Advice for patients with newly diagnosed hypothyroidism

The following advice should be given to the patients who are diagnosed recently with hypothyroidism:

• inform that it will take at least a week after initiating therapy for the patient to start feeling better
• there will be no noticeable effect if one dose is missed
• take a double dose on the day after a missed tablet (except in active ischaemic heart disease and atrial fibrillation)
• in patients who present with muscle weakness, stiffness, or cognitive defects that it may take up to six months to fully resolve the symptoms
• Levothyroxine should be taken on an empty stomach to maximise absorption
• treatment is life long and a yearly measurement of TSH level is necessary and the dose may be adjusted accordingly
• in the UK, patients with hypothyroidism are eligible for a medical exemption certificate for prescription charges (1)

Reference:

• 1. Vaidya B, Pearce SH. Management of hypothyroidism in adults. BMJ. 2008;337:a801