I had a hemithyroidectomy in 2015. I have been on levo since then and results were stable, all good. No.problems.About 5 months ago my gp.prescribed spironolactone for hypertension . Gradually my tsh has risen to 4.2 and free t4 is now 17.5.
My gp has said to reduce the levo !?
I have read that spironolactone can affect the thyroid / thyroid functioning.
I have also been having insomnia for no reason and upset tummy .
Any advice or experience wold be greatly appreciated
Can you share your latest thyroid results in full to include reference range for each test?
Has your GP explained why you need to reduce your dose?
NICE guidelines state that our views should be taken into account.
The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :
nice.org.uk/guidance/ng145
"Your responsibility”
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. “
Your symptoms and TSH point towards you needing an increase in dose.
You can try different GPs at the same practice, some are more conservative than others. Also ask for the increase on a 'trial' basis which often goes down better.
Are you taking Levo on its own, on an empty stomach, with nothing other than water for an hour afterwards.
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
Do you do tests as per the protocol recommended here? Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).
Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
Yes to all of the above re testing.Everything has been stable for 10 years untill i started spironolactone.
The reduction was suggested due to raised t4.
Hello Thingybob :
So what were your results and ranges prior to the TSH being 4.20 and the T4 17.50 ?
and you really do need to insist that you are dosed and monitored on your Free T3 and Free T4 - as detailed on previous replies - otherwise we can't know how well your are converting the T4 into T3 which is the active that run your body much like duel runs a car with the gear box being your thyroid.
It's recommended that once taking thyroid hormone replacement the TSH is kept under 2 - hypo symptoms start creeping in when TSH over 2 and years ago a diagnosis of hypothyroidism and treatment started when the TSH goes over 3 :
It could be a coincidence - though a quick look offers several issues to be understood.
Please get your ferritin, folate, B12 and vitamin D run as your metabolism has now slowed and your body struggling to extract key nutrients through food and no thyroid hormone replacement works well when said co-factors are not maintained at optimal levels which we can advise on as just being in a NHS range range, somewhere, anywhere, not conducive to optimal health and well being.
T4 - Levothyroxine is a pro-hormone and needs to be converted in your body into T3 which is the active hormone that runs your body and your thyroid synchronises all your bodily needs from your physicality and stamina through to your mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.
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