HomeEditor PicksWhat Drugs Can Affect The Thyroid

What Drugs Can Affect The Thyroid

Medications That Affect T4 Requirements

Thyroid Medication Tips

Thyroid hormones are metabolized primarily by deiodination, but glucuronidation and sulfation are also important routes of elimination. Cytochrome P-450 hepatic enzyme inducers can increase the metabolic elimination of T4 and T3 by 20%, which is not clinically important in people who are euthyroid. Those requiring thyroxine replacement therapy, however, may need higher doses to maintain euthyroidism. Ritonavir, a potent P-450 mixed hepatic enzyme inhibitor and inducer, can increase thyroxine glucuronidation, necessitating a twofold increase in thyroxine dosage to maintain euthyroidism.

Serotonin reuptake inhibitors may also alter T4 requirements. In nine patients receiving thyroxine therapy, an elevation in thyrotropin levels and a reduction in FT4 levels were noted after the addition of sertraline hydrochloride. An increase in thyroxine clearance was thought to have occurred.

Final Words Keep Learning

I hope you have learned a few things that will help you in your journey to feel better.

I know that the information in this article may seem overwhelming, as there are so many diseases, medications, toxins, triggers, and more that can affect your Hashimotos, your well being, and generally how you feel. But, take it slow and continue to focus on discovering your root cause.

And, for support and encouragement along the way, join my community if you havent already! to have helpful information delivered right to your email inbox. And join me on , too. Were all in this together.

How Drugs And Alcohol Affect Thyroid Function

Substance abuse involving alcohol, opioids and stimulants will cause damage to- and throw of the balance-of nearly every organ and system in the body. The affect that drugs and alcohol cause on the thyroid is especially harmful and opens drug and alcohol users to a host of medical problems on top of their substance abuse issues.

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Drugs That Can Cause Hypothyroidism

There are many drugs that have the potential to induce hypothyroidism. Drug- induced hypothyroidism is an underactive thyroid gland due to a reaction to a medication. If your hypothyroid symptoms began after starting a medication, you may be suffering from drug-induced hypothyroidism. Here is a list of some medications known to cause hypothyroidism. For a detailed explanation of the mechanisms by which these drugs exert their influence on thyroid hormone, read: Drugs That Suppress TSH or Cause Central Hypothyroidism, Best Pract Res Clin Endocrinol Metab. 2009 Dec; 23 793-800.

Drugs impact thyroid function at many different levels; from the hypothalamus to pituitary, synthesis and secretion by the thyroid gland, metabolism, binding of thyroid to its major binding protein, altering thyroid receptor function, and absorption of medication from the GI tract.

Drugs that affect thyroid function in normal patients:

Inhibition of T4/T3 synthesis

Vitamins Could Throw Off Thyroid Lab Test Results

Is Night or Day the Time to Take Thyroid Medication?

Q. I feel perfectly healthy, but my latest physical showed an abnormal thyroid lab test. I take a handful of vitamins, no drugs, and I dont want to start any now. My doctor wants me to begin prescription thyroid hormone. Should I get a second opinion?

K.S., Pueblo, Colo.

A. Thats up to you, but before you get a second opinion, you may want to repeat the lab work minus the handful of vitamins. Many natural over-the-counter supplements can affect lab work related to numerous functions, including your thyroid gland.

Natural estrogens such as soy can elevate thyroid-stimulating hormone. Tyrosine, an ordinary amino acid, happens to be a thyroxine precursor, meaning it could lower a persons TSH. Tyrosine is taken for many conditions, including depression; its found in protein shakes.

Other problematic supplements include biotin, kelp and bladderwrack. You dont have to stop taking these; you just need to know that they may throw off otherwise normal thyroid lab tests. This is important information because the last thing you want to do is take medicine for a condition that does not truly exist.

Why dont you go on a vitamin holiday? Stop taking everything for a week, then retake your lab tests.

Q. I take a diuretic, furosemide , for my high blood pressure, but now my potassium also is low. Before I begin a prescription dose of potassium, I was wondering if certain foods might help my situation. Ill eat anything.

