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Condition guide · /thyroid-care/

Thyroid care and treatment

Reviewed by Dr. Arjun Mehta, PharmD — Head Pharmacist. Updated May 2025.

20M

Americans affected
 

1 in 8

Women lifetime risk

Daily

Replacement dose

6 wks

Time to retest

About this condition

The thyroid gland sits at the base of the neck and produces hormones (T3 and T4) that regulate metabolism. Hypothyroidism (underactive thyroid) is the more common problem, especially in women and after age 40. Hyperthyroidism (overactive) is less common but more dramatic in presentation.

Hypothyroidism is treated by replacing the missing hormone with daily levothyroxine, taken on an empty stomach. Dose is titrated to TSH blood levels, and most patients need treatment for life. Hyperthyroidism is treated with carbimazole or methimazole (anti-thyroid drugs), radioactive iodine, or surgery.

Treatment options

Levothyroxine

Synthetic T4, the standard treatment for hypothyroidism. Take 30–60 min before food. Lifelong for most patients.

Liothyronine

Synthetic T3. Faster-acting; used selectively in patients who don’t respond to T4 alone.

Carbimazole

Anti-thyroid drug for hyperthyroidism. Slows hormone production. Specialist supervision.

Beta-blockers

Propranolol controls symptoms (tremor, palpitations, anxiety) of hyperthyroidism while definitive treatment takes effect.

Common questions

How is hypothyroidism diagnosed?

A blood test showing raised TSH and low free T4. Symptoms — fatigue, weight gain, cold intolerance — are common but non-specific.

Can I switch brands of levothyroxine?

Switch carefully — different brands can differ slightly in absorption. Re-check TSH 6 weeks after any brand change.

What can affect levothyroxine absorption?

Calcium, iron, soy and coffee all reduce absorption. Take levothyroxine at least 30–60 minutes before food or drinks other than water.

Dr. Arjun Mehta, PharmD · Head Pharmacist

/our-pharmacists/arjun-mehta/ — Reviewed May 2025

This guide is reviewed every 12 months or sooner when clinical guidance changes. If you have a specific medical question, call our pharmacist team — we answer the phone, not a bot.