Recently, some family doctors call to ask about the treatment of hypothyroidism. What can be done to make up for it? In addition to increasing the dose of thyroxine, factors affecting the absorption of thyroxine should also be considered.

Lifestyle change and nutritional supplements are mostly ineffective, while thyroxine does not "creep in" until three to six weeks later, so it's a long wait for doctors, patients and families.

In addition to prescribing drug and waiting, what else can we do? Since no quick fix is available, check for any obstacle before TSH concentrations return to normal.

• Drugs: Any medications that can affect the absorption of thyroid hormones should be avoided as much as possible. This includes gastrointestinal medications, antacids (such as Sucralfate), calcium supplements, and iron supplements. Calcium and iron supplements should be taken at prolonged intervals. Thyroxine should be taken on an empty stomach, and it is not suitable to take antacids or gastrointestinal medicines at the same time. There are also antiepileptic drugs being used (phenytoin, carbamazepine, phenobarbital), which are likely to interfere with the uptake of thyroxine, which should be discussed with neurologists or psychiatrists.
• Special factors: Medication discontinuation, wrong dosage of medication, wrong time of taking medication, improper drinks (such as milk) or diets combined with other supplements.
• Diseases: Autoimmune thyroiditis (where thyroid hormone levels decrease over time) and other conditions that can cause sick euthyroid syndrome may result in low thyroid hormone levels on thyroid tests. It's important to note that in sick euthyroid syndrome, there is typically no need for thyroid hormone supplementation. Instead, the focus should be on treating the underlying condition that is causing this syndrome.

After eliminating the above factors and giving a correct dose, patience should be required.