Blood test and feeling a bit down

This article seems to lay it out pretty well. There’s a known interaction between thyroxin and epilepsy meds:

“The interaction among thyroxine, seizures, and anticonvulsants is complex. It has been known for quite some time that thyroid hormone lowers the seizure threshold in humans and can cause seizures in patients with Graves’ disease (Epilepsia. 1980;21:91-96). Thyroxine therapy for hypothyroidism has also been shown to induce seizures in certain cases (Neurology. 1985;135:1792-1793). This pro-seizure effect on the brain is not well defined, other than to say that it is believed to be a direct action on cerebral cells by thyroid hormone. Seizures have also been reported in patients who were previously “controlled” on a stable dose of anticonvulsant when thyroxine replacement therapy was initiated (Neurology. 1996;47:605-606). It is thus not clear that thyroxine “suppresses” antiseizure medications in a direct way. Surprisingly, much of the literature has focused on the effects of anticonvulsant therapy on intrinsic thyroid function rather than the converse. Such medications as carbamazepine and phenytoin have been shown to displace thyroxine from plasma protein-binding sites and potentially increase its clearance. Free thyroxine (T4) and triiodothyronine (T3) will be increased, while serum T4 and T3 levels will be decreased. Authors have speculated, therefore, that thyroid-stimulating hormone should be followed to determine if a patient on anticonvulsants has normal thyroid levels (JAMA. 1996;275:1495-1498).”

Thanks for your most helpful replies. I'm not currently taking a my thyroid meds right now . I'm just taking lots of seizure medication that I have been taking for years . I'm confused as to why my throid levels have decreased so much since being normal in Feb. I must admit I'm a quite concerned

So Kevin, wow, no thyroid meds, with yoor thyroxin numbers high like that? Yeah, that would freak a doctor out. 

They'll probably look at your meds, and if they can’t find whats causing it, they’ll likely wait and retest. Keep in mind, there’s akways the chance the lab tests are wrong.

When reading  your test results, keep in mind that TSH (thyroid stimulating hormone) is produced by the pituitary gland, tells your thyroid to produce thyroxin. Your results make sense that your TSH has dropped in response to high thyroxin levels. This is your pituitary working to correct the too high levels of thyroxin. 

How your thyroxin levels are so high without (thyroid) meds is a good question. Most likely, you changed your seizure meds in the last six months. There’s a lag time of about three months for thyroid shifts. You’ll have to look back at your seizure meds to see what dose or med changes were made in the last six months or more.

15 pills for seizures. That’s quite scary. The risk of drug interactions and side effects is unavoidable. But you’ll be better off if you can research each drug, its interactions and side effects. If you can’t  find info online about your meds, a pharmacist can answer some questions.

Hope that helps.

Hi Kevin, yes, it seems a bit of a mystery. How about while you’re waiting for your appointment, you research side effects of your 15 meds  and their effects on thyroid function? Really, in all likelihood, its your meds.

Kerp in mind, your body is responding to your high thyroxin levels by decreasing the TSH production. So your thyroxin levels should go down naturally if your body continues it’s course.

Then there’s the whole stress/adrenal thyroid connection. Very high stress can cause adrenal burnout, which contributes to thyroid disease. Could be your adrenals  are exhausted. Adrenal health9  is important to good thyroid health.

Hi Kevin,

I don’t know anything about the seizure medication, but my thyroid results were the same as yours about a year ago. Specifically the TSH .01 . This means that you have hyperthyroidism (producing too much thyroid hormone) This happened suddenly for me as well. 6 months prior to these results I was actually on the other end of results with slight hypothyroidism (no meds tho). I started on anti thyroid medication at first and then had my thyroid removed. The cause of the enlarged thyroid and excessive thyroid hormone was from Graves’ disease. 

With hypothyroid disease, you can get spikes in thyroxin as well as lows. As the thyroid gland struggles and sputters, it toggles between hypo and hyper-thyroid. To assume you are hyper is premature, even though your blood results show as hyper at the moment.

MVC. He is most definitely a Graves person. You wasted a lot of words blaming it on Levo....made me laugh though!!!

Hi Kevin, here’s an exerpt from the article I posted previously:

...”Surprisingly, much of the literature has focused on the effects of anticonvulsant therapy on intrinsic thyroid function rather than the converse. Such medications as carbamazepine and phenytoin have been shown to displace thyroxine from plasma protein-binding sites and potentially increase its clearance. Free thyroxine (T4) and triiodothyronine (T3) will be increased, while serum T4 and T3 levels will be decreased.”

What this means basically, is that anticonvulsants can mess with thyroxin levels because they interefere with thyroxin receptor sites. The thyroxin can’t get into the cells and your body makes more. But basically its confusing to your body because while there’s too much thyroxin in your blood, there isn't enough getting into cells.  Wventually, your body realizes there’s too much in the blood and the TSH drops. 

I’m guessing you got lucky on the timing of your bloodwork. 

I believe I was on the anti thyroid for about 3 or 4 months before getting it removed. I was very symptomatic with tremors and anxiety, heat sensitivity. Blurry vision. There was an option to do radiation pill to destroy the gland, but I couldn’t be isolated for the 10 days after so I opted for surgery. You will learn so much from your doctor and if he seems unsure, have him refer you to an endocrinologist.