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335297 tn?1210597884

Hypothyroidism Caused by Treatment???

Three months ago, I completed 36 weeks of treatment (Peg + Copeg) for HCV, Genotype I. I was UND at 12, 24, and 36 weeks. I had many of the side-effects during treatment and after treatment as well.

Now at three months post-treatment, I have been diagnosed with hypothyroidism (under-active thyroid) and this appears to explain my symptoms. It seems hypothyroidism has symptoms similar to depression. My doctor has prescribed replacement hormone therapy with a drug called Euthyrox. I started taking this five days ago and was told I might start feeling better in two weeks.

Here are my questions:
1. Has anyone on the forum had a similar experience with hypothyroidism?
2. Also, does anyone have knowledge as to what may cause hypothyroidism in hcv treatment?
3. Is hypothyroidism a possible side-effect of interferon?

At the least, I am relieved to have possibly found the cause for my post-treatment side-effects.

Thanks to all for the great forum. It has help me through this challenge of treatment.
17 Responses
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179856 tn?1333547362
I've never heard of it but it doesn't mean it can't happen........Lord knows I don't know everything LOL.  I'm just still a brain fried fog liver trying to get by with the little I have left........   ;)  Not much.

HI AMIRTRACY how have you been doing? I haven't seen you in a long time!

I tell you if you think possibly you might have a problem with it............go get the blood test.  It's not worth the chance!
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Avatar universal
can your tsh tests be normal all through treatment and then AFTER treatment your thyroid gets fried?
hi nygirl ;)
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179856 tn?1333547362
Honestly my numbers have been perfect but really I don't "feel" any difference from the meds - my hair is now growing back nice and thick and full (it's straight something I never really had before). My skin is still dry because of the autoimmune problems I developed and I can't lose an ounce at ALL which is freaking me out because I"ve aLways been able to just lose five pounds at the drop of a hat........

But as for 'feeling' nope feel the same.

That stuff above was sos interesting that I"m going to have to read it all again. My brains just caN"t grasp it all and I don't think I want to eat MUNG (which reminds me of something on the SciFi channel) but the other amino acides...now I could buy them at a store and I will try it.

Thank you for going out of your way to post it all to me, I can't imagine why a PM wouldn't work!  That makes no sense at all considering I get them from random people that just come in to check out the forum all the time, yours should have gone through!!!!!!!!!
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298631 tn?1210625430
Yes, three weeks may be too soon to notice a difference with the replacement hormone. As I said, I started on it while on tx, so the combo of the brain fog from tx AND the brain fog from thyroid issue did do a number!

I did start to notice some general improvement to energy and mental functioning in about 2-3 months. As I got close to end of tx and now just after (I'm 6 weeks post), I really feel much better. Of course for me, it's hard to separate the effects of tx versus the thyroid meds but my sx from tx seemed pretty constant from about 4 months on so the big change was getting on the thyroid replacement.

I'm in sales and I have always prided myself on excellent follow up skills. For the past 6 months, if I didn't write it down immediately, it was gone! Thankfully, my memory seems to be getting better again, so hang in there - it's NOT permanant! :-)

Best of luck to you for a SVR! I've got until July for my 6 month PCR and the suspense is killing me!

Robin
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335297 tn?1210597884
Thanks for the feedback on hypothyroidism.

I have now been taking small doses of Euthyrox (hormone replacement) for almost three weeks and have not noticed any improvement but my doctor tells me to be patient. I am really becoming concerned with my cognitive abilities; I can't remember things and have a difficult time making the simplest decisions. I, too, and worrying if these conditions might be permanent. Any reassurance would be welcome.

As for hair loss, I had an interesting experience on treatment. I did not lose any hair but my beard which is usually a little curly turned straight. Now at four months post-treatment, my beard appears to be turning back to normal. Unfortunately, many of the other symptoms of fatigue, irritabillity, headaches, sore eyes, and overall aches and paims remain.

In two months (at 6 months post-treatment), I will have a viral load test and I pray for svr.

Best wishes to all on the forum!
Helpful - 0
298631 tn?1210625430
I also developed hypothyroidism on tx, however, I already had the beginning of a visible goiter (lovely word that) and I suspect that I was low for a long time before tx.

