Thyroid and Endocrine Medicines

Name: Thyroid and Endocrine Medicines
Creator: Dr Zamiel Hussain

Thyroid and endocrine medicines are used to manage hormone-related conditions that affect metabolism, energy levels, weight, mood, temperature regulation, and many other body systems.

Some endocrine treatments replace hormones the body is not producing enough of. Others reduce hormone production or control hormone-related symptoms. Treatment decisions are individualised and usually depend on symptoms, blood test results, age, pregnancy plans, and co-existing medical conditions.

This page explains the main types of thyroid and endocrine medicines used in primary care, what they are used for, and what monitoring is usually required.

These articles are intended as educational sources, not diagnostic nor taking place of a proper medical assessment. If you need help, please book an appointment with one of our GP’s.

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Why endocrine treatment matters

Hormones act as chemical messengers. When hormone levels are too low or too high, symptoms can be wide-ranging and sometimes subtle.

Endocrine treatment often aims to:

restore hormone balance
relieve symptoms
reduce longer-term complications
support fertility, pregnancy, and bone health where relevant

In primary care, thyroid conditions are among the most common endocrine problems managed and monitored.

Learn more:

Diabetes and Endocrine Health
Hormone Health

Main Types of Thyroid and Endocrine Medicines

Thyroid hormone replacement (hypothyroidism)

Thyroid hormone replacement is used when the thyroid is underactive (hypothyroidism). Treatment replaces thyroid hormone to help normalise metabolism and relieve symptoms such as tiredness, weight gain, constipation, cold intolerance, and brain fog.

The most common replacement medicine is levothyroxine.

Monitoring and review typically include:

thyroid function blood tests (usually TSH, and sometimes free T4)
symptom review
medication timing and adherence checks

Thyroid hormone replacement is usually long term, but doses may change over time.

How to take levothyroxine correctly

Take on an empty stomach Levothyroxine is best taken first thing in the morning with water, at least 30 minutes before food.

Avoid taking with certain supplements Iron and calcium supplements can reduce absorption. Leave at least 4 hours between levothyroxine and these products.

Take at the same time each day Consistency helps maintain stable thyroid hormone levels and improves accuracy of blood tests.

Do not adjust dose without advice Dose changes should be guided by symptoms and blood tests. Contact a GP if you feel over- or under-treated.

Thyroid medicines that reduce an overactive thyroid (hyperthyroidism)

Some medicines reduce thyroid hormone production when the thyroid is overactive (hyperthyroidism).

Common examples include carbimazole and propylthiouracil.

These medicines may be used:

to control symptoms while the condition settles
before definitive treatment
as longer-term treatment in selected cases

Because they can rarely affect blood counts or liver function, monitoring and safety advice are important and treatment is often guided alongside specialist services.

Beta blockers for thyroid symptoms

Beta blockers can be used to help control symptoms of an overactive thyroid, such as palpitations, tremor, and anxiety, while other treatments take effect.

A common example is propranolol, though suitability varies.

These medicines treat symptoms but do not correct the underlying thyroid hormone imbalance.

Steroid replacement for adrenal insufficiency

Some people require steroid replacement therapy when the adrenal glands do not produce enough cortisol. This is specialist-led and requires an individualised plan, including stress dosing during illness.

Primary care may support ongoing prescribing and monitoring, but specialist guidance is central.

You can read more in: Steroids explained

Hormone treatments affecting reproductive and menstrual health

Endocrine prescribing can also include hormone-based treatments used for:

menstrual symptoms
contraception
perimenopause or menopause symptoms
certain gynaecological conditions

These treatments are typically covered in dedicated Women’s Health content, but may also be reviewed as part of primary care endocrine management.

Bone and calcium-related endocrine medicines

Some endocrine conditions affect bone health or calcium balance. Treatment may involve:

vitamin D or calcium supplementation
medicines used to reduce fracture risk, often involving a DEXA scan
specialist-led therapies for parathyroid disorders

Management depends on blood test results and overall risk assessment.

Monitoring and Long-Term Review

Thyroid and endocrine medicines commonly require monitoring, which may include:

thyroid function tests
symptom review
medication adherence and timing
periodic blood tests depending on the condition and medication

Small changes in dose can make a noticeable difference to symptoms, so structured review is important.

You can read more in:

Common Side Effects and Safety

Most endocrine medicines are well tolerated when monitored properly. Potential issues may include:

symptoms of over- or under-treatment (for thyroid hormone replacement)
side effects from anti-thyroid medicines
interactions with other medications
the need for careful adjustment during pregnancy or illness

Safety depends on correct diagnosis, appropriate monitoring, and clear follow-up.

Thyroid and Endocrine Medicines in Remote GP Care

Many thyroid and endocrine medication reviews can be done remotely, particularly when blood test results are available and symptoms can be discussed clearly.

If symptoms are severe, rapidly changing, or suggest complications, in-person assessment or specialist review may be needed.

Frequently Asked Questions

1. How long does levothyroxine take to work?

Some people notice improvement within a few weeks, but thyroid hormone levels and symptoms can take longer to stabilise. Blood tests are usually used to guide dose adjustments.

2. Can I take levothyroxine with other medicines or supplements?

Some supplements and medicines can affect levothyroxine absorption, particularly iron and calcium. A GP or pharmacist can advise on spacing doses to reduce interactions.

3. What symptoms suggest my thyroid dose may need review?

Symptoms of under-treatment may include tiredness, weight gain, constipation, and cold intolerance. Symptoms of over-treatment may include palpitations, anxiety, tremor, heat intolerance, or unintentional weight loss. A GP can assess symptoms and arrange blood tests where appropriate.