Thyroid Hormone Replacement (Levothyroxine)

Levothyroxine is a synthetic form of thyroxine (T4), the same hormone your thyroid naturally makes. Once absorbed, your body converts it to the active hormone it needs to regulate metabolism, body temperature, heart rate, and energy.

Dr. Golian starts you on a dose tailored to your weight, age, heart health, and lab results, then fine-tunes it over time. Because hormone levels shift slowly, it often takes several weeks to feel the full effect, and your dose is adjusted based on follow-up TSH testing rather than guesswork.

Before starting, Dr. Golian reviews your symptoms, medical history, and a baseline thyroid panel, often coordinated alongside a comprehensive physical exam. She will also complete a medication reconciliation, since certain supplements like calcium and iron can interfere with absorption.

Levothyroxine works best taken on an empty stomach, typically first thing in the morning with water, at least 30 to 60 minutes before food or coffee. Let Dr. Golian know if you are pregnant, planning pregnancy, or have a history of heart disease, as these affect how your dose is set.

After you begin or change a dose, Dr. Golian rechecks your thyroid levels in about six to eight weeks to confirm you are in the optimal range. Once stable, monitoring usually continues once or twice a year, or sooner if your symptoms change.

Take your medication consistently at the same time each day and refill it from the same manufacturer when possible. If symptoms such as fatigue, weight change, palpitations, or anxiety appear, reach out so your dose can be reassessed, and when your thyroid condition involves nodules or other complexity, Dr. Golian can arrange endocrinology support through Cedars-Sinai coordination here in Los Angeles.