Levothyroxine can be misused, and it can lead to overdose.
Taking medication is sometimes outside of a patient’s control. This is the case with people who have hypothyroidism (underactive thyroid), who have an enlarged thyroid (goiter), or who have or have had thyroid cancer.
These severe health issues may require a patient to take medication such as levothyroxine. MedlinePlus describes this as a thyroid hormone that can benefit people with the aforementioned health issues.
Levothyroxine is meant for people whose thyroids cannot release hormones correctly.
There are reports of levothyroxine misuse. On June 2015, the Daily Mail reported that some healthy athletes were taking thyroid medication so they could use it as a stimulant. It is one of the few drugs not illegal in several sports leagues during the time of the report.
Patients and doctors are warned not to use levothyroxine to treat obesity or weight problems. The University of Michigan also warns that many common over-the-counter drugs can amplify the effects of levothyroxine.
How It Is Used
People with an underactive thyroid experience problems with how their body functions, such as hair loss, depression, fatigue, weight gain, stunted growth, skin dryness, and irregular or heavy menstruation cycles. The medication is meant to stop these symptoms.
Levothyroxine is also approved for children and infants. It is sold as a capsule or tablet and usually taken once daily. MedlinePlus suggests taking it with water, and it must be taken between 30 minutes to one hour before breakfast.
The medication is sold in a generic version and as brands Levoxyl, Synthroid, and Tirosint.
If giving levothyroxine to an infant or young child, it can be crushed and mixed with one to two teaspoons of water and administered using a dropper. The crushed medication should not be mixed with soybean infant formula or food.
How It Is Misused
Statistics on the misuse of levothyroxine are scarce. However, Harvard Medical School mentions that levothyroxine and other thyroid replacement hormones are overprescribed.
- Between 2006 to 2010, thyroid medication prescriptions rose from 50 million to 70 million prescriptions
- People with borderline hypothyroidism — symptoms that cause discomfort but are not serious enough to seek treatment — are also overmedicated
Some people may become overmedicated if they change from one form of levothyroxine to another. Common symptoms of overmedication include the following:
- Difficulty sleeping
- Unexplained weight loss
- An increase in temperature when others are cold
Energy, Performance & Weight Loss
It is known that despite these issues, some people misuse levothyroxine to enhance their stamina or even lose weight. This is because people who have underactive thyroid experience problems with their metabolism. The medication corrects this health issue and creates normalcy, causing a person to lose weight.
People with an underactive thyroid are also known to experience fatigue, and levothyroxine can indeed help patients feel normal amounts of energy.
A 2009 study published in the Journal of Endocrinological Investigation mentioned that people who have hypothyroidism had more energy six months after they began their hormone replacement treatment. This supports the idea that levothyroxine’s regulation of hormones provides more energy.
In August 2015, Runner’s World reported that the U.S. Anti-Doping Agency (USADA) and UK Anti-Doping requested that the World Anti-Doping Association (WADA) add thyroid medication to its list of banned substances.
USADA and UK Anti-Doping argued that thyroid medicine could make it easier for athletes to train harder because they may decide to use it to recover quickly, and it would be unfair to artists who use no substances at all.
WADA argued that thyroid medicine such as levothyroxine does not create advantages in athletes who do not have thyroid issues.
Some people report using the medication so they can lose weight in online forums that have not been vetted by researchers. Examples of self-reports on weight loss with levothyroxine are available on sites such as Everyday Health.
What Happens When Stopping Levothyroxine Use?
MedlinePlus reports that people who use levothyroxine to treat thyroid and metabolic issues start out with a small dose. Doctors routinely check on patients to make adjustments, and this may result in a dosage increase.
Patients should learn the name brand of their prescription because every brand has a different formulation. Taking a different one without consulting a physician could change how a person reacts.
Information about dependency on levothyroxine is not widely available, showing that more studies are needed. Athletes and people who misuse levothyroxine to increase their energy levels or lose weight have not been thoroughly examined.
However, we do know that people who have thyroid cancer tend to experience the following symptoms as they quit or reduce their doses of levothyroxine before specific tests:
- Depression and anxiety: It is normal for these feelings to return as part of levothyroxine reduction
- Hypothyroidism: The medication is technically a hormone replacement. Not taking it means that this hormone’s presence in the body is diminished. A person’s metabolism may slow down as a result of no longer taking levothyroxine
- Pale or dry skin: A reduction in the hormone could cause a person to have dry, pale skin. Hair loss and brittle nails are also common as the medication’s dose is reduced
- Insulin resistance: In addition to assisting with metabolism, thyroid hormones help the body respond to blood sugar levels. Insulin resistance means it will take longer to become stable after an increase in blood sugar.
Withdrawal symptoms as a result of misuse have not yet been established. But MedlinePlus lists side effects common to levothyroxine and cautions patients that overdose is common.
- Heat sensitivity
- Changes in menstruation cycle
- Difficulty sleeping
Treatment for Levothyroxine Misuse
Levothyroxine does not cause regular drug-seeking behavior as described by the National Institute on Drug Abuse. No longer taking the medication produces depression and anxiety, but it does not seem to be because of the medication’s influence on the brain and body.
Recovery parameters for levothyroxine have not been established. However, patients who want to quit using levothyroxine should always talk to their doctor. This includes people who may have misused the medication so they can lose weight or improve their athletic performance.
Patients with a normal thyroid may experience toxic shock, and the risk for this increases if the medication is used along with amphetamines. The University of Michigan says some people will have to use this hormone replacement for the rest of their lives. This makes it challenging to understand dependency.
Other than that, patients should discuss any concerns with their doctor, who will help them understand if they should quit the medication or not. People who have misused levothyroxine can also request treatment referrals from a physician.