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All the patients received only LT 4 treatment, and none of them had a history of therapy with triiodothyronine (T 3 ) or combination therapy with LT 4 and T3

Some people feel better after a few weeks, while others, especially those with worse symptoms or higher doses, may need more time to fully recover

Note that paroxetine and fluoxetine should be avoided in women taking tamoxifen due to drug interactions Gabapentin : an anticonvulsant that may reduce vasomotor symptoms, particularly helpful for women with night sweats, though side effects include dizziness and fatigue Clonidine : an antihypertensive agent with modest efficacy for hot flashes, considered only when other options are unsuitable due to its side effect profile Cognitive behavioural therapy (CBT) : NICE-recommended psychological intervention that helps women manage the impact of symptoms Lifestyle modifications form an important foundation: Maintaining a healthy weight through balanced diet and regular physical activity Wearing layered clothing and keeping ambient temperature cool Avoiding known triggers (alcohol, caffeine, spicy foods) Practising stress-reduction techniques Ensuring good sleep hygiene When to contact your GP : Women should seek medical advice if hot flashes significantly impact quality of life, interfere with sleep or daily activities, or if symptoms occur alongside unexplained weight loss, night sweats with fever, or other concerning features