Back pain and levothyroxine : Back pain and... - Thyroid UK

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Back pain and levothyroxine


Back pain and levothyroxine, any suggestions p lease?

I have a degenerative spine, Ibuprofen really helped but stopped and went to paracetamol, these really don’t help but I know antacids really affect levothyroxine, any advice on what medication best?

68 Replies

Ibuprofen isn't an antacid.

Combination of Paracetamol and Ibuprofen can help with pain. For stronger (Short term ) relief - Cocodamol 8/500 and Ibuprofen work well. Anything stronger has to be on prescription. If taking Co-codamol it's advisable to take Lactulose medicine and drink extra water.

Who said you can't take Ibuprofen when on Levothyroxine? If GP said this was it for some other reason? Some GPs prefer Naproxen, but that's presription only. I've never taken Naproxen.

Naproxen isn't prescription in the US, it's the generic for Aleve but about a third of the price.

helvellaAdministrator in reply to wipster56

Most Naproxen medicines are Prescription-only Medicines (POM) in the UK. However, at least one is P: Pharmacy - meaning you can buy it in a pharmacy but the pharmacist has to be convinced and might ask questions.

Boots Period Pain Relief 250 mg Gastro-Resistant Tablets

Feminax Ultra 250mg Gastro-resistant Tablets

Period Pain Reliever 250mg Gastro-resistant Tablets

There could be others, but these are the only ones listed on the Electronic Medicines Compendium site.

Might not be ideal for any males... :-)


I take a Proton Pump Inhibitor - Lansoprazole - to reduce stomach acid production, to protect my throat and oesophagus from further damage caused by rising stomach acid due to hiatus hernia.

But I take my Levothyroxine very early between 3am and 4am.

Do you take your Zantac at least 2 or even 4 hours away from your Levothyroxine?

And have you had any tests to check levels of the following nutrients :

Vitamin D



and Ferritin

in case you are defficient in any because of malabsorption?

Are you taking a daily maintenance dose of Vitamin D?

Levothyroxine needs acid to work.

Also it shouldn't be taken at the same time as any other medication or supplements. Vitamin D has to be taken 4 hours away.

Do you take your Levo on an empty stomach and AT LEAST one hour before any food of drink?

Just make sure to take the Zantac at a different time. Do you have a hernia?

Are you confusing antacids with NSAIDS? There is a piece of research that identified various/variable changes to thyroid hormone levels brought about by different NSAIDs including Ibuprofen; rather than interaction with Levothyroxine. However, that wouldn't be the case with Paracetamol as it isn't considered an NSAID because it doesn't have the same degree of anti-inflammatory effect.

Just in case you haven't tried it physiotherapy can be very effective. Although you have problems with your spine various exercises can alter your posture and place less strain on the sensitive parts. You do need a physio who is good with a detailed understanding of anatomy.

hachiko in reply to jimh111

To my surprise I read that back pain can be caused by stress too.

jimh111 in reply to hachiko

I guess stress tightens the muscles inducing pain. Also poor sleep reduces growth hormone levels and GH is used for tissue repair.

hachiko in reply to jimh111

Good points. If that's the case, what's the best cure, do you know?

jimh111 in reply to hachiko

Physio can improve muscles that don't get used and so are prone to occasional spasms. Also magnesium deficiency (blood tests no use) causes tensioning of muscles and stress, so magnesium supplementation may work. My back pain imporoved with physio and getting my thyroid treatment right.

LAHs in reply to jimh111

Yes, soaking in a bath with epsom salts (a magnesium salt) in it should work. we have some hot springs in our area and when I had a bout of sciatica I was absolutely desperate and went for a soak in one. It did help a lot.

My heart goes out to you Black1 I thought life as I knew it was over when I had that sciatica, I even pulled out a pair of old crutches so that I could go shopping. I got rid of it with massage and those soaks. Right at the beginning the doc did give me steroid pills but they wear off and you are back to square one - and the side effects are awful, dizziness and feeling like you aren't really there.

hachiko in reply to jimh111

How much magnesium per day is optimal to take?

jimh111 in reply to hachiko

Just follow the RDA recommendations on the label. Magnesium is safe unless you have kidney disease or low blood pressure.

If I’m reading this right, you mean that you stopped taking ibuprofen even though it worked well, because it irritated your stomach lining and you needed to take antacids? Which is why you moved to paracetamol?

Have you tried the new ibuprofen patches?

Black1 in reply to Jazzw

Thank you so much, may be I mixed up my question as just finished work and in pain.

Just to clarify, I know ibuprofen is an NSAID but because I seem to need it long term, I have changed to paracetamol which is not as effective.

