Will thyroxine be affected by pain relief during and after op?

[Flecmac]

Having major surgery on Tuesday and will have epidural and morphine etc. Will this affect thyroxine absorption? Also do I need to stop taking:

Vit D with K2 spray

Vit B complex

Multi vit with iron

Selenium drops

Cod liver oil

[cjrsquared]

The answer is it depends. If you are having any surgery involving your gastro intestinal tract then absolutely you will need to stop your supplements, hopefully only for a short time until gut motility returns.

If your surgery doesn’t involve your gastrointestinal tract the effect of morphine alone will also effect gut motility, it slows down how fast the gut moves contents along and can cause severe constipation. This can be aggravated by oral iron supplements.

If you are worried about levothyroxine absorption you could increase your dose for several days before to allow 2 or 3 days without, as it has such along half life. ( something a surgeon suggested to my grandmother 20 years ago!) I think the sprays will be ok but doctors know little about nutrition and they may panic about the k2 saying that it will increase risk of blood clots.

Sorry I can’t be definite but I wish you well for your surgery.

[Flecmac in reply to cjrsquared]

Thanks

[Greybeard]

Hospitals won't usually allow patients to take anything that isn't officially prescribed so a bit of cloak and dagger may be required if you intend to take them while in hospital.

[Hillwoman in reply to Greybeard]

This is worrying for those of us who have to self-treat with T3 and who might become inpatients...

Flecmac I tend to agree with the others that supplements are best left for a few days if you'll be needing morphine. The only exception I can think of is with mega-dosing of vitamin C (something I'm doing under supervision), in which case it would be wise to gradually reduce the dose beforehand. The reason is a problem known as 'rebound ascorbate deficiency', that occurs when supplementation is stopped suddenly.

[Flecmac in reply to Greybeard]

Do you mean take my own pain relief? All meds gave to be handed over for staff to administer anyway.

[Greybeard in reply to Flecmac]

Anything that isn't on prescription can be a problem.

[Jose651]

I had a Hip Replacement 2 weeks ago. 😀

At the Pre Op Assessment - 3 weeks prior - the Anesthetist checked all medication and supplements that I was taking.

His advice was to stop taking Vit C, Milk Thistle, B Complex, Vit D & Vit K2, and minerals 1 week before Operation.

I took my Thyroid Hormone Replacement very early that morning as usual.

Best wishes mcdermott, 👍

[Flecmac in reply to Jose651]

I asked the dr at pre op, but she said it was OK, but I don’t want to risk it. I have been using topical magnesium and used it last night, so hope that’s not a problem!! May stop that niece, although I struggle sleeping and it helps a little I think. I can’t use it for a long time with an open wound so that’s a problem, struggle swallowing tablets. I tinker I will have to stop them all.

Thank you

[Jose651 in reply to Flecmac]

I have just googled ' should I stop topical Magnesium before surgery'.

Lots of info there may help.

J ☘️

[Flecmac in reply to Jose651]

Thank you.

[humanbean]

Definitely stop all your supplements immediately. I'm surprised that you weren't told to do this already.

I don't think there is a problem with thyroid meds. I would suggest taking them as normal.

One thing to be aware of is that doctors/nurses are told to take prescribed meds away from the patient when they go into hospital so they can control what drugs the patient receives. I would resist this furiously. In my experience you will end up missing doses and/or you will get meds after breakfast, even if they should be taken on an empty stomach.

If you take regular pain relief, then do not let nurses take it away or you will end up without it and be in pain, but if you are being supplied with pain relief before, during or after surgery then you need to be aware that you could end up double dosed and this must be avoided. It is probably best to avoid taking your own pain relief before surgery altogether since you know you will be given sedation and morphine.

Also, don't take more meds in with you than you need for the length of your stay, because they might go missing. If you have a family member coming to visit you might want to get them to take in each days meds for you. I've heard of people having T3 taken away from them and thrown in the bin. I imagine this might happen with any supplements too.

[Hillwoman in reply to humanbean]

I've also heard of inpatients having their privately obtained or privately prescribed meds taken from their bedside lockers by nursing staff. This is actually theft, and perhaps staff who do this need to be told quite firmly not to tamper with patients' belongings. Although, difficult when you're recovering from surgery. 😟

[Flecmac in reply to Hillwoman]

Indeed!

[Hillwoman in reply to Flecmac]

I think Greybeard63's advice to take the cloak and dagger approach is the most practical in these difficult circumstances. I wish it didn't have to be this way though.

All the best. x

[Flecmac in reply to Hillwoman]

Thank you.