Aa
hyperthyroid /Tx side
Okay, NOW I'm starting to worry...I had to inform my endocrinologist's nurse today of what I knew about hep c, it's treatment and the sides effects from it because she was puzzled as to why I suddenly have developed hyperthyroidism...I told her that I felt the changes were probably temporary and may change after I'm finished with txing...she was talking about more permanent solutions like ablation or surgery...(Yikes!) And when I mentioned the possibility of taking a temporary medication, and it needing to be liver friendly..she said,"Oh...That's right..Hmmm..."
Shouldn't an Endo DR be aware of chemo type effects on the endocrine system?!? Am I wrong here? Does anyone take meds for hyperthyroid that are liver friendly?
Shouldn't an Endo DR be aware of chemo type effects on the endocrine system?!? Am I wrong here? Does anyone take meds for hyperthyroid that are liver friendly?
Oh man I wish I could go hyper again for a few weeks before summertime I know EXACTLy what you mean girl!!!!!
Just be safe. That's most important of all of the things. A few extra pounds now is better than losing it 6 feet under - who cares how skinny you get then! (ouch that was supposed to be a joke but it didn't come out that way!)
:O
Sometimes my sense of humor even shocks me!
I am so very glad your endo is on top of it...whoever thought of this stuff pre-treatment right?
Debby
Just be safe. That's most important of all of the things. A few extra pounds now is better than losing it 6 feet under - who cares how skinny you get then! (ouch that was supposed to be a joke but it didn't come out that way!)
:O
Sometimes my sense of humor even shocks me!
I am so very glad your endo is on top of it...whoever thought of this stuff pre-treatment right?
Debby
I do love you!...:) The hyperthyroid issue is being addressed as we speak...it appears my Endo may try to control it (for now) with beta blockers to keep the heart rate and blood pressure in check...if that doesn't work, and if I show + for thyroid antibodies, then more serious stuff...But for now, probably a "manage and watch" approach...I can't say I'm all that upset about the auto weight loss that I'm getting as a side effect! ...Hmmm...At this rate, I'll be in a bikini by the end of June...(And not risk having Green Peace called if I'm at the beach!LOL)
I'm almost 1/2 way though my txing...I'm going to fight like mad if I have to to keep from having tx stopped...I only have to do 24 weeks and I was UND at 4 weeks...Thanks for caring...(((((((((((((((((HUGZ)))))))))))))))) ~Melinda
I'm almost 1/2 way though my txing...I'm going to fight like mad if I have to to keep from having tx stopped...I only have to do 24 weeks and I was UND at 4 weeks...Thanks for caring...(((((((((((((((((HUGZ)))))))))))))))) ~Melinda
I thought this was of particular importance to someone who doesn't want to read the whole thing.
Remission of Graves’ disease is unlikely (92, 95) and
large doses of antithyroid drugs would be necessary to control
the hyperthyroidism. The higher doses may adversely
affect liver function and possibly decrease the polymorphonuclear
white blood cells. Furthermore, the time to achieve
remission of Graves’ disease with antithyroid drug treatment
is long, and relapse of hyperthyroidism may occur. Because
of these problems, definitive treatment of hyperthyroidism
with radioiodine or by thyroidectomy followed by levothyroxine
substitutive treatment may be an appropriate option
(96), especially if the patient requires continued or reinstitution
of IFN
Remission of Graves’ disease is unlikely (92, 95) and
large doses of antithyroid drugs would be necessary to control
the hyperthyroidism. The higher doses may adversely
affect liver function and possibly decrease the polymorphonuclear
white blood cells. Furthermore, the time to achieve
remission of Graves’ disease with antithyroid drug treatment
is long, and relapse of hyperthyroidism may occur. Because
of these problems, definitive treatment of hyperthyroidism
with radioiodine or by thyroidectomy followed by levothyroxine
substitutive treatment may be an appropriate option
(96), especially if the patient requires continued or reinstitution
of IFN
The reason they think to radiate and kill the thyroid for hyperthyroid is because it is so dangerous. You can suffer a thyroid storm and have a heart attack or stroke out. Hypo is MUCH less dangerous a situation.
