Medications that can affect thyroid function

[Eddie83]

FYI. Izabella Wentz recently sent out an article listing the 9 medications she believes are the most common thyroid disruptors. Those are: lithium, amiodarone, fluoride, HRT/estrogen, Proton Pump Inhibitors, Interferon, Accutane, Iodine (excess), Botox. I have previously heard that beta-blockers also disrupt thyroid, but that was not mentioned.

thyroidpharmacist.com/artic...

[greygoose]

Beta blockers, from what I've read, lower levels of FT4 in the blood, but I don't know how they do that. I don't think they affect the thyroid gland itself.

[Valarian in reply to greygoose]

I believe some (including Propranolol) are thought to inhibit conversion from FT4 to FT3, although any effect appears to be slight, and slow. uptodate.com/contents/beta-....

However, their main value is in controlling some of the symptoms of hyperthyroidism while patients are waiting for their first endo appointment, or for the anti-thyroids to kick in, which can take four to eight weeks.

[greygoose in reply to Valarian]

Yes, I realise that's their main value.

[Eddie83]

My son (a pharmacist) sent me additional info on meds he is aware of that affect thyroid function: zoloft and seroquel.

---------------------------

She forgot a few, though she included the biggest culprits (amiodarone, lithium and estrogen/estradiol). Sertaline (Zoloft) and Quetiapine (Seroquel) should also be on her list:

Hypothyroidism

a) Hypothyroidism has been temporally associated with the postmarketing use of sertraline, although no causal relationship has been established [14].

b) Patients with thyroid disease who are also receiving treatment for depression should have thyroid function tested periodically. There are reports of small decreases in serum thyroxine levels and small increases in serum thyrotropin levels after starting treatment with sertraline and other antidepressants (McCowen et al, 1997).

Hypothyroidism

a) Summary

1) Cases of dose-related hypothyroidism have been reported with quetiapine use. Thyroid monitoring, including both TSH and free thyroxine (T4), is recommended with quetiapine therapy [11][15].

Beta-blockers generally DO NOT effect thyroid function, we have hundreds of patient's on them here at the hospital long-term and they rarely cause any shifts in thyroid lab values.

[Paula101]

I know fluoride is a not thyroid friendly & so have been using flourish free toothpaste for last 2 & a bit years.

[userotc]

This supports my view that we should aim to come off all medication which only masks symptoms anyhow. Natural treatments are best.

As a recent example, we've managed to get my mum off all medication including blood pressure tablets she's been on for years. We regularly monitor and it is now around normal. Our current aim is to keep her off hrt - wish us luck!

[Ellie-Louise in reply to userotc]

Best of luck. I wouldn’t touch HRT.

I was advised to, and used sage which was wonderful for my menopause. My sister who is younger than I am went on HRT and developed breast cancer, I’m not saying there was a connection but you never know.

[Eddie83 in reply to Ellie-Louise]

There is a connection, of course. If they gave her too much estrogen, and/or didn't balance it with progesterone, and/or gave her a non-bioidentical version, that is trouble. Were I female, and given what I now know about the effect of thyroid, I think I would want to make sure I have in-range FT3 & FT4 levels, and correct those if necessary, before risking taking higher-order hormones.

[Eddie83 in reply to userotc]

Absolutely. Big Pharma is yet another exercise in "follow the money". Allopathic docs have had it drummed into their heads that they should give patients Big Pharma drugs, rather than treatments using substances that are naturally present in the body ... because that is what Big Pharma want$.

[Clarrisa in reply to userotc]

My physiology instructor felt people should be checked if they still require their blood pressure medication following their retirement from work.

[Cammy7182]

Iodine affects thyroid function. In South Africa Graves Disease is treated with radio active Iodine. I have first hand experience of the destruction it causes to the thyroid gland. 18 years later my thyroid still does not function properly. One of the levels are always out of range. I suffered very badly from excessive weight gain in the first year after treatment and still do. I deeply regret believing that specialist knows best, in my case they did not.

Unfortunately sometimes even doctors are clueless about how our bodies function and their method of 'one size fits all', destroys more than what they build.

Sorry for my negativity, but having been excessively obese for basically my whole adult life and not being able to find any lasting weight loss results makes me believe that actually no one knows anything.

[Eddie83 in reply to Cammy7182]

It is my understanding that methimazole can be used to turn down thyroid output, without resorting to the Nuclear Option (radioactive iodine). Is RAI the only treatment for reducing thyroid output in South Africa? If so, it sounds like South African medicine isn't too good.

Since RAI kills the thyroid, I doubt you can expect it to ever function right. I assume the RAI has caused you to become hypothyroid. Is that correct? If so, have you been offered T4 or T3+T4 treatment?

[Eddie83 in reply to Eddie83]

Disregard my comments about treatment. I lost track of the input I had given you before.

[Cammy7182 in reply to Eddie83]

Hi Eddie83

I am not up to date with the newest treatment on offer .

