How Long Can You Go Without Thyroid Medication?

By - Rubab Sikandar

Have you ever thought, what controls almost everything in your body? It’s the thyroid. An all-controlling hormone factory.
 
The thyroid is a small butterfly-shaped gland. Its located on the front of your neck. From there it rules almost everything – your body temperature, weight, hair, etc.
 
The thyroid gland sometimes does not produce enough hormones for your body. To make enough production, doctors suggest thyroid medication.
 
You may ask what if I forgot to take my thyroid pill this morning? How long can you go without thyroid medication?
 
Skipping your dose once in a while may not harm that much. But, skipping medication for a while may cause thyroid medication withdrawal symptoms.

What is Thyroid?

The thyroid is a gland.  It generates thyroid hormones. This small, butterfly-shaped gland usually controls everything in your body. From your temperature, heart rate, blood pressure to metabolism and weight. It even controls the features of your skin, hair, and nails.
 
The gland takes iodine from your blood and makes the hormone thyroxine, T4. T4 has four iodine molecules. Another thyroid hormone T3 has three iodine molecules.

How does the thyroid gland work?

The thyroid gland stays in constant communication with your brain. Your brain gives a signal to the gland. And the glad raises thyroid-stimulating hormone (TSH) production.
 
When your body has enough thyroid hormone the gland works normally.
 
Sometimes the gland doesn’t produce the right amount (too much or too little) of hormones. It means you have thyroid disease.

Hypothyroidism vs Hyperthyroidism

There are two types of thyroid diseases: hypothyroidism and hyperthyroidism.
 
Hypothyroidism or underactive thyroid. In this condition, your body makes less thyroid hormone than you need. The symptoms of hypothyroidism include:

Several conditions are responsible for those symptoms. They include thyroiditis, imbalanced iodin due to salt craving thyroid, Graves’ disease, nodules, or other diseases. These affect the efficiency of the thyroid gland.
 
You can also inherit the condition from your ancestors.
 
Hyperthyroidism is a condition of having an overactive thyroid gland. Here your body produces excess thyroid hormones. And it consumes additional energy from the body. Symptoms of Hyperthyroidism includes:

How Long Can You Go Without Thyroid Medication?

If you have thyroid disease, doctors usually prescribe thyroid replacement medication. For example, levothyroxine, aka, Synthroid. And missing a dose of levothyroxine symptoms can be fatal.
 
Your first query must be what happens if I miss my thyroid medication for a day. Well, for a day the reactions won’t be that noticeable. Yet, for longer gaps, the effects can be severe.
 
Your hypo or hyperthyroid symptoms will relapse in the first place. And the side effects of stopping thyroid medication will show up later. The side effects include sleep apnea, depression, and type 2 diabetes.
 
Moreover, people with hypothyroidism are at higher risk of medical complications. The complications worsen in case of discontinuing the medication. You may suffer a myxedema coma – a fatal slowing of metabolism. It is a life-threatening complication but rare.
 
People also experience swelling all over the body in myxedema coma. Swelling is prominent on the face, tongue, lips, and limbs.
 
Lastly, life expectancy without thyroid medication can be shortened with thyroid cancer.

Different Medication for Thyroid Problem

Thyroid disease is difficult to diagnose. You can easily confuse the symptoms with other conditions. For example, social anxiety, HOCD, OCD, PTSD, and dementia. But blood tests, imaging, and physical exams can easily detect it.
 
Doctors usually prescribe medication based on your thyroid condition. The medication aims to bring your thyroid hormone levels back to normal.
 
If you have hypothyroidism, the main treatment is thyroid replacement medication. This treatment includes a synthetic way to add thyroid hormones back into your body. Levothyroxine is one common drug doctors usually prescribe for controlling hypothyroidism.
 
If you have hyperthyroidism, treatment options may include:

• Anti-thyroid drugs: Medicines like methimazole and propylthiouracil slows down your thyroid from making hormones.
• Radioactive iodine: This treatment damages the cells of your thyroid. So, It prevents the gland from making higher levels of thyroid hormones.
• Beta-blockers: They only help control your symptoms. This treatment does not affect the amount of hormone production.
• Surgery: Your doctor may surgically remove your thyroid (thyroidectomy). This will stop the gland from creating hormones. However, for the rest of your life, you need to take thyroid replacement hormones. You have to be cautious about foods to avoid after total thyroidectomy.

How long can you go without thyroid medication after thyroidectomy? And how long can you go without thyroid medication? Quite long but with difficulty.
 
