Q: I’m a 48-year-old woman. I found out four years ago that I have thyroid disease. I’ve been taking Synthroid, but recently my husband lost his job, and with it our health insurance. I’ve been off the medication now for a month. What will happen if I’m unable to take Synthroid because I cannot afford it anymore? Is there a substitute that I can take until my husband finds a job?
A: Unfortunately, many people find themselves in situations similar to yours — no health insurance and not knowing what to do about medications they’ve been taking regularly.
I assume that you were taking Synthroid (levo-thyroxine) because you have an underactive thyroid. Doctors call this hypothyroidism. It’s a common condition, especially in women.
Doctors use a blood test called thyroid stimulating hormone (TSH) to determine the correct levo-thyroxine dose. Once the right dose is found, the test only needs to be done yearly.
For anyone who has stopped taking levo-thyroxine or other thyroid medication for a month or more, I usually restart the person on a slightly lower dose than what she was previously taking. I would then have her take a blood test to measure TSH in six to eight weeks.
Perhaps your previous doctor will be comfortable renewing your prescription for thyroid medication if you have had a TSH done within the past year. If it has been more than one year, your doctor may be willing to prescribe the medication, perhaps at a lower dose, if you promise to do a blood test in two months.
Synthroid is the trade name for l-thyroxine. The good news is that there are some excellent generic versions of this drug and the cost is quite reasonable.
Without thyroid replacement, you will likely have less energy. Other symptoms of untreated hypothyroidism include fatigue, muscle aches, slight weight gain, constipation, dry skin, and intolerance to colder temperatures.
There aren’t any over-the- counter remedies, foods, herbs or legal supplements that can substitute for prescription thyroid medication. In fact, taking high doses of iodine can actually block the release of any thyroid hormone your gland is still making on its own.
But for some conditions, certain over-the-counter medications can work as well as prescription drugs. This is especially true for antihistamines and medications that inhibit the production of stomach acid.
Anyone who is having trouble paying for medications or getting new prescriptions should talk to the pharmacist. She may be able to suggest alternative generics that could be just as effective.
Even though a person may not have insurance, the previous doctor is often willing to write prescriptions for a few months until the person has made new arrangements for health care.
Dr. Howard LeWine, is a clinical instructor of medicine at Harvard Medical School and practicing internist with Harvard Vanguard Medical Associates and Brigham and Women’s Hospital in Boston. He serves as chief medical editor of Internet publishing at Harvard Health Publications. Additional consumer health information at .
