Thyroid (armour) 1.5gr (90mg) Tabs

• Anticoagulants (e.g., Warfarin): May enhance anticoagulant effect, requiring dose reduction of anticoagulant.
• Digitalis glycosides (e.g., Digoxin): Thyroid hormones may decrease therapeutic effect of digitalis; increased digitalis dose may be needed.
• Antidiabetic agents (e.g., Insulin, Metformin): Thyroid hormones may increase blood glucose levels, requiring increased dose of antidiabetic agent.

• Calcium carbonate/supplements, Iron supplements, Antacids (aluminum/magnesium hydroxide), Sucralfate, Bile acid sequestrants (Cholestyramine, Colestipol), Proton pump inhibitors (PPIs): May decrease absorption of thyroid hormones. Separate administration by at least 4 hours.
• Soy products, Dietary fiber: May decrease absorption of thyroid hormones. Separate administration.
• Amiodarone, Beta-blockers (e.g., Propranolol), Propylthiouracil (PTU), Methimazole: May alter thyroid hormone metabolism or peripheral conversion of T4 to T3.
• Carbamazepine, Phenytoin, Phenobarbital, Rifampin: May increase metabolism of thyroid hormones, requiring increased thyroid hormone dose.
• Estrogens (oral), Selective Estrogen Receptor Modulators (SERMs): May increase TBG levels, increasing thyroid hormone requirements.
• Androgens, Anabolic steroids, Asparaginase, Glucocorticoids: May decrease TBG levels, decreasing thyroid hormone requirements.

• Not available

• Symptoms of hypothyroidism (e.g., fatigue, weight gain, constipation, cold intolerance, dry skin, hair loss, depression, bradycardia).
• Symptoms of hyperthyroidism (e.g., palpitations, tachycardia, anxiety, nervousness, tremor, weight loss, heat intolerance, diarrhea, insomnia).

Thyroid hormone replacement is essential during pregnancy for both maternal and fetal health. Hypothyroidism during pregnancy can lead to adverse outcomes for the mother and impaired neurocognitive development in the fetus. Dose requirements often increase during pregnancy (by 25-50% or more).

Thyroid hormones are excreted in breast milk in minimal amounts and are generally considered safe for nursing infants. No adverse effects on the infant have been reported with maternal use of thyroid hormones at replacement doses.

Essential for normal growth and development, including brain maturation. Dosing is weight-based and requires careful titration and monitoring to avoid over- or under-treatment, which can have significant long-term consequences (e.g., intellectual disability, growth retardation).

Start with lower doses and titrate slowly due to increased sensitivity to thyroid hormones and a higher prevalence of underlying cardiovascular disease. Monitor closely for cardiac side effects (e.g., angina, arrhythmias).

• Desiccated thyroid contains both T4 and T3, which may appeal to patients seeking a 'natural' option or those who feel suboptimal on levothyroxine alone.
• Dosing is typically in grains (gr) or milligrams (mg), with 1 grain = 60 mg.
• Monitoring can be more complex than with levothyroxine. While TSH is still the primary marker, Free T3 and Free T4 levels are often monitored, and TSH may be suppressed even with appropriate dosing due to the direct T3 content.
• Patients should be advised to take the medication consistently at the same time each day, on an empty stomach, and separate from interacting substances.
• The ratio of T4 to T3 in desiccated thyroid is approximately 4:1 by weight, which is different from the physiological production ratio in humans (closer to 14:1 T4:T3).
• Consistency between batches and manufacturers of desiccated thyroid has historically been a concern, though quality control has improved.

• Levothyroxine (synthetic T4, e.g., Synthroid, Levoxyl, Tirosint)
• Liothyronine (synthetic T3, e.g., Cytomel, Triostat) - typically used as an adjunct or for specific conditions like myxedema coma.