Taking Levo at same time as other drugs??

[Loobs39]

Hi, I have had to start taking Amlodipine (for high blood pressure) and started to take it in the morning as I take my levo at night and didn't know if I could mix them. That didn't work so switched them around - even worse!! Is there any problem with taking them at the same time, does anyone know?

[helvella Administrator]

The problem with thyroid hormones is that even a small interaction can be enough to make a significant change to the dose.

If, say, 20 micrograms of thyroid hormone somehow interacts with other substances, that is definitely an important impact (T4 or T3). And thyroid hormone doses are themselves critically important.

With vast numbers of other medicines, the precise dose is almost unimportant. With paracetamol as an example, often in 500 milligram tablets, it would be unlikely for anyone to notice even a 100 milligrams up or down. If a small amount interacts with food or other medicines, it really doesn't matter. The dose itself isn't critical, and the effect of a small amount not getting absorbed is immaterial.

The next problem is that there is so little real research into interactions - it often appears that only the very worst interactions (as with iron compounds) have ever been researched. Just because we can't readily find any evidence of a specific interaction means little. So we end up having to assume the possibility of an interaction with anything.

[Loobs39 in reply to helvella]

It definitely makes sense to take drugs separately - I just need to be a bit more organised I think - the fact that I am feeling cold at the moment is significant for me and makes me think my levo is not as effective as it has been. Thanks for taking the time to reply.

[SmallBlueThing]

I recall feeling dopey when taking Amlodipine, but the real killer was leg oedema.

I now take Felodipine, despite Lercanidipine and Lacidipine looking to be better options. Felodipine taken an hour after thyroid hormones was causing terrible crashes by the afternoon, but this aspect has been solved by separating by at least four hours. You've been allowing more time than that, yet say it didn't work for you, so I wonder if you're confusing an interaction problem with a usual side effect? I've only been able to tolerate some drugs by starting on the minimum dose, and get on better with calcium channel blockers (the ones ending with -pine) when a prolonged release coating is available, which isn't the case for Amlodipine.

[Loobs39 in reply to SmallBlueThing]

I think you may be right - I seem better on it than I was to start with - I will switch to mornings now I have been on it a few weeks and hopefully there will be no side effects. I did expect swelling feet , especially as I am currently doing seasonal work which includes a lot of driving but not a problem so far - fingers crossed.

[SmallBlueThing in reply to Loobs39]

Returning to mention that ARBs (drugs ending -sartan) are recommended for under 55s or who are not of African Caribbean origin, but see you've written about previously being on Losartan, below.

[Marz]

Reading your earlier posts/threads I read that as you were feeling well you didn't think testing more than the TSH was needed. I also noticed your post about Cholesterol levels. Apologies for straying from your question but both raised blood pressure and cholesterol are linked to thyroid issues and possibly Low T3. I don"t know what dose of T4 you are taking but it is possible it is not converting into the ACTIVE hormone T3. I also noticed your Ferritin and B12 is/was low which can inhibit a good conversion. You also need good Folate levelös to work with the B12 injections if you are still having them.

thyroiduk.org

Private testing in the home available in the above link under the heading - About Testing. These are the tests you need - TSH - FT4 - FT3 - ANTIBODIES TPO & Tg - Folate - Fertitin - VitD.

No point testing B12 as you have been supplementing. Did they do a full iron Profile when your Ferritin was low ? - to rule out anaemia.

Low iron/Ferritin/Folate can increase blood presdure. Iron is transported around the body in the red blod cells. Oxygen clings to the iron. Low iron = low oxygen so the heart beats faster to produce more oxygen. Do you take magnesium ? - also good for BP.

If your Ferritin is still low then a full iron profile is needed.

Hope you soon find answers 😊

[Loobs39 in reply to Marz]

Thanks for replying - I am getting in a bit of a muddle with my medication at the moment after a couple of years of feeling (reasonably) OK - hard to tell as the menopause has caused problems too!! I have always been told I would suffer from high blood pressure as an adult, as a result of a kidney disease as a child so I just assumed that was the cause. My cholesterol, although high, is not, apparently, a problem as the ratio of HDL to LDL is fine. I am still having B12 injections every 3 months and supplementing folate and ferritin. The problem has arisen because, after taking Losartan every morning for 5 years and having no problems with it, my doctor recommended stopping as my blood pressure was too low! I stopped and it then became too high. However, when I started back on the Losartan after 2 months off it, I couldn't tolerate it - I was incredibly breathless, so the doctor has now put me on Amlopidine as it is a calcium based medication which is recommended for over 55's. I started off taking it in the morning and the effect was horrendous - I felt like I was walking through treacle and fell asleep several times in the day. I decided to switch to evenings but that is when I take my levo (75 mgs) hence my question. I was worried about interaction so switched to levo in the morning - I haven't felt warm since. So, I am going to do as you suggest and get tested for FT3 - never had it tested so I will be very interested to see what the result is. I think that now I have been on Amlopidine for several weeks I will try mornings again and switch levo to night. Fingers crossed it works.

[Hidden in reply to Loobs39]

I took Amlodipine slow release an hour after my Levothyroxine each morning but it made me feel so ill I asked to go back on Felodipine. Tried stopping the calcium channel blocker but my bp was 188/96! Now stopping both Bisoprolol and Felodipine and seeing how I cope. Had Afib attack yesterday but nothing too violent

Di

[Marz in reply to Loobs39]

I can understand the kidney blood pressure connection. However there is also the thyroid connection to consider. Glad you are thinking about more thorough testing. Do you have Hashimotos ?

drmalcolmkendrick.org

😊

[Loobs39 in reply to Marz]

Yes I do have Hashi's but my antibodies plummeted once gluten free. Admittedly I haven't had it tested since then but no reason to think it has increased again - I will get it tested at the same time as the T3. If my T3 is fine I won't do anything further but if bad, I will go to one of the recommended endo's to get a private prescription.

[Marz in reply to Loobs39]

Sounds like a good plan 😊😊

[helvella Administrator in reply to Loobs39]

In some people bed-time dosing of levothyroxine can make a significant difference to absorption - possibly to the extent to being like an increment of dose. Changing to morning dosing could, by the same argument and observation, be equivalent to a dose reduction.