Levothyroxine is the usual go-to medication for hypothyroidism symptoms. If symptoms persist or you can’t take it, doctors may prescribe liothyronine (Cytomel) or a combination pill, like Armour Thyroid.

Not every person with hypothyroidism needs medication. Treatment options depend on how low your thyroid hormone levels are and whether you have severe symptoms.

Doctors may recommend medication soon after diagnosis to prevent complications, but in some cases, they will do so only if lab results show disease progression or if symptoms change.

Read on to learn about the different types of medication for hypothyroidism, how they work, their possible side effects, and questions to ask a doctor.

Levothyroxine is a synthetic form of thyroxine (T4), a hormone made by your thyroid gland. It’s the most used medication for hypothyroidism and the most commonly prescribed treatment in general.

Levothyroxine helps replace your thyroid hormone levels so they improve to a healthy range. Most people take it once daily on an empty stomach, about 30 to 60 minutes before breakfast.

Common brand names for levothyroxine include:

Research from 2024 shows that levothyroxine remains the most widely used and effective treatment for balancing thyroid hormone levels in people with hypothyroidism.

However, if symptoms don’t improve with levothyroxine, even when your thyroid-stimulating hormone (TSH) levels are normal, a doctor may suggest other options, such as:

  • Liothyronine (Cytomel): This is a synthetic form of the T3 hormone (triiodothyronine). Because T3 works faster than levothyroxine, it may lead to more fluctuations in hormone levels.
  • Desiccated thyroid extract (Armour Thyroid): This extract comes from pig thyroid and contains both T3 and T4. While there’s anecdotal evidence that some people feel better on it, it’s not FDA-approved, so its safety and effectiveness aren’t regulated.

The American Thyroid Association notes that some doctors may prescribe levothyroxine and Cytomel as separate pills, taken at different times of the day. A 3- to 6-month trial may help determine whether this approach works for your case.

Before trying a new medication for hypothyroidism, consider talking with the healthcare professional about the potential risks and benefits based on your symptoms and lab results.

When taken at the right dose, hypothyroidism medications rarely cause side effects. But too much can lead to symptoms of hyperthyroidism, such as:

Adjusting your dose can often help manage these effects. Regular blood tests help the prescribing doctor ensure that you are getting the amount of medication you need.

Thyroid hormone medications need to be taken at very specific doses to work safely and effectively. Even small changes in the amount you take can affect how much hormone is produced and released into your body. That’s why a doctor will check blood levels regularly to make sure the dose is just right.

Some people may have sensitivities to fillers or dyes in certain medication brands. If you notice new or odd symptoms after switching brands or formulations, talk with a doctor. They may want to adjust your dosage or change the medication.

In most cases, yes. Hypothyroidism is a lifelong condition. If your thyroid no longer produces enough hormones, as with severe Hashimoto’s disease, ongoing treatment helps prevent symptoms and long-term complications, such as high cholesterol or heart problems.

However, there are exceptions. If hypothyroidism symptoms are temporary, for example, during or after pregnancy (postpartum thyroiditis), your thyroid gland may recover, and long-term treatment may not be necessary.

In such cases, a doctor may recommend monitoring your TSH and other hormone levels over time before deciding whether to continue or stop medication.

Knowing what to ask can help you feel more confident about your treatment options.During or after diagnosis, you may want to ask the doctor:

  • What medication are you prescribing, and why?
  • How soon should I expect to feel better?
  • When should I take my medication each day?
  • Should I take it with or without food?
  • Are there foods, supplements, or medications I should avoid?
  • What happens if I miss a dose?
  • How often will I need blood tests to check my thyroid levels?
  • Will I need to increase or decrease my dose over time?
  • Can I switch brands or formulations if I have side effects?
  • Is it OK to take this medication during pregnancy?
  • Will I need to take this medication for life?

Also, let the doctor know if you take calcium, iron, antacids, or cholesterol medications, as these can affect how well your thyroid medication works.

Levothyroxine is the primary medication for hypothyroidism. It replaces low levels of thyroid hormone and is usually taken once a day on an empty stomach.

Some people may need other medications, such as liothyronine (Cytomel), a combination of T3 and T4, or desiccated thyroid, especially if symptoms persist.

You may need to take thyroid medication for life, but not always. A doctor will guide you best depending on what’s causing your condition.