Arthritis and under active thyroid

[marditart]

Hi please can anybody tell me if they are experiencing arthritis earlier than you would necessarily expect? I've had an under active thyroid for over 20 years my gp only prescribes me 75mg of tyroxine when Mr G Skinner used to prescribe over 200mg! I'm 56 and reaching the ultimate point of frustration I'm a hairdresser and luv my job but am reaching the point were my feet hips and knees are really governing my life now. as I don't have current test results but will obtain them and post. I take lots of vitamins etc and follow a good healthy diet and with my job cover approximately 14,000 steps a day. Sorry in advance for what seems like an essay.

[Mollymalone79]

Hi marditart, I’m 45 and have arthritis in both hips. The pain has eased since my thyroxin dose has stabilised at 125mcg and I take naproxen day and night to manage pain.

[Marz]

Reducing inflammation in the gut can help to reduce inflammation elsewhere ! Conditions ending in 'itis ' - indicate inflammation !

[Nanaedake]

Please get vitamin levels tested and post them here along with the supplements you are taking. It's very common with thyroid disease to have low vitamin D even when taking supplements but you won't know without testing. It could cause joint/muscle aches.

[waveylines]

Why has your GP cut your medication to 75mcg when you were on 200mcg with Dr Skinner?

Definately get your vitamin D level checked & post alongside your last blood test of thyroid hormones.

[Nanaedake]

If marditart is in the UK, the efficacy of levothyroxine has changed since 2013 so it could be due to that?

[Cariad-y-Mor in reply to Nanaedake]

Hello Nanaedake - sorry to cut across marditart 's post but am interested in your comment that the efficacy of levothyroxine has changed since 2013. I was not aware of this....do you know how it changed ? Maybe I am just " clutching at straws" but having been fine on levothyroxine for probably 20 years I started to go downhill ( rapidly) since probably around 2013/ 14. Was just wondering if there could be a connection.

[helvella Administrator in reply to Cariad-y-Mor]

The issue was the levothyroxine report published in 2913.

gov.uk/government/publicati...

I am not convinced this had more than a marginal impact. Might have helped to ensure that the worst cases pulled their socks up (and clearly hit the old Teva product), but I don't think there is clear evidence of a significant change - and certainly not enough to explain a drop from 200 to 75 micrograms.

[Nanaedake in reply to helvella]

I can't speak for other people but it caused a huge drop for me from 250mcg to now taking only 112 mcg. That's about half. This was evidenced in my blood tests. I became badly overdosed when switching from TEVA to Eltroxine on the same dose and had to reduce dose significantly. I was extremely ill as a result. I have no thyroid antibodies so not likely to experience fluctuations due to that.

I'm not saying this is the reason for marditarts change in dose, it's just a possible aspect to consider based on my experience.

[helvella Administrator in reply to Nanaedake]

Yes - the specific case of old Teva - I fully agree. But I don't think there was a major change to any other make.

But even then, it appears that Teva had changed an ingredient (without authorisation) and it was that which affected the ability of the tablet to deliver the dose. I don't think there is evidence of Teva being especially bad prior to that - but I do not know exactly when the change was made.

[Nanaedake in reply to helvella]

I don't know about other makes but Actavis told me they reformulated around 2013. It might not have been a major change, I've no idea. As for TEVA, it was also the manufacturing methods which generated heat that damaged the ability of the drug to deliver the correct potency. Also, the report I read at the time stated that it was the molecular size of the solvents and the percentage proportion of one solvent to another that affected the bioavalability of levothyroxine. There was more information in the New Zealand report...so I think that it was more complex than the MHRA report reveals.

[helvella Administrator in reply to Nanaedake]

The New Zealand report, though, was about a completely different product - it was when the production of GSK Eltroxin was passed on to Aspen and moved to Germany (from north America). Different formulation to that used by GSK, different factory, but still called "Eltroxin".

[Nanaedake in reply to helvella]

I see.

[Nanaedake in reply to helvella]

I think the illicit ingredient change to TEVA was prior to 2009 because I recall reading that yellow card reports were arriving from around that time and then peaked around 2011 which then triggered the investigation. I think it was around 2011 that a recall of patients at high risk such as heart disease, thyroid cancer and pregant was issued by the Chair of the Commission for Human Medicine in a letter to doctors. I took a copy from the internet. However, I don't know if any patients were recalled (I certainly wasn't). None of the doctors I've spoken to were or are aware of the issue. The investigation must have taken 2 years since the report was not issued until 2013.

[Nanaedake in reply to Cariad-y-Mor]

I can't say if there is a connection for you but you can read the MHRA report for yourself.

assets.publishing.service.g...

Basically the drug was wrongly classified, the dissolution tests applied were inadequate and the drug manufacturing regulations were not suitable for levothyroxine production quality control in the UK. There was a nearly 50% difference between the most efficacious levothyroxine and the least among the 100mcg tablets. This meant that they were not bioequivalent so switching between formulations (or different manufacturers pills) caused changes in thyroid hormone levels. TEVA had their licence withdrawn for the manufacture of levothyroxine and other manufacturers reformulated too I believe.

[Cariad-y-Mor in reply to Nanaedake]

Thank you helvella and Nanaedake Ah yes now I do remember reading something about Teva levothyroxine some time ago. As you say Nanaedake I don't think that is what caused my " deterioration" because , as far as I can remember, I have never taken Teva. Thank you .

[SlowDragon Administrator]

Do you have Hashimoto's? Have you had vitamin levels tested recently? You need to know if you have high thyroid antibodies and what FT3 and FT4 are

Are you on strictly gluten free diet? It helps many, especially if high antibodies (Hashimoto's)

For full Thyroid evaluation you need TSH, FT4, TT4, FT3 plus TPO and TG thyroid antibodies. Plus vitamin D, folate, ferritin and B12.

Essential to test thyroid antibodies, FT3 and FT4, plus vitamins

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting.

If on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances too, especially gluten. So it's important to get tested.

Arthritis and gluten

everydayhealth.com/rheumato...

arthritis.org/living-with-a...

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...