If you skip your thyroid treatment risks and complications will be a part of your life.

Going Without Thyroid Hormone Replacement Medication (For Hypothyroidism Patients)

Doctors usually prescribe thyroid hormone replacement medication like levothyroxine (Synthroid) for hypothyroidism. The medication helps with fatigue, weight gain, or hair loss- symptoms of hypothyroidism.

Skipping Synthroid can cause side effects of stopping thyroid medication which include:

Going Without Antithyroid Medication (For Hyperthyroidism Patients)

How long you can go without thyroid medication for hyperthyroidism? Not long.
 
Doctors prescribe antithyroid medication for hyperthyroidism. Stopping the medication can cause thyroid medication withdrawal symptoms, such as:

If you do not treat your hyperthyroidism, it can increase the risk of stroke or heart attack. There is also the risk of developing a thyroid storm. It is a dangerous condition with a high death rate.
 
Before even thinking about how long can you go without your thyroid medication check the side effects. I am sure the list will make you look for your pillbox.

Can you live without a thyroid?

How long can you go without thyroid medication? Better not long. Now, you may ask, can you live without a thyroid gland? The simple answer is yes, but with a decreased quality of life.
 
Your body can survive for many years without a thyroid gland. Without proper levels of the two main thyroid hormones (T3 and T4), you will develop symptoms like anxiety, depression, and dementia. Besides, your body steadily gains weight, loses mental functionality, and develops poor metabolism.
 
A lack of thyroid hormones increases the risk of depression, heart disease, and many more. It can also shorten your life expectancy.
 
Eventually, Your condition will turn into a myxedema coma. Your mental functions will decline, so your digestive functions and the immune system. Slowly you will become a drooling baby. Finally: death.
 
Can you live without a thyroid? Yes. But you need lifelong treatment with thyroid hormone replacement medication.

Side Effects Of Stopping Thyroid Medication

Is it wise and safe to stop taking your thyroid medication? To simply put: No.

It is risky to stop thyroid medication. Significantly if you have damaged, partial, or no thyroid.

If your doctor has prescribed your thyroid medication, it’s because you need it.

The medicines play their intended part to keep your body’s function regular. Therefore, stopping thyroid medication will impact the specific action your medication is performing.

You may face several severe side effects for stopping thyroid medication that includes:

Thyroid Medication Withdrawal Symptoms

Thyroid medication withdrawal – a phase that you face when doctors suggest a temporary pause of thyroid medication.

A thyroid cancer patient undergoes specific procedures and treatments that require a high level of TSH (thyroid-stimulating hormone). This high level of TSH also helps to detect your residual, recurring, or metastatic thyroid cancer.

0.4 to 4mIU/L is the usual level of TSH in your body. However, for the cancer treatment with radioactive iodine ablation, you need TSH as high as 30mIU/L.

Doctors sometimes prescribe short-term stops of your thyroid medication to achieve that. Approximately four to six weeks, the pause lasts before your treatment or test.

Now, when you stop taking your thyroid medication, your hormone level decreases immensely. It results in thyroid medication withdrawal symptoms that can lead to the symptoms of acute hypothyroidism.

The symptoms may become severe in many to perform their daily chore. So, it is advisable not to execute any crucial decision or task during this period.

The symptoms usually include:

Patients usually restart their medication after their treatment. Usually, adjusting your thyroid hormone level to the appropriate dose determines your recovery period – from weeks to months.

Life Expectancy Without A Thyroid

Life expectancy without a thyroid is one concerning issue for a thyroid patient. The good news is an underactive thyroid, or no-thyroid, does not reduce or shorten your life expectancy. But for this, medication is crucial.

However, a study shows that age can affect your life span if you have thyroid cancer. A cancer patient over 45, especially over 60 years old, may face a reduced life span. However, if you are younger than 45, stop worrying about a decreased life.

Nevertheless, one study shows that people with low thyroid function live up to 3.5 years longer overall. In addition, they may live 3.1 years more without cardiovascular disease than people with high or normal thyroid.

Can You Stop Taking Thyroid Medication Once You Start?

Stopping thyroid medication without your doctor’s suggestion is always a No. It may cause you severe effects.

How long can you go without your thyroid medication? Not long. Your hypothyroid symptoms may return with more severe symptoms.

If you stop taking thyroid medication, you may feel tired and sluggish in the beginning. Then slowly, you will face other health issues like sleep apnea, depression, and type 2 diabetes.

