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Can Levothyroid Be Discontinued If One Had A Heart Attack?
Question: My 80 year old mother is hospitalized, had a blood clot which led to a heart attack 3 days ago and now they are saying she has kidney disease, too. She used to be very active, lived alone, needed no help. They are giving her levothyroid, if you are not supposed to discontinue use suddenly and your not supposed to take if you have a heart attack, what is the safest way to get off of it? She was also on paxil and buspar at the same time which have interactions & your not supposed to just stop taking the paxil, she hasn't taken that for 4-5 days now & was hallucinating earlier, think that could be why? She's not on any narcotics. Today is her last day of warfarin, which they gave her coq10 and vit. E when she was on it & it says they are contraindicated, too! Now she is totally disorientated, paranoid, delusional & hallucinating. She is like a very old person all of a sudden
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello again!
Welcome and thank you for asking on HCM!
I passed carefully through your question and would explain that her clinical situation seems to be a little complicated due to many issues:
- her heart attack
- her kidney dysfunction
- low oxygen saturations
- abrupt paxil and buspar discontinuation
- levothyroid may contribute in this situation.
So, she seems to be in delirium, which is a common complication after a heart attack, especially considering the above factors too.
Kidney disease, could be a complication of acute heart attack. Anyway, the kidney function should be closely monitored, because many drugs are metabolized and excreted by the kidney. Which means that a reduce of the doses of her actual drugs may be needed as long as her kidney function is severely altered.
You should also know that the toxins that are acumulated in our organism during kidney dysfunction (because of impaired excretion) could lead to delirium and confusion.
Considering the kidney issues, I would not recommend starting again paxil and buspirone during these days, because they may aggravate the situation. Besides they have no effects on hallucination and delusions.
Regarding levothyroid, I would recommend first checking her thyroid hormone levels, before deciding to discontinue it. This decision should be made after the consult with an endocrinologist.
Regarding coq10 and vitamin E, these drugs do not aggravate her situation. They may interact with warfarin: coq 10 decreases warfarin effects, while vitamin E increases its effects.
But these are minor interactions and there is nothing to worry as long as her INR levels are therapeutically correct.
You should try to be more patient, as it may take her a long time to recover from this situation.
I would advice you to discuss with her doctor on the above issues.
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello again!
Welcome and thank you for asking on HCM!
I passed carefully through your question and would explain that her clinical situation seems to be a little complicated due to many issues:
- her heart attack
- her kidney dysfunction
- low oxygen saturations
- abrupt paxil and buspar discontinuation
- levothyroid may contribute in this situation.
So, she seems to be in delirium, which is a common complication after a heart attack, especially considering the above factors too.
Kidney disease, could be a complication of acute heart attack. Anyway, the kidney function should be closely monitored, because many drugs are metabolized and excreted by the kidney. Which means that a reduce of the doses of her actual drugs may be needed as long as her kidney function is severely altered.
You should also know that the toxins that are acumulated in our organism during kidney dysfunction (because of impaired excretion) could lead to delirium and confusion.
Considering the kidney issues, I would not recommend starting again paxil and buspirone during these days, because they may aggravate the situation. Besides they have no effects on hallucination and delusions.
Regarding levothyroid, I would recommend first checking her thyroid hormone levels, before deciding to discontinue it. This decision should be made after the consult with an endocrinologist.
Regarding coq10 and vitamin E, these drugs do not aggravate her situation. They may interact with warfarin: coq 10 decreases warfarin effects, while vitamin E increases its effects.
But these are minor interactions and there is nothing to worry as long as her INR levels are therapeutically correct.
You should try to be more patient, as it may take her a long time to recover from this situation.
I would advice you to discuss with her doctor on the above issues.
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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