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*Only for medical professionals to read for reference.
One is alternative medicine and the other is adjuvant therapy.
Have you figured it out? There is a more interesting phenomenon.
The indications in the drug manual of levothyroxine sodium tablets (youjiale) also include replacement therapy for hypothyroidism, antithyroid drug therapy and adjuvant therapy for hyperthyroidism.
Regardless of the cause of the disease, hypothyroidism is due to less thyroxine, and hyperthyroidism is due to more thyroxine.
Why can levothyroxine sodium tablets be used? Question 1: What is levothyroxine sodium tablets? First introduce the thyroid hormones.
Thyroid hormones include thyroxine, also known as tetraiodothyronine (T4) and triiodothyronine (T3), which are combined with thyroglobulin (TBG) in the body and stored in the follicles of the thyroid.
For thyroid hormone to function, it must be released into the blood.
The content of T3 is 1/10 of that of T4, but its physiological activity is about 5 times that of T4, and T4 is deiodized in the liver and kidneys.
T3.
Simply put, the content of T3 is low, but the activity is high, and the metabolism is fast, which plays a major role; the activity of T4 is low, but the content is high, and the metabolism is slow, which plays a supplementary role.
Naturally, both T3 and T4 can inhibit the secretion of thyroid stimulating hormone (TSH) through negative feedback.
Levothyroxine sodium tablets are synthetic tetraiodothyronine.
Like endogenous hormones, it is converted into T3 in peripheral organs and then exerts specific physiological effects.
Question 2: Why use levothyroxine sodium tablets for hypothyroidism? The use of levothyroxine sodium tablets for hypothyroidism is easy to understand, because patients with hypothyroidism do not synthesize thyroid hormones themselves, giving levothyroxine sodium tablets is an alternative treatment.
Taking levothyroxine sodium tablets is equivalent to supplementing T4.
T4 supplementation is enough, and T3 converted from T4 is also enough, so the thyroid hormones that can perform physiological functions are also sufficient.
Therefore, we usually take thyroxine tablets when supplementing thyroid hormones, and supplementing with T4.
After the drugs are absorbed into the body, they will be converted into T3 to function.
[However, a small number of patients do not respond well to T4.
At this time, they need to take dry thyroid tablets (T4+T3), T3 and other drugs.
] Question 3: Why can levothyroxine sodium tablets still be used as an auxiliary medicine for antithyroid drugs? Here is a reminder, please pay attention to the distinction: For the treatment of hyperthyroidism, levothyroxine sodium tablets are used as an adjuvant to antithyroid drugs rather than directly used to treat hyperthyroidism! Clinically, for patients with exophthalmos or goiter, a small amount of levothyroxine sodium tablets can be given as appropriate to inhibit TSH.
Because when antithyroid drugs are given to treat hyperthyroidism, the patient's thyroxine will gradually decrease, so the inhibition of TSH gradually weakens, and the increase in TSH will aggravate exophthalmos or goiter.
In another case, there may be such patients in the clinic: when the antithyroid drug is a little too much, hypothyroidism occurs; when the antithyroid drug is slightly reduced, hyperthyroidism occurs.
As the dose of antithyroid drugs is difficult to adjust, simultaneous administration of levothyroxine sodium tablets and antithyroid drugs can better balance the level of thyroid hormones.
■ At present, there are 2 options for the treatment of hyperthyroidism: (1) Use of antithyroid drugs (ATD) alone, such as tapazole or propylthiouracil.
(2) Antithyroid drugs + Levothyroxine sodium tablets.
The first option is that the amount of antithyroid drugs is less, but the possibility of hypothyroidism is greater.
The second option, as mentioned above, can better avoid hypothyroidism and reduce hormone level fluctuations, but it should be noted that this option will use more anti-thyroid drugs and have more side effects.
■ Levothyroxine sodium tablets for hyperthyroidism need to pay attention to: only in the treatment of hyperthyroidism with antithyroid drugs, levothyroxine sodium tablets can be used for supplementary treatment, otherwise, in the case of hyperthyroidism , Do not use levothyroxine.
