What happens if you stop taking thyroid meds
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Effects of Stopping Thyroid Medications
Thyroid Function and Relapse Risk
When patients stop taking thyroid medications, such as carbimazole, the thyroid function can vary significantly. Research has shown three distinct patterns: continued suppression, partial suppression, and failure of suppression. Continued suppression is associated with a good prognosis, while failure of suppression often leads to clinical relapse of thyrotoxicosis. Specifically, patients whose thyroid uptake remains below 8% at the end of treatment are more likely to stay euthyroid, whereas those with uptake above 8% tend to relapse within one to ten months.
Withdrawal in Nursing Home Patients
In nursing home settings, some patients can discontinue thyroid hormone therapy without adverse effects. A study found that 50% of nursing home residents could successfully stop their thyroid hormone therapy without developing clinical hypothyroidism. This suggests that many older patients may have been prescribed thyroid hormone therapy for transient conditions or inappropriate reasons, and discontinuation can be safe and beneficial for some.
Impact on Insulin-like Growth Factors (IGFs)
Stopping thyroxine (T4) treatment in patients who have undergone total thyroidectomy can lead to significant changes in insulin-like growth factors (IGFs) and their binding proteins (IGFBPs). IGF-I and IGF-II levels drop significantly within five weeks of stopping T4, but return to normal after resuming treatment. Similarly, IGFBP-1 levels decrease and IGFBP-2 levels increase during hypothyroidism, but these changes are reversible upon restarting T4 therapy. These findings highlight the complex relationship between thyroid hormones and the IGF axis.
Biochemical and Cardiac Effects
In patients with differentiated thyroid carcinoma (DTC), withdrawal of T4 therapy leads to notable biochemical changes. Total cholesterol, LDL, HDL, and triglycerides levels increase significantly, as do liver enzymes, total protein, and albumin concentrations. Creatinine levels also rise, while sodium levels decrease. Despite these biochemical changes, no significant alterations in cardiac function and structure were observed through ultrasound indices. These biochemical shifts could pose risks, particularly for older patients or those with chronic conditions.
Conclusion
Stopping thyroid medications can lead to a range of outcomes depending on the patient's condition and the type of medication. While some patients may experience a relapse of thyrotoxicosis or significant biochemical changes, others, particularly older adults in nursing homes, may discontinue therapy without adverse effects. Monitoring and individualized assessment are crucial to manage the potential risks and benefits effectively.
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