Type 1 Thyroid medication

zicksi101

Well-Known Member
Messages
113
Type of diabetes
Type 1
Treatment type
Insulin
After being told to phone my GP surgery, I was told by the receptionist today that levothyroxine has been added to my prescription as a recommendation from the endocrinologist.

I do not know what my latest test results are saying yet. I have not been told that I have an underactive thyroid.

So my current situation is that I been given a prescription for a pill, without the manual on how to manage it as a type 1 diabetic who is on insulin. Are there any basic guidelines at all on how I should proceed whatsoever?

I have been told to take a 50mg tablet a day as a starting point. On the leaflet it states that this will likely increase my blood glucose levels, but quite frankly I don't have the first clue what to expect.

Fortunately, I've had type 1 for long enough to know that I'm the one responsible for it.

After speaking to my mother, who has had an underactive thyroid for a while (but not diabetes), she mentioned that there is a 25mg levothyroxine tablet as well. Given my lack of symptoms, I am thinking about asking the GP if I can start on the lowest dose.

With my complete and utter lack of symptoms, frankly I am struggling to comprehend that it is actually possible for me to have an underactive thyroid at the moment.
 
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AndyS

Well-Known Member
Messages
784
Type of diabetes
Type 1
Treatment type
Insulin
Dr probably prescribed it based on elevated TSH (Thyroid Stimulating Hormone) levels.
Unfortunately getting levels quite right on that can take a little while since there is a bit of a lag in the body responding.

Chances are that your Dr settled on the 50 microgram dose based on your weight and TSH levels and you will then be called back in for more blood work in 3 to 6 months while they titrate up or down to what you need. Example of the calcs here: http://www.globalrph.com/thyroid_calc.htm

Since being diagnosed T1 my thyroxine dosage has varied by around 125mcg and I didn't see much in the way of changes though I did increase my testing rate.

While you may not be obviously symptomatic for under active thyroid the TSH is kind of a definitive answer really and your body may be compensating to some degree such that you aren't noticing the symptoms.

Best advice I can give you is to just up your testing for a few weeks to see what impact it has on your BG and insulin requirements (if any) and speak to your Dr and get your blood test results to get a better understanding of his/her reasons fro the decision to start you on thyroxine.

From my own experience and research I have seen no adverse interactions of any diabetes medication with Levo Thyroxine, though if you are on simvastatin then I would suggest that you talk to your Dr about switching since there are known and documented details about simvastatin causing problems with levothyroxine, mainly inhibiting the thyroxines effectiveness. Since I was on the max dose of thyroxine when they started me on statins I insisted on atorvastatin and my GP actually agreed with me on that score.

If you still aren't sure or you want to make sure it is not likely to cause issues with anything else you may be taking then you are probably best to talk to your pharmacist to start with since they tend to have more of a clue about drug interactions than Dr's in my experience.

Otherwise nothing to worry about with thyroxine, you will have a bit more energy though which is nice :)

/A
 
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zicksi101

Well-Known Member
Messages
113
Type of diabetes
Type 1
Treatment type
Insulin
Thanks Andy, that's very helpful to know.

Yes you're right, I fully appreciate what you're saying in that it's best to go by objective measures.

It sounds like I'm best to just get started and see what happens as I'm not on any medications other than insulin at present, so hopefully it will be fairly straightforward to incorporate the thyroxine from a diabetes point of view.

I do know that my thyroid tests from a year ago indicated my TSH was slightly elevated, and coupled with thyroid antibodies, but then things got interesting because my TSH actually came back down a little without thyroxine in that subclinical case. As you say I'll understand more when I get the results.
 

AndyS

Well-Known Member
Messages
784
Type of diabetes
Type 1
Treatment type
Insulin
just be sure that they get you scheduled for follow up blood work within 2-3 months since they really need to keep an eye on it while they work out your dose.

if the thyroxine is too high it may mean you see an increase in hypos, hence why you need to keep a close track of things.