Thyroid UK
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Levothyroxine and Adrenal insuffieciency

I would appreciate any assistance to understand the below statement. Does it mean if you have Adrenal insuffiency, you should not be treated with levothyroxine. What if you have to take levothyroxine because you have had a thyroidectomy 17 years ago and you can't live without a medicine?

Levothyroxine is contraindicated in patients with uncorrected adrenal insufficiency since thyroid hormones may precipitate an acute adrenal crisis by increasing the metabolic clearance of glucocorticoids [a too-rapid withdrawal of cortisol]. Patients known to suffer from adrenal insufficiency should therefore be treated with replacement glucocorticoids before starting any Levothyroxine sodium treatment. Failure to do so may precipitate an acute adrenal crisis when thyroid hormone therapy is initiated.



4 Replies


No, it says the adrenal insufficiency should be treated with glucocorticoids before Levothyroxine is prescribed.


This exact question was dealt with a few days ago: if I remember correctly they are referring to extremely low cortisol levels that need specific tests to diagnose. Most of us don't fall into that category even when tested. And as you say we will be worse without the drug. If you search you should find previous replies.


thank you cwill. what if you have high cortisol and not low cortisol does it still mean that the levothyroxine would not be able to work properly?


Not sure about that.


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