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Dr. Andrew Rynne

Family Physician

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Hi, I recently ran out of levothyroxine and skipped a

Answered by
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Dr. Vaishalee Punj

General & Family Physician

Practicing since :2003

Answered : 2144 Questions

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Posted on Tue, 25 Dec 2018 in Internal Doctor Category
Question: Hi, I recently ran out of levothyroxine and skipped a single dose, although I’m back to normal dosing now: I take 100 mcg daily for hypothyroidism, I normally don’t feel great when I do this and I have done it before, I was wondering how dangerous it is to skip a dose and how long does it take for normal levels to return. Thank you.
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Follow up: Dr. Vaishalee Punj 0 minute later
Hi, I recently ran out of levothyroxine and skipped a single dose, although I’m back to normal dosing now: I take 100 mcg daily for hypothyroidism, I normally don’t feel great when I do this and I have done it before, I was wondering how dangerous it is to skip a dose and how long does it take for normal levels to return. Thank you.
doctor
Answered by Dr. Vaishalee Punj 29 minutes later
Brief Answer:
It is not dangerous to skip the dose

Detailed Answer:
Hello and welcome to Ask A Doctor service.

I have reviewed your query and here is my advice.

It is not dangerous to skip a dose of thyroid supplement. Body keeps a reserve of these hormones.

It takes more than 3 weeks to reflect any changes in dose in the thyroid hormone test.
E.g If I change your dose today, I will need to test your thyroid profile after 3 weeks to see the changes.

Hope this answers your query. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vaishalee Punj 0 minute later
Brief Answer:
It is not dangerous to skip the dose

Detailed Answer:
Hello and welcome to Ask A Doctor service.

I have reviewed your query and here is my advice.

It is not dangerous to skip a dose of thyroid supplement. Body keeps a reserve of these hormones.

It takes more than 3 weeks to reflect any changes in dose in the thyroid hormone test.
E.g If I change your dose today, I will need to test your thyroid profile after 3 weeks to see the changes.

Hope this answers your query. Let me know if I can assist you further.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj 34 minutes later
Thank you, doctor, I have done this before and can feel odd for a few days, but it is not dangerous you say? Thank you.
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Follow up: Dr. Vaishalee Punj 0 minute later
Thank you, doctor, I have done this before and can feel odd for a few days, but it is not dangerous you say? Thank you.
doctor
Answered by Dr. Vaishalee Punj 31 minutes later
Brief Answer:
It is not dangerous

Detailed Answer:
Hi again

If one dose of thyroid supplement is skipped, I will expect only mild symptoms like muscle fatigue, sleepiness, etc. If occasional dose is missed many times, then chances of long term complications can be increased to some extent.
Otherwise I do not see it as a cause of any emergency situation like heart attack or stroke, etc.

If you have been taking it in high doses or for a long time, then its better to take it regularly. If the dose has been low or for sometime only, then there is no harm in skipping a dose.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vaishalee Punj 0 minute later
Brief Answer:
It is not dangerous

Detailed Answer:
Hi again

If one dose of thyroid supplement is skipped, I will expect only mild symptoms like muscle fatigue, sleepiness, etc. If occasional dose is missed many times, then chances of long term complications can be increased to some extent.
Otherwise I do not see it as a cause of any emergency situation like heart attack or stroke, etc.

If you have been taking it in high doses or for a long time, then its better to take it regularly. If the dose has been low or for sometime only, then there is no harm in skipping a dose.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj 1 hour later
Thank you, I take 100 mcg daily, and usually take it, it was just a one-off skipped dose accidental i ran out. I am back on it now. and yes, mild symptoms. I have done it before and the symptoms usually go in a few days. I am hoping i will be fine...
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Follow up: Dr. Vaishalee Punj 0 minute later
Thank you, I take 100 mcg daily, and usually take it, it was just a one-off skipped dose accidental i ran out. I am back on it now. and yes, mild symptoms. I have done it before and the symptoms usually go in a few days. I am hoping i will be fine...
doctor
Answered by Dr. Vaishalee Punj 16 hours later
Brief Answer:
You will be fine

