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Levothyroxine treats hypothyroidismlow thyroid hormoneLevothyroxine is also used to treat or prevent goiterenlarged thyroid glandwhich can be caused by hormone imbalancesradiation treatmentsurgeryor cancer.
Occasionallychronic autoimmune thyroiditis may occur in association with other autoimmune disorders such as adrenal insufficiencypernicious anemiaand insulin-dependent diabetes mellitusPatients with concomitant adrenal insufficiency should be treated with replacement glucocorticoids prior to initiation of treatment with levothyroxine sodiumFailure to do so may precipitate an acute adrenal crisis when thyroid hormone therapy is initiateddue to increased metabolic clearance of glucocorticoids by thyroid hormonePatients with diabetes mellitus may require upward adjustments of their antidiabetic therapeutic regimens when treated with levothyroxinesee PRECAUTIONSDrug Interactions
The mechanisms by which thyroid hormones exert their physiologic actions are not completely understoodbut it is thought that their principal effects are exerted through control of DNA transcription and protein synthesisT 3 and T 4 diffuse into the cell nucleus and bind to thyroid receptor proteins attached to DNAThis hormone nuclear receptor complex activates gene transcription and synthesis of messenger RNA and cytoplasmic proteins.
In womenlong-term levothyroxine sodium therapy has been associated with increased bone resorptionthereby decreasing bone mineral densityespecially in post-menopausal women on greater than replacement doses or in women who are receiving suppressive doses of levothyroxine sodiumThe increased bone resorption may be associated with increased serum levels and urinary excretion of calcium and phosphorouselevations in bone alkaline phosphatase and suppressed serum parathyroid hormone levelsThereforeit is recommended that patients receiving levothyroxine sodium be given the minimum dose necessary to achieve the desired clinical and biochemical response.
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