When combined with levothyroxine sodium tablets to treat hyperthyroidism, the administration cycle of levothyroxine sodium tablets should be the same as that of antithyroid drugs.
During pregnancy, it is not advisable to combine levothyroxine and antithyroid drugs to treat hyperthyroidism, because the addition of levothyroxine requires an increase in the dose of antithyroid drugs.
Antithyroid drugs can pass through the placenta and may cause hypothyroidism in the fetus .
Question 4: What should I pay attention to when taking levothyroxine sodium tablets? 1.
Regular medication: Levothyroxine sodium tablets should be taken every day.
After getting up every day, half an hour before breakfast, give the daily dose on an empty stomach.
If there is any missed dose, double the dose should be taken until all missed doses are made up.
If you have trouble taking the medicine in the morning, you can choose to take it 4 hours after dinner, that is, take the medicine before going to bed.
In this way, factors that may affect drug absorption can be avoided as much as possible.
2.
Review cycle: As long as the dosage of the medicine changes, you need to wait 4-6 weeks for review, at least 4 weeks (because the half-life of levothyroxine sodium tablets is very long).
3.
Influencing absorption: In order not to affect the absorption of the drug, pay attention to a period of time apart from other drugs when taking the drug.
It is 1 hour apart from hypertension drugs, vitamins, and tonics; 2 hours apart from iron and calcium foods or drugs, 4 hours apart from milk and soy foods; 12 hours apart from cholestyramine and lipid-lowering resin drugs.
4.
The initial dose of the elderly, patients with coronary heart disease and other populations should be reduced as appropriate in accordance with the doctor's advice, and the frequency of reexamination should be appropriately increased.
5.
During thyroid replacement therapy, pregnant women must be closely monitored to avoid hypothyroidism or hyperthyroidism, so as to avoid adverse effects on the fetus.
6.
Patients who need TSH suppression therapy, especially the elderly and menopausal women, should be alert to related manifestations such as arrhythmia, osteoporosis, and thyrotoxicosis.
Source of this articleResponsible editor of the sixth hospital pharmacistXiao Ma Ma copyright statement
One is alternative medicine and the other is adjuvant therapy.
Have you figured it out? There is a more interesting phenomenon.
The indications in the drug manual of levothyroxine sodium tablets (youjiale) also include replacement therapy for hypothyroidism, antithyroid drug therapy and adjuvant therapy for hyperthyroidism.
Regardless of the cause of the disease, hypothyroidism is due to less thyroxine, and hyperthyroidism is due to more thyroxine.
Why can levothyroxine sodium tablets be used? Question 1: What is levothyroxine sodium tablets? First introduce the thyroid hormones.
Thyroid hormones include thyroxine, also known as tetraiodothyronine (T4) and triiodothyronine (T3), which are combined with thyroglobulin (TBG) in the body and stored in the follicles of the thyroid.
For thyroid hormone to function, it must be released into the blood.
The content of T3 is 1/10 of that of T4, but its physiological activity is about 5 times that of T4, and T4 is deiodized in the liver and kidneys.
T3.
Simply put, the content of T3 is low, but the activity is high, and the metabolism is fast, which plays a major role; the activity of T4 is low, but the content is high, and the metabolism is slow, which plays a supplementary role.
Naturally, both T3 and T4 can inhibit the secretion of thyroid stimulating hormone (TSH) through negative feedback.
Levothyroxine sodium tablets are synthetic tetraiodothyronine.
Like endogenous hormones, it is converted into T3 in peripheral organs and then exerts specific physiological effects.
Question 2: Why use levothyroxine sodium tablets for hypothyroidism? The use of levothyroxine sodium tablets for hypothyroidism is easy to understand, because patients with hypothyroidism do not synthesize thyroid hormones themselves, giving levothyroxine sodium tablets is an alternative treatment.
Taking levothyroxine sodium tablets is equivalent to supplementing T4.
T4 supplementation is enough, and T3 converted from T4 is also enough, so the thyroid hormones that can perform physiological functions are also sufficient.
Therefore, we usually take thyroxine tablets when supplementing thyroid hormones, and supplementing with T4.
