Treatment and Thyroid issues?

[Believer7777]

I am 6 months into treatment (1a, UND week 12). They ran a Thyroid panel and the test shows hypothyroidism ( levels are above 10, which they indicated needed medicine).

Here is my question - since there are so many variables with treatment, I'm concerned the treatment is affecting my Thyroid, and I don't want to go on medicine if my levels return to normal after treatment. Any thoughts?  Has anyone had Thyroid issues?  Thanks for your help!!

[willbb]

Hi there... actually most of us have thyroid issues during treatment.,and unfortunately it is not something that will go back to normal at the end of tx.

What happens is the thyroid ..like everything else when treating (immune wise) gets ramped up and actually works too hard  and that is the reason you are usually hyperthyroid for a time at the beginning of treatment. Then it literally burns out...hence hypo thyroid condition. Like I said this condition is not reversible ,however it is easily rectified with the proper dose of Synthroid daily.

!0  is very hypo...you would be best to follow the docs orders on this one and get it at the proper level as hypothyroid can cause a myriad of symptoms..

Hope that helps..

Will

[willbb]

it is not something that will go back to normal at the end of tx. ..


...meant to say "most often"      .......  rarely levels will return on their own if thyroid not too badly damaged..more often than not tho .. you would need the replacement hormone "synthroid"

[Believer7777]

Will. Thanks for the recommendation. I'm concerned with having to be on thyroid medicine for life if there is a chance my levels will rebound. I'm told once you take thyroid medicine, you're on it for life.

I'd love to hear more thoughts- again I appreciate help in this process.

[Anne1717]

Hi - I have been on thyroid medication for 25 years and it's a non issue really.  No side effects - nothing - so don't worry !!!

[paen53]

I went hypo but not until almost 6 months post tx. Have been on 50 mg. Synthroid since the first of the year. Have seen a noticeable decrease in fatigue and some knee issues. I haven't met my deductible yet for the year and pay out of pocket yet, but it's under $10.00 per month even at that.

My Dr. had told me prior to tx that this was almost a given - to "burn out" your thyroid. I thought I had lucked out, but that wasn't the case. Pretty much a non-issue for me now that it's all balanced out and a small price to pay for the SVR, IMHO.

Good luck to you in finishing tx, Pam

[willbb]

As Anne says, thyroid medicine is really a non-issue. it is actually the MOST prescribed med in N.A.  As people age thyroids tend to wear out  irregardless of HCV.TX.

You would be best to start on the synthroid and your doc can monitor the level of your hormone with a simple blood test regularly(TSH) ,and if it is going to come back on its own then he can keep adjusting the dose. Most of us have our thyroid checked regularly anyway.

  If needed for life ..then it is a simple once a day pill with no side effects and the benefits of  it are huge. Some symptoms of hypothyroid are. Fatigue(sometimes severe, lack of appetite,constipation,weight gain. lack of energy,muscle pain. loss of hair..just too name a few.

Some endocrinologists believe it is the most important gland in the body as it regulates all metabolisme...so best to not let it go to chance on returning to normal.

Best

Will

[willbb]

it is actually the MOST prescribed med in N.A.    

Sorry...narcotics are...used to be Synthroid..until recently.

[Trish77]

There is actually a higher rate of incidence of thyroid issues amongst people with HCV and that those with more advanced fibrosis are at greater risk of acquiring thyroid disease..  Not everyone on treatment will have thyroid issues and in fact it's only around 20% of people on treatment who have thyroid issues and they are not always permanent. Reference:  http://www.hepatitis-central.com/hcv/ifn/sideeffects.html

For a number of people who experience thyroid issues on treatment, the reality is that they were probably going to have thyroid issues anyway and they likely already had the pre-existing environment for it and the interferon triggered it quicker.  There are certain antibodies that can be tested for prior to treatment that will show their existence and therefore the increased potential for this.  

There's some indication that interferon-induced thyroid disease disappears for some people after awhile and they did some studies on a small group of people three years post treatment and all of the people they studied no longer had their thyroid issues.  It does disappear for some people but I would prefer to be more realistic in that there's a good chance they'll hang around as well.

On that note, I concur with what the others have said about managing thyroid disease.  I developed that also and it's a pill a day, seeing my endocrinologist every six months and monitoring it to make sure my dosage of replacement hormone is right for me.  True that some people end up with more serious thyroid issues and may need to have it removed - again, more likely in those with advanced fibrosis.  However what's important is that you get to your doctor to have them assess you and get you regulated for where you are at now and take this a step at a time.  It's important that your thyroid get treated according to what's required and that you get under the care of a good endocrinologist.

Good luck with this.

Trish

[willbb]

  True that some people end up with more serious thyroid issues and may need to have it removed -

You would never have to have a thyroid removed for being  underactive(hypo)

[buggs1]

the best way to determine if you need help is not by one high or low reading   a series of high or low readings would be a much better indicator

[Trish77]

I have Hashimoto's and a nodule on my thyroid that my doctor monitors yearly with ultrasound.  My understanding is that he'd remove the thyroid if it was necessary if things got sinister.  I am not hyperthyroid, I'm hypothyroid.

Aside from that, your distinction is noted.  Because of my own situation I wasn't aware that it's more of a hyperthyroid thing than a hypothyroid and thanks for clarifying that further - important and good to know.

