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You are likely to need treatment for hypothyroidism for the rest of your life. As a result, you need to take your medicine as directed. For some people, hypothyroidism gets worse as they age and the dosage of thyroid medicine may have to be increased gradually as the thyroid continues to slow down.

Most people treated with thyroid hormone develop symptoms again if their medicine is stopped. If this occurs, medicine needs to be restarted.

If a serious illness or infection triggers your hypothyroidism, your thyroid function most likely will return to normal when you recover. To check whether thyroid function has returned to normal, thyroid hormone medicine may be stopped for a short time. In most people, a brief period of hypothyroidism occurs after thyroid medicine is stopped; there is often a delay in the body's signals that tell the thyroid to start working again. If the thyroid can produce enough hormone on its own, treatment is no longer needed. But if hormone levels remain too low, you need to restart thyroid medicine.

While taking thyroid hormone medicine, you need to see your doctor once a year for checkups. You will have a blood test (thyroid-stimulating hormone [TSH] assay) to make sure you have a normal hormone level.

Treatment if the condition gets worse

Sometimes symptoms of hypothyroidism continue, such as sluggishness, constipation, confusion, and feeling cold. This may occur if you are not taking enough thyroid hormone or if your medicine is not absorbed from your gastrointestinal tract. Having a bowel disease or taking certain other medicines may block thyroid hormone. Your doctor may increase your dose of thyroid medicine if you are taking estrogen or phenytoin (Dilantin).² Take calcium supplements at least 4 hours before or after taking thyroid hormone.⁸

Your doctor may suggest you try the combination therapy of T3/T4 medicine if T4 medicine is not controlling your symptoms.

If your dose of thyroid hormone is too high, you may develop complications such as irregular heartbeats and, over time, osteoporosis. If you have heart disease, too much medicine can cause pain (angina) and irregular heartbeats. Your doctor will watch your thyroid levels using a thyroid-stimulating hormone (TSH) test. If necessary, your doctor will lower your dose.