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Vitamins + thyroid
May 10, 2014 5:54 PM   Subscribe

Why am I getting this medical effect from vitamin pills, and should i be worried?

I was diagnosed with mild hypothyroidism (Hashimoto's) about five years ago, and put on Synthroid 50 mcg daily. My primary care doctor has recommended a Vitamin D supplement. I took the vitamin D for a while but noticed nothing happening and stopped. At my next physical, which was about a month ago, she recommended again that I take it. I have been taking a multivitamin and 5000 IU Vitamin D daily for three weeks and have noticed the following effects:

--I feel notably less draggy and more energetic (I had been feeling tired and sore all the time). I still feel that I am getting up too early in the morning (5:30) in order to get to the school where I work. I am not getting up in the pitch dark and coming home in the dark anymore which was really getting me down.

--I feel less anxious and depressed. A major project had begun to seem insurmountable. I now feel better about it even though the deadline is approaching. The other difficulties in my life are not objectively better either (my workplace is a mismatch for me socially and my mother is very ill).

--I have been exercising more. I am walking from a train station to and from work (even though I fear and loathe the four-way intersection I need to cross) two days a week, have walked to run errands several times after work, and have done more out-of-doors things on the weekends.

--I feel HOT. It is dry, not sweating. This is probably the most abnormal feature. I am having trouble separating this sensation from the return of hot weather in my part of the country and the fact that the people I live with are old and want the house to be warm. A real test would be whether I am too warm at one of the locations of my workplace (I work for a school with two campuses and alternate days). There the air conditioning is malfunctioning and makes the room painfully cold, or it has been painfully cold before I started the vitamins. It is still too cold there.

I have tried taking my temperature and plan to start charting it. A few evenings ago I measured an oral temperature of 98.8 vs. formerly (before the vitamins) 97.5 or so.

I am not sure that these things are happening because of the vitamins or because I have been getting outside in the sunlight. The winter in my area was very protracted and maybe I have seasonal affective disorder.

However, my fear is that the vitamins are enabling me to metabolize the Synthroid too much and that I am getting an overdose. I do not want to have Graves' disease. A friend of my mother's had it and told horror stories about her eye problems, which required extensive surgery (yes, displacing the eyeballs!) to reduce the abnormal material in her eye sockets that made her eyes protrude painfully. I already have dodgy retinas (vitreous detachment), about which I posted on AskMe two years ago, and I don't think they would survive that kind of surgery. I am also afraid of heart involvement. It is too soon to visit my doctor again.

Should I just drop the extra Vitamin D pill and continue with the multivitamin? Or should I see my doctor or an endocrine specialist? I did not think you get such a DRASTIC effect from vitamins. I had thought that as long as you ate a balanced diet, taking vitamins was unnecessary.
posted by bad grammar to Health & Fitness (13 answers total) 5 users marked this as a favorite
 
Have you had a follow up TSH test since you notices these changes?
posted by KathrynT at 6:01 PM on May 10 [1 favorite]


Being hypothyroid and having low vitamin D levels - especially D3 is very common and yes getting the level up will make a big difference in your energy level. I doubt that the vitamins are causing you to metabolize the Synthroid too much - and 50mcg is not a very high dosage. I'm not a doctor but have been dealing with low thyroid issues myself for many years. I found taking 5000IU of Vit D made a huge difference in my energy level. I would guess that the feeling hot is more due to kicking your metabolism up through exercise but as KathrynT suggests it's worth getting your levels checked - and you should be annually.
posted by leslies at 6:05 PM on May 10 [1 favorite]


You know that you should take your synthroid alone, with no other medication, and not within an hour of eating? I take mine upon first arising and take my other meds including vitamin d after my shower. I have my thyroid levels tested every three months and have never been even slightly at risk for Graves. I think you should discuss your concerns with your doctor to put your mind at ease.
posted by janey47 at 6:11 PM on May 10


I take Vitamin D alone (I have no thyroid problem) and it has these very effects on me: increased energy and drive to get stuff done, decreased anxiety and depression, less sensitive to cold. I'm Vitamin D deficient to begin with, and from the sound of it, so are you.

Consider that if these things would normally happen to you because of the sunlight, this is a sign that you were lacking vitamin D in the first place.
posted by Andrhia at 6:39 PM on May 10


Synthroid should be taken on an empty stomach (at least 2 hours after eating) with a full glass of water. Wait one hour before eating or drinking anything but water, then another three hours (four total) before taking any supplements (vitamin, mineral, or fiber).

