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Does The Level Of Cortisone Affect The Rate At Which Thyroxine Is Metabolized?
Question: I have Addisons Disease and hypothyroidism. Over 12 months ago, on specialist advice I gradually reduced my cortisone dose rate from 40mg of hydrocortisone per day to 32mg per day. My thyroxindoseremained constantat 1200 ug per week. I developed hyperthyroidism with a T4 level of 28 pmol/l. Does the level of cortisone affect the rate at which thyroxin is metabilised?
Brief Answer:
Need dose adjustment of thyroxine.
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. With history of addison's disease body metabolism is slowed down and it takes more times to get the drug out of the system. With thyroxine of 1.7 microgram per kg in a day, 1200 microgram might be more than you need. That has likely led to hyperthyroid symptoms. The easy solution is to to titrate the dose and reduce it to the minimum possible , have regular thyroid functions test and see at which dose euthyroid state is achieved.
For example if you are 70 kg then daily need of thyroixine is 70 x 1.7 / kg which is 119 microgram and for 7 days it gets 833 microgram. So you have been taking 400 microgram more than what you would need at 70 kg. With addison's weights are even lesser so that makes the requirement further decreased.
As far as a direct interaction between cortisone and thyroxine is concerned, there isn't any and these drugs don't affect each other in efficacy and output.
Nutshell, reduce thyroid dose and regularly follow up on the levels till euthyroid status is achieved. Talk to your doctor and let them help.
I hope it helps. take good care of yourself and dont forget to close the discussion please.
Regards
Khan
Need dose adjustment of thyroxine.
Detailed Answer:
Thank you for asking
I read your question and i understand your concern. With history of addison's disease body metabolism is slowed down and it takes more times to get the drug out of the system. With thyroxine of 1.7 microgram per kg in a day, 1200 microgram might be more than you need. That has likely led to hyperthyroid symptoms. The easy solution is to to titrate the dose and reduce it to the minimum possible , have regular thyroid functions test and see at which dose euthyroid state is achieved.
For example if you are 70 kg then daily need of thyroixine is 70 x 1.7 / kg which is 119 microgram and for 7 days it gets 833 microgram. So you have been taking 400 microgram more than what you would need at 70 kg. With addison's weights are even lesser so that makes the requirement further decreased.
As far as a direct interaction between cortisone and thyroxine is concerned, there isn't any and these drugs don't affect each other in efficacy and output.
Nutshell, reduce thyroid dose and regularly follow up on the levels till euthyroid status is achieved. Talk to your doctor and let them help.
I hope it helps. take good care of yourself and dont forget to close the discussion please.
Regards
Khan
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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