Hydroxyurea and Levothyroxine

[mumblipeg]

I'm new to taking Hydroxyurea. Diagnosed with MPN a couple weeks ago. My dilemma is that I have had a complete thyroidectomy and need Levothyroxine daily. Will Hydroxyurea interfere with how much Levothyroxine I need for total replacement? Also what test do I need to check my Levothyroxine level? T3 Free seems to be the only accurate test and I'm having a time getting that ordered. All of the TSH and T4 tests are so off when I don't have a Thyroid gland. Anybody dealing with this?

[Scottishterrier]

Hi I have et jak2+ since 1994 but in 1999 was put on Hu for a clot on the liver but three years ago I was diagnosed with hyperthyroidism and I was was put on thyroxine 25 mg at first taking it noticed and upset stomach but didn't last long I however see my consultant tomorrow and ask the question is there a link between mpn illness and either hypo thyrodism or hyper thyroid ism because I have noticed the increase in the amount of people who are suffering one or another off the illness recently seems strange but I do take both first thing in the morning

Stay safe

Scottish terrier

[hunter5582]

The best answer to your question would need to come from your endocrinalogist and hematologist. CHecking the combination of levothyroxine and hydroxyurea on ePocrates does not show any interactions but does show this advisement.

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

It seems your notion that you need to be checking your thyroid function levels is on target. If you are initiating HU then you definitely need to be monitored more closely until it is clear that your thyroid levels are stable. Your endocrinologist should automatically order the proper tests if aware of the addition of HU to your treatment plan. Suggest pushing that office to follow up appropriately.

[mumblipeg in reply to hunter5582]

Thank you! I'm pushing for follow-up.

[Mtnlife]

I recommend checking with your doctors. I have been on both for two years now with no ill effects whatsoever.

[Norma1831]

Writing to reassure you, based on my experience, a positive outcome is more than possible I also take Hydroxyurea and Levothyroxine daily. Already prescribed Hydroxyurea when the requirement for Levothyroxine was identified by my GP from routine blood tests.

Followed Hunter’s helpful advice to see an endocrinalogist which made all the difference. Notice Hunter has already replied to you, and based on my experience recommend you actively consider his response.

The endocrinologist worked with my GP to fine tune daily dose over time to eventually resolve the intense fatigue initially experienced on Levothyroxine. At the time it felt like a roller coaster with periods of unpredictable intense fatigue interspersed with normal periods. My hematologist was also involved.

Still experience some fatigue, which is manageable, notice this is a common symptom with ET and discussed many times in this forum-have no concern on this point. The overall outcome has been very positive. Hope this is helpful.

Do hope you stay in touch to share your experience.

[Mieshie]

My husband was diagnosed with Thyroid cancer in 2016. It was removed and he has since been on daily levothyroxine, currently 125 mg taken very early AM. He gets two hormone tests. T4 Free has been less rogue than TSH results but dose change has brought both values to normal. It takes several weeks to see change but adjusting the dose multiple times has worked. The last endocrine doctor visit resulted in change to 6 days of whole pill and 1 day of 1/2 pill, taking the 1/2 pill on the same day each week. He also goes twice a year for thyroid testing unless he feels something is not right. So, it's more like 3 times a year because 'not right' has occurred and the dose is always adjusted whether by small or large amount. He doesn't have an MPN. He's 75 years.

In contrast, I have hypothyroidism and then ET which was diagnosed a year later. I have always suspected a relationship but cannot prove it. HU did not work for me and had to change ET treatment. I have been on weekly peginterferon for 2 years. I take 25 mg levothyroxine daily, very early AM at least 2 hours before food or other meds, in particular high blood pressure drug conflict. I have at least 6 hours before taking weekly peginterferon. I have steady state thyroid hormones and my ET is fairly stable, as well. I am 74 years.

We are both pleased to have fully engaged endocrine doctors and support staff. My husband needs extra attention and feels he is getting it--comfortable with his doctor and treatment. I wish the same situation for you.

[mumblipeg]

Thanks all! I'm hopeful that this will get resolved--Have been on Levo for 35 years and Hydroxy for two weeks! They don't like each other!