Interestingly, although I have seen 100 different doctors for every routine test throughout my life, none ever commented on the thyroid. The last GP said "that's not where your thyroid is" when I pointed out the slight lump. Fortunately, my gastro agreed that there was something so I went to an ENT (who knew where the thyroid gland actually is!), had some scans and biopsy (benign nodule), and we monitored my levels carefully. They were within normal range at the start of tx even though I had an enlarged thyroid.

Long story short, my levels dropped on tx and I went on levothyroxine at about 6 months. I am now 6 weeks post tx and I am still on it but I have follow up labs to see if it is permanant change or temporary while on tx. Am also thinking of finding a better endocrinologist to check out all the other hormone interactions as dointime elaborated on.

As to hair loss, I am quite disgusted. I had a lot of loss starting at the typical 4 month mark, and it has gotten quite thin all over. I have a few "sprouts" on the top of my head indicating that some is coming back in but overall, I am still losing a lot and it is getting thinner. Grrrrr. I'm gonna be really PO'd if it doesn't reverse soon.

In anyone's experience, how long after tx did hair loss stop and regrowth start in earnest? I'm going to post a related question to the rest of the forum also.

Thanks,

Robin
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Avatar universal
Was anyone provided the rate of hypothyroidism that is associated with use of Pegays - before they began treatment? Was anyone told that hair loss either is or would be permanent? It seems like a high rate of permament endocrine system damage would discourage people from treatment (and hence paying for this expensive medication), but I didn't notice any where in the medication package insert where these numbers were disclosed. Am I only dreaming that the manufacturer would intentionally not disclose this information? The package insert describes hair loss as "temporary", but it has been reported to me as otherwise. Has anyone had hair loss that was NOT temporary?
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335297 tn?1210597884
Thanks for all the very helpful information on hypothyroidism (under-active thyroid). It has now been about 10 days since I received the results that I have an underactive thyroid and have begun hormone replacement with Eurothyrox. I do not see any positive results yet but my doctor has been reassuring and told me to hang in there. He has started me on a small dose and wants to see how things look after I have taken the medicine for one month.

I was asked about the length of my treatment which was 36 weeks. I am geno 1 and had a 2 log drop at 6 weeks but not UND until 12 weeks. The conventional wisdom in the US seems to be to complete 48 weeks in this case. I live in the United Arab Emirates and my doctor said he thought 36 weeks was sufficient in my case. Part of his thinking was due to my having severe side-effects during treatment. As I read the discussions here during treatment and saw that most in my situation went for 48 weeks or longer, I considered going further but in the end, I decided "enough was enough".

I was UND at the the end of treatment and it is now 3-months post-treatment. I will have a viral load test and fibroscan at six month post-treatment and pray for svr.

Thanks again for all the support. I agree that the forum is a great help.
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Avatar universal
Protein Deficiency

How can a Protein Imbalance be corrected without too much increase in calorie intake? The solution is found in Mung Beans and Mung Sprouts. Mung Beans when sprouted have 2.5 times (30 gms) of Protein compared to Wheat (12 gms) and 4.0 times compared to Unpolished Brown Rice (8 gms) for every 100 gms you eat. Mung Beans Mung Sprouts Wheat Rice (Polished)
Protein* 24.0 30.0 12.1 6.8
Carbohydrate* 59.9 69.4 78.2
Fats* 1.2 1.7 0.5
Calories* 348.0 300.0 341.0 345.0
Calories / Protein gm 14.5 10.0 28.2 50.7
* Per 100 gms. The Recommended Daily Allowance (RDA) for Proteins is 45 gms. for people without any Protein deficiency


The choice would be therefore to incorporate Mung Beans / Mung Sprouts in your diet in a very serious way. I recommend a daily intake of two 100 gms bowls of Mung Sprouts. Mung Sprouts are the obvious choice as it has the least amount of Calories i.e. 10 calories per gram of Protein.

