Safe mix of meds?: Hi all, long time sufferer of... - Thyroid UK

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Safe mix of meds?

AlexHank1983 profile image
18 Replies

Hi all, long time sufferer of Hypothyroidism and Fibromyalgia. Have just been given Gabapentin for the Fibro and I'm concerned if it will have an effect on the absorption of Levo as it's an anti seizure drug?

Also does anyone take collagen supplements with Hypothyroidism?

Thanks :)

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AlexHank1983
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18 Replies
SeasideSusie profile image
SeasideSusieRemembering

Some medications can affect absorption of Levo so it's always best to take anything else as far away from Levo as possible, opposite ends of the day if possible but if not then the maximum time gap you can manage. Depending on how many times a day you take the Gabapentin, either take the Levo at least 2 hours before or at least 4 hours after.

You can always Google for any specific information about Gabapentin and Levo, but here's a general article

pharmacytimes.com/publicati...

AlexHank1983 profile image
AlexHank1983 in reply to SeasideSusie

Thank you that's really helpful! Have been Googling all morning but to be honest it's a bit of a mine field with lots of conflicting info.

Thanks again :)

MaisieGray profile image
MaisieGray

I read a report from 2016 I think, of an euthyroid man who developed symptoms of hypothyroidism on starting gabapentin, and this was resolved by taking a low dose of levothyroxine. So as long as you take your levo within the 2 hrs before / 4 hrs after guideline, you should be perfectly fine taking both meds.

AlexHank1983 profile image
AlexHank1983 in reply to MaisieGray

Ok thank you!! :)

shaws profile image
shawsAdministrator

Re Fibromyalgia - TUK had an Adviser who was also an expert in the use of T3 and he also ran the Fibromyalgia Research Foundation before his untimely death.

He stated that fibro was due to Thyroid Hormone Resistance and that person could only recover on higher doses of T3 and I will look to see if I can find information. His website was closed when he died through an accident.

thyroiduk.org.uk/tuk/relate...

thyroiduk.org.uk/tuk/relate...

AlexHank1983 profile image
AlexHank1983 in reply to shaws

Thank you this is really interesting!

shaws profile image
shawsAdministrator in reply to AlexHank1983

Before the introduction of blood tests for the diagnosis of hypothyroidism we were always diagnosed upon clinical symptoms and given NDT (natural dessicated thyroid hormones) even on a trial basis. NDT contains T4, T3, T2, T1 and calcitonin.

Once blood tests were introduced along with levothyroxine, about ten years afterwards ' new diseases' were named i.e. CFS, Fibro and ME.

thyroiduk.org.uk/tuk/about_...

humanbean profile image
humanbean

I know you didn't ask about this, but I'm going to say it anyway...

Do you have any results for thyroid function testing done in the last year or two?

Have you ever had any nutrients tested in the last year or two? Particularly vitamin D, vitamin B12, folate, iron and ferritin?

If you have been diagnosed with fibromyalgia the chances are good that you could make yourself feel rather better, possibly even a lot better, than you currently do if you optimise your thyroid levels and your nutrient levels. (And personally, I would rather take a vitamin supplement than a drug like gabapentin with all its side effects.)

Patients are entitled (by law) to get copies of their blood test results, with the reference ranges, from their surgery. Make sure you get copies on paper printed out from the surgery's computer system , not handwritten ones or verbal ones. Ask the receptionists for copies, not your doctor. They may tell you to come back later or the next day, which is fine, but don't allow yourself to be fobbed off indefinitely.

An alternative is that you could ask for access to your medical records online, but some surgeries won't do this, even though by law they should.

Each time you go to the surgery to ask for any info from your medical records take proof of identity with you.

AlexHank1983 profile image
AlexHank1983 in reply to humanbean

Ok thanks I will, I've never had a copy of them and I was diagnosed around 10 years ago! I don't think I would even know what all those numbers mean lol.

shaws profile image
shawsAdministrator in reply to AlexHank1983

To get the best results from blood tests. Always get the very earliest and fasting (you can drink water). Also allow a gap of 24 hours between last dose of thyroid hormones and the test and take afterwards. This helps keep the TSH at its highest as food can reduce TSH and doctors only take notice of this - even if it is from the pituitary gland and not the thyroid gland.

AlexHank1983 profile image
AlexHank1983 in reply to shaws

Ok thank you, I recently had a test but I might try this and book myself in for another!

shaws profile image
shawsAdministrator in reply to AlexHank1983

Also if you take coffee at breakfast, allow a gap as food and coffee interfere with the uptake. Always get a print-out from the surgery of your results and make sure ranges are also stated. Members cannot comment upon them unless ranges are given. Labs differ and so do their ranges.

humanbean profile image
humanbean in reply to AlexHank1983

Post a copy of any results you get in a new post and ask for feedback. The details we need are the test name, the test result, and the reference ranges. So, we need something like this :

TSH 3.6 (0.27 - 4.2)

Sometimes reference ranges come in the form of < 10 or > 3 rather than two numbers. Sometimes reference ranges are not supplied at all for some tests, which is annoying. If that happens you should include the units of measurement.

You can post a single picture in the first post in a thread, but if you do this in preference to typing out the results, make sure you exclude any of your personal details in the picture.

AlexHank1983 profile image
AlexHank1983 in reply to humanbean

Ok thank you for your help!

SlowDragon profile image
SlowDragonAdministrator

How much Levothyroxine are you currently taking?

Do you always get same brand of Levothyroxine?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

Is this how you do your tests?

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

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

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 primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

You are legally entitled to printed copies of your blood test results and ranges.

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Come back with new post once you get results and ranges

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

AlexHank1983 profile image
AlexHank1983 in reply to SlowDragon

Thank you for all this good info! I don't know about vitamins unfortunately but a few years ago I was given a course of vitamin D. I think I will book in for a new test soon and come back with a new post.. wish I had joined this site a long time ago!

SlowDragon profile image
SlowDragonAdministrator in reply to AlexHank1983

Fibromyalgia is often linked to low FT3 and/or low vitamins

AlexHank1983 profile image
AlexHank1983 in reply to SlowDragon

Oh and I'm on 100mg of Levothyroxine a day.. company is North Star..

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