I have been advised that if I carried on taking ibuprofen I would need antacids which are contraindicated with levothyroxine. So I meant to say has anybody got any analgesia advice?

So sorry for any confusion I caused and thank you so much for the replies.

I had not heard of ibuprofen patches, but will definitely try if they are effective

csi9132 in reply to Black1

Do you take ibuprofen, or any NSAID with food? You should not take it on an empty stomach. I have taken 800MG of ibuprofen three times a day for several weeks once when I suffered sciatic pain from a pinched nerve. I took it with food and never had any problems with it.

You could try Ibuprofen gel.

I am on Levothyroxine and also a PPI.

When pain is severe the combination works well either paracetamol then something to eat then ibuprofen or cocodamol then ibuprofen. If you have food or milk and a biscuit before taking Ibuprofen you should be OK shouldn't you?

Are you taking 400 you 600mg @ 3 or 4 times a day then?


After a few open surgery (herniated disc,smashed nerves,degeneration to bottom of spine) back operations and still being prescribed 100 ibuprofen per month (for the last eight years) along with all my other meds, I can honestly say that when you take ibuprofen for back pain on a regular basis,you will need to take with Omeprazol,which will basically protect your stomach lining.I take 125mg of levothyroxine a day and not had a problem with mixing😀x

Thank you for your advice

The above link is your post/replies of six months ago. Did you have the suggested tests done ? - for thyroid and vits and minerals ?

When everything is optimal in their respective ranges you may be surprised how much better things will be. I find B12 injections help my spinal issues which are nerve related due to stenosis.

Black1 in reply to Marz

Thank you, yes I did have All bloods including vitamins tested.

My thyroxine has been increased as low to 125 mcg, B12 on low side ( 222) limits ( 190-900) Gp won’t give injections so

Taking B12 spray and vitamin D 50 and just on range so

taking 4000 in units vitamin d.

I had a Thyroid ectomy in 2009 and GP kept me very hypo for years despite me asking to increase medication and now I have crumbling and degeneration of whole spine ( just had results of MRI spine.

So your post gives me hope , which is great, thank you and hopefully with all the medications will feel better soon😀

mcdermott in reply to Black1

I have lumber scoliosis and disc problems with lots of pain especially morning and night. I’m pretty sure this is because gp kept me hypo for 15 + years only allowing 25mcg and stopping it! I’ve had a battle to get to 75mcg. Last April I had major surgery to remove a tumour from a nerve to the spine, resulting in a distorted rib cage and more pain. I am sure lack of the right hormones has resulted in all of this and all my other symptoms!!! Not much can be done for spines. The NHS have a lot to answer for!!!

Black1 in reply to mcdermott

I am so sorry for the back pain you have, I do hope the increase in Levo helps🤞

I hope you are well onto recovery with your other health issues and I wish you better health for the future x

mcdermott in reply to Black1

Thank you x🤞

I take naproxen with levothyroxine and tramadol. I also wear matrifen patches for lower back pain, I too have degenerative discs in my lower back and neck. and they are the only medication I have taken that control the pain.

Black1 in reply to Redhead48

Thank you, I have made another appointment with another Gp to discuss MRI spine as letter just sent to me in post and will mention all your suggestions

I too have the same condition and usually manage it by just taking care and avoiding what sets it off but this last two weeks it's been agony, I suspect picking up my new baby grandson has had something to do with it. Like you I manage with ibuprofen if just a few days but as I'm asthmatic and have stomach issues don't want them for long. My doctor gives me voltarol suppositories which I find helpful as they at least avoid the stomach. You can end up with a sore rear end though so we can't win.

Gill50 in reply to Summer64

So sympathise, I got a compression fracture from picking up my grandson at Christmas and have been in increasing pain since then. I have osteoporosis in my spine with wedge fractures. Nothing is working for my pain at the moment. I am also on 100mgs of thyroxine and also on predisalone (decreasing) for PMR!! I can only take ranitidine for stomach protection as others cause IBS!! This sounds dire reading it back! I have an app with GP tomorrow to ask for increase in pain relief as my pain is sometimes at 10 out of 10!! It is totally miserable for me but also others witnessing it. I am going to be 69 this year and still work, but maybe for not much longer.

Black1 in reply to Gill50

Thank you for replying, I hope things improve for you soon

Thank you, I have made a GP appointment and mention thing as anything hopefully helps.

Go see a chiropractor, mine really helps and it can slow down the degenerative spine. I’ve the same problem but I do suffer the pain and don’t take pain killers regularly.

