Taking your medicine

• Take your medicine exactly as directed.

• Take your medicine at the same time every day. Keep your pills in a container that is labeled with the days of the week. This will help you know if you’ve taken your medicine each day.

• Try to take your medicine with the same food or drink each day. This will help you control the amount of thyroid hormone in your body. You may need to take some medicines, such as thyroid pills, without food.

• Don’t stop taking medicine. If you do, your symptoms will return. Make changes to your medicine routine only as your health care provider instructs.

• Stay away from over-the-counter medicines, such as decongestants, that contain pseudoephedrine or ephedrine during treatment.

• Check with your provider if you should stop taking iodine supplements, or any medicines containing iodine, such as expectorants.

• Avoid all herbal supplements. It's hard to find out how much iodine they contain.

• Tell your provider if you're pregnant or planning to get pregnant.

• Keep a card in your wallet that says you have Graves' disease. Make sure it has:

  • Your name and address.

  • Contact information for your provider.

  • Names and doses of your medicines.

Keeping track of symptoms

During your routine visits, tell your provider if you have any symptoms of too little thyroid hormone (hypothyroidism). This can be a side effect of treatment. Also tell your provider if you have symptoms of too much thyroid hormone.

Symptoms of too little thyroid hormone include:

• Tiredness or low energy, and slow speech and movements.

• Puffy hands, face, or feet.

• Weight gain.

• Hoarseness.

• Muscle pain.

• Slow heartbeat (less than 60 beats per minute).

• Feeling cold when others feel comfortable (cold intolerance).

• Heavier menstrual periods.

• Coarse and brittle hair and hair loss.

• Decreased sweating and dry skin.

• Constipation.

• Trouble sleeping.

• Depression and anxiety.

Symptoms of too much thyroid hormone include:

• Restlessness and shaking.

• Shaking.

• Rapid weight loss.

• Sweating.

• Fast heartbeat (more than 100 beats per minute) or palpitations,

• Feeling hot when others feel comfortable (heat intolerance).

• Insomnia or sleeplessness, altered sleep pattern.

• Anxiety and nervousness.

• Frequent urination or bowel movements.

• Irregular and inconsistent menstrual blood flow or not having periods.

• Eye symptoms, including swollen lids, pain, redness, and double vision.

Watching your diet

Your thyroid uses iodine to make thyroid hormones. Therefore, you may be sensitive to having too much iodine in your diet. Work with a registered dietitian nutritionist to help you create a meal plan. Also:

• Stay away from food items that are rich in iodine, such as seafood, including fish, sushi, shellfish, kelp, or seaweed.

• Stay away from food items that are fortified with iodine, such as iodized salt or products that have iodized salt as an ingredient.

• Use noniodized salt and oil, unsalted nuts, homemade bread, and bakery products.

Caring for your eyes

• If you have eyelid swelling, sleep with your head raised (elevated).

• If you have eye irritation, ask your provider about ointments or artificial tears. Use eye medicines as directed. Contact your provider again if the eye irritation doesn't improve or it gets worse.

• Wear glasses and sunglasses with side guards to protect your eyes from dust and wind.

• If you have trouble closing swollen eyelids, you may need to tape them shut at night.

Follow-up care

Follow up with your provider, or as directed. Make and keep appointments to see your provider and have regular blood tests. You will need to have blood tests for the rest of your life to check your hormone levels.

When to contact your doctor

Contact your provider right away if:

• You have anxiety, shakiness, or sleeplessness that gets worse.

• You have a sore throat while taking medicines.

• You have a fever of 100.4°F ( 38°C) or higher, or as advised by your provider

• You feel sweaty and hot when others around you are comfortable.

• You are short of breath.

• You have trouble focusing your eyes, or double vision.

• You have bulging eyes or vision changes.

• You lose weight for no obvious reason.

• You have a fast heartbeat (more than 100 beats per minute) or an irregular heartbeat.

• You have an enlarged thyroid gland (goiter) that gets larger.

• You have diarrhea.