L.L., Chicago

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How Long Does It Take To Recover From Thyroid Surgery

It will take your body a few weeks to recover after your thyroid is surgically removed . During this time you should avoid a few things, including:

  • Submerging your incision under water.
  • Lifting an object thats heavier than 15 pounds.
  • Doing more than light exercise.

This generally lasts for about two weeks. After that, you can return to your normal activities.

Who Can And Cannot Take Levothyroxine

Levothyroxine can be taken by adults and children. However, levothyroxine is not suitable for some people.

Do not take levothyroxine and go back to your doctor to discuss your treatment if you have:

  • had an allergic reaction to levothyroxine or any other medicines in the past
  • an overactive thyroid
  • a health problem that affects your adrenal glands

Check with your doctor before taking levothyroxine if you have:

  • had a heart attack
  • diabetes the dose of your diabetes medicine may need to change because levothyroxine can raise blood sugar levels

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Key Laboratory And Imaging Tests

TSH is the most sensitive test to detect thyroid dysfunction. A low TSH is most frequently diagnostic of spontaneous hyperthyroidism. In addition to some types of drug-induced thyroid dysfunction, the differential diagnoses for a low TSH are:

  • Graves disease

  • Recovery phase after treatment for hyperthyroidism

  • Laboratory artifact

  • Rare genetic conditions

When the TSH is abnormal, the next test in the evaluation of thyroid dysfunction is the measurement of TT4 and FT4 and/or TT3. While alterations in serum T4 and T3 levels are parallel to each other, there are some conditions associated with discrepancies in these tests, including non-thyroidal illness, amiodarone therapy, T3-toxicosis, hypothyroidism, and some rare conditions of impaired de-iodination.

Thyroid autoantibodies may be of some use in the evaluation of hypothyroidism, although they are not particularly specific and sensitive. For example, transient hypothyroidism after painless thyroiditis is not easily differentiated from permanent Hashimotos hypothyroidism because autoantibodies are present in both conditions. Furthermore, up to 20% of the general euthyroid population may have positive thyroid antibodies , although these individuals may progress over many years to hypothyroidism.

What Are Others Medications For Hyperthyroidism

Can hypothyroidism affect milk supply, and is it safe to use Fenugreek with thyroid medication?


  • This medicine can help block the body’s reaction to hyperthyroidism
  • It can control heart-related symptoms, such as palpitations, tremors, and agitation

Iodide solutions

  • Usually given as drops of liquid medicine, iodide solutions can prevent the release of hormone from an overactive thyroid gland.
  • Given only to treat Graves’ hyperthyroidism
  • Must be given with an antithyroid medicine
  • May cause short term decrease in thyroid hormone levels, so often used prior to thyroid surgery
  • Common side effects are a metallic taste and nausea

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What Is The Thyroid

The thyroid gland is a small organ thats located in the front of the neck, wrapped around the windpipe . Its shaped like a butterfly, smaller in the middle with two wide wings that extend around the side of your throat. The thyroid is a gland. You have glands throughout your body, where they create and release substances that help your body do a specific thing. Your thyroid makes hormones that help control many vital functions of your body.

When your thyroid doesnt work properly, it can impact your entire body. If your body makes too much thyroid hormone, you can develop a condition called hyperthyroidism. If your body makes too little thyroid hormone, its called hypothyroidism. Both conditions are serious and need to be treated by your healthcare provider.

How Do Adderall And Adhd Medications Affect The Thyroid

A stern warning with medications for ADHD like Ritalin, Adderall, Focalin, Concerta, Dexedrine, Metadate and Vyvanse is that the medications are not to be taken if you have thyroid issues. These warnings are for very good reasons. Not only do stimulants like ADHD medication and amphetamine now work for treating symptoms of hyperactivity in those with thyroid issues, but increased dosages can worsen behavioral problems.

It is very important to test a patient for thyroid problems before diagnosing ADHD or prescribing medications to treat ADHD. In many cases, treating the thyroid issue alone will take care of hyperactivity, lack of focus, and other symptoms of ADHD.

If you have not been prescribed ADHD medications and are abusing these medications for recreational purposes, they can cause or worsen thyroid problems and worsen behavioral problems.

