Levothyroxine Online Prescription

Levothyroxine - An Overview

Levothyroxine sodium (T4) is a medication sometimes prescribed to people for hypothyroidism and conditions causing pituitary thyrotropin suppression. Through Push Health, people in need of a levothyroxine prescription can connect with a licensed medical provider in their area online and get a levothyroxine prescription when appropriate to do so.

What Is Levothyroxine Used For?

What is levothyroxine? Levothyroxine, marketed under the brand names Euthyrox, Levoxyl, Synthroid, Tirosint, Unithroid, and others, is a medication that contains levothyroxine (T4) sodium. Synthetic T4 in levothyroxine is based on T4 produced by the thyroid gland. Oral levothyroxine sodium has the same physiological effect as endogenous T4 and helps maintain normal T4 levels in the setting of a T4 deficiency. As much as 80% of the T4 ingested orally is absorbed by the GI tract. Most T4 is bound by plasma proteins and, is this state, is not considered metabolically active. Much of the T4 in the body is broken down by the liver. T4 is eliminated through the urine and the stool. The adequacy of therapy with levothyroxine should be assessed through periodic monitoring of T4 and TSH test levels in addition to clinical status. Levothyroxine and a similar medication, liothyronine, differ in that levothyroxine is T4 while its counterpart is T3 thyroid hormone. Both hormones are found in Armour Thyroid medication.

What Is Hypothyroidism?

Hypothyroidism - also called underactive thyroid - is a condition in which the thyroid gland does not produce enough thyroid hormone to meet the body's needs. Thyroid hormone (primarily T4/thyroxine) helps regulate metabolism, energy production, heart rate, body temperature, and many other physiological processes. When thyroid hormone levels are insufficient, nearly every system in the body can be affected.

Common symptoms of hypothyroidism include:

• Persistent fatigue and low energy
• Unexplained weight gain
• Cold intolerance
• Constipation
• Dry skin
• Hair loss
• Mood changes
• Brain fog
• Slowed heart rate
• Muscle weakness
• Puffy face, especially around the eyes

Hypothyroidism is diagnosed with a blood test measuring TSH (thyroid-stimulating hormone). A TSH above the normal reference range suggests that the thyroid is underactive. Levothyroxine is a standard treatment as it replaces the T4 that the thyroid gland is not producing in adequate amounts. Hypothyroidism is one of the most common chronic conditions in the United States. It is significantly more common in women and becomes more prevalent with age.

Levothyroxine - Dosage and Cost

Levothyroxine is available as tablets for oral administration in doses ranging from 25 mcg to 300 mcg. Levothyroxine tablets also contain inactive ingredients such as acacia, confectioner's sugar and magnesium stearate. Levothyroxine should be stored at 25° C and be protected from light and moisture. The actual levothyroxine dose depends on a variety of factors such as age, weight, other medical conditions and other medications being used but the ultimate regimen depends on the judgement of the prescribing medical provider. Levothyroxine can take up to six weeks before reaching the peak therapeutic effect. Routine assessment of thyroid lab testing is necessary for levothyroxine dosing. Generic levothyroxine tablets are affordable. At many pharmacies, levothyroxine 25 mcg tablets cost approximately 15 cents per tablet. Levothyroxine coupons may be available from the manufacturer or other sources.

Can I Buy Levothyroxine Online?

Levothyroxine requires a prescription from a licensed medical provider to be dispensed in the United States. As a result, one cannot just buy levothyroxine online and levothyroxine OTC is not available from pharmacies. The first step to getting a levothyroxine sodium prescription is a consultation with a medical provider. Push Health connects people who are in need of a levothyroxine prescription with licensed medical providers who can prescribe levothyroxine medication tablets when appropriate to do so.

Levothyroxine vs. Synthroid - Brand vs. Generic

Euthyrox, Levoxyl, Synthroid and Tirosint are all branded formulations of levothyroxine sodium. Generic levothyroxine and all branded versions contain the same active ingredient - synthetic T4 - at the same listed dose. They are considered bioequivalent by the FDA.

The most important clinical point is consistency as switching between different brands or between brand and generic can cause small but clinically meaningful fluctuations in T4 and TSH levels for some patients. For most patients with hypothyroidism, generic levothyroxine is appropriate and significantly more affordable (~15 cents / tablet vs. $1-3 / tablet for branded products). Patients who are stable on a specific brand may prefer to remain on it. A prescribing provider can advise on whether brand or generic is most appropriate for a specific patient's situation.