Incorporating Protein rich Foods like Thallipeat, Methkuth and Protein Rich preparations will help you to maintain adequate Proteins and Nitrogen balance in your Body. It will allow the body to produce its own Amino Acids including Tyrosine.

So how long should you use Tyrosine(Forte)? My answer is, it should not take you more than 2 months to increase Protein Rich foods and phase out Oral supplementation of Tyrosine from your life.

Hypothyroidism is also associated with Anemia and extremely low Blood Pressure (Systolic of 90 and Diastolic of 60 is commonly encountered). You can also monitor your progress by watching your Blood Pressure and Basal Body Temperature go up.

Self Inflicted Hypothyroidism

When you first begin putting on weight, you use your "Intellect" to cut down on the food you are eating. When there is a shortage of food, the body uses its intellect to slow down the Rate Of Metabolism to conserve the dwindling supply of calories coming from your meager diet. The Rate of Metabolism is slowed down by reducing the levels of Thyroid Hormones in the Body. As the Rate of Metabolism lowers, you begin to put on more weight and you also cut down on food intake thinking you will slow down weight gain. This is a vicious cycle that repeats over and over again. The rate of weight gain rising with each cycle of cutting down of calorie intake.

Believe me, this is a true nightmare that millions of women are living through - with probably no help in sight.

Dieting over prolonged and extended periods can permanently reprogram the Thyroid into low gear. Now the rate at which you begin putting on weight is alarming (1 Kg / 2 lbs per month) and you think you have a Thyroid Problem. Little realizing that you might have created it with your "Superior Intellect". So you go and get your T3, T4 and TSH levels checked and satisfy yourself that nature has indeed bestowed a Thyroid Problem in your life. Now you think you were Smart in the first place to have suspected you have a Thyroid Problem and the tests have "proved" you right.

The truth of the matter is that your "Superior Intellect" inflicted Hypothyroidism in your life. The deeper truth is that you don't have a Thyroid malfunction but a Protein Deficiency. So much for your T3, T4 and TSH Test Report and our ability to interpret it and correct the situation. The truth of the matter is that your body does not have adequate reserves of Proteins and Nitrogen to produce its own Amino Acids like Tyrosine and other Essential and Non Essential Amino Acids. Remember, there are approximately 28 Amino Acids, that work synergistically together to keep the Body in balance.

From the above, it is now clear to you that, to decrease weight, you must begin to eat right. The trick to reducing weight is to actually increase food intake to normal levels, so that your Body has adequate levels of Proteins and Nitrogen reserves, to increase your Rate of Metabolism.

This now brings me to the topic of "Positive Weight Release / Hormonal Sliming" and "Why a Woman's Body is not designed for Dieting" or "Why Women should not Diet"

Sounds unbelievable doesn't it ? Well, let me tell you one more secret - 95% women who "think" they have a Weight Problem, do not have one, they always have a Hormonal Imbalance.


Dietary Recommendations for person with Hypothyroidism

Include in your diet apricots, dates, egg yolk, molasses, parsley, potatoes, prunes, raw seeds, and whole grains. Eat fish or chicken and raw milk and cheese.

Omit these foods entirely: Brussels sprouts, cabbage, kale, mustard greens, peaches, pears, radishes, spinach, and turnips. These foods further suppress Thyroid functions.

Begin moderate exercise program such as walking or yoga. Exercise is very important to help enhance Thyroid function, increase rate of metabolism and raise body temperature. Brisk walking for 30 to 60 minutes daily will be found beneficial.

Avoid fluoride (including that found in toothpaste and tap water) and chlorine (also found in tap water). Chlorine and fluoride block iodine receptors in the Thyroid gland resulting in reduced iodine-containing hormone production and finally in Hypothyroidism.

Tyrosine is an amino acid required by the body to help manufacture Thyroid Hormones from Iodine. Take Tyrosine (Forte) / AppetiteX twice a day on empty stomach half hour before Breakfast and before Lunch. Do not take with Milk. Take other Nutritional Supplementation like Vitamin - A (Forte), Vitamin - C, Vitamin - E and B-Complex (Forte) to assist in boosting the production of Thyroid Hormones in the body. Eat Protein rich foods (preferably Vegetarian) like Thallipeat, Methkuth, Sesame Seeds / Chutney, Tahini daily to exceed the Recommended Daily Allowance of 45 gm for Proteins.

