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Anyone on Synthroid and Lithium?


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I've been taking Synthroid for almost 20 years now for hypothyroidism. I've been thinking about trying (again) to take Lithium1, but I've read that it can cause hypothyroidism.

Anyone out there taking Synthroid and lithium together, and can tell me what their experience is, at what dose level, etc.,?

1. In an earlier post I mentioned that I tried Lithium for less than a week a few years ago, and had a terrible reaction to it. My pdoc speculates that it was probably because I couldn't tolerate it with the 200 mg. of topirate I was taking at the time.

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Hey gf!

Have you tried using one of the online drug interaction checkers? I just got done checking mine at drugs.com (for some reason, the link posted in the "Cocktails" forum didn't work)....

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Drug Interaction Results

Drug interaction results for the following 2 drug(s):

lithium

Synthroid (levothyroxine)

Interactions between your selected drugs

No results found - however, this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs that your selected drugs interact with

• There are more than 1000 other drugs known to interact with lithium

• There are more than 1000 other drugs known to interact with Synthroid (levothyroxine)

Interactions between your selected drugs and food

s2.jpgSynthroid (levothyroxine) (Moderate Drug-Food)

ADJUST DOSING INTERVAL: Consumption of certain foods as well as the timing of meals relative to dosing may affect the absorption of T4 thyroid hormone (i.e., levothyroxine). T4 absorption is increased by fasting and decreased by foods such as soybean flour (e.g., infant formula), cotton seed meal, walnuts, dietary fiber, calcium, and calcium fortified juices.

MANAGEMENT: Preparations containing T4 thyroid hormone should be administered on a consistent schedule with regard to time of day and relation to meals so as to avoid large fluctuations in serum levels. Foods that may affect T4 absorption should be avoided within several hours of dosing if possible.

Hopefully this helped out some, tho it would be much better if someone could come along and share their experience....

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What seems to make sense to me is if the Lithium does cause hypothyroidism, that you may need to have the Synthroid adjusted accordingly (taking into consideration, of course, that you're not already on the maximum dose), or have something else tacked on. You'll probably want to go in and have blood work done occasionally to be sure your thyroid is functioning properly.

But you already know this stuff, lol.

smartass.gif

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Well now, this is interesting:

Drug interaction results for the following 2 drug(s):

lithium

topiramate

Interactions between your selected drugs

s2.jpglithium and topiramate (Moderate Drug-Drug)

MONITOR: Coadministration with topiramate may increase the serum concentrations of lithium. The exact mechanism of interaction is unknown but may involve competition for renal excretion and/or sodium depletion induced by topiramate, which is a weak carbonic anhydrase inhibitor. There have been isolated case reports of patients treated with lithium who developed symptoms of toxicity (e.g., impaired concentration, confusion, lethargy, tremors, bradycardia, nystagmus) in association with elevated serum lithium levels following the addition or increase in dosage of topiramate. A reduction in the lithium dosage was necessary to maintain therapeutic levels during coadministration with topiramate. However, topiramate at a daily dosage of 200 mg has been reported by some investigators to exhibit little or no pharmacokinetic interaction with lithium.

MANAGEMENT: Caution is advised if topiramate must be used concomitantly with lithium. Pharmacologic response and serum lithium levels should be monitored closely and the dosage adjusted accordingly, particularly following initiation, discontinuation or change of dosage of topiramate in patients who are stabilized on their lithium regimen. Patients should be advised to notify their physician if they experience early symptoms of lithium toxicity such as drowsiness, dizziness, diarrhea, vomiting, muscle weakness, incoordination, ataxia, tremor, blurred vision, tinnitus, excessive thirst, or increased urination.

Other drugs that your selected drugs interact with

• There are more than 1000 other drugs known to interact with lithium

• There are more than 800 other drugs known to interact with topiramate

Interactions between your selected drugs and food

No results found - however, this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

You mentioned 'topirate' in your first post; did you really mean 'topiramate'? Just wondering, because I couldn't find a result for topirate. I read the meds you're currently taking - one of which is topiramate. Are you SURE this is a combination you want to risk again? Can you do without the topiramate? In my honest opinion, I think your previous experience practically voids any experience anyone else may have had as pertains to your situation - especially having had a negative reaction in the past! I detect some huge red flags....

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Autumn, you're so funny ;) Thanks for your articles--I did a search on that same site, actually. Synthroid interacts with lots of meds, a couple of which I took with it and it didn't cause me a problem at all, so go figure.

Airmarshall--I'm still nervous about it, since my last experience, so I'm going to go easy this time!

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The first time I needed Synthroid was when I was on Lithium the first time. This time, I was on lithium a month or two and have had to raise my dosage of Synthroid from 50 mcg to 75 mcg. I need to go get my blood work done to see how it's all working out, but Im feeling fine.

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