Detailed Answer:
Yes you will be fine. 100mcg is neither a high dose nor a low dose. So I will expect some mild symptoms when skipping its dose. When you see that you will run out of it, You can take a lower dose (like half of 100 mcg) for 3-4 days until you refill it.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Vaishalee Punj 0 minute later
Brief Answer:
You will be fine

Detailed Answer:
Yes you will be fine. 100mcg is neither a high dose nor a low dose. So I will expect some mild symptoms when skipping its dose. When you see that you will run out of it, You can take a lower dose (like half of 100 mcg) for 3-4 days until you refill it.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vaishalee Punj 8 hours later
Hi, further to recent conversations with Dr Vaishalee, which I was very happy with, I have some further questions regarding my hypothyroidism. It occurs to me that I have not had my TSH tested for over a year, possibly more, when my TSH was 0.73 mU/L. At the time, I was on 100 mcg levothyroxine daily, and had been pretty well consistently since 2011, and as I am at the present. I just got worried because I skipped a dose last Sunday, and have not been tested for over a year (my fault). I was wondering if I am in danger of becoming hypothyroid again, even to the extent of myxedema give the circumsatnces? I am due to find out the results of a blood test next week, so that is underway. But could myxedema be a danger, even though I am on quite high doses of levothyroxine daily?
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Follow up: Dr. Vaishalee Punj 0 minute later
Hi, further to recent conversations with Dr Vaishalee, which I was very happy with, I have some further questions regarding my hypothyroidism. It occurs to me that I have not had my TSH tested for over a year, possibly more, when my TSH was 0.73 mU/L. At the time, I was on 100 mcg levothyroxine daily, and had been pretty well consistently since 2011, and as I am at the present. I just got worried because I skipped a dose last Sunday, and have not been tested for over a year (my fault). I was wondering if I am in danger of becoming hypothyroid again, even to the extent of myxedema give the circumsatnces? I am due to find out the results of a blood test next week, so that is underway. But could myxedema be a danger, even though I am on quite high doses of levothyroxine daily?
doctor
Answered by Dr. Vaishalee Punj 16 hours later
Brief Answer:
Myxedema is seen in severe hypothyroid cases

Detailed Answer:
Hi
Thanks for reverting back

Myxedema is seen in severe hypothyroid and untreated/discontinued patients. These people do not have a reserve of thyroid hormones in their body. A precipitating cause like an infection or low room temperature is also there.
In your case there is some body reserve of thyroid hormones that will prevent you from going into a myxedema coma. But if supplements are not taken for more than a few days, then I will expect a hypothyroid state.
Skipping a dose occasionally does not result in myxedema or hypothyroid state.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vaishalee Punj 0 minute later
Brief Answer:
Myxedema is seen in severe hypothyroid cases

Detailed Answer:
Hi
Thanks for reverting back

Myxedema is seen in severe hypothyroid and untreated/discontinued patients. These people do not have a reserve of thyroid hormones in their body. A precipitating cause like an infection or low room temperature is also there.
In your case there is some body reserve of thyroid hormones that will prevent you from going into a myxedema coma. But if supplements are not taken for more than a few days, then I will expect a hypothyroid state.
Skipping a dose occasionally does not result in myxedema or hypothyroid state.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj 6 hours later
Oh I understand, skipping a few days could make me hypothyroid, but one day not. But skipping a lot could make me myxedemic, I understand now, thank you.
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Follow up: Dr. Vaishalee Punj 0 minute later
Oh I understand, skipping a few days could make me hypothyroid, but one day not. But skipping a lot could make me myxedemic, I understand now, thank you.
doctor
Answered by Dr. Vaishalee Punj 17 hours later
Brief Answer:
Myxedema is uncommon

Detailed Answer:
yes, skipping a lot and not having natural reserve of thyroid hormones can make you myxedemic. I think you still have some natural reserve in your body.

Take care
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Nagamani Ng
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doctor
Answered by Dr. Vaishalee Punj 0 minute later
Brief Answer:
Myxedema is uncommon

Detailed Answer:
yes, skipping a lot and not having natural reserve of thyroid hormones can make you myxedemic. I think you still have some natural reserve in your body.

Take care
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Nagamani Ng
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