Hives from levothyroxine?

[Jojoretro]

looking for ado r for my partner… he’s been on levothyroxine (accord) since late August and around 4-5 weeks in developed urticaria Tash and extreme itching. Anyone else had similar experience and did a change of brand help? I will add he has also had to start taking Ramipril in the last few weeks. Doctor has prescribed fexofenadine but it hasn’t helped and he doesn’t tolerate it (drowsiness, confusion etc.)… despite this, they’ve just doubled the dose of the fexofenadine!? Not sure what to do as it’s impossible to get seen by a doctor, it’s all just phone calls.

[Poppy_Ann]

Hi there, whilst I have no help for you with your problem but can you help me i have heard the word hives but I have no idea what they are.Sorry for being stupid but I just googled it so now I know i never think to check with google it must be due to not growing up with mobiles and tablets.

Hope you find a cure to your problem Regards Poppy Ann.

[Me2U in reply to Poppy_Ann]

Itching symptoms with usually large patches red

[Mantras131]

I developed hives after taking Teva but it came on quite quickly. It could be a problem with the brand if he’s not had it before. Anything else introduced that was new at 4/5 weeks? Hope it is resolved soon.

[SlowDragon Administrator]

Hives is common issue with autoimmune thyroid disease

verywellhealth.com/thyroid-....

What were his blood test results BEFORE starting on levothyroxine

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

How much levothyroxine is he currently taking

Has dose been increased since starting on levothyroxine

Which brand is he taking

Is he taking levothyroxine correctly, always on its own, on empty stomach and then nothing but water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

For full Thyroid evaluation he needs TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements is he taking

VERY important to test TSH, Ft4 and Ft3 together and test early morning …..last dose levothyroxine 24 hours before test

[RedApple Administrator]

Hives is quite common when the dose of levothyroxine is too low. It may well be exacerbated by the Ramipril, as this is also a side effect of that medication.

Please let us have details of the dose of levothyroxine that's been prescribed, and the most recent thyroid test results so that we can give more help.

In the meantime, if the fexofenadine isn't helping, he can try various different antihistamines which you can buy yourself from a pharmacy. The generic brands of Cetirizine and Loratidine are easily available and a good starting point.

[Me2U in reply to RedApple]

This question seems very apt for me currently. I was diagnosed 20 odd years ago but just this last week or so have developed quite severe itching on my neck/ throat area for which I was unsure for why. Your answer might answer this?!

[Zephyrbear]

I get terrible hives if I have anything other than the Wockhardt brand of Levothyroxine… and currently my surgery pharmacy are having problems getting it ( nothing to do with Wockhardt themselves but a distributor problem). So I’m having to go without as I will not accept a substitute! I only take 25mcg/day as I also take 55mcg T3(Liothyronine) /day so I can afford to go without for a few days until they can source it.

As it is, I am taking a 10mg Cetirizine (antihistamine)tablet daily to stave off any hives that may occur due to anything else I might be taking, but any brand other than Wockhardt of levothyroxine certainly did.

[gabkad]

It's most likely the rampipril. There are other ACE inhibitors he can try.

[Batty1]

I had severe hives because of inactive ingredient “Acacia” .

[Taffhamster]

I can't claim to be an expert, but I see that Ramipril can cause a rash. With me, it caused a chronic cough and it got bad enough one weekend that I ended up calling 111. (Not the same as your partner's issue, but within the irritation "ballpark" and a noticeable problem.)

I'd suggest you call 111 if you're having trouble getting a GP appointment – they may be able to arrange a GP or out-of-hours cover appointment for you. They did the latter for me, and the doctor I saw switched me to Amlodipine for high blood pressure, which sorted out the cough fairly quickly.

Good luck.