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Who Is Affected By Thyroid Disease

Thyroid disease can affect anyone men, women, infants, teenagers and the elderly. It can be present at birth and it can develop as you age .

Thyroid disease is very common, with an estimated 20 million people in the Unites States having some type of thyroid disorder. A woman is about five to eight times more likely to be diagnosed with a thyroid condition than a man.

You may be at a higher risk of developing a thyroid disease if you:

  • Have a family history of thyroid disease.
  • Have a medical condition .
  • Take a medication thats high in iodine .
  • Are older than 60, especially in women.
  • Have had treatment for a past thyroid condition or cancer .

Which Drugs Can Lower Tsh Without Inducing True Thyroid Dysfunction

Can Drugs Affect Thyroid Function?
  • Glucocorticoids in high doses during initial treatment; in contrast, prolonged exposure to glucocorticoid therapy or endogenous hypercortisolism do not result in thyroid dysfunction

  • Dopamine or dobutamine

These drugs do not generally cause clinically significant central hypothyroidism, and their suppressant effect on TSH production is transient. An exception is bexarotene, in which the associated central hypothyroidism that is occasionally seen normalizes after the discontinuation of the medication.

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Why Does This Story About The Impact Of Antibiotics On Gut Health Matter

It matters because gut health is important for thyroid health and hormone production.

Evidence shows that the gastrointestinal tract interacts actively with T3 and T4 thyroid hormones. What many people dont know is that the gut plays a major role as a reservoir for the hormones produced by the butterfly-shaped gland, particularly T3. Additionally, the gut may also take part in the regulation of hormone activity.

Bacteria in the gut support numerous functions in the body, and the production of active thyroid hormones is one of them. About 20% of thyroid function depends on the sufficient supply of healthy gut bacteria to convert T4 to T3 hormone. The impaired gut health disrupts the production of active thyroid hormone. Numerous factors can impair gut health ranging from an unhealthy diet to antibiotics.

Imbalance of gut microbiota can decrease thyroid hormone levels, dull thyroid hormone receptor sites, elevate the levels of inactive T3, lower TSH, and promote the development of autoimmune thyroid disorders. For example, the most common cause of hypothyroidism is the autoimmune condition Hashimotos thyroiditis. Since about 80% of the immune system resides in the gut, then poor digestive health is a major factor in triggering and worsening autoimmune conditions such as Hashimotos. Thats why repairing gut health is a significant factor in the management of Hashimotos disease.

Gut health and thyroid health go hand in hand

Inhibition Of Conversion Of T4 To T3

Most T3 is produced from the peripheral conversion of T4 to T3 by the enyzme 5-deiodinase. Amiodarone and iodinated contrast media can inhibit the conversion of T4 to T3 both in the peripheral circulation and in the pituitary gland, and can produce confusing thyroid function abnormalities . Within 1 week of ipodate administration, elevations in FT4 levels, reductions in total T3 levels, and a transient rise in thyrotropin levels occur; these return to normal within 2 weeks. Similar findings are observed during the first week of amiodarone administration. A transient elevation in thyrotropin levels occurs during the first 3 months of amiodarone treatment but during ongoing therapy, elevations in FT4 and reductions in T3 levels persist in patients who are euthyroid. Therefore, normal FT4 and T3 levels in a patient taking amiodarone are highly suggestive of overt thyroid dysfunction.

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Different Types Of Autoimmune Thyroid Disease

Falk: What on earth is autoimmune thyroid disease?

Kirk: Autoimmune thyroid disease is a complex term. Its not really one disease. Its rather a term that refers to a number of different ways that the immune system could affect the thyroid gland.

Falk: Where is the thyroid?

Kirk: The thyroid is on the base of the neck in the midline, so if you were to take your fingers and press right at the bottom of the neck, you probably wouldnt feel it because most thyroid glands are difficult to feel. Its about 4 centimeters tall on either sideits the shape of a butterfly, we like to say. Thats where its located.

Falk: So that organwhat is the thyroid supposed to do in the first place?