I take vitamin D which can reduce muscular inflammation. I also take magnesium tablets before bed and apply magnesium lotion as it helps relax muscular tension.

I don’t take it, but Tumeric tablets are supposed to really help with pain.

You might be easing the pain with all these drugs but there are other options to give your body a rest.

Chiropractors also use heat/cold method on the painful areas and can suggest stretches to help.

Hope you feel a bit better soon. :)

I take Celecoxib (anti inflammatory), Co codamol 30/500 and Lansoprazole to protect my stomach, and have no problem with levothyroxin interaction.

Strength and Sympathy for you . Pain is so debilitating and so very stressful . Have you tried some fish oil Vitamin "D"/K2 , Magnesium , Epsom Salt in warm water baths . Chiropractic gentle spine adjustments . Traumeel Homeopathic Ointment .

Sending you Healing Hugs .

Did you mean that you take antacids because the ibuprofen bothers your stomach? If so, separate calcium carbonate from Levothyroxine by 4 hours.

It turns out that many people on levo have back pain !!. In my case reducing levo and taking some T3 made my back pain much better!!!

vocalEK in reply to marinria

It isn't the levo causing the back pain. "Thyroid hormones play an important role in bone mineral homeostasis and bone density. Both hyperthyroidism and, to some extent, hypothyroidism are associated with reduced BMD leading to increased fracture risk." So keeping someone hypothyroid can destroy their BMD.

crmavb in reply to marinria

Hi Marinria

I suspect I may need to reduce my levo as I remember this happening to me before. I’ve had back pain for two weeks now, so I’m trying to reduce my levo from today. Can you remember how long before you saw a result? Or any info on how you came to your conclusion for yourself.

marinria in reply to crmavb

Hi there!! It takes me just a day or two to feel better but I am still experimenting. I hope you get better soon

Ibuprophen and aspirin both are anti-inflammatory meds as well as pain. Tylenol (acetomenaphin) is a pain reliever, but does not suppress inflammation. Find out whether Bromelain would be contraindicated due to any other meds you take. "Bromelain is an enzyme found in pineapple juice and in the pineapple stem. People use it for medicine. Bromelain is used for reducing swelling (inflammation), especially of the nose and sinuses, after surgery or injury."

Black1 in reply to vocalEK

Thank you for all your helpful advice

hachiko in reply to vocalEK

Which is best for back pain? Ibuprofen, paracetamol or aspirin? How big of a dose? - I'm new to back pain and to pain medication.

(Seems to be muscle related, not spine)

vocalEK in reply to hachiko

My goto for pain is ibuprophen. Paracetamol is used to treat mild to moderate pain. The biggest brand name in the U.S. is Tylenol. I have never found it very effective for pain, but usually when I have pain it is accompanied by inflammation. Here is an article comparing the two from Australia.

hachiko in reply to vocalEK

Maybe a good idea to try Ibuprofen for few days, as medication for few days then.

Ibuprofen 400mg (large pink tablets),three times a day should relieve your pain. I take Ibuprofen and 2 paracetamol when needs must but beware,can tend to make you feel somewhat drowsy.Sorry!

Best wishes 😊x


Physio didn't help me... I've since been diagnosed with Osteoporosis of the spine and Osteopenia of the hip. I am on 75mcg levothyroxine and take antacid of Lansoprazole. I still don't think Levothyroxine has ever helped. Paracetamol doesn't help for back pain either.

Black1 in reply to Hidden

I hope you find something that helps you too

Regardless of what causes your back pain, talk to your doctor about getting some physical therapy. It should help and teach you what exercises and stretching that will strengthen and condition the muscles and ligaments that attach to your spine. Perhaps you can then rely less on drugs.

Have you tried taking art least 1,000 mg of vitamin C - this always helps me with back pain and is for the adrenals too.

Hi Black1, I have spinal stenosis and life long hypothyroidism, on Levo; I had to stop Ibuprofen after lesions found in gut. No ulcers but couldn’t take further risk. Overseas doctor put me on Fevadol (US) after a bad fall and U.K. equivalent is Solpadeine, of which I take the red Max tabs, when needed. To date no adverse reactions (since 2014) and despite the ‘3 day warnings’ my liver/kidney tests come back clear. (Naproxen was prescribed by GP and was told to take Lansaprazole with it to negate gut reactions...but didn’t give me prescription for that! I chose to stick with SolMax.)

Good luck with your choices, and your health.

Thank you and glad your pain relief effective 😀

I think you are taking B12 but just to mention vitamin B12 can be highly effective for sciatic pain, see .

