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What Causes Hyperthyroid Symptoms While On Thyroxine?

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Posted on Sat, 19 Sep 2015
Question: have you any evidence that tyroxine and leflunamide taken for ra and underactve thyroid i find i get overactive symtoms and have taken thyroxine for many many years although my ra didnt start until six years ago can you help me please thank you from XXXX
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Answered by Dr. Shafi Ullah Khan (4 hours later)
Brief Answer:
Dose reduction advised. Liver metabolism reduced due to cirrhosis plus age

Detailed Answer:
Thank you for asking

I read your question and i understand your concern. Thyroxine supplements giving hyperthyroid symptoms with history of RA meds and liver cirrhosis secondary to RA meds, is very common. The reason is thyroid supplements are metabolised in the liver and with the liver cirrhosis even if early due to RA meds has led to reduced metabolism of thyroxine supplements and thus causing these hyperthyroid symptoms. Also with advancing age of 60 plus, drug metabolism is reduced.

All you need to do is reduce the dose of thyroxine and keep an eye on your thyroid hormones assay. Thats it. Leflunomide is a good alternative for RA. You may discuss other options like rituximab or other monoclonal antibodies with your rheumatologist if the RA symptoms don't respond to leflunomide.

I hope it helps. take good care of yourself and dont forget to close the discussion please.

Regards
Khan
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shafi Ullah Khan

General & Family Physician

Practicing since :2012

Answered : 3613 Questions

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What Causes Hyperthyroid Symptoms While On Thyroxine?

Brief Answer: Dose reduction advised. Liver metabolism reduced due to cirrhosis plus age Detailed Answer: Thank you for asking I read your question and i understand your concern. Thyroxine supplements giving hyperthyroid symptoms with history of RA meds and liver cirrhosis secondary to RA meds, is very common. The reason is thyroid supplements are metabolised in the liver and with the liver cirrhosis even if early due to RA meds has led to reduced metabolism of thyroxine supplements and thus causing these hyperthyroid symptoms. Also with advancing age of 60 plus, drug metabolism is reduced. All you need to do is reduce the dose of thyroxine and keep an eye on your thyroid hormones assay. Thats it. Leflunomide is a good alternative for RA. You may discuss other options like rituximab or other monoclonal antibodies with your rheumatologist if the RA symptoms don't respond to leflunomide. I hope it helps. take good care of yourself and dont forget to close the discussion please. Regards Khan