Kirk: The thyroid does a lot of things. It produces thyroid hormones. These hormones affect essentially every cell in the body. A simple way to think about what thyroid hormone does, is it is a contributor to metabolism and activity so it may rev up the system, so to speak. If its produced in appropriate quantities it keeps many organs and systems in equilibrium.

Falk: So if your thyroid is overworking or hyperactive, how do you feel?

Kirk: If your thyroid is overactive or if youre producing too much thyroid hormone you may lose weight without meaning to, you may be very hot, you may be sweaty, anxious, or have tremors that you or others may notice. We often hear people say that they have rapid heartbeat or fluttering sensation which we refer to as palpitations.

Considerations Relating To Ppis And Other Acid Blockers

How Thyroid Medication Changes your Blood Pressure

With clients and readers, and in my research, I have consistently found medications and supplements that suppress stomach acid may cause impaired absorption of thyroid hormones, and that includes the above proton pump inhibitors, as well as antacids, calcium, magnesium-aluminum and iron. For that reason, I always recommend spacing out calcium, iron and magnesium supplements by at least 4 hours from thyroid medications.

I also recommend a careful re-evaluation of the use of acid-suppressing medications in everyone with Hashimotos and hypothyroidism. I suggest looking for the actual trigger for the acid reflux symptoms, which is often a food sensitivity or infection. Its especially important to look at common food sensitivities such as dairy and gluten to see if that resolves the acid problem. If not, I have found the Alletess IgG Food Sensitivity Test to be highly reliable for identifying acid reflux inducing foods. One can test for H-pylori which can also cause acid reflux symptoms and be a hidden trigger for you.

Low stomach acid, again, is common in people having Hashimotos. Plus, having low or no stomach acid puts people at a greater risk for many health issues such as contracting parasites from our food, developing food sensitivities, developing small intestinal bacterial overgrowth , and developing nutrient depletions.

Betaine with Pepsin can also be helpful to re-acidify gastric pH.

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Are Thyroid Drugs Safe

Thyroid medicines are safe when taken at the recommended dose and prescribed by a doctor. You must ONLY take what your doctor recommends. The correct dosage for you is based on your age, health, current natural thyroid hormone levels, and weight.

When you first start treatment for hypothyroidism, your doctor will regularly monitor the levels of different thyroid hormones in your blood to determine if your dosage of thyroid medication needs adjusting. Once the correct dosage has been established for you, the frequency of these blood tests will decrease. Thyroid drugs are generally taken for life.

It will take a few months for your thyroid levels to get back to normal but as long as you are taking your thyroid drugs as prescribed, then you should not have many side effects. Side effects generally happen because you are taking too much thyroid hormone.

Thyroid hormones should NEVER be taken by people without thyroid problems to treat obesity or for weight loss. Some fatalities have occurred when they have been used if these drugs are taken in large dosages for this indication.

Also, talk to your doctor about your diet. Some people with hypothyroidism are particularly sensitive to the effects of iodine, and it may trigger or worsen hypothyroidism. In addition, high fiber diets and certain types of foods such as soy or cruciferous vegetables may affect how your body responds to thyroid drugs.

Understanding Your Thyroid Test Results

With Cory Rice DO

Healthy TSH levels are usually an indicator that the whole system is working as it should.

Thyroid disorders are complicated, fickle, and highly individual meaning thyroid issues are going to look very different for each person. In any case, its important to have a basic understanding of how the thyroid gland works and the hormones it produces. This understanding can help you advocate for yourself and ask the right questions when you visit your healthcare provider. It can also clue you into some of those mysterious symptoms you may be experiencing.;

An introduction to the thyroid gland

First things first: The thyroid gland is part and parcel of the endocrine system, which is a collection of glands that produce all-important hormones responsible for metabolism, growth, sexual function, sleep, and your mood.;

The gland, which is tiny and butterfly-shaped, is found at the bottom front of your neck. It makes the two main thyroid hormones, triiodothyronine and thyroxine both of which have a major hand in your energy levels, internal temperature, hair, skin, weight, and more. For this reason, T3 and T4 are definitely not to be taken for granted and you probably know this already if youve experienced any of the frustrating symptoms of a thyroid disorder.;

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