Black1 in reply to jimh111

Thank you, I read article , very interesting but reduces B12 recently, so

May increase again

I sympathise with you for pain it is so exhausting. I am currently on a lovely pain relief cocktail of, imipramine,pregabalin, cocodamol 30/100 and tramadol. I also have a Barrett’s oesophagus so need to watch my tummy. I take omeprazole and ranitidine twice a day. I avoid levo problems by taking it at bedtime. Taking the omeprazole has caused no issues with levo. It really is a case of careful planning to get meds right. As others have said it really is essential to get vitamins and minerals right. Take care.

Black1 in reply to Miffie

Thank you

Vit D can affect bone pain. I buy my own Vit D3 and K2 supplements for that after the NHS prescription ran out, plus magnesium oil and espsom baths, turmeric spray, omega 3. TENS, massage cushion, chiro and osteopath. NHS can also give you ibuprofen suppositories so you get the pain relief without it going to your stomach. Not the most pleasant thing to do but it's quick and easy and you get the pain relief - I was given them as an inpatient and they said it's the normal method of taking it in Europe as it avoids the stomach issues. I have bad GERD so can't tolerate the tablets either. I've not found much relief with anything else. I believe the Alexander technique and pilates with an appropriately trained professional can be of great help. If you have good posture and strong muscles it can help support your spine. It might not cure the pain but at least you can prevent further issues and support yourself the best you can.

Black1 in reply to bluefall

Thank you so much for all the information especially as I use to do Pilates but instructor left, so stopped but must restart again as no back pain then 😀

They don't tell you but Levothyronine gives you bone loss. I fell and broke my wrist and the bone Doc said my bones were almost non-existent because of this drug.

vocalEK in reply to Cripanemic

Found this: "The doses of thyroid hormone used to treat hypothyroidism (underactive thyroid) don't harm bone and shouldn't be cause for concern. Only high doses, used for thyroid cancer treatment, can cause bone loss. High doses or long-term use of medicines called proton pump inhibitors (PPIs) can raise the risk of bone loss."

Black1 in reply to vocalEK

Thank you so much for all your advice, that is very kind

For me, I got rid of my need to have any painkillers for back pain (was on diclofenac for years) when I tried Boron (30 mg daily) tablets. It may or may not help you but worth a try maybe? I was shocked at how much better I got. It takes some time to reach full effect (several weeks) so don't expect instant results. I buy mine from Hakala labs in the USA because you can't buy 30mg strength tablets here. You could try Swanson's boron, I believe they do a 6mg dose, you'd need 5 daily, but worth doing so on a trial basis to see how you get on. :)

Thank you so much

Whilst all these painkillers are helpful, attention must be given to the liver and therefore inflammation. Ask your GP for a liver function test to keep a check on the state of the liver It woud be beneficial if you could get in contact with either a Homeopath or Naturopath, Osteopath and ask their advice. There are a lot of free radicals circulating in the Human Body which also cause inflammation. Antioxidants are key in helping to reduce the amount of free radicals, which we are subjected to every single day.

CBD oil has been suggested to help with neuropathic pain and inflammation.

Aloe Vera juice with Chondroitin, MSM & Glucosamine

Monavie Active Juice. which is an antioxidant drink.

Sadly because of the rules on this page, I am unable to give you the links which would help you

Thank you for all your advice x

I assume you've heard the old saw. Don't take other meds 2 hours before, or 1 hour after taking thyroid hormones. My personal opinion is that 2 hours is too restrictive.

I also had spinal problems (degen at L5-S1, herniations at L4-L5 and L3-L4). My degeneration was completely due to gluten enteropathy, whose major effects were crashing my thyroid (hypothyroid) and making it impossible for my digestive system to process protein (hypoproteinemia). I was able to treat it and now I have no back pain or instability. Write me if you want to know how I treated it.

BTW my son is a pharmacist and doesn't think much of paracetamol. It's too easy to overdose on acetaminophen, and it's not all that effective anyway.

Thank you so much for replying, I am going to see GP next week and may get back to you if no joy

Change your thyroid medication to Armor thyroid. It’s natural not synthetic. I had the same pain problem with Levothyroxine. Try getting of the ibuprofen. It will thrash your stomach. Instead try Boswellia and Hops from the vitamin store for pain. I still take gabapentian but my doctor wants me to take the thyroid on an empty stomach. Make sure you are getting enough potassium. I hope this helps

Levothyroxine is a prescription drug. It comes as a tablet or capsule you take by mouth. It also comes as an injectable solution that’s only given by a healthcare provider.

Levothyroxine oral tablet is available as the brand-name drugs Levoxyl, Synthroid, and Unithroid. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

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