Hypothyroidism Support Group
Hypothyroidism is the disease state caused by insufficient production of thyrohormone by the thyroid gland. There are several distinct causes for chronic hypothyroidism, the most common being Hashimoto's thyroiditis and hypothyroidism following radioiodine therapy for hyperthyroidism. Advanced hypothyroidism may cause severe complications, the most serious one of which is...
Hi there guys, you fantastic people helped me out hugely awhile back on advice on how to balance my thyroid and I am thrilled to say I slowly with each dose increase saw my levels rise and my symptoms dissipate after years of quite frankly hell. For the last 6 months I was experiencing a somewhat hypo day once every couple of weeks that's all - I had my life back and it was great. Can you sense the but coming?......
Unfortunately over the last few months I have had to deal with a nerve problem and long story short was put on amitriptyline which has done wonders for the pain but just as I started to experience the pain relief I have been hit with a major crash of hypo symptoms. The horrendous tiredness is now again a constant companion and utterly debilitating, I'm freezing cold, aching etc etc. Basically I feel like how I used to be at my worst and I am quite honestly terrified - after 18 months of painfully slow and difficult titration I feel like I am back to square one.
I have had labs drawn today and will get the results on Wednesday.
I guess my main question at the moment is is there a known link between the amitriptyline and thyroid levels? (Elavil I believe in the US). I can see on my leaflet that comes with the meds that it should be 'used with caution' in those on thyroid medication but do any of you know why?
Thanks in advance to anyone that can help shed some light.
Unfortunately over the last few months I have had to deal with a nerve problem and long story short was put on amitriptyline which has done wonders for the pain but just as I started to experience the pain relief I have been hit with a major crash of hypo symptoms. The horrendous tiredness is now again a constant companion and utterly debilitating, I'm freezing cold, aching etc etc. Basically I feel like how I used to be at my worst and I am quite honestly terrified - after 18 months of painfully slow and difficult titration I feel like I am back to square one.
I have had labs drawn today and will get the results on Wednesday.
I guess my main question at the moment is is there a known link between the amitriptyline and thyroid levels? (Elavil I believe in the US). I can see on my leaflet that comes with the meds that it should be 'used with caution' in those on thyroid medication but do any of you know why?
Thanks in advance to anyone that can help shed some light.
"Basically I feel like how I used to be at my worst and I am quite honestly terrified - after 18 months of painfully slow and difficult titration I feel like I am back to square one.
I have had labs drawn today and will get the results on Wednesday.
I guess my main question at the moment is is there a known link between the amitriptyline and thyroid levels? (Elavil I believe in the US). "
Please post your labs when you get them (I'm sure you will).
Just fyi, after 18 months...it's not uncommon to need an adjustment anyway...even without the addition of elavil. It's just the nature of the thyroid beast.
But to answer your question: Elavil CAN cause some issues with hypothyroid patients. Now, according to the drug companies and certain reports - there's mixed opinions on WHY.
Some say it can cause an erratic heartbeat in patients who are on synthroid (which can happen anyway)
Some say it can cause hypothyroidism or hyperthyroidism to worsen (but they don't know why)
None of that really matters, though. You feel like crap, so you need labs, right? And, if you get your meds adjusted and it doesn't help - perhaps you can ask your doc if you can go off elavil or ask for something different? But do ONE THING at a time, K?
I suspect that you probably just need an adjustment in your meds. That's my best guess. Your labs will tell the tale.
However, I couldn't take elavil because of some serious side-affects. I'd explore that as a second option if you're labs look "optimal for you".
I hope that helps! Good luck.
More info:
http://www.drugs.com/answers/i-am-prescribed-elavil-i-take-synthyroid-will-it-60075.html
http://www.netdoctor.co.uk/depression/medicines/amitriptyline.html
http://whatmeds.stanford.edu/medications/elavil.html
That's calmed me down a lot and appreciate your advice.
I'll absolutely post the labs when I get them and as you say that'll I'm sure give the game away. Back shortly :)
Labs 3 months ago when I was on 137.5 T4 and 20 T3 were
T4 - 21 (10-24)
T3 - 5.1 (range is 2-7ish can't quite remember)
Note I do fudge my T3 result by only taking half my T3 dose the day before labs which is ridiculous but if I didn't it would get pulled from me. However I fudge it exactly the same each time but in reality my T3 is going to be higher.
We added in an extra 12.5 T4 after which I felt better so I'm assuming it rose but as mentioned I've got worse recently. New labs show...