Trish

[researchmonkey326]

And is a spiked ALT result an indication of thyroid issues?  Mine went from 35 to 174 between week 4 and 8

[Believer7777]

Thanks for all the help- I have been highly fatigued, exhausted, and issues with concentration and memory. Since I'm on treatment, I assumed this was standard- so I'm happy to know it might be a thyroid issues and some sx will disappear. Has anyone started thyroid meds during hep c treatment? Also, how severe are my TSH levels at 10.2 ?

[Trish77]

rm326:  My ALT and AST rose when I went hyperthyroid.  That wasn't the only indicator, my doc could tell when I told him how I was feeling, asked me to put my hands out in front of me and he watched them shake noticeably and put me on beta blockers right away.  Once you've got one autoimmune disease, you need to monitor that ALT and AST while on treatment as you're more prone to additional autoimmune diseases and that ALT/AST is one indicator.  Other things can cause a rise in those counts also so that's not to say it's automatically thyroid issues, it's simply one of the potential causes.  Hope you've been checked out for this?

B7777:  I think a number of us started thyroid meds while on treatment.  I first started with beta blockers and meds to counteract being hyperthyroid.  My TSH was the other extreme at .02.  Very low.  After awhile my hyperthyroid flipped over to hypothyroid and then I went on synthroid while on treatment, yes.  Your 10.2 count is incredibly out of range it seems so there's a good chance it's contributing to your fatigue and exhaustion but you'd need to seen an endocrinologist about it and you hopefully will see one who understands the impact Interferon can have on thyroid.  It's a good thing when it gets under control and it can be done and monitored throughout treatment.  Good luck with that.

[Anne1717]

WOW !! 10????  No wonder you are exhausted and I am surprised you are not comatose.  I thought I was dying 25 years ago when I first went on Synthroid and my TSH was 4.2.

[Believer7777]

Trish: thanks so much. I went to endocrinologist last week, due to a 9.0 reading with my hep doc.  Endo rechecked thyroid and TSH is now 10.2. Also tested PPO and said that antibodies are present, not sure what that means.

Anne, I am just about comotose! It's so hard to make it to the office and I'm beat 24/7. Sounds like I need to take the meds sitting at the pharmacy :). With all other medicine, I just wanted to get feedback before having to take more pills - im sure you all can relate.

[Trish77]

I got told the same thing, that I have thyroid antibodies and what I think your endo is telling you is that you have Hashimoto's, which is the autoimmune type of thyroid.  That typically means you already had they thyroid antibody and if you had been tested ahead of time before treatment, they would have found it existed and you might have known ahead of time to expect this and your doc would have monitored.  They really don't test for the thyroid antibody as a matter of course when starting treatment but I tend to think they should.  I think people would probably go ahead and do treatment anyway but doctors might respond faster to symptoms of hyper or hypo thyroidism appearing.  

I had to refresh my memory on all this and this has good information that might help to clarify this antibody thing related to thyroid issues.

http://www.labtestsonline.org/understanding/analytes/thyroid_antibodies/glance.html

[willbb]

Get on the synthyroid ...get the level down to no higher than 2 and you should  feel better

[researchmonkey326]

Thanks, yes.  Just found out today from the blood draw yesterday.  They called right away for me to be retested on Friday as well as see the dermatologist so it's moving along quickly.  Not feeling great though.  All other blood counts were still in normal range at least.

[buggs1]

1.Find out your thyroid test results from your doctor's office. 2.If you can, get a hard copy printout for your own review and home medical files. 3.If "normal" or "reference" ranges are not indicated on the lab results, ask your doctor's office to tell you what these ranges are. 4.Note the level of your Thyroid Stimulating Hormone (TSH). At most labs in the U.S., up until late 2002, the normal range is from around 0.5 to 5.5. That range changed to .3 to 3 as of early 2003. 5.If the TSH level is below normal, your doctor may determine that you are hyperthyroid (overactive thyroid.) 6.If the TSH level is above normal, your doctor may determine that you are hypothyroid (underactive thyroid.) 7.If your doctor ran a test called Total T4 or Total Thyroxine, normal range is approximately 4.5 to 12.5. If you had a low reading, and a high TSH, your doctor might consider that indicative of hypothyroidism. 8.If your doctor ran a test called Total T4 or Total Thyroxine, normal range is approximately 4.5 to 12.5. If you had a low reading, and a low TSH, your doctor might look into a pituitary problem. 9.If your doctor ran a test called Free T4, or Free Thyroxine, normal range is approximately 0.7 to 2.0. If your result was less than 0.7, your doctor might consider that indicative of hypothyroidism. 10.If your doctor ran a test called Total T3, normal range is approximately 80 to 220. If your result was less than 80, your doctor might consider that indicative of hypothyroidism. 11.If your doctor ran a test called Free T3, normal range is approximately 2.3 to 4.2. If your result was less than 2.3, your doctor might consider that indicative of hypothyroidism. 12.If your test results come back "normal" but you have many of the symptoms or risk factors for thyroid disease, make sure you ask for an antibodies test. Some doctors believe in treating thyroid symptoms in the presence of elevated antibodies and normal TSH levels. 13.If your test results come back "normal" but you have many of the symptoms or risk factors for thyroid disease, consider going to a reputable holistic M.D. or alternative physician for further interpretation and diagnosis.

[willbb]

  Or........go on synthryoid as your doc suggested and get your TSH down to 2 and see if you feel better.

[Anne1717]

I agree with Will - it is a very simple solution.  I don't know how you are managing actually.  I fell like sleeping just reading your post !!

[Anne1717]

In other words    +1 Will

[willbb]

oh my