After the drugs are absorbed into the body, they will be converted into T3 to function.
[However, a small number of patients do not respond well to T4.
At this time, they need to take dry thyroid tablets (T4+T3), T3 and other drugs.
] Question 3: Why can levothyroxine sodium tablets still be used as an auxiliary medicine for antithyroid drugs? Here is a reminder, please pay attention to the distinction: For the treatment of hyperthyroidism, levothyroxine sodium tablets are used as an adjuvant to antithyroid drugs rather than directly used to treat hyperthyroidism! Clinically, for patients with exophthalmos or goiter, a small amount of levothyroxine sodium tablets can be given as appropriate to inhibit TSH.
Because when antithyroid drugs are given to treat hyperthyroidism, the patient's thyroxine will gradually decrease, so the inhibition of TSH gradually weakens, and the increase in TSH will aggravate exophthalmos or goiter.
In another case, there may be such patients in the clinic: when the antithyroid drug is a little too much, hypothyroidism occurs; when the antithyroid drug is slightly reduced, hyperthyroidism occurs.
As the dose of antithyroid drugs is difficult to adjust, simultaneous administration of levothyroxine sodium tablets and antithyroid drugs can better balance the level of thyroid hormones.
■ At present, there are 2 options for the treatment of hyperthyroidism: (1) Use of antithyroid drugs (ATD) alone, such as tapazole or propylthiouracil.
(2) Antithyroid drugs + Levothyroxine sodium tablets.
The first option is that the amount of antithyroid drugs is less, but the possibility of hypothyroidism is greater.
The second option, as mentioned above, can better avoid hypothyroidism and reduce hormone level fluctuations, but it should be noted that this option will use more anti-thyroid drugs and have more side effects.
■ Levothyroxine sodium tablets for hyperthyroidism need to pay attention to: only in the treatment of hyperthyroidism with antithyroid drugs, levothyroxine sodium tablets can be used for supplementary treatment, otherwise, in the case of hyperthyroidism , Do not use levothyroxine.
When combined with levothyroxine sodium tablets to treat hyperthyroidism, the administration cycle of levothyroxine sodium tablets should be the same as that of antithyroid drugs.
During pregnancy, it is not advisable to combine levothyroxine and antithyroid drugs to treat hyperthyroidism, because the addition of levothyroxine requires an increase in the dose of antithyroid drugs.
Antithyroid drugs can pass through the placenta and may cause hypothyroidism in the fetus .
Question 4: What should I pay attention to when taking levothyroxine sodium tablets? 1.
Regular medication: Levothyroxine sodium tablets should be taken every day.
After getting up every day, half an hour before breakfast, give the daily dose on an empty stomach.
If there is any missed dose, double the dose should be taken until all missed doses are made up.
If you have trouble taking the medicine in the morning, you can choose to take it 4 hours after dinner, that is, take the medicine before going to bed.
In this way, factors that may affect drug absorption can be avoided as much as possible.
2.
Review cycle: As long as the dosage of the medicine changes, you need to wait 4-6 weeks for review, at least 4 weeks (because the half-life of levothyroxine sodium tablets is very long).
3.
Influencing absorption: In order not to affect the absorption of the drug, pay attention to a period of time apart from other drugs when taking the drug.
It is 1 hour apart from hypertension drugs, vitamins, and tonics; 2 hours apart from iron and calcium foods or drugs, 4 hours apart from milk and soy foods; 12 hours apart from cholestyramine and lipid-lowering resin drugs.
4.
The initial dose of the elderly, patients with coronary heart disease and other populations should be reduced as appropriate in accordance with the doctor's advice, and the frequency of reexamination should be appropriately increased.
5.
During thyroid replacement therapy, pregnant women must be closely monitored to avoid hypothyroidism or hyperthyroidism, so as to avoid adverse effects on the fetus.
6.
Patients who need TSH suppression therapy, especially the elderly and menopausal women, should be alert to related manifestations such as arrhythmia, osteoporosis, and thyrotoxicosis.
Source of this articleResponsible editor of the sixth hospital pharmacistXiao Ma Ma copyright statement
