Hypothyroidism — what to take?

Medical body content is still in Romanian:

Causes

Hashimoto's thyroiditis (most common), post thyroid surgery, post radioactive iodine, medications (lithium, amiodarone), iodine deficiency, congenital.

Symptoms

Fatigue, weight gain, cold intolerance, constipation, dry skin, hair loss, hoarse voice, depression, cognitive difficulties, bradycardia, periorbital oedema, heavy periods. Severe hypothyroidism (myxoedema) — an emergency.

Diagnosis

Elevated TSH + low FT4 = clinical hypothyroidism. Elevated TSH + normal FT4 = subclinical. Anti-TPO, anti-Tg antibodies for autoimmune thyroiditis. Thyroid ultrasound.

Treatment

Levothyroxine (L-T4) — Euthyrox, Letrox. Starting dose: 1.6 mcg/kg/day in adults. Adjust based on TSH at 6-8 weeks. Take in the morning on an empty stomach, 30-60 min before breakfast.

TSH target: 0.5-2.5 mIU/L (individualised).

Important interactions

• Calcium, iron, magnesium — reduce L-T4 absorption (4h gap).
• Coffee — 30-60 min gap.
• Soy, fibre — similar effect.
• PPIs, antacids — reduce absorption.

OTC supplements

Strictly alongside L-T4:

• Selenium 100-200 mcg/day — reduces anti-TPO antibodies in Hashimoto's.
• Vitamin D3 — frequent deficiency.
• Zinc.
• Iodine — ONLY in confirmed deficiency (excess can worsen the disease!).

Do NOT use animal thyroid extracts or high-dose iodine without medical supervision.

Medical disclaimer: the information in this guide is for informational purposes only and does not replace advice from a doctor or pharmacist. For diagnosis and treatment, consult a healthcare professional.