The only medication I believe is out there that works is in fact levothyroxine which is synthroid. At least it's the only medication I've ever heard anyone with a thyroid issue being on (and this includes both treaters and regular folks with out HCV).
It's very critical that they get your condition under control - you are going to have to do what you hve to do.
Get the nuclear imagine scan. See if your thyroid does flip flop over like mine did (because that is what is most common). Take it from there. But make sure you are doing something to get it under control. It is a serious situation. Taking less interferon won't matter - once the autoimmune issue presents........you have it.
I hope it goes away when you are done but take care of it for today.
The only medication I believe is out there that works is in fact levothyroxine which is synthroid. At least it's the only medication I've ever heard anyone with a thyroid issue being on (and this includes both treaters and regular folks with out HCV).
It's very critical that they get your condition under control - you are going to have to do what you hve to do.
Get the nuclear imagine scan. See if your thyroid does flip flop over like mine did (because that is what is most common). Take it from there. But make sure you are doing something to get it under control. It is a serious situation. Taking less interferon won't matter - once the autoimmune issue presents........you have it.
I hope it goes away when you are done but take care of it for today.
Prior to txing, I'd been suspicious that I had intermittent hypothyroid issues...But, because of so many other things (I had a parathyroid tumor, hypercalcemia, hypogycemia, kidney stones and gall bladder attacks -and then of course, the hep c diagnosis) and because my labs were always "in range", it wasn't investigated further...
I was warned that the interferon may "bring forth" any underlying, yet to be diagnosed disease processes...So, I guess, getting further testing for the now hyperthyroid issue is the net step...By the way, Levoxyl is one of the meds that can cause liver damage...that link was invaluable...Now my endo and I are on the same page...:) ~Melinda
I was warned that the interferon may "bring forth" any underlying, yet to be diagnosed disease processes...So, I guess, getting further testing for the now hyperthyroid issue is the net step...By the way, Levoxyl is one of the meds that can cause liver damage...that link was invaluable...Now my endo and I are on the same page...:) ~Melinda
Some symbols (arrows) in the "diagnosis" section got replaced by numbers in the above table. To get a better overview check the link:
http://jcem.endojournals.org/cgi/reprint/89/8/3656.pdf
http://jcem.endojournals.org/cgi/reprint/89/8/3656.pdf
Hey, we are taking thyroid tests the same week, me on Wednesday, you on Thursday! Got to compare notes afterwards!
To me your words seem to be Greek as usual, not English (I understand that pretty well after living 4 years in the States), but Greek. I don't even understand what you are saying I said.
Here is the quote I was thinking of:
"The development of thyroid disease does not seem to be
related to the dose of IFN-alfa (57). In contrast, the duration of
IFN-alfa treatment has been related to the occurrence of thyroid
dysfunction in some studies (43, 58). However, two or more
cycles of IFN-alfa therapy did not increase the risk of the development
of thyroid disease (59). In fact, it has been pointed
out that patients with negative thyroid autoantibody tests
during the first treatment with IFN continue to have negative
thyroid antibodies during successive administrations,
even with different schedules (29)."
Where do you find any support for lowering interferon doses? Look at the table on page 4:
"TABLE 1. Management of patients with chronic hepatitis C who develop IFN-alfa-induced thyroid disorders
Thyroid disorders/Diagnosis/Treatment/Antiviral treatment
Hypothyroidism/TSH1 L-T4/Continue IFN
Destructive thyrotoxicosis/TSH2, FT41, FT31, RAIU2
Asymptomatic/No therapy/Continue IFN
Symptomatic/Beta-blocking drugs
Controlled/Continue IFN
Uncontrolled/Withdraw IFN until euthyroidism or hypothyroidism occurs. May
then resume IFN.
