Treatment of immune thyroiditis

Autoimmune thyroiditis can lead to decreased levels of thyroid hormones , which include thyroxine-T4 and triiodothyronine-T3.

Immune thyroiditis is usually treated with hormonal replacement medications to compensate for the decrease in thyroid hormone levels and return them to normal levels, which will improve the symptoms caused by hypothyroidism .

In general, these drugs can be given on a daily basis and often the patient needs to use them for life. These alternatives include the following:

1. Artificial thyroid hormone replacement

Synthetic hormonal alternatives are oral medications that contain chemical compounds similar to natural thyroid hormones, which include the following:

• levothyroxine

It is a synthetic thyroid hormone drug similar in structure to the natural hormone thyroxine, which is converted in the human body into triiodothyronine, and this drug is one of the inexpensive and most effective drugs in the treatment of immune thyroiditis.

• Liothyronine (Liothyronine-T3)

It is the synthetic form of the natural hormone triiodothyronine, which can be given alone or in combination with levothyroxine, and although its use is relatively limited, it may benefit some people who have had a thyroidectomy or who do not respond well with levothyroxine.

2. Natural thyroid hormone replacement

A natural thyroid hormone replacement called Armour Thyroid, an oral preparation derived from pig thyroid glands, contains levothyroxine and triiodothyronine.

Although it is a natural alternative, there are some considerations about the efficiency of this product in achieving normal levels of thyroid hormones in the blood, given that the hormonal balance in animals is different from what it is in humans.

The importance of monitoring the treatment of immune thyroiditis

An important thing in the treatment of immune thyroiditis is periodic monitoring of the drug dose and levels of thyroid hormones in the blood, in order to verify the appropriate dose for the patient, and to avoid high hormonal levels in the blood that would cause the opposite symptoms of hypothyroidism, namely hyperthyroidism. .

Excessive amounts of thyroid hormone can cause various symptoms, including irregular heartbeat or osteoporosis , so periodic checkups should be done to monitor the hormonal level in the blood.

Usually, a test of the level of thyroid stimulating hormone is used to determine the appropriate dose for the patient, as the level of this hormone reflects the amount of thyroid hormones in the blood, that is, the higher the normal rates, the lower the level of levothyroxine and triiodothyronine.

In general, the TSH test can be done periodically at the beginning of diagnosing the problem, 6 to 8 weeks after the start of treatment, and after any changes made to the dose, in addition to conducting it approximately every 12 months after the appropriate dose is stable.

Factors affecting the efficacy of treatment of immune thyroiditis

There are several factors that may affect the efficiency of hormonal alternatives, including: Adherence to the dose prescribed to the patient, as not taking it at the specified times or forgetting it frequently may lead to an imbalance in hormonal levels in the blood, in addition to eating some foods or using some other medications that would Decrease or increase the effectiveness of alternative hormones, including levothyroxine.

However, these medicines or foods can be taken 4 hours before or after taking levothyroxine.

Here are some types of foods and medicines that can interfere with the action of levothyroxine:

1. Food

Here are some foods that reduce the absorption of levothyroxine in the body:

• Foods rich in dietary fiber.
• Grapefruit juice.
• Soybean flour.
• Soy milk for children .
• Cottonseed meal is a protein-rich substance extracted from cottonseed oil that is used in cooking in many Asian countries.

2. Medicines

Here are some medications and supplements that may affect the action of levothyroxine:

• Calcium supplement.
• Iron supplements.
• Antacids containing magnesium and aluminum.
• Some stomach ulcer medications, such as: Proton pump inhibitors .
• Some cholesterol-lowering drugs.

Side effects of immunosuppressive thyroiditis

Although synthetic thyroid hormones, including levothyroxine, are relatively safe, they may cause some side effects in some people, the most prominent of which are:

• allergic reactions;
• Hot flashes and sweating.
• Nausea or vomiting.
• Feeling colder than usual.
• hair loss;
• Skin dryness.
• Change in weight .
• Changes in appetite.
• Feeling stressed and depressed.
• irregularity of the monthly period in women.
• Arrhythmia.

source : wikipedia