T4 - 19
T3 - 5.3
So T4 has dropped from 21 to 19 despite the increase. Well strike me down it makes sense :)
As I force (sorry I mean guide) my doc on dose changes I'm thinking I need to increase my T4 again. Would you suggest 12.5 or 25mcg?
Thanks everso, you were of course right, yippee
Hahahahahahahaha!
"Righty ho, labs are back and interestingly my T4 level has dropped since my last increase.
Labs 3 months ago when I was on 137.5 T4 and 20 T3 were
T4 - 21 (10-24)
T3 - 5.1 (range is 2-7ish can't quite remember)
Note I do fudge my T3 result by only taking half my T3 dose the day before labs which is ridiculous but if I didn't it would get pulled from me. However I fudge it exactly the same each time but in reality my T3 is going to be higher. "
Nothing wrong with that!
"We added in an extra 12.5 T4 after which I felt better so I'm assuming it rose but as mentioned I've got worse recently. New labs show...
T4 - 19
T3 - 5.3
So T4 has dropped from 21 to 19 despite the increase. Well strike me down it makes sense :)
As I force (sorry I mean guide) my doc on dose changes I'm thinking I need to increase my T4 again. Would you suggest 12.5 or 25mcg?
Thanks everso, you were of course right, yippee "
The answer is: It depends. If you're super-sensitive, I'd go for 12.5. If not, I'd go for 25 mcg. Since you're sitting at about 75% of range for Free T4 you have some wiggle room, so 25 mcg might be ok. Unfortunately with balancing a thyroid...it's a trial and error type thing until you find YOUR optimal. It may not seem like it but your thisclose to being optimized.
Good luck!
I think I'm going to pack in 25mcg as I only felt properly near to optimisation after the dose increase had bedded in last time so my T4 level would of been greater than 21. I'm guessing I probably need to be around the 23 mark but I'll keep a close eye and observe any weird hypo symptoms. Darn it I'd conveniently forgotten how bad this feels but at least this time round I know I can feel good.
Roll on 4-6 weeks, sigh
I hope your drama has all sorted itself and things are now calmer - us hormonally wonky special ones should not have to deal with such things I feel, no fair!
I conveniently forget just how bad it can get as well....then BAM - right between the eyes with a 2x4! A few months after I hit optimal, I let quite a bit of time slide by....and I was like a turtle on my back...just no way to get up.
No one should have to fight so hard when they feel so bad... :(
Sounds like the 25 mcg should be ok for you...I only feel ok when I'm slightly over the top of the range - emphasis on slightly - for Free T4.
Glad your drama is sorted, good news.
See, thyroid disease is a bit like an ant hill. The thyroid (ant hill) is trying its best to remain stable and support life (the ants). However sometimes a storm comes along (Hashimoto's/Thyroid Disease) and beats it down (thyroid). So, the ants have to get to work to try an compensate ...but they can't...because the ant hill is too beaten down (Thyroid disease).
So, we have to get ahead of it and STAY ahead of it.
My personal thyroid guru (yes I have one ....thank you baby Jesus) has labs every three-four weeks regardless of how she's feeling and she's always on top of her thyroid health.
Because of insurance purposes and well, just plain laziness, I have mine more like every six to eight weeks AFTER I hit "optimal". I recommend every four to six weeks at most (do as I say...not as I sometimes do,k? lol)
If you do that...you'll spot a problem before you manifest symptoms - which is why the symptoms journal is also important.
It works like this: T4 takes about four-six weeks to get into your system. So, get labs around week four - but you're not gonna feel that T4 level for another week or so...and you have time to adjust it. T3 is a different story - you'll feel it almost immediately (within hours).
So, yes, you have to "get ahead of it" once you hit Optimal by keeping an eye on your levels. They may fluctuate a tiny bit which isn't cause for worry, but you'll figure out where your comfort level is...and just how much of a fluctuation is OK for YOU...and when you need an "adjustment".
That was a loooooong explanation just to say, "Yes, you're right...you have to keep an eye on it" lol
BTW: SOME people who have a fairly stable thyroid (NOT ME) can wait three to six months for labs once they hit "optimal". And continue that fairly regularly (3-6 month labs). You may be one of those people. I AM NOT (crazy thyroid).
I can't believe how ropey I feel after feeling so much better for months, so horrid. However learnt a valuable lesson and fingers crossed I'll pick up a bit soon. I'd be in a full on state of panic if it wasn't for you guys - shall keep repeating to myself that it WILL all be ok and just need to grit my teeth for the next month or 2 or 3. This thyroid business is an absolute pain in le bottom that's for sure.