Graves’ hyperthyroidism/TSH2, FT41, FT31, RAIU1, TSHRAb+
Mild/Antithyroid drugs/Continue IFN
Severe/Radioiodine/Withdraw IFN until thyroid function normalizes after radioiodine
therapy. IFN may then be resumed."
And I know the writer's issue was hyper, you were the one talking about Hasimoto's disease.
I do understand that I don't know much about problems with the glands and if this can affect the thyroid, but your talk about lowering interferon doses seem to be contradictory to everything I read.
Here is the quote I was thinking of:
"The development of thyroid disease does not seem to be
related to the dose of IFN-alfa (57). In contrast, the duration of
IFN-alfa treatment has been related to the occurrence of thyroid
dysfunction in some studies (43, 58). However, two or more
cycles of IFN-alfa therapy did not increase the risk of the development
of thyroid disease (59). In fact, it has been pointed
out that patients with negative thyroid autoantibody tests
during the first treatment with IFN continue to have negative
thyroid antibodies during successive administrations,
even with different schedules (29)."
Where do you find any support for lowering interferon doses? Look at the table on page 4:
"TABLE 1. Management of patients with chronic hepatitis C who develop IFN-alfa-induced thyroid disorders
Thyroid disorders/Diagnosis/Treatment/Antiviral treatment
Hypothyroidism/TSH1 L-T4/Continue IFN
Destructive thyrotoxicosis/TSH2, FT41, FT31, RAIU2
Asymptomatic/No therapy/Continue IFN
Symptomatic/Beta-blocking drugs
Controlled/Continue IFN
Uncontrolled/Withdraw IFN until euthyroidism or hypothyroidism occurs. May
then resume IFN.
Graves’ hyperthyroidism/TSH2, FT41, FT31, RAIU1, TSHRAb+
Mild/Antithyroid drugs/Continue IFN
Severe/Radioiodine/Withdraw IFN until thyroid function normalizes after radioiodine
therapy. IFN may then be resumed."
And I know the writer's issue was hyper, you were the one talking about Hasimoto's disease.
I do understand that I don't know much about problems with the glands and if this can affect the thyroid, but your talk about lowering interferon doses seem to be contradictory to everything I read.
The best anyone can hope for if there were no preexisting thyroid conditions before treatment is when it becomes an issue during treatment. In my case there were symptoms of thyroid problems before TX but after 5 to 6 weeks there about I started noticing more mood swings and apatite changes and a tightness at the base of my throat then it would ease off and went through this cycle over several months and when getting blood test the thyroid would show up normal THS 2.774 in the beginning then hit a low at about week 20 of 0.18 then a high of 51 THS and .67 of T4 direct until I started synthroid. So it can be easily be masked over by the inf/riba symptoms in the early stages of treatment.
So the lesser of the two evils while treating is to wind up with a hypo thyroid during treatment and hope like hell it returns to normal. I tried to taper off just before the ending treatment when I had higher concentration of both drugs in my system but had to go back on the synthroid for a couple of weeks and then tried again. I did noticed some bouncing while tapering down but to date I no longer have the tightness at the base of my throat and am still waiting for the test results but am being penalized for missing the doc’s appointment a couple of weeks ago and now have to wait until May 8th for the results of all test, O well, no news is good news!
jasper
So the lesser of the two evils while treating is to wind up with a hypo thyroid during treatment and hope like hell it returns to normal. I tried to taper off just before the ending treatment when I had higher concentration of both drugs in my system but had to go back on the synthroid for a couple of weeks and then tried again. I did noticed some bouncing while tapering down but to date I no longer have the tightness at the base of my throat and am still waiting for the test results but am being penalized for missing the doc’s appointment a couple of weeks ago and now have to wait until May 8th for the results of all test, O well, no news is good news!
jasper
the writers issue was hyper...
my point WAS what you just said...you can adjust for lower or higher output, and then wean back off when tx is over....the harder case is if the tissue is attacking itself or enlarging, which usually means stop or cut down tx, or remove the thyroid. In those cases you need permanent meds.
