Case Levothyrox : are you more hypo or hyper ?

ALLILI MOURAD/SIPA

Published the 24.10.2017 at 07h20

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Keywords :

thyroïdeHormone thyroïdienneLévothyrox

According to the MSNA, the adverse reactions reported since the arrival of the new Levothyrox would be due to “an imbalance of the thyroid” caused by the change of formula, not to the new formula itself. This is what emerges from the first results of the survey of pharmacovigilance, according to which ” no adverse effect of a new type, which would be specific to the single new formula has not yet been found “.

Has the search for ” more stability “

According to its press release, the MAN continues : “Any change of specialty or formula can alter the hormonal balance and may require a readjustment of the dosage ” which can take ” a certain period “.

It is pointed out that the new formula of the Levothyrox has been claimed by the MAN in the laboratory Merck in 2012 to, according to it, to make the product more stable over time. The change is therefore not about the active ingredient (thyroid hormone), nor on its dosage, but on other substances (excipients), supposed to be amorphous and are designed to allow the manufacture of the tablet.

An “imbalance thyroid” therefore, pending the completion of the investigation, but in practice, to rebalance, we need to know if you have mild hyperthyroidism or mild hypothyroidism compared to the previous formula.

Hyperthyroidism, an acceleration of the functioning of the body

In the case of hyperthyroidism, all the metabolic processes of the body are somehow “accelerated” : the heart rate is fast and permanently and may become irregular, the function of the intestines is also increased (diarrhoea), the sweat glands produce too much sweat and sick all the time too hot, and less clothes than the other people around him. The nervous system is also stimulated so that the patient becomes hyperactive, irritable, and nervous, with trembling hands. Despite a net increase in his appetite, the person loses weight, both fat than muscle, because the normal power supply is incapable of meeting the needs required to address the accelerated degradation of the protein. There are also disorders of the rules, which are scanty, painful, or absent, as well as an increase or a decrease in libido.

But in the case of a hormonal imbalance linked to a small variation of dose, the signs to look for are more subtle : a simple increase in unusual but sustained appetite, a feeling of being too hot and not being able to bear the heat, elevation of the discreet the temperature of the hands that are warm and clammy, excessive perspiration, with excessive thirst. We can also find a high heart rate above 80 beats per minute and permanent, palpitations, fine tremor, fast and steady hands, nervousness, restlessness, emotional fragility, chronic diarrhea…

Hypothyroidism, a slowing down of the functioning of the body

The signs of hypothyroidism are caused by a deficiency of thyroid hormone levels in relation to needs, lack of which leads to a slowdown of metabolic processes.
The person may feel fatigue, physical and mental, a sleepiness, a decrease in body temperature with shivering acquired, a constipation, a slowing of the heart, weight gain, modest contrasting sometimes with a loss of appetite, joint stiffness, muscle cramps, and muscle pain. There may be a deficit in muscle that predominates on the roots of members. The person suffering from hypothyroidism may also have memory disorders. A depressive state or a syndrome of confounding are more prevalent in the elderly.
There may be also a variety of conditions of the rules, disturbances of libido and lack of ovulation with a difficulty to have children. Hypothyroidism can present as an isolated impairment of the heart with congestive heart failure.
But in case of under-dosing moderate in Levothyrox, linked to a small variation of dose, the signs to look for are rather a persistent fatigue with drowsiness, decreased body temperature and a sensitivity to the cold acquired, a constipation, a slowing of the heart, cramps, and muscle pain, and disorders of the rules…

These disorders may be sufficiently intense to poison the daily life and hormone assays (TSHus) are not necessarily contributing, because the change can be modest and stay within the boundaries of the normal. This is the difference compared to the older assays measured in the same laboratory, which may be contributory. It will be necessary, with your doctor, adjust the dose with very small variations, upward or downward, in order to regain the lost balance.