptoms like a rash, extreme itching, swelling, severe dizziness, and difficulty breathing, as they could indicate an allergic response and should be reported to a healthcare provider right away. Rare events like seizures or hypersensitivity reactions to inactive ingredients in the treatment have also been reported. Though infrequent, these side effects can be severe, so prompt medical help should be sought if such symptoms arise.

Notably, a majority of adverse reactions associated with Levoxyl are primarily symptoms of hyperthyroidism due to overuse. The signs could present in various ways. Common symptoms usually include fatigue, increased appetite, weight loss, fever, and increased sweating. Other signs may encompass headache, hyperactivity, anxiety, and difficulty sleeping, alongside symptoms of muscle weakness. Severe indications mainly concern cardiac situations, causing palpitations, increased pulse rate, and even heart failure.

Overdosage of Levoxyl

An overdose of Levoxyl can lead to a condition called hyperthyroidism. In severe cases, an overdose of levothyroxine can cause a life-threatening condition called thyroid storm, characterized by fever, rapid heartbeat, and confusion. It can also lead to other dangerous conditions like decreased bone mineral density, especially in menopausal women.

If you suspect an overdose of Levoxyl, seek emergency medical attention immediately. Treatment may involve reducing the dose or temporarily discontinuing the medication. Your healthcare provider may also prescribe medications to help control symptoms, such as beta-blockers to reduce heart rate and blood pressure. It is important to take Levoxyl as prescribed by your healthcare provider and to follow up regularly to monitor your hormone levels and adjust your medication dosage as needed.

Also, if a person with pre-existing coronary artery disease takes an excessive dose of levothyroxine, it can potentially cause an increase in heart rate and cardiac workload, leading to chest pain, shortness of breath, and other symptoms of coronary insufficiency.

Are there any precautions?

Initiating treatment with Levoxyl signifies an essential step in your health journey. Like embarking on a journey, starting a new medication can sometimes feel overwhelming. However, with the right understanding of the dos and don'ts of taking Levoxyl, you can navigate this segment of your health journey with confidence.

If you've been prescribed Levoxyl, the first step is to follow the dosage recommended by your healthcare provider. Here, timing is key: taking your dose of Levoxyl on an empty stomach, ideally, 30 minutes to an hour before breakfast, ensures optimal absorption. For young patients who may find swallowing tablets difficult, Levoxyl provides flexibility. Tablets can be crushed and dissolved in a small quantity of water. However, remember not to store this mixture for future use—it's best consumed immediately.

Although Levoxyl is instrumental in managing hypothyroidism, it's not a remedy for all health conditions bearing similar symptoms. If you're facing health concerns like uncorrected adrenal insufficiency or obesity, it's essential to clarify that these are separate medical conditions that require distinct treatments.

Sometimes, hypothyroidism may co-occur with adrenal insufficiency. In acute cases where the adrenal gland fails to produce the required hormones, immediate medical attention is necessary. During such instances, managing the adrenal crisis rightly takes precedence over treating hypothyroidism with Levoxyl.

While undergoing Levoxyl treatment, routine blood tests are often part of the process. These tests help your healthcare provider monitor your response to the medication and adjust the dosage if needed. It's important not to alter or stop your Levoxyl course, even if your thyroid function appears normal, without your healthcare provider's approval.

Before you begin your Levoxyl therapy, make sure your doctor is aware of your medical history, especially if you have thyrotoxicosis, adrenal gland dysfunction, heart conditions, high blood pressure, or diabetes. Regular monitoring of blood sugar levels is recommended for diabetic patients, as Levoxyl may affect these levels.

Remember, Levoxyl therapy is specific to unique medical needs. Age, for instance, impacts how your body responds to Levoxyl. Children might experience side effects such as headaches, vision changes, and hip or leg pain, while older adults could be more susceptible to heart-related side effects.

Finally, Levoxyl's usage during pregnancy and breastfeeding is generally considered safe. Still, it requires clear communication with your doctor for possible dosage adjustments.

Armed with this information, you can embark on your Levoxyl journey with well-informed confidence, turning what might seem an overwhelming medical regimen into a manageable part of your everyday life. Control the narrative of your health journey by understanding your treatment, asking questions, and discussing any concerns with your healthcare provider. With the right knowledge, you're in the driver's seat of your well-being.

Why doesn't Levoxy work for me?

If you're taking Levoxyl, have tried adjusting the dose, and still continue to experience hypothyroidism symptoms or have faced side effects, it's natural to feel frustrated and concerned. You may find yourself asking, "Why isn't Levoxyl working for me?" This isn't uncommon, and there are several reasons why a specific treatment may not yield the desired results.

Firstly, the absorption of Levoxyl could be hindered due to numerous factors, such as the simultaneous consumption of certain types of food or medications. Incorrect dosing, despite adjustments, could also be a reason. Meticulously following the prescribed regime is vital for treatment efficacy.

Furthermore, the presence of particular underlying conditions or genetic variations might influence how your body responds to this medication. For instance, some people have a genetic variation that affects their body's ability to convert T4 into T3, the active form of thyroid hormone. For such individuals, standard therapy might not be as effective.

Another potential issue could be an interaction between Levoxyl and certain products, such as soybean infant formula, walnuts, and dietary fiber, that can decrease the absorption of the medication. Always discuss your diet and over-the-counter medications or supplements with your healthcare provider while on Levoxyl.

When considering alternatives to Levoxyl, one of the existing therapies is using natural desiccated thyroid (NDT), which are derived from pig thyroid glands. NDT contains both T4 and T3 thyroid hormones, mimicking the thyroid hormones your body produces naturally. This might provide relief if you're unable to convert T4 into T3 adequately.

Some of the most popular brands of NDT in the US are Armour Thyroid and NP Thyroid. However, you can also buy desiccated thyroid online in the form of a supplement, such as VitaliThy. This NDT supplement not only provides a complete thyroid hormone profile but also comes enriched with spica prunellae siccus extract, ashwagandha extract, and selenium yeast, all of which contribute to enhanced thyroid health.

Conclusion: Levoxyl is effective, but it comes with a set of side effects

Managing hypothyroidism requires an understanding of your condition, knowing the options available to you, and maintaining an open dialogue with your healthcare provider. Levoxyl can be highly effective for many, but each individual's physiology may respond differently to thyroid hormone replacement therapy. If you're finding that Levoxyl isn't working for you or you are experiencing side effects, it's pivotal to communicate this with your doctor.

Exploring alternative treatments like natural desiccated thyroid (NDT) extracts, such as Armour Thyroid, NP Thyroid, or the dietary supplement VitaliThy, might benefit you. NDTs offer a complete thyroid hormone profile, providing both thyroxine (T4) and the more potent triiodothyronine (T3), effectively riding on the natural distribution of circulating thyroid hormones. This might be especially helpful if your body struggles with converting T4 into T3. NDTs could deliver a more consistent level of thyroid hormones available in the bloodstream, potentially improving your quality of life. If you want to make the switch, VitaliThy, a natural desiccated thyroid you can buy online, can be a great option.

Remember, it's all about finding the treatment that fits you best. Stay patient, stay informed, and don't hesitate to seek consultation regarding your treatment plan. 

Wojciech Majda
Wojciech Majda

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