Professional advice - thyroxine at altitude

[sazzles206]

Hi, I've moved from London to the middle of the Andes (c2,500m) and feel like my thyroxine isn't quite working. I've been on 200mg/day for around 10 years - is it just general sluggishness being at altitude or does anyone know whether high elevation affects the way thyroxine is absorbed? Thank you for any help!

[galathea]

I found an interesting blog which says that lower oxygen levels ted to make your body produce rt3 thereby rendering you more hypo...... tiredthyroid.com/blog/2011/...

Might be worth following through the link, it sounded plausible.

[Jackie]

Hi How adventurous. Is it possible to somehow have blood tests, I doubt it? I would think you need a little T3 and perhaps less T4. Normally it would depend on your TSH, T4 and Free T3, or have you had a recent test before moving? FT3 must not go over and normally we start on 10 or 20mcg ( split, 12 hours apart) and a retest after 6 months. Tricky treatment without tests as sometimes hypo and hyper have the same symptoms, so beware of that. What about vit D, hormonal? normally that is taken after a blood test and also an important test for corrected calcium ( as must not go over range). I hope you had all these tests before you went or a mine field.

Best wishes,

Jackie

[helvella Administrator]

Here is a document which contains lots of abstracts on the interaction of thyroid and altitude:

dropbox.com/s/fouhvgxf9rwle...

Simply based on a PubMed search.

From these, clearly there are numerous directions in which altitude could affect thyroid factors including dietary intake, hypoxia, blood parameters, cytokines,...

You also did not say if the make of levothyroxine you are taking has changed. That too could make quite a difference.

For anyone with a passing interest but not caring enough to wade their way through the multi-page document, I've posted a couple of interesting ones below:

Wien Med Wochenschr. 2000;150(8-9):178-81.

[Altitude hypoxia: effects on selected endocrinological parameters].

[Article in German]

Dimai HP, Ramschak-Schwarzer S, Leb G.

Source

Klinischen Abteilung für Endokrinologie und Nuklearmedizin, Medizinischen Universitätsklinik Graz. [e-mail]

Abstract

During the past few years, the investigation of altitude hypoxia and its effect on metabolic functions in humans has increasingly attracted the attention of endocrinologists. Most of the studies have been performed as field studies at moderate or high altitude, but with conflicting results. One of the possible reasons certainly is the fact that standardisation of field studies is almost impossible. Furthermore, many factors such as wind, temperature, radiation and others, may affect certain endocrine parameters, but they cannot be individually quantified. Hence, their inclusion into statistical analyses of the obtained data is not useful. Nevertheless, several endocrine parameters were shown to be affected by altitude hypoxia. Among them, there is erythropoietin, a hormone which is well known to stimulate erythropoiesis. This hormone shows a rapid increase after ascent to moderate or high altitude. There is also evidence that urinary and serum noradrenalin levels increase significantly, whereas adrenalin seems to be less affected. Another "stress-hormone", cortisol, also shows a significant increase. Furthermore, the biologically active fraction of the thyroidal hormones thyroxine and triiodothyronine increases significantly. And last but not least, one of the most important proinflammatory cytokines, interleukin-6, shows a manyfold increase compared to the basal level. However, the clinical significance of most of these studies is not yet clear. Hence, from an endocrinological point of view, no specific recommendations may be given to people staying at moderate or high altitude.

PMID: 10960959 [PubMed - indexed for MEDLINE]

AND

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2004 Dec;22(6):410-2.

[Influence of oral sodium selenite and vitamin E on thyroid hormones in patients with cardiovascular disease at altitude].

[Article in Chinese]

Jin M.

Source

First People's Hospital of Lanzhou, Gansu Province 730050, China. [e-mail]

Abstract

OBJECTIVE:

To investigate the effect of oral sodium selenite and vitamin E on thyroid hormones in patients with cardiovascular disease at altitude.

METHODS:

Ninety patients with cardiovascular disease were divided into A group (n = 42, sodium selenite + VE), B group (n = 28, sodium selenite only) and control group (n = 20). Serum selenium (Se), plasma glutathione peroxidase (GSH-Px), plasma malondialdehyde (MDA) and serum T(3) and T(4) were determined before and after 6 month treatment.

RESULTS:

Serum Se in A and B group after 6 month treatment were higher than before [(0.71 +/- 0.22) micromol/L vs (0.31 +/- 0.17) micromol/L, (0.68 +/- 0.18) micromol/L vs (0.33 +/- 0.14) micromol/L respectively, P < 0.01], and so were plasma GSH-Px levels [(87.12 +/- 13.61) U/L vs (58.43 +/- 18.93) U/L, (84.79 +/- 12.13) U/L vs (57.12 +/- 17.36) U/L respectively] while plasma MDA were lower than before [(4.86 +/- 1.18) nmol/ml vs (8.66 +/- 0.96) nmol/ml, (4.18 +/- 1.23) nmol/ml vs (8.71 +/- 0.87) nmol/ml respectively, P < 0.01]. Serum T(3) and T(4) levels in A and B group were also obviously decreased (P < 0.01). The levels of plasma GSH-Px were positively correlated with those of serum Se (r = 0.781, P < 0.01). The levels of plasma MDA and serum T(3) and T(4) were negatively correlated with those of serum Se (r = -0.385, -0.687, -0.412 respectively, P < 0.05). 31 cases (73.81%) in A group and 20 cases (71.42%) in B group completely recovered to normal; 4 cases (9.52%) in A group and 2 cases (7.43%) in B group partly recovered. The recovered rates were significantly different from that of control (P < 0.05).

CONCLUSION:

Supplementation of adequate selenium may correct the abnormal function of secretion in thyroid hormones of patients because of lack of selenium at altitude areas.

PMID: 15748470 [PubMed - indexed for MEDLINE]

Rod

[ Link fixed 17/07/2019 ]

[sazzles206]

Wow, thank you all so much! I'll have a look through all the info but Rod, it may be as simple as getting some selenium in my diet - regrettably no brazil nuts here (ironically, in south america!) but I'll give that a go and get some more tests done. Thank you very much, what a helpful community! x