I received Eltroxin 0.1 six months after the initial treatment. At that stage I weighed 136kg. From 79kg. During all the years I received numerous comments from GP' s and Specialists alike ' you eat too much/ you need to exercise more/ etc". My complaints fell on deaf ears. No-one was interested in trying to find a reason why I struggle so much. Within 7 months after treatment I weighed a whopping 158kg.

No amount of exercise or dieting or limiting of food intake produced any weight loss.

Four years ago I fell I'll, cause unknown, lost 30 kg' s. Three months of daily vomiting and nausea.

Then dr's changed my meds to Euthyrox and I lost even more weight. I was so extremely happy!!!

But it was short lived. A few months later, my right lower leg started swelling, it still does, cause unknown. I have had MRI, Doppler and CT scan, also lymphogram. No reason. Weight gain is also back. I exercise. I diet. I watch what I eat. I eat mostly salads, game meat/ chicken/fish. But still it increases.

Dr's say thyroid is fine. But they test only T3 and TSH. Even those are not in range. Either too low or too high for one of them.

I am nearing the 100kg point again and that will be my limit. I vowed to never pass that point again. I will rather be dead. People say that you can be fat and happy. That's a lie !!

My knees pain every night. My lower legs burn/ pain and has needles and pins feelings, I have back problems, I developed osteoporosis, it looks like first signs of rheumatoid arthritis on my fingers.

All from hypothyroidism and being obese. A body can only take so much, before it breaks, so does the spirit.

[Eddie83 in reply to Cammy7182]

That crap about "you eat too much and you need to exercise more" is the standard B.S. used by doctors who don't know how to diagnose and/or treat thyroid correctly. This is exactly what Kent Holtorf says in his little video about "thyroid runaround". Google:

site:nahypothyroidism.org thyroid runaround

... and listen to the whole thing if you can take the time.

Didn't I talk to you about being on T3+T4 or NDT? Or was that someone else? Both Eltroxin and Euthyrox are the same-old levothyroxine (T4). Have you ever been on anything but T4-only?

[Cammy7182 in reply to Eddie83]

Hi.

Thanks for the reply.

I think it was someone else. No. I have been on Eltroxin for 15 years. Then Euthyrox for past 4 years.

When I see the GP, he says there is nothing wrong with thyroid. I was at the Endocrinologist a total of 7 times last year. Although levels were not all in range, they said it's all good. No other medication or treatment needed or suggested. I begged, I cried, I pleased, please , PLEASE try something else! My whole life revolves around weight issues.

People say you should not become depressed, HOW don't I? When I wake up, shower and then, ..........get dressed, and on a daily basis I feel my clothing becoming tighter and tighter. I am wearing a size 20 - 22 again!!!! I feel I rather want to die and end all this hurt and negativity. Hating myself more with each passing day and dr's not caring enough to listen.

I do not have a medical aid, can't afford It, government hospitals and clinics are thus my only options . Private dr's are way to expensive and booked months and months in advance.

I feel that no-one cares enough about someone else. It's not their problem, they don't have to live with it. So it's not an issue.

If a Dr do not prescribe meds, you can't get them. And to all those that I've seen, 1x 0.1 Euthyrox suffice in the needs of my body. No matter what I say or how I feel.

[Eddie83 in reply to Cammy7182]

If the GP has never measured your FT3, then his statement about "there is nothing wrong" is a lie by omission. I suggest you ask the GP how he knows that your T4->T3 conversion is working well. My guess is that he won't have an answer.

[Cammy7182 in reply to Eddie83]

Hi Eddie83

Thank you. I am having an appointment on Wednesday. Will ask and give you feedback, if I receive any.

Regards

[Valarian in reply to Cammy7182]

Interesting. In the U.K., we usually get at least one shot of treatment with antithyroids (usually Carbimazole) before they suggest RAI, and some people remain on low dose Carbimazole for years.

What happens In South Africa if you refuse RAI ?

[Cammy7182 in reply to Valarian]

Hi

I have no idea. Was to stupid to ask the dr's that time , 19 years ago, what effect it will have. Did not educate myself properly. Assumed they knew best.

I was 25 years old. Since then I have been obese. Weighing between 136 - 158 kg's. My life passed by in tears, self hate and disgust. I got divorced in 1997 and is alone since then. Because who would love me, when I can't even love myself?

[Valarian in reply to Cammy7182]

Sorry to hear this Cammy. I’m sure there is plenty to love about you !

Hopefully this group encourages people to ask the right questions to help them make an informed decision.

[Eddie83 in reply to Cammy7182]

After a lifetime of chronic illness, including 21 very bad years, I no longer assume that any doctor knows best. There are far too many hacks out there to make such an assumption.

[hachiko]

Should one use toothpaste without fluoride then?

[Paula101 in reply to hachiko]

I would certainly recommend its use. I try & use as few chemicals as I possibly can. A nice one is Aloe Dent fluoride free. I get it from my local herbarium. And our water is not fluoridated thank goodness!

[hachiko in reply to Paula101]

Next time when I buy

[Eddie83 in reply to hachiko]

So far as I know, fluoride has no role in the human body. The only halogen that does have a role in the body, is iodine.

