Thyroid medications, such as levothyroxine, are a safe way to treat hypothyroidism. However, if stopping medication is necessary, doctors can advise on the best practice.

Thyroid medication, such as levothyroxine, is safe and not habit-forming. Therefore, there is generally no need to stop taking it if it is treating hypothyroidism effectively. Additionally, if someone takes the correct dose of their medication, their hypothyroidism symptoms will likely return if they stop taking it.

However, high doses may cause symptoms of hyperthyroidism, or an overactive thyroid.

If a person only has temporary thyroid dysfunction, such as due to pregnancy, they may need to wean off of their thyroid medication.

Before weaning off thyroid medication, a person can discuss their plans with a healthcare professional and ask for a thyroid panel.

This article discusses how to wean off thyroid medication, the effects, and the symptoms relating to dose lowering.

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Before weaning off thyroid medication, a person needs to discuss their concerns with a healthcare professional. They can perform a thyroid panel to check thyroid function and thyroid-stimulating hormone (TSH) levels. This involves testing the function of the thyroid gland with a blood test.

If TSH levels are too low, a person may need to adjust the dose of their medication. If they are within typical ranges, they may be able to safely reduce their dosage to see how the body responds.

Time frames and dosage

It takes 4–6 weeks for thyroid medication to fully leave the body and for TSH levels to rise to the level they will be without levothyroxine. Most guidelines recommend adjusting the dose according to lab results every 4 to 6 weeks.

A doctor can decide a person’s lowered dosage. If someone develops new symptoms of hypothyroidism, they need to return to the doctor promptly. Otherwise, they should consult a doctor in 4 to 6 weeks for another thyroid panel.

Read more about levothyroxine.

The right thyroid medication dosage usually depends on a combination of body weight and the severity of hypothyroidism. People with a higher body mass index and those with higher TSH levels typically need a higher dose.

A person may need to lower their dose if:

  • they lose weight
  • their TSH levels drop
  • they no longer have thyroid dysfunction
  • they develop symptoms of hyperthyroidism

Outside these circumstances, weaning off thyroid medication may cause some symptoms to return.

People taking too much thyroid medication may experience factitious hyperthyroidism. This means that medication has caused the thyroid to become overactive. A person may notice symptoms such as a racing heart, feeling very hot, anxiety, and insomnia. Lowering the medication dosage may cause those symptoms to disappear.

A person should not experience symptoms when lowering the dose of levothyroxine. Thyroid symptoms are a sign that the body may again be developing hypothyroidism.

If this happens, they may notice symptoms such as:

  • dry skin
  • a feeling of fullness in the throat
  • unexplained aches and pains
  • low energy
  • brain fog
  • depression
  • weight gain
  • a slow heart rate
  • infertility

In people who develop medication-induced hyperthyroidism, symptoms should improve. They may notice:

  • feeling less anxious
  • a slower heart rate
  • better sleep
  • potentially slight weight gain

Inadequate iodine consumption is the leading global cause of hypothyroidism. However, in the United States, Hashimoto’s thyroiditis is the leading cause of hypothyroidism.

Some dietary sources of iodine include:

  • seaweed
  • salt with iodine, or most table salt
  • fish
  • seafood
  • eggs
  • cheese

In people who get enough iodine, diet changes are not generally part of the standard treatment for hypothyroidism. In developed nations, iodine deficiency is rare.

However, there is no conclusive evidence that dietary changes can treat hypothyroidism or eliminate the need for thyroid medication.

Some small studies have found that certain diets, such as gluten-free eating regimens, may improve thyroid function. However, this data is inconclusive and does not show dietary changes can replace thyroid medication.

Some strategies that can help a person wean off thyroid medication include:

  • Making appropriate lifestyle choices: While these will not necessarily improve thyroid function, thyroid disease can affect the heart and cause high cholesterol. Taking part in exercise and following a balanced diet that is low in sodium and trans fats may help offset these effects.
  • Keeping track of symptoms and how they change over time: The symptoms of hypothyroidism will not appear immediately, and hyperthyroid symptoms will not immediately disappear. Often, symptoms change steadily over several weeks.
  • Regular checking: A person can ask a healthcare professional to check thyroid levels regularly at each dose reduction.
  • Accepting that it may not be the time to wean off: If symptoms worsen, a person can go back to taking thyroid medication. There is no compelling reason for people with thyroid dysfunction to avoid thyroid medication.
  • Working with a doctor: Changing the dosage too quickly or without medical supervision may trigger health issues and further thyroid dysregulation.

Thyroid medication is a safe way to treat hypothyroidism. However, some people may develop hyperthyroidism if the dose is too high. Others see improvement in symptoms that allow them to reduce their dosage.

It is important to stop taking thyroid medication only if there is a medical reason and only with ongoing medical monitoring.

With a doctor’s support, a person may be able to lower their dosage or even eliminate thyroid medication.