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What Are The Side Effects Of Levothyroxine?
Question: swollen parotid glands for 4 weeks, given anti biotics no effect.
had thyroidectomy 3 years ago and XXXXXXX been on levothyroxine for 3 years. concerned about side effects
had thyroidectomy 3 years ago and XXXXXXX been on levothyroxine for 3 years. concerned about side effects
Brief Answer:
Thyroid
Detailed Answer:
Did you undergo surgery and radiation for your thyroid for cancer or for hyperthyroidism due to Graves disease or Toxic goitre?
Most patients treated with 131-I experience dose-related reductions in flow of saliva (from parotid and other glands) and some experience temporary decreased or altered sense of taste ('hypoguesia'). Although previously thought to reduce the risk of salivary gland inflammation ('sialadenitis'), the use of lemon candies in the first 24 hours was associated with higher rates of sialoadenitis, , hypoguesia and dry mouth ('xerostomia') due to increased delivery of radioiodine to salivary gland tissue via the bloodstream. Therefore, the use of lemon candies or other such means as a way to reduce radiation sialadenitis remains controversial. Since radioiodine is washed out rapidly after the administration of lemon juice, additional studies are needed to determine optimal timing of administration to reduce delivery of radioiodine to the salivary glands and provide optimal washout.
Nonsteroidal anti-inflammatory drugs (NSAIDS) are usually adequate for relieving symptoms of acute sialadenitis; steroids ( i.e.glucocorticoids) are rarely required but are effective in more severe cases. In a related observation, dental caries and teeth extraction were markedly higher in patients who developed postradioiodine xerostomia, and I advise my patients about proper oral hygiene and regular dental care.
Amifostine, which functions as a radioprotectant by scavenging radiation-induced free radicals in non-malignant tissue, has been advocated to reduce the frequency and severity of sialadenitis after radioiodine therapy. But, it is possible that amifostine would protect normal thyroid tissue from radiation-induced damage, and therefore I limit it's use to the occasional patient who requires multiple radioiodine administrations for metastatic disease rather than for adjuvant remnant ablation. Fewer side effects have been reported with subcutaneous administration, 500 mg, before radioiodine ingestion
Thyroid
Detailed Answer:
Did you undergo surgery and radiation for your thyroid for cancer or for hyperthyroidism due to Graves disease or Toxic goitre?
Most patients treated with 131-I experience dose-related reductions in flow of saliva (from parotid and other glands) and some experience temporary decreased or altered sense of taste ('hypoguesia'). Although previously thought to reduce the risk of salivary gland inflammation ('sialadenitis'), the use of lemon candies in the first 24 hours was associated with higher rates of sialoadenitis, , hypoguesia and dry mouth ('xerostomia') due to increased delivery of radioiodine to salivary gland tissue via the bloodstream. Therefore, the use of lemon candies or other such means as a way to reduce radiation sialadenitis remains controversial. Since radioiodine is washed out rapidly after the administration of lemon juice, additional studies are needed to determine optimal timing of administration to reduce delivery of radioiodine to the salivary glands and provide optimal washout.
Nonsteroidal anti-inflammatory drugs (NSAIDS) are usually adequate for relieving symptoms of acute sialadenitis; steroids ( i.e.glucocorticoids) are rarely required but are effective in more severe cases. In a related observation, dental caries and teeth extraction were markedly higher in patients who developed postradioiodine xerostomia, and I advise my patients about proper oral hygiene and regular dental care.
Amifostine, which functions as a radioprotectant by scavenging radiation-induced free radicals in non-malignant tissue, has been advocated to reduce the frequency and severity of sialadenitis after radioiodine therapy. But, it is possible that amifostine would protect normal thyroid tissue from radiation-induced damage, and therefore I limit it's use to the occasional patient who requires multiple radioiodine administrations for metastatic disease rather than for adjuvant remnant ablation. Fewer side effects have been reported with subcutaneous administration, 500 mg, before radioiodine ingestion
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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