Hello,I have been investigating the above recently via this forum and elsewhere. It concerns me that I take two medications that have an effect on Levothyroxine.
Omeprazole 20mg daily, taken before bed and Propranolol 30mg taken twice daily usually before breakfast and before bed. Levothyroxine, 200mcg, taken as early in the morning as possible with regard to the advice not to take other meds and food/drink within 30-60 minutes.
Is it correct that Omeprazole interferes with the uptake of T4, and would this be on a 24/7 basis? Same question for Propranolol inhibiting the conversion of T4 to T3?
I ask this because this past winter I have felt the cold more than ever before, but it is an internal cold that does not respond to external heat sources. My skin is dry, especially on my hands. Hair is dropping out but this could be due in part to age. My self diagnosis is insufficient T3.
I am on the verge of having blood drawn to test Thyroid function. Should T3 supplementation be advised, and the only route to this is via private prescription, what is the typical cost of say, a minimal dosage for 28 days?
Now, where in the body is the T4 to T3 conversion carried out? If the Liver is involved would the presence of NAFLD further inhibit that conversion?
All of this results from my GP seeking to reduce my T4 intake due to TSH regularly being around 0.1.
Thanks for reading as far as this. I hope you can understand where I am coming from. Any advice or further information would be greatly appreciated.
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Eccleston
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Levothyroxine, 200mcg, taken as early in the morning as possible with regard to the advice not to take other meds and food/drink within 30-60 minutes.
Actually, we recommend levo be taken 60 mins before food or 2 hours after. But for most other supplements/medication, it should be 2 hours away. So it rather sounds like both your medications are being taken too close to your levo, so both will be affecting your absorption.
Omeprazole reduces stomach acid levels. Stomach acid is necessary to remove the hormone from the levothyroxine pill. And, you probably have low stomach acid, anyway, as you're hypo. So reduing it even further is likely to have quite a dramatic effect on your absorption of levo in the gut. But it doesn't affect the uptake of T4 at a cellular level.
Propranolol will reduce conversion of T4 to T3 on a continual basis, all the time you're taking it.
Conversion mainly takes place in the liver but also in the peripheral tissues where needed. I'm afraid I don't know anything about NAFLD. But it does sound as if your FT3 is likely to be low. So, it would be a good idea to get a private test. Doctors are obsessed with TSH - they don't know any better - so just refuse the reduction until FT4 and FT3 have been tested. You're only over-medicated if your FT3 is well over-range, whatever your TSH say.
You would think these other drugs would get flagged and the implications explained to you by your doctor.
Also consider the timing of the blood draw - we advise an early morning - by 9.00am - appointment - and the thyroid panel should be at least a TSH, FreeT3 and Free T4 -
It should be a fasting blood draw on an empty stomach with you taking your T4 for that day - after - the blood draw - so we measure what your body is holding and working with - not what you have just ingested.
So you need to leave around a 24 hour window from your last dose of T4 - and if also measuring your core strength vitamins and minerals - ferritin, folate, B12 and vitamin D these need to be stopped around a week before the blood test so we measure what your body is supporting you with.
No thyroid hormone replacement works well until the core strength vitamins of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels - as with metabolism running slow and being hypothyroid the body can struggle to extract key nutrients through food - no matter how well and clean you eat - and maintaining key nutrients at optimal a necessary co-factor for optimal thyroid hormone conversion of T4 into T3.
I would like tonlet you and anyone know that there is a natural alternative to Omeprazole and similar medicines. If is a Swedish invention called IQORO, now available on the NHS in the UK. It is a devise that you use 3 times fit 30 seconds a day to retrain your tummy and swallowing muscles and you should be cured from acid reflux after a few months to a year. There are no side effects and it worked for me.IQORO team worked on this invention huf over 2O years. I still get some acid but am managing it by being careful what I eat. IQORO has recently won an international award. The down side is remembering to exercise with it , but it is fantastic alternative; my gastroenterologist started to recommend it to her patients, seeing the progress I have made. Anti reflux medication is not good for you longer term. Good luck!
I have read about this. No idea it was available on the NHS. It’s quite pricey otherwise.
Are your thyroid meds optimal? I think if they are not ‘there’ or ‘near there’ this could still be problematic because hypothyroidism itself creates the problem (muscles) in the first place.
I paid for mine, before they advertised it as being available on the NHS. If you contact IQORO they might give you more details. I view my money as well spent. All the best
I recommend meditation and mindfulness. Having Mindfulness coach for 12 weeks saved me. I also recommend Eckhart Tolle book ‘The power of now’ ( found it much better than medication) but you need to slow down and put yourself first . All the best.
Gosh you could talking about me , last November GP reduced my Levo to 100mcg via a text message, I have no Thyroid, they had already reduced it in July to 125mcg. I have had the most miserable winter, been beyond cold hair falling out, 5 more lbs in weight gain and now been told they will no longer test T4! TSH is the ONLY way to go apparently. I am also on Propanalol and was given Omeprazole but I haven't taken it so far. Saw a different GP Last Thursday who has agreed to 125 again but has anyone else been told that new guidelines say not to test T4 only TSH?
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