[Cammy7182]

Hi Eddie

I just received test results for TSH and FT3

TSH 5.5 mIU/L Range: 0.35 - 5.50

FT3 2.7 pmol/L Range: 3.5 - 6.5

Regards

C

[Eddie83 in reply to Cammy7182]

You are still obviously hypo. FT3 well into the normal range is what will make you feel well; my FT3 is about 70% up in the normal range.

[Cammy7182]

Hi Eddie

Thanks for the reply. I am having blood drawn again today. To test TSH, T3, T4, FT3 and FT4.

I am also supposed to discuss a change of meds with the GP. As they feel that Euthyrox does not work for me.

It's my experience that they do not know what to give me to optimally treat the thyroid. I am going out of my mind . I SHALL not cross the 100kg border again. I made that promise to myself.

So if this does not work , I have to accept the fact that I need to do something on my own.

I appreciate your support

Regards

C

[Eddie83 in reply to Cammy7182]

See my note below. It seems like most patients who have weight issues, do much better if they push their FT3 well up into the range, somewhere between the middle and top of range. My FT3 is about 75% up in range.

[Cammy7182]

Hi Eddie

I have been to GP. It seems the results I send you yesterday was for Oct '17.

These ones were for Dec '17:

TSH 0.27 mIU/L range 0.35 - 5.50

Free T4 15.5 pmol/L range 11.5 - 22.7

The following was for Jan '18

TSH 0.47 mIU/L range 0.35 - 5.50

Free T4 15.2 pmol/L range 11.5 - 22.7

Free T3 3.4 pmol/L range 3.5 - 6.5

If you could recommend any tablet and dosage I could advise the GP. I told them today I am tired of hearing ' everything is fine' - the added weight indicates that it is NOT .

Regards

C

[Eddie83 in reply to Cammy7182]

Regarding that most recent test: with FT4 in-range, and FT3 below-range, it appears you need to be on T3+T4 or NDT because you cannot convert well. The usual recommendation here is that FT3 should be about 75% up in range - which is about where mine is.

I can't make a recommendation without knowing your weight. However I can tell you how to do it, if you're willing to do the arithmetic. First, compute your T4-only full-replacement dose, on the basis of 1.5-1.7 mcg/kg body weight. For instance, if you weight 100kg, then you need 150-170mcg of T4 (levothyroxine), assuming you can convert well (which you don't).

Then you follow the recommendations made by Ridha Arem MD in his book "Thyroid Solution". (Lots of experimentation required.) You assume that the T3 "power factor" is 4. That is, each 4mcg T4 is roughly equivalent to 1mcg T3. Let's suppose your computed T4-only dose was 150mcg. Then pick a reasonable amount to subtract, say 25mcg, setting your T4 dose at 125mcg. Then add in 25/4=6mcg T3. You stay on that dose for at least 5 weeks. Then if you still don't feel well (or testing indicates the need), you subtract more T4 from your 125mcg dose, and add in more T3 using that power factor of 4.

NDT has a T3:T4 ratio of about 1:4. It is believed that the healthy thyroid actually makes T3 & T4 in a ratio of approx 1:18, but that is debatable. (For instance, I am currently on a T3:T4 ratio of 1:8; I have found that setting my ratio above 1:12 does not get my FT3 up high enough.)

The cheapest way to dose T3 is to use 25mcg tabs, which can be halved (and sometimes quartered, depending on brand; some brands crumble more than others. I have found the U.S. SigmaPharm generic T3 can be quartered.)

If you did decide your T4-only dose is about 150mcg, and you reduce that in 25mcg increments, here are the first 3 approx. doses you would see:

T4 T3 T3:T4

150 0 --

125 6 1:20

100 12.5 1:8

If you should decide you want to use NDT, you will find tables on the internet for Armour and other brands that tell you how many micrograms are in each grain of NDT. You might have to add some T4 to NDT, because NDT has that T3:T4 ratio of 1:4 which means that many people are going to be getting more T3 than they need. (Of course there are some people who do very well on NDT because their bodies are happy with the 1:4 ratio.)

[Cammy7182 in reply to Eddie83]

Hi Eddie.

Thanks so much for the detailed information provided. I never knew these things and I guess the dr's I have been seeing also do not.

I will show it to the GO when my new test results are back and take it from there.

May God bless you for all the support you provide me and others.

Regards

C

[Cammy7182]

Hi Eddie

I have been unsuccessful in my search for T3. I only found one supplier in South Africa for Thyroid S. But a doctor need to purchase it. I am not allowed to buy it.

Do you know anything about Thyroid S? Will it help? What dosage is needed? Apparently it only comes in one strength.

I still have to find a doctor who can order it for me, how knowledgeable he is about thyroid conditions, I don't know. So I would like to ask for a bit of help, please.

I weigh 86kg's.

Regards

C

[Eddie83 in reply to Cammy7182]

I will attempt to send you a private msg about this.

[Cammy7182 in reply to Eddie83]

Hi

Thank you. I will appreciate.