When and How to Take Levothyroxine

Levothyroxine is typically taken once daily in the morning on an empty stomach, 30 to 60 minutes before eating breakfast. This timing ensures maximum absorption as levothyroxine absorption can be significantly reduced by food, particularly high-fiber foods, calcium-rich foods, and soy products.

Can I take levothyroxine with coffee? Coffee can reduce levothyroxine absorption by as much as 25-35% when consumed with the medication. Patients who take levothyroxine in the morning should wait at least 30 minutes before drinking coffee.

Can I take levothyroxine at bedtime instead? Yes. Several studies have demonstrated that taking levothyroxine at bedtime (at least 3-4 hours after the last meal) is as effective as morning dosing and may improve absorption in some patients. This approach works well for patients who find it difficult to wait before eating or drinking coffee in the morning. Patients should discuss bedtime dosing with their provider.

Take levothyroxine consistently. Regardless of whether levothyroxine is taken in the morning or at bedtime, consistency matters. Taking it at the same time each day with the same routine reduces variability in absorption and makes TSH monitoring more accurate.

Levothyroxine - Food and Drug Interactions

Levothyroxine has a narrow therapeutic window and is unusually sensitive to interactions with foods and medications that affect its absorption. Patients should be aware of the following:

Foods and supplements that reduce absorption (take at least 4 hours apart from levothyroxine):

• Calcium supplements and calcium-fortified foods (milk, cheese, fortified juice)
• Iron supplements
• Soy products and high-soy diets
• High-fiber foods in large quantities
• Walnuts
• Coffee (wait at least 30 minutes)

Medications that reduce levothyroxine absorption (take at least 4 hours apart):

• Antacids containing calcium, magnesium, or aluminum (Tums, Maalox, Mylanta)
• Proton pump inhibitors (omeprazole, lansoprazole)
• Cholestyramine and colestipol (bile acid sequestrants)
• Sucralfate (Carafate)
• Ferrous sulfate (iron tablets)
• Calcium carbonate supplements

Medications that may require dose adjustment:

• Rifampin and certain other antibiotics
• Phenytoin and carbamazepine (seizure medications)
• Certain HIV antiretrovirals
• Estrogen-containing medications (oral contraceptives, hormone therapy)

Patients should inform their prescribing provider and pharmacist of all supplements, vitamins, and medications before starting levothyroxine. TSH monitoring helps detect when absorption changes have affected dosing adequacy.

Levothyroxine - Side Effects

When taken at the correct dose for an individual patient, levothyroxine is generally well tolerated and causes minimal side effects. The goal of levothyroxine therapy is to restore normal thyroid hormone levels. In most patients, correct dosing results in symptom relief rather than side effects. Excessive levothyroxine use can cause symptoms consistent with hyperthyroidism (overactive thyroid), including palpitations, increased heart rate, heat intolerance, increased sweating, anxiety, tremor, weight loss, and insomnia. Signs of insufficient levothyroxine can cause symptoms consistent with hypothyroidism, including fatigue, weight gain, cold intolerance, and brain fog.

Patients with a known allergy to levothyroxine or any inactive ingredient in the tablet formulation should not use levothyroxine. Gelcap formulations such as Tirosint contain fewer inactive ingredients and may be appropriate for patients with sensitivities to tablet excipients. Levothyroxine is not recommended during the recovery phase of subacute thyroiditis or for the suppression of benign thyroid nodules in iodine-sufficient patients. Chronic heavy alcohol use can affect thyroid function and TSH levels and patients interested in alcohol consumption while using levothyroxine should discuss possible issues with their medical provider.

How to Get a Levothyroxine Prescription with Push Health

1. Complete a brief health intake. Answer a few questions about your symptoms, any recent TSH test results, current thyroid medications, and relevant medical history - including any history of thyroid disease, thyroid cancer, or thyroid surgery.
2. Connect with a licensed medical provider. A provider will review your information and evaluate whether levothyroxine is appropriate for your situation - including your current TSH level, symptoms, and medical history. Same-day consultations are available.
3. Receive your prescription electronically. If levothyroxine is appropriate, your provider will send a prescription to a pharmacy of your choice - no office visit required.
4. Pick up your medication and schedule follow-up testing. Generic levothyroxine is available at most retail pharmacies, typically under $10 for a 30-day supply. A follow-up TSH test approximately 6-8 weeks after starting or changing your dose is important to confirm the dose is appropriate.

No health insurance or subscription is required. Medical providers are available now.

More Levothyroxine Information

• Levothyroxine - Medline