can propranolol interfere in levothyroxine drug therapy for hypothyrodism?

hi all 2 days back i had thyroid function test done as i was complaining of brain fog, brittle hair, lack of concentration etc and my result came as

TSH 10.5 (0.3-4.5)

FT4 17.5 (12-22)

FT3 4.5 (3.9-6.9)

doc prescribed levothroxine 50mg and calcium and vitamin D supplement. i have some doubts, will this drugs reverse my symptoms like hair loss and memory fog? he asked me to take this tablet on an empty stomach before breakfast but i have a habit of drinking 4-5 glasses of water right after i get up from bed so now i take this medicine after that, does this minimize the benefit of levothyroxine tablet? iam also taking propranolol for migraine but i forgot to tell that to my doc, does this have any impact on my thyroid function test? please someone give me an advice on this.

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  • Hi shajumet, yes beta blockers reduce thyroid function. With a TSH as high as yours you need to find another treatment for your migraines. I had wall to wall migraines when my thyroxine was very low. That is something that has improved on treatment.

    Your doctor needs to aim for a TSH of 1 usually to feel well. I'm afraid there's no instant fix, it can take months or years to regain your health. Make sure your GP doesn't keep you on a starting dose of levo too long. Every 2 weeks to a month you need to raise your meds by 25mcg at a time.

    Have you had your iron checked? Anaemia of any kind can also cause hair loss. Your B12 Vit D3 Folate Ferratin and Iron need to be at the top of the ranges to enable you to convert the T4 in levo to the active T3 your body needs.

  • Thanks helcaster for the reply, do I have to completely stop propranolol? Iam taking only 20mg at night ever since I started this my migraine disappeared completely. I read somewhere beta blockers can't be withdrawn instantly, is it true? I didn't do iron, ferritin or vid D test. Doc(internal) asked me to take this levo for a month and repeat the thyroid function test to see if there is any changes

  • I only took a small dose to prevent migraines, it didn't always work. You could cut down gradually if you're concerned, or speak to your doc. I'd like to think he/she would know they have an adverse effect on thyroid function. I did get offered beta blockers again for palps but I refused on these grounds and the gp agreed. You have to keep informed and be one step ahead of the docs a lot of the time.

    My migraines have reduced considerably since thyroid meds. Now if I get one I just take migraleve which is available free on prescriptions as thyroid patients don't pay prescription charges. Something else I found out myself.

    You can't actually use the thyroid meds efficiently if you are deficient in those vits and minerals. Gently coax your gp to test these when you next have your thyroid tested.

    Try supplementing with selenium, really helps the uptake of thyroid meds.

    Are you taking levo on an empty stomach? A lot of people take it on waking, water is fine as it's not a food. Wait one full hour before breakfast. Cut down on coffee as this isn't really compatible.

    Your TSH is really high. A rule of thumb is that you'll need 10mcg per stone in weight. It's just a guide. Increase by 25 MCG every month at the most. A lot of doctors keep you on a starting dose such as yours far too long.

    Get your cholesterol tested too. It rises when you're hypo, but should reduce on optimal thyroid meds.

  • yes i wanna give it a try, wont be taking propranolol again, lets see how my headache will respond. i just want to get rid of this lazy feeling as soon as possible. okay will do those test next time i visit him. ye i am taking on empty stomach. i did my lipid profile , total cholesterol was 210, HDL 38, LDL & VLDL was in normal limit but triglycerides was 399, he asked me to take satin but i refused i wanna try on diet & exercise first.

  • Hi Shajumct, diet and exercise is good. Increase your good fats from nuts seed avocados etc. Lots of info online. Your tryglicerides should improve on levo, but it won't hurt to work with it and get those levels down.

    If you take any other drugs or supplements make sure you have a good 4 hour gap.

    Many of us have to be really patient with this disease.

    Good luck with everything!

  • You can either take your levothyroxine in the morning, with a full glass of water and have your breakfast about half to one hour later. I think most wait 1 hour. You can also take it at bedtime on an empty stomach (not having eaten for about 2 hours beforehand).

    When you have your next blood test, don't take your meds until afterwards and it is best to have it as early as possible.

  • Thanks I'll do this way

  • Also, if you take supplements take 4 hours apart from levo.

  • Hi, you should also leave 4 hours between taking calcium and thyroxine.

  • Thanks iam taking calcium supplement after dinner and levo morning

  • You can find hundreds of papers which refer to the effect of propranolol on thyroid hormones.

    It has been used to help those with high levels of thyroid hormone after taking excessive tablets, in thyroid storm, in Graves and numerous other circumstances.

    It both helps to protect against the impact of high thyroid hormones levels on the heart and reduces the rate at which T4 is converted to T3.

    So the taking of propranolol is potentially important. I would have hoped that any doctor prescribing levothyroxine would know what other prescribed medicines you are taking?

    (I also question the wisdom of taking such large quantities of water.)


  • thanks helvella for the input. you can say i was literally feeling like a fish, needs water still thirsty all the time, that was one of the reason i went to see Internal medicine, he asked to me to do this thyroid function test, glycated hemoblobin test and renal function test. glycated hemoglobin test result was 5.7% i guess that was well within normal accepted limit so he ruled out diabetes mellitus and still need to collect my renal function report as they told me it takes 2 days.

  • Somewhat different to drinking that much because you read somewhere that it was a good idea! I understand and am glad it is being looked at.


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