Topiramate and interaction with Levothyroxine and Liothyronine (and new blood test results)

[ShonaGreen]

Hi, I've recently had a bad spell of migraines, pretty much constant for the last week with sensitivity to sunlight, bright light and noise, nausea, bad fatigue and breathlessness. I take 80mg Amitriptyline for chronic migraines which has helped, although I still get some migraines. These usually only last for a day but I'm still sensitive to bright light and noise all the time, and just being outside can trigger a migraine these days.

My GP has suggested increasing to 100mg Amitriptyline and starting 25mg Topiramate which I started yesterday.

I thought it would be useful to check my thyroid levels, as increased to 75mg Levothyroxine and 25mg Liothyronine two months ago. My recent results are below (test taken at 8am with fasting. Last dose of Liothyronine was 11 hours earlier and last dose of Levothyroxine was 24 hours earlier). I think these seem OK with my vitamin levels improving (I use Better You sprays for Vit D and Vit B, Igennus Vit B Complex and Magnesium Threonate), but please let me know if you think there's room for improvement.

But after doing some research I think Topiramate could affect thyroid function/medication, so I thought I'd ask if anyone has any knowledge of this? As background, my initial thyroid results potentially indicated central hypothyroidism as I had low TSH, Free T4 and Free T3. My Endocrinologist thinks this is the case too so is happy to prescribe Liothyronine which seems to be helping, as it's gradually increasing my Free T3 levels. My GP is aware of my thyroid medication and I asked about possible interaction with Topiramate but they said it would be OK. However, I'd rather not start taking it it could potentially affect my thyroid levels, as it's taken a while to get where I am, and whilst I may not feel great, it's a lot better than what I felt this time last year! Thanks for your help, it's much appreciated!

[SlowDragon Administrator]

Migraine often hypothyroid symptom

Ft4 is still probably too low

Suggest you get increase In levothyroxine....either 25mcg or 12.5mcg and retest in 6-8 weeks

Presumably you stopped taking vitamin B complex a week before blood test?

Suggest you get some folate on its own (solgar do one) and take this in the week you stop vitamin B complex in run up to next test

[ShonaGreen in reply to SlowDragon]

Thanks SlowDragon , yes I stopped taking vitamin B complex a week before the blood test. I'll get the folate too. I thought the migraines could be a symptom of hypothyroidism too so expected my blood test results to be a lot lower but thankfully they're not too bad. As GP just prescribed Topiramate, I'm not sure they'll be open to increasing Levothyroxine too but will make the request and hope for the best!

[Algic]

After several different medications for a rare form of migraine topirimate works. I've been on 100mg morning and night for around 8yrs.if I didn't take it I can have a combined classic and hemiplegic migraine which can last for weeks.

Antidepressants of which amytriplene is one are more likely to intereact. I can't tolerate it. I'm on venaflexine but last week was really not well and phoned 111. Advised me to try and get an appointment of some description with gp. But they would get someone to ring back. It turned out I could have been having a sever reaction and going down the route to Neuro shock. So they had everything set up & on standby should this be the case, A pharmacist phoned me and went through all the problems and symptoms . I was getting the rarer side effects which also closely resemble very low hypothyroidism. ( I've had a few problems lately)

Once we started going through the reported side effects it was amazing how much was the residual symptoms the Drs were puzzled by if my results were normal. This even included my hair falling out. The gp has reduced the dose by half a tablet to start with. The result has been amazing. I'm starting to eat after not having an appetite so I was having meal replacement s. I'm able to do things other than mope.