Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
Converting a state of hypothyroidism (underactivity) to a normal state
(euthyroid state) with levothyroxine may decrease the actions of certain
beta-blocking drugs,
[for example, metoprolol (Lopressor) or propranolol (Inderal)]. It
may be necessary, therefore, to change the dose of beta-blocker. For the same
reason, the dose of digoxin (Lanoxin), a drug used to manage heart failure or an
irregular heart rhythm (for example,
atrial fibrillation), also may need to be changed.
Converting hypothyroidism to the euthyroid state with levothyroxine may
increase the blood level of theophylline (Slo-Bid), and it may be necessary to
change the dose of theophylline.
Taking levothyroxine at the same time as cholestyramine (Questran) or
colestipol (Colestid), two
cholesterol-lowering drugs, may decrease the effect
of levothyroxine and lead to hypothyroidism. This occurs because the
levothyroxine binds to the cholesterol-lowering drugs and is not absorbed.
Taking the levothyroxine one hour before or four hours after cholestyramine or
colestipol is necessary to prevent the binding.
PREGNANCY: Thyroid hormone therapy during
pregnancy is usually safe but
should be supervised by a physician.
NURSING MOTHERS: Thyroid hormone therapy in
nursing mothers is usually safe
but should be supervised by a physician.
SIDE EFFECTS: Levothyroxine therapy is usually well-tolerated. If symptoms
occur, often they are due to toxic levels of thyroid hormone and the symptoms
are those of hyperthyroidism. Symptoms may include all or some of the following:
chest pain, increased heart rate or pulse rate, excessive sweating, heat
intolerance, nervousness, headache, insomnia, diarrhea,
vomiting, weight loss,
or fever. Women may experience irregular
menstrual cycles.
Hypothyroidism is any state in which thyroid hormone production is below normal. Normally, the
rate of thyroid hormone production is controlled by the brain at the pituitary.
Hypothyroidism is a very common condition and the symptoms of hypothyroidism are
often subtle.
Hashimoto's thyroiditis is the most common cause of hypothyroidism in the US. This conditions is caused by inflammation of the thyroid gland. Symptoms may include: fatigue, weight gain, cold intolerance, excessive sleepiness, dry or coarse hair, difficulty swallowing, a lump in the front of the throat, and many more. Treatment is usually hypothyroid medication.
Thyroid nodules are the most common endocrine problem in the United States. The term "thyroid nodule" refers to any abnormal growth that forms a lump in the thyroid gland. The vast majority of thyroid nodules are benign.
There are many types of thyroid disease. Some occur due to the function of the thyroid itself such as hypothyroidism, hyperthyroidism, Hashimoto's thyroiditis, etc. Some causes of thyroid disease occur due to problems with the structure of the thyroid gland such as goiters, thyroid nodules, and thyroid cancer. Treatment of thyroid disease depends on the cause of the disease.
Hypothyroidism during pregnancy can be treated with synthetic thyroid hormones to maintain the proper thyroid hormone balance. Hypothyroidism symptoms include fatigue, weight gain, lethargy, and constipation. Treatment of hypothyroidism in pregnant women is important, because inadequate levels of thyroid hormones may affect the fetus, and child during growth and development.
Thyroiditis is the inflammation of the thyroid gland. The inflamed thyroid gland can release an excess of thyroid hormones into the blood stream, resulting in a temporary hyperthyroid state. Some forms of thyroiditis can be diagnosed based on tenderness and enlargement of the thyroid gland. A thyroid scan sometimes is used in making the diagnosis. Thyroiditis can also be diagnosed with a biopsy of the thyroid gland.
Pendred syndrome, a genetic disorder that causes hearing loss. Generally, the hearing loss is affected in early childhood. Pendred syndrome also affects other parts fo the body (for example, the thyroid gland). Treatment is generally cochlear ear implants.
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