Hypothyroidism and Hydroxycarbomide

[jodary]

Hi has anyone on here who suffers from hypothyroidism and takes thyroxine found that after an increase in Hydroxycarbomide they have needed an adjustment to thyroxine dose ? After my increase in hydroxycarbomide I have found some of my hypothyroid symptoms returning but am told there is no connection.

[hunter5582]

There is this notice from ePocrates.

Additional Considerations levothyroxine monitor thyroid function more frequently when starting, adjusting, or stopping other drugs, incl. short-term therapies, OTC drugs, herbal supplements.

Depending on what symptoms you are experiencing, I would also consider the possibility that the issue is related to hydroxycarbamide adverse effects rather than a thyroid issue.

You know your body best. If there is an issue related to an increase in your dose than it is something that needs to be addressed.

[jodary in reply to hunter5582]

Yes thank you . I have a clinic appointment tomorrow and I will be stating my concerns. I have noticed my red blood count was just below range on previous dose and although I have only increased hydroxycarbomide by another 2 a week I’m wondering if it’s pushed them lower. I’m still confused by them telling me they don’t go by red blood cell count only by haemoglobin, I did ask why test them then and was told it’s part of the full blood count. If I was anaemic it would certainly explain how I currently feel. But confusingly it could also be my thyroid as symptoms are very similar. Thank you for replying, it’s always good when you feel somewhat alone with this .

[hunter5582 in reply to jodary]

The symptoms you describe below are consistent with direct adverse effects from hydroxyurea. Sometimes the simplest explanation is the best explanation per my GP.

One of the potential HU adverse effects is anemia, which has different forms. Hemolytic anemia is a specific concern. Which measures on a CBC that would be used to monitor depends on which form of anemia is a concern. Note that a full assessment for anemia would involve more than a CBC.

I do not recall whether you are consulting with a MPN Specialist. Suggest that your questions are best answered by an MPN-expert doctor. It would likely help for you to get an explanation of how each of the erythrocyte numbers are used to assess your status. They cannot be considered in isolation of each other.

It is very reasonable to want to understand and address the increase in symptoms you are experiencing. It can get confusing when the symptoms of hypothyroidism, anemia, MPNs, and hydroxycarbamide overlap. The fact that the increase in concerns is directly related to a dose increase is certainly suggestive.

Hope you get answers soon.

[jodary in reply to hunter5582]

I’m fully expecting to be told that an increase by 2x 500 a week is not responsible for my symptoms. I will see what happens tomorrow and thank you again

[Scottishterrier in reply to hunter5582]

Hi Hunter I am also on Hu but for the last three years I am getting mixed diagnosis at the start I was diagnosed with hyperthyroidism as weight dropped off me I am on 25mg of thyroxine but now it seems I have hypothyroidism yet still 7 stone five I was told when had hyper it burnt the thyroid out I have had et Jak 2+ since 1994 have had clot different dosage over the years and still on it have never been told hyper and hypothyroidism are connected to et but seems there are a good few of us on here with mpn so does make you wonder if it is connected Stay safe

Scottish terrier

[hunter5582 in reply to Scottishterrier]

While I am not aware of any direct connection between ET or hyper/hypo thyroid disease, the body is an integrated system. There can be connections between the different parts of the body. Sometimes "unrelated" conditions can have impact on each other. I consult with and Integrative medicine specialist specifically for this reason. The main issue I address with this doc is systemic inflammation that is a central theme in a number of the conditions I manage, PV - eczema - osteoarthritis - plantar fascitis - tendonitis - GERD.

Wishing you all the best.

[Mostew]

What symptoms are you experiencing?Also have you had blood test for thyroid recently.?

If you arnt already seeing an MPN consultant ask for a referral. It would be good to discuss your concerns.

I have just increased

Levo but havnt got any particular side effects

. I'm on low dose hydroxicarbamide every other day and take medicinal mushrooms that are supposed to help with chemo drug side effects

[jodary in reply to Mostew]

I am feeling tired, somewhat weak and lethargic. Have had some light headness , a few palpitations and upset stomach. But somewhat vague and some days not too bad. Seem to be ok when I’m in bed . My gp won’t test my thyroid as my tsh was 0.5 last time and as their range goes up to 4.4 it’s got a long way to go before it gets there so as far as they are concerned it’s fine. I’ve always had this problem with them . They won’t test T3 or T4 .

[Mostew in reply to jodary]

I have times when I'm lightheaded especially in shops.

Because gp wouldn't accept results from monitor my Health

I was able to put case forward for them doing one. They eventually agreed .

Odd as , M my health, is NHS lab

I also, last time got Guys to make request to GP FOr full blood test.

It's hard to be sure what is caused by what .

Do hope you feel better soon

[jodary in reply to Mostew]

Thank you , I am just wondering if I could be suffering with anaemia so will see what bloods show tomorrow .

[SoledadBarcelona in reply to jodary]

You must know how your thitoides is. Testing T3Free, T4free, etc and hormones is the most important. The whole panel of thyroides because you must know it to face style of life such us strict diet, proper exercise with a personal training, etc everything.

[Mostew]

Oh you responded to hunter as I was typing my response Let us know how you get on tomorrow.

[jodary in reply to Mostew]

Thank you I will

[ALlady]

Your reported symptoms seem to be the same as mine were when I slipped into anemia a few months back. I am also on HU. My hematologist acted quickly when my counts decreased and I reported the same symptoms you mention. He ran a thyroid profile as well as an iron level analysis. My thyroid readings were all within normal levels, but the iron was not. I was given an iron infusion and HU was incrementally decreased from two x 500mg a day at that time to one 500mg every other day at present. Three months later I feel wonderful, am finally losing some of the pounds caused by the HU, and iron levels and CBC look good. There will be consideration of a further lowering of my dosage.

I have PV and last Nov had a platelet level of 1296 and hematocrit of 56%.

[jodary in reply to ALlady]

I have reported my symptoms today on my clinic telephone call appointment and they were dismissed as apparently my haemoglobin is fine so I can’t be anaemic. I questioned again about my low red blood count and was told they don’t go by that. I am currently on 8 HU a week and platelets won’t budge from mid 700s . So she wants an increase but I am arranging my own thyroid, ferritin, folate B12 and vit d to see if there’s any clue there to why I have these symptoms and will proceed from there as to what I do next. Thank you for your reply am glad you are doing well .

[jodary in reply to ALlady]

I don’t know much about PV but if you are not going to be on HU , how are your platelets going to be controlled ?