The thyroid gland, a small, butterfly-shaped organ located in the neck, plays a significant role in regulating the body’s metabolism. It produces hormones, primarily thyroxine (T4), which influence how the body uses energy, affecting digestion, heart and muscle function, and brain development. When the thyroid gland does not produce enough of these hormones, a condition known as hypothyroidism develops, leading to a general slowing down of various bodily functions. To address this deficiency, synthetic thyroid hormone replacement medicine, such as levothyroxine, is prescribed to restore hormone levels to a healthy range.
Common Effects of Non-Adherence
Discontinuing or inconsistently taking thyroid medication causes the body to experience the effects of insufficient thyroid hormone, leading to a return or worsening of symptoms that are generally noticeable relatively quickly.
A person might experience persistent fatigue, weight gain, and digestive issues like constipation.
Skin and hair changes are common, including dry skin and hair loss. Individuals may also feel unusually cold due to a slowed metabolism.
Muscle aches, stiffness, and weakness are often present. Additionally, a slowed heart rate and reduced mental clarity, often described as “brain fog,” can manifest, impacting concentration and memory.
Long-Term Health Consequences
Untreated hypothyroidism over an extended period can lead to more severe and chronic health problems that affect various body systems. These complications develop gradually, often over months to years.
Cardiovascular issues are a significant concern, as low thyroid hormone levels can lead to increased cholesterol levels, specifically low-density lipoprotein (LDL) cholesterol. This can elevate the risk of developing heart disease and may contribute to heart failure. Hypothyroidism can also cause the heart to beat slower, and may lead to fluid retention, which can result in high blood pressure.
Nerve damage, known as peripheral neuropathy, can develop, affecting the nerves that carry information from the brain and spinal cord to the rest of the body. This condition may cause pain, numbness, or tingling sensations in the arms and legs, and can sometimes lead to muscle weakness or partial loss of muscle control.
Mental health issues such as worsening depression and anxiety are also commonly observed in individuals with untreated hypothyroidism.
Fertility problems can arise, and in pregnant individuals, untreated hypothyroidism can increase the risk of complications such as high blood pressure, birth defects, premature birth, or miscarriage. The thyroid gland itself may also enlarge, forming a goiter, which can sometimes cause difficulties with swallowing or breathing.
Thyroid Storm and Myxedema Coma
While rare, profoundly untreated or critically undertreated hypothyroidism can escalate into a life-threatening emergency known as Myxedema Coma. This severe complication is characterized by extreme lethargy, significantly low body temperature (hypothermia), and can progress to unconsciousness or a comatose state.
It typically occurs in individuals with long-standing, unmanaged hypothyroidism, often triggered by additional stress on the body like an infection, trauma, or exposure to cold. Myxedema Coma is a medical emergency that requires immediate hospitalization and aggressive medical intervention. Symptoms can include decreased breathing, low blood oxygen levels, high carbon dioxide levels, and low blood sodium levels.
Thyroid Storm, conversely, represents the extreme opposite, being a severe and acute manifestation of hyperthyroidism (an overactive thyroid). It is characterized by an excessive release of thyroid hormones, leading to symptoms such as very high fever, rapid heart rate, and altered mental status. It is not a direct consequence of not taking thyroid medicine for hypothyroidism, but rather a distinct emergency arising from uncontrolled hyperthyroidism.
Importance of Consistent Medication
Consistent adherence to thyroid hormone replacement therapy, such as levothyroxine, is important for maintaining overall health and preventing the recurrence of symptoms and long-term complications. This medication is typically a lifelong treatment, as it replaces hormones the body cannot produce sufficiently on its own.
Taking the medication at the same time each day, usually on an empty stomach 30 to 60 minutes before breakfast, optimizes absorption.
If a single dose is missed, it is generally advised to take it as soon as remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped to avoid taking too much medication, and double-dosing is not recommended.
It is important to note that missing one dose may not significantly impact overall hormone levels due to the medication’s long half-life, but consistent non-adherence will lead to a decline. Individuals who struggle with remembering doses, experience side effects, or have any questions about their treatment should contact their healthcare provider immediately. Regular blood tests are necessary to monitor thyroid hormone levels and ensure the dosage remains appropriate, as needs can change over time. Consulting a doctor is also important if considering any changes to the medication regimen.