Hashimoto's is an autoimmune disease, so your levels (T3, T4, and TSH) will go up & down. Your endocrinologist should be checking your levels often and adjusting your dosage accordingly.

Take the vitamin D as directed, and report your symptoms to your endo.
posted by editorgrrl at 6:47 PM on May 10


Vitamin D effects neurotransmitters in your brain, specifically norepinephrine and serotonin.
These good things that are happening are probably due to the vitamin D.
posted by SyraCarol at 6:50 PM on May 10


IANAD, but my understanding is that Graves' disease is not the same thing as hyperthyroidism, but rather that hyperthyroidism is the primary symptom of Graves' disease (but hyperthyroidism also can be a symptom of other things). In Graves' disease specifically, the antibody that attacks the thyroid (and causes the hyperthyroidism) also attacks the muscles of the eyes. (Or at least that is the current theory. Hopefully someone else can explain this better!)

I take Vit D for a clinical deficiency, and like people have noted above, your response sounds similar to mine. (As for not needing vitamins if you eat a good diet: low Vit D is super-common now that people work indoors all winter.) I also find that Vit D really helps with seasonal affective issues, so you may be getting a double-whammy with springtime AND the Vit D suddenly lifting any lingering seasonal affective symptoms.

Again, IANAD, but I'd personally be worried about hyperthyroid if I started seeing increased anxiety, large muscle weakness, heart palpitations, tremor, unexplained weight loss, etc. That being said, thyroid levels can fluctuate over time anyway, so it couldn't hurt to ask your endo (or PCP?) to run your TSH and see what's going on. You can probably just call your PCP's office and ask if you can have this run.
posted by pie ninja at 7:05 PM on May 10


Just as an aside: There is vit D in your multivitamin most likely. You might want to lower the overall amount, talk to your doc about it.
The general rule is 4000 IU/day, higher amounts only for people with deficiency and over the short term.
"Taking vitamin D for long periods of time in doses higher than 4000 units per day is POSSIBLY UNSAFE and may cause excessively high levels of calcium in the blood. However, much higher doses are often needed for the short-term treatment of vitamin D deficiency. This type of treatment should be done under the supervision of a healthcare provider."
posted by travelwithcats at 7:10 PM on May 10


As a counterbalance to travelwithcats, from the Mayo Clinic: "Taking 50,000 international units (IU) a day of vitamin D for several months has been shown to cause toxicity."

The key factors here being: 1) ten times more than you're taking, 2) for *several months.* Yes, you can definitely get too much vitamin D, but it takes a little effort.
posted by Andrhia at 7:49 PM on May 10 [1 favorite]


Wait one hour before eating or drinking anything but water, then another three hours (four total) before taking any supplements (vitamin, mineral, or fiber).

Not sure where you are getting this from, but Nope, this is overkill. Take Synthroid 30 minutes before eating, with that water, and you'll be fine. Sometimes the Rx will say an hour before but that is not a medical necessity, just a precaution, because with a very small percentage of patients the medication constricts the throat and can make it harder to swallow. Wait an hour if you want to, though, that's fine.

As far as drinking goes, you only really have to be careful to avoid some specific stuff, like grapefruit juice or calcium fortified OJ.

Most importantly, you can (and may even be instructed by your doctor to) take most common medications (adderall, wellbutrin, lisinopril, over the counter stuff like Advil, etc.) right along with your Synthroid. There are a very few exceptions; you can check with your doctor if unsure.

It is true that you don't want to take vitamins or supplements within a couple hours of taking your Synthroid, though, as they may affect the absorption of your thyroid medication.
posted by misha at 8:54 PM on May 10 [1 favorite]


As a clarification to my earlier statement, two doctors have told me in the last month to take my synthroid separately from any other meds and not within an hour of eating. OP, as I mentioned in my original post, I think you would be well served by discussing this with your doctor rather than trying to seek consensus here.
posted by janey47 at 11:41 AM on May 11


Thank you, all. I did not want to thread-sit. I take Synthroid first thing in the morning with water, 30 minutes before eating. Waiting 1-2 hours for breakfast would be a pain as I have a long commute to work.
posted by bad grammar at 3:15 PM on May 11 [1 favorite]


FWIW, my doctor told me to just take the meds on a regular schedule, even if it meant with food, and she'd test my levels and adjust the dosage to compensate. The important part was to do it the same way every day.
posted by instamatic at 4:30 PM on May 11 [2 favorites]


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