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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by Maxime on February 1, 2004, at 3:48:07
I've been feeling ultra depressed lately. I am on synthroid for hypothyroidism. I went to my GP and she did a blood test. Well my TSH was more messed up than it was on a lower dosage and she asked me if I had been taking my meds. Yes, I have. Anyhow, she has increased it once again to 1.5 mg.
I need your advice on something. You know, my GP is stupid, you know that, right? I mean don't you think she would be interested to know WHY my thyroid got worse even though my meds increased? Anyhow, I did some research and there are meds that prevent the absorption of Synthroid. One, is any med that is a dopamine agonist, which would be my Parnate. Another is Tegretol and Dilantin (and other anti-seizure meds). Now I am not on Tegretol but Trileptal is an oxygenated version of it. Should I call her or something? I mean will this increase do anything if my other meds are going to interfere? I can't go on feeling like this. What should I do? Call her? And why wouldn't she have looked it up herself? Let me know what you would do. My whole body hurts.
Maxime
PS. I am right aren't I that Parnate is a dopamine agonist?
Posted by gardenergirl on February 1, 2004, at 10:54:43
In reply to Please help me re. Synthroid, posted by Maxime on February 1, 2004, at 3:48:07
Maxime,
When are you taking the Synthroid? It needs to be taken in the morning on an empty stomach, with no eating or other meds for at least an hour for adequate absorption. I take mine when my alarm goes off and then go work out, although not lately :( or go hop in the shower before breakfast. I also space out my multivitamins and calcium so that I don't take them within an hour of the Synthroid to aid in absorption. Given that I have to take 4 Nardil's a day, I really had to plan out when I take what, and I use an alarm system and a pill box to keep me honest.Hypothyroidism can be hard to get a handle on initially. Once you start taking Synthroid, the thyroid can actually start making *less* TSH as it tends to rely on the med instead. So it is not uncommon to have to raise the dose until you get to a balance point.
Frankly, I don't know if your meds are contributing to the decrease in absorption. I ran a quick check for drug interactions on a software program I have. Nothing came up related to Synthroid and Parnate (also no interactions between my Nardil and Synthroid), but you are right, Tegretol does affect absorption. Also, Trileptal did not show any drug interactions with Synthroid.
You may already know this, so please forgive me if it seems insulting. Parnate is a monoamine oxidase inhibitor. MAOI's block the destruction of monoamines, one of which is dopamine. So yes, an MAOI is a dopamine agonist.
Good luck with your hypothyroidism. I know it can be a pain in the butt to manage.
Hope this helps,
gg
Posted by noa on February 1, 2004, at 12:48:02
In reply to Re: Please help me re. Synthroid » Maxime, posted by gardenergirl on February 1, 2004, at 10:54:43
I don't know about these medications and whether they interfere with thyroid hormone absorption, but I agree with gg about it being hard to get a handle on it. Please get more info. A good place to start is at http://thyroid.about.com.
Some books are "Living Well with Hypothyroidism", "The Thyroid Solution", and "Thyroid Power".
Some people, for example, need both synthroid and cytomel, which is a different form of thyroid hormone, in order to get the hypothyroidism under control. Or, as you mention, there may be an unresolved underlying cause for the hypothyroidism that needs to be addressed. Perhaps you should see an endocrinologist to investigate this.
Posted by Maxime on February 1, 2004, at 13:41:07
In reply to Re: Please help me re. Synthroid » Maxime, posted by gardenergirl on February 1, 2004, at 10:54:43
Thanks for your response. I have a hard time not taking everything together in the morning. I would just forget otherwise.
But on www.rxlist.com it said that any drug that is a dopamine agonist will reduce the absorption of synthroid.
I could take it at night but I am afraid it would keep me awake. I might try though. Of course that is when I take my sleep meds. Sigh. And my trileptal which like I said is chemically identical to Tegretrol except it has an oxygen atom attached to it!
Again, I appreciate your response. I will figure something out so that I am not taking everything together.
Maxime
> Maxime,
> When are you taking the Synthroid? It needs to be taken in the morning on an empty stomach, with no eating or other meds for at least an hour for adequate absorption. I take mine when my alarm goes off and then go work out, although not lately :( or go hop in the shower before breakfast. I also space out my multivitamins and calcium so that I don't take them within an hour of the Synthroid to aid in absorption. Given that I have to take 4 Nardil's a day, I really had to plan out when I take what, and I use an alarm system and a pill box to keep me honest.
>
> Hypothyroidism can be hard to get a handle on initially. Once you start taking Synthroid, the thyroid can actually start making *less* TSH as it tends to rely on the med instead. So it is not uncommon to have to raise the dose until you get to a balance point.
>
> Frankly, I don't know if your meds are contributing to the decrease in absorption. I ran a quick check for drug interactions on a software program I have. Nothing came up related to Synthroid and Parnate (also no interactions between my Nardil and Synthroid), but you are right, Tegretol does affect absorption. Also, Trileptal did not show any drug interactions with Synthroid.
>
> You may already know this, so please forgive me if it seems insulting. Parnate is a monoamine oxidase inhibitor. MAOI's block the destruction of monoamines, one of which is dopamine. So yes, an MAOI is a dopamine agonist.
>
> Good luck with your hypothyroidism. I know it can be a pain in the butt to manage.
>
> Hope this helps,
> gg
>
Posted by Maxime on February 1, 2004, at 15:18:05
In reply to Re: Please help me re. Synthroid, posted by noa on February 1, 2004, at 12:48:02
Thanks NOA. The references/resources you gave me will help be able to ask my MD the right questions.
Maxime
> I don't know about these medications and whether they interfere with thyroid hormone absorption, but I agree with gg about it being hard to get a handle on it. Please get more info. A good place to start is at http://thyroid.about.com.
>
> Some books are "Living Well with Hypothyroidism", "The Thyroid Solution", and "Thyroid Power".
>
> Some people, for example, need both synthroid and cytomel, which is a different form of thyroid hormone, in order to get the hypothyroidism under control. Or, as you mention, there may be an unresolved underlying cause for the hypothyroidism that needs to be addressed. Perhaps you should see an endocrinologist to investigate this.
Posted by noa on February 1, 2004, at 15:25:08
In reply to Re: Please help me re. Synthroid, posted by Maxime on February 1, 2004, at 15:18:05
You're welcome. And as gardenergirl said, thyroid hormones should be taken on an empty stomach, with no food within 3 hours before or 1 hour after.
I know that it is a hassle with all the different dosing instructions. It took me a long time to get used to keeping track of them all, and I still mess up sometimes. But it makes a difference in absorption.
Also, my endocrinologist warned me to not eat too much soybean products, and if I do, to not eat any within 4 hours of taking the synthroid. There are certain foods that inhibit thyroid functioning, like soy, spinach, kale, etc.
Good luck.
Posted by Mrs. R on February 2, 2004, at 13:09:37
In reply to Re: Please help me re. Synthroid}}Garden Girl, posted by Maxime on February 1, 2004, at 13:41:07
>I have a hard time not taking everything together in the morning. I would just forget otherwise. <<
Maxime: The Synthroid I take also was interferred with by the Lexapro I take. I used to take all my meds in the morning but switched to taking the Synthroid just before I went to bed. I make sure not to eat anything for at least 2 hours before. I, too, had a hard time remembering but after a while it just comes naturally now.
Good luck,
Mrs. R
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