Natural Thyroid Extract Supplements from Health Food Stores are found beneficial to raise Basal Body Temperatures.

Apply ThyroidCare Blend 2 to 3 times a day to the Thyroid Gland. This will help regulate Thyroid function. Leave on overnight for best results.

HypoThyroCare and Gentian (Forte) are Herbal Dietary Supplements which helps to regulate the function of the Thyroid Gland.

The Bitters of Digestive Aid Herbal Dietary Supplements when placed on the tongue help stimulate the Endocrine System of which the Thyroid is a part.

Avoid Sulfa and Antihistamines which aggravate this problem.

Increase intake of Organic Calcium Supplements like Super Calcium and Osteo-Pak Fortified with Organic Calcium and other supporting nutrients..

Basal Temperature Measurement:
Check if early morning Basal Body Temperature is below 97.5° F. to confirm Hypothyroidism. Leave Thermometer in armpit for 10 minutes to register highest possible temperature. Menstruating women should perform test on 2nd, 3rd & 4th day of menstruation. Menopausal women or women with irregular periods can check on any day.

In case of Low Basal Temperature, Copper, Zinc and Iodine levels should be checked and corrected.

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Avatar universal
I tried to pm you but looks like it didn't work, so I've copied a bit of that article here:-
----------------------------------------------

Symptoms of Stealth Hypothyroidism

Some times the Free T3, Free T4 and Ultrasensitive TSH Hormone levels check out to be OK, but the body still manifests all the symptoms of Hypothyroidism - especially the early morning temperatures are consistently below 97.5° F. sometimes even as low as 95° F or lower and one begins to wonder if something is wrong with the Thermometer. What is the explanation for this ? The phenomenon is know as Estrogen Dominance.


Estrogen Dominance & Thyroid Function

Estrogen causes food calories to be stored as fat. Thyroid Hormone causes fat calories to be turned into usable energy. Thyroid Hormone and Estrogen therefore have opposing actions.

Estrogen dominance inhibits Thyroid action and lowers the rate of metabolism of the Body. Natural Progesterone inhibits Estrogen action.

The symptoms of Hypothyroidism may also occur because of Estrogen Dominance (deficiency of Progesterone). Hypothyroidism, which results in weight gain and a host of other symptoms, can be corrected by the presence of Natural Progesterone in the body. Natural Progesterone levels can be enhanced in the body by supplementation of the diet with Herbal Dietary Supplement Wild Yam during the perimenopausal years and once corrected can be easily maintained by increasing the intake of Protein rich Food in the Diet - 2 bowls of Mung Sprouts per day is adequate in most cases to continue maintaining your Body in a Hormonally Balanced state. To increase Progesterone levels during the Menopausal years, topical application of Progest Gel containing Bioidentical Progesterone Hormone is recommended..

Many other presumed Thyroid dysfunctions (like falling hair, water retention, loss of memory, dry skin) and Autoimmune Disorders are actually caused by Estrogen Dominance.

The crucial nutrient for Thyroid Hormone synthesis in the body is Iodine. Herbal Dietary Supplements like Kelp are a rich source of natural Iodine. Natural Iodine along with Tyrosine an amino acid can help the Thyroid manufacture normal levels of Hormone T3 and T4. In the presence of adequate levels of Natural Progesterone, Estrogen Dominance will disappear and the Thyroid Gland / Body will begin functioning normally i.e. the symptoms of weight gain will disappear.

Kelp along with Tyrosine (and Wild Yam / Progest Gel in cases of Estrogen Dominance) can therefore increase the Rate of Metabolism of the body and result in corresponding Weight & Body Dimension reduction. Weight & Body Dimensions reduced in this manner have no rebound effect and you do not have to be on the Program for ever and for ever.

Administration of Tyrosine

The Body has approximately 28 different Amino Acids, some of which are obtained from the Protein rich food you eat and others are manufactured within the body itself from adequate reserve of Proteins and Nitrogen.