The biggest threat is the myxedema crisis. It’s a rare but life-threatening condition that arises due to uncontrolled hypothyroidism.

Therefore, without your doctor’s advice, do not stop taking your medication.

What If I Forgot To Take My Thyroid Pill This Morning

If you forgot to take your thyroid pill in the morning, take it as soon as you realize. However, if our next dose’s time is close, you better skip the dose and resume your regular schedule the next day.

While taking a forgotten dose, remember to follow the medication rules. Do not take your pill with meals, other medicines, or supplements, as they can impact the total absorption of your thyroid medication.

For your missing morning pill, take it an hour before your lunchtime. If you forgot your nighttime dose, take it the first thing in the morning. Then start your new day.

However, if you forgot to take medicine for a few days, you must consult with your doctor. Never take a double dose to make up for your missing dose.

When You Do Not Need Medication

Endocrinologists can detect the level of your thyroid production by standard blood tests. They will test TSH (thyroid-stimulating hormone) and free T4. These two tests are reliable enough to find if you need thyroid hormone replacement or not.
 
But, the following conditions do not need any medication immediately.

1. If you have slightly elevated TSH levels and normal free T4, you do not need any immediate medication. This condition is called subclinical hypothyroid. It is the early stage of hypothyroidism. You only need monitoring now.

2. If you have low free T3, you do not need T3 medication. This is an indication of inflammation, digestive issues, or a diet too low in carbs or calories. You can relate this condition to the low-carb thyroid myth also. Staying too low-carb for too long can reduce the level of T3. Especially, while doing the keto diet, you may face this.

3. If you have elevated thyroid antibodies with normal thyroid hormone levels, you do not need thyroid hormone replacement. It is Hashimoto’s disease that does not turn into hypothyroidism easily.

Nevertheless, if your

1. TSH levels are abnormally high, and your free T4 levels are abnormally low.
2. You have low free T4 and normal TSH.

You need to start medication soon. Consult your doctor.

Having A Healthy Diet to Manage Thyroid Issues

A healthy diet is always a way to live happy and healthy. Indeed, food alone can not cure your thyroid disease. However, combing proper nutrients with medication can minimize your symptoms. Besides, it will fix thyroid function.
 
If you have hypothyroidism avoid foods that contain high calories. They can also enhance your weight gain. Try to minimize the consumption of goitrogens-containining foods. Avoid processed foods, millets, and supplements like selenium and zinc.
 
Eat vegetables, fruits, and lean meats. They are low in calories, and contain iodine. Besides, they are fulfilling. You can also prevent weight gain with these foods.
 
If you have hyperthyroidism, avoid foods rich in iodine. For example, iodized salt, fish and shellfish, dairy products, and iodine supplement. Also, avoid soy and caffeine. They can worsen the symptoms of hyperthyroidism.

Eat foods containing low iodine, iron, vitamin D, and calcium. Tea, black coffee, herbs and spices, unsalted nuts, nut butter, cabbage, broccoli, lean meats, lentils, and beans keep the thyroid level under control.
 
What foods to avoid after total thyroidectomy? The answer is nothing. You don’t need to avoid any food after total thyroidectomy.
 
Removal of the thyroid gland does not need any permanent changes in your diet. Yet, you may face weight loss due to overactive hormones. The surgery helps you to gain some of the weight back. Moreover, hormone replacement therapy helps keep your metabolism at a normal level. Just consider a healthy diet to avoid weight gain.

FAQs

What happens if you forgot to take your thyroid medication?
 
You need to take your thyroid medication at the same time every day. If you are taking thyroid medication for several years, skipping a dose may not affect you much. Because it has a longer half-life. But, for new patients, skipping a dose may create problems. It will make things tricky for the doctor may not determine the right dose for you.
 
If you realize you forgot your medication, take it soon. If its close to your next dose, skip it and resume your usual schedule.
 
Do I have to take thyroid medication forever?
 
Yes. You have to keep taking your thyroid medicine forever. Keep up with your treatment and you will see results soon. With a proper level of thyroid hormones, you can lead a healthy life.
 

Final Thoughts with Thyroid

How long can you go without thyroid medication? The simple answer is you should not go without your medication.
 
Remember, thyroid disease is a life-long complicated condition. You can develop new symptoms right after the treatment started. The reason can be either the wrong medication dose or by discontinuation of the medication.
 
Follow the schedule your endocrinologist prescribed and stick with the same brand. In that way, you can avoid the side effects of stopping thyroid medication.