I'm not certain that sythroid or the hypo hormones do any real liver harm, but then there are those that think all hormones are evil, I'm not one of them,
If someone needs to be on a suppressant drug there are some concerns, but left untreated far more damage will occur to kidneys etc. so it must be treated.
yes I did read your article, before I posted...and put in laymens terms one need to determine what type thyroid disease they truly have and then proceed.
they may have parathyroid problems, they may have an adrenal or pituitary malfuction simultaneously. I've had gland problems for 30 years due to exposure to 1000 Nuclear tests where I grew up....
what is it that you thought I made up??
my point WAS what you just said...you can adjust for lower or higher output, and then wean back off when tx is over....the harder case is if the tissue is attacking itself or enlarging, which usually means stop or cut down tx, or remove the thyroid. In those cases you need permanent meds.
I'm not certain that sythroid or the hypo hormones do any real liver harm, but then there are those that think all hormones are evil, I'm not one of them,
If someone needs to be on a suppressant drug there are some concerns, but left untreated far more damage will occur to kidneys etc. so it must be treated.
yes I did read your article, before I posted...and put in laymens terms one need to determine what type thyroid disease they truly have and then proceed.
they may have parathyroid problems, they may have an adrenal or pituitary malfuction simultaneously. I've had gland problems for 30 years due to exposure to 1000 Nuclear tests where I grew up....
what is it that you thought I made up??
Have you read the paper I linked to? My issue was hypothyroidism, I can't remember if this relates to hyper as well, but with hypo it certainly said that thyroid issues were NOT dose related, so lowering the interferon dose would not have any impact on the thyroid readings. The interesting question is whether or not one has thyroid antibodies in the blood. Once you get a high thyroid reading, the antibody is either there or not.
Sometimes I wonder if you make stuff up as you go.
Sometimes I wonder if you make stuff up as you go.
take a bow Jasper...
my theory is as the SOC does it's bit it also is returning what are the normal IGF-1 levels, very often quite low in HCV patients due to pituitary suppression, to more normal levels. As the virus is killed off IGF-1 has been seen to return to more normal levels in the research. Ergo this then means a rise in Thyroid hormones as the pituitary returns to more normal signalling. That may be why hypo people become normal or even hyper...
or never before hypers become that way.
the trick is to get a definitive diagnosis, as autoimmune/Hasimoto's is a different story...
in that case depending on where you are in treatment it may be possible to lower INF doses to stop the autoimmune response.
However, it's important to know whether what you have is signaling weakness of the hormones or actual Hashimoto's as the way to treat the latter is a tougher choice.
which type disease did they say you have?
my theory is as the SOC does it's bit it also is returning what are the normal IGF-1 levels, very often quite low in HCV patients due to pituitary suppression, to more normal levels. As the virus is killed off IGF-1 has been seen to return to more normal levels in the research. Ergo this then means a rise in Thyroid hormones as the pituitary returns to more normal signalling. That may be why hypo people become normal or even hyper...
or never before hypers become that way.
the trick is to get a definitive diagnosis, as autoimmune/Hasimoto's is a different story...
in that case depending on where you are in treatment it may be possible to lower INF doses to stop the autoimmune response.
However, it's important to know whether what you have is signaling weakness of the hormones or actual Hashimoto's as the way to treat the latter is a tougher choice.
which type disease did they say you have?
Got to put credit where credit belongs. I got that link from digging in the archives and finding a post from Geterdone! It helped me heaps when I was in a thyroid predicament as well. Glad I could pass the knowledge on, that's how the forum works, what would we do without it?
Thanks again for that link! I faxed a copy of it to my endocrinologist, and it has probably saved me from having to take some not-so liver-friendly meds! (Not to mention the potential for his suggesting killing off my thyroid!) You may have just made a difference that will affect me for the rest of my life...Thanks again... ~Melinda
Thanks! I've been trying to find this kind of info..Just had'nt pinged the right spots yet!
~Melinda
~Melinda
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