If your diet lacks adequate level of Proteins, you will end up having an Amino Acid / Nitrogen deficiency. This can also happen if your Calorie / Food intake is restricted in which case Proteins will automatically be in short supply.

The use of Tyrosine (Forte) as a Dietary Supplement raises the production of Thyroid Hormones in the body. These in turn increase the Rate of Metabolism which raises the Body Temperature back to normal levels of 98.0°F to 98.4°F.

The effect of Tyrosine can be determined by monitoring your Basal Body Temperature, as per the procedure given in my earlier Circular to you.

When Tyrosine raises the Body Temperature, it infers that your Body is not able to manufacture adequate quantities of it along with other Amino Acids. The reason can be that, in these days of "Enlightened Eating Habits" (pun intended) you have reduced your calorie intake to such low levels that you inadvertently landed up in a state of Protein Deficiency creating a Nutritional Imbalance in your Body.

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179856 tn?1333547362
Thanks Doin - I could only read the carolroberts one here cause of the firewall but it was interesting.  I WISH I could figure out how to lose the 14 pounds I've gainned (i refuse to weigh myself anymore since it's just not working like it used to when I could stop eating large meals and lose weight immediately now i could eat a piece of lettuce and gain probably)...........
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Avatar universal
Thanks for your reply, very helpful, especially about the test,

dointime
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179856 tn?1333547362
ps I just looked it up and I am on the same drug as you Euthyrox which is levothyroxine that I couldn't spell before. It is a hormone relpacement.



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179856 tn?1333547362
I developed a hyperthyroid condition at about week 30 of treatment. I had to wait three weeks for an appt for a nuclear imaging scan - by the time I got to it my thyroid had completely flip flopped and I am not hypothyroid.  This is very common, the interferon causes the autoimmune disease.

I was taking synthroid to manage the problem but now I've switched over to the levothroxane (can't spell it but it's something like that) because it supposedly works better when you are hypo.

Unfortunately a lot of the symptoms are exactly the same as the side effects from treatment so you get a real double whammy and also it covers them up. Thank God they do give us the thyroid tests!

Being hyper is much more dangerous than being hypo. When you're hyper you are just that "hyper" - trouble sleeping, hair falling out, irregular heart beating.  When you are hypo it's the opposite, tired and lethargic, weight gain.

You can google and find a TON of into easy enough.  Grave's Disease is for hyper and Hashimoto Disease for hypo.

Make sure you have a good endo doc.  It is important that you stay on top of this but the good news is if you are hypo you can manage it pretty easily by just taking one little pill a day.

Good luck!

(PS The doctors always tell us that it 'might' go back to normal eventually but I"ve never seen anyone on here who had their thyroid just get better).


PS Why did you only do 36 weeks of treatment?  What caused you to stop so early?  Are you still now UND?  I did 72 weeks (geno 1a and geno1b combo) and am SVR one year.
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335297 tn?1210597884
My symptoms at 3 months post-treatment were headaches, tiredness all the time, inability to concentrate, severe memory loss, jittery, mood swings. Actually, my symptoms seemed to mimic depression and one doctor was leaning towards diagnosing my problem as depression when he ordered a blood test to check my thyroid level. The test showed that I had a low T4 level and a high TSH level which means I have an underactive thyroid perhaps due to the long treatment with interferon.

The treatment for underactive thyroid is to take a hormone replacement for a while (and possible for a long while) and get the levels correct. I have been taking the medicine about a week and haven't noticed much change yet but the doctor said it may take 2 to 4 weeks before I begin to see improvement. I am relieved though to have found the problem.

If you have these symptoms, you might ask you doctor. The blood test was simple and the thyroid medicine is inexpensive.

Good luck.
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Avatar universal
Interferon is well known to have side effects on the thyroid.

I am 6 months post treatment and think I might have the same problem.  Can you describe your symptoms in more detail please?

I hope you do get to feel better soon,

dointime
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186606 tn?1263510190
Thyroid dysfunction is very common during treatment and post treatment.  not sure of the cause, except for the statement my doc made which is that the interferon "burns out" the thyroid in a sense.

This is very common.
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