Further to My Fist Question

I have now had my visit to the GP who almost fell over backwards to help! He asked me what I wanted and I asked for a trial to see if there are any improvements. I didn't have to get any of my downloaded reports out. I have the feeling that the reading of Thyroid antibodies and the blood test going missing made the difference! I have now been given a starting dose of Levothyroxine 25mcg which seems a bit low, then again I did have a triple by pass last year and am still taking bisoprolol and Rampiril to control heart and blood pressure.

Thanks to all of you

Bumley

10 Replies

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  • Ah!!! Bisoprolol.. that's a beta blocker, Beta blockers can hinder conversion of T4 (levothyroxine) into the active hormone Liothyronine. Make sure you have selenium which is essential for conversion, also, take your levothyroxine on an empty stomach, last thing at night is best, and as far away from other meds as possible.

    If you feel no better on Levothyroxine, insist on getting your free t3 measured to see if you are converting the T4 ok. If not then a amall dose of T3, split over the day would be the way top get round non conversion.

    Hava a dig around the internet and the various sites, theme of 'why isn't my levothyroxine working' and you'll come up with the link between beta blockers and thyroid meds....

    Nel x

  • Thanks, its complicated! Can I get selenium at a chemist? I will print this out and speak to my GP if these results are needed.

    Thanks, but shouldnt doctors know this?

    Bumley

  • Yes you can buy selenium at a chemists or Holland and Barrat, even Asda sell a version. I use Lamberts selenium, and I buy on line

    health4youonline.com/health...

    Usual dose is 200 mcg a day (1 tablet).

    Because we would normally make some t3 in our thyroid gland, and rely on conversion for the rest, putting us on T4 only and expecting the body to convert all that it needs, puts a lot of stress on mineral resources. Crucial for conversion are Zinc, Copper, Selenium and Iron.

    Doctors should know this but many of them have simply forgotton, or have not kept up with their learning. There seems to be a massive over reliance on tests and not much reliance on common sense - which is why forums like this exist. If the docs knew how to treat sensibly we wouldn't need the forums.

    If the doctor is particularly dim, I tell them that they can do a CPD unit (Continuing Professional Development) on thyroid meds and they will learn as well as doing the required amount of study.... here's the link :)

    pulsetoday.co.uk/story.asp?...

    Nel x

  • Nel,

    In my excitement I have not given you the full picture about my drugs, sorry.

    In addition to levothyroxine (new), Ramipril (10 mg) and Bisoprolol (10mg),I also take Clopidogrel (75mg),Ranatidine (150mg), Omega 3 capsules (cannot digest oily fish) and both background insulin and rapid response insulin.

    I have spotted on web site for selenium that Clopidogrel is a problem with selenium as it can cause increased bleeding and bruising.

    I haven't taken any selenium yet and please accept my apologies for not giving your the full picture

    Bumley

  • Hi Bumley,

    Oh dear, what a lot... so if you can't take selenium, consider taking T3 instead of T4. Not sure what the doc will make of it though... I get it on prescription from my doc and I buy extra on line. However, you might mansage ok with just the T4. 85% of people do fine with it. The rest of us are on the forums :(

    I'll bet your bottom dollar that the reason you can't digest stuff is because you have too little stomach acid and the Ranatadine is completely the wrong thing to take. Doctors have forgotten what they were taught and are swayed by the advertising they see. Have a look at this site by Dr Myhill and consider getting some Betaine HCL (ebay £10 for about 180 Lamberts brand).... I know it sounds mad but it's the truth........ lack of stomach acid causes bloated stomach, acid reflux, lack of proper vitamins as food not digested.... you can test it really easily. Drink a glass of water with a level teaspoon of bicarbonate of soda in it, first thing in the morning. If you burp with a minute or two then you probably have enough acid, 3 minutes or more and you're probably short of acid, not at all and you're definately short. prohealth.com/library/showa...

    Nel .

  • Nel,

    Took the test this morning and burped in a matter of 30 seconds. Very impressed with the logic of digestion and tablets. My dosage of Ranatidine is 2 x 150mg per day. I reduced this to one a day so this test helped assess that. I am taking the Levothyoxine last thing at night.

    I have also stopped taking the statin. My logic being that cholesterol levels are 1.5 and I do stick to a low fat diet with lots of fibre. I aim to do this for a week or so and then get a cholesterol test to check

    Thanks

    Bumley

  • Wow! 30 seconds, you can keep that dollar then :) You're the first person I've ever met who actually did have some stomach acid... most people manage to go for several minutes or not at all!!

    The way that they used to test for hypothyroidism, before the dreaded tsh test, was by checking cholesterol levels as hypo ususally means higher cholesterol levels.

    It's a bit of a debateable myth about cholesterol anyway. if your D3 levels are low, because of a lack of sun, the cholesterol builds up, so that the second you get out in the sun the cholesterol can be turned into D3. so it may be worth you checking your d3 levels. My neighbour had high cholesterol , she went off to Saudi for a month and when she came back the cholesterol had dropped loads.... ( she sat around in the sun a lot )..... Cholesterol is a building block and most of it is made by our own body.....

    I won't let them measure mine, I don't want to know and I wouldn't take statins so no point in knowing.]

    Nel :)

  • The interaction checker that I often refer to says this:

    Interactions between your selected drugs

    levothyroxine ? bisoprolol

    Applies to: levothyroxine, bisoprolol

    Thyroid hormone therapy may reverse decreased hepatic blood flow associated with hypothyroidism. Increased hepatic metabolism and decreased serum levels of some beta-blockers may result. Data are available for propranolol only. No special precautions are necessary. When hypothyroidism is converted to a euthyroid state, a decrease in beta-blocking effectiveness is possible.

    drugs.com/interactions-chec...

    If you follow that link I think you will see the page I could see.

    Some beta blockers appear to affect the binding of thyroid hormones so may result in small changes in free or total levels and hence their overall effects. However most often the evidence is based on propranolol - and I do not know how different bisoprolol is from that.

    Given a heart issue I think 25 mcg is probably an appropriate dose to start. And don't forget that high blood pressure *can* be related to hypothyroidism.

    Rod

  • I started day before yesterday with a dose of levothyroxine in the morning, will now change to before bed. I take a Statin at night but I will change this to dinner times. I will make a query with my GP about the bisoprolol.

    Thanks again and will investigate the interactions a little more thoroughly.

    In view of the fact I have thyroid antibodies I am stuck with this thing for life and better get it right.

    thanks again for your wonderful help

    Bumley

  • I would actually be more concerned about the statin. :-)

    There is quite some evidence that statins taken when hypothyroid can have unpleasant side effects such as, in extreme cases, rhabdomyolysis or, in lesser cases, simple muscle discomfort.

    Rod

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