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Rebecca alerted me to relationship between dry eye and thryroid

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  • Rebecca alerted me to relationship between dry eye and thryroid

    I have had dry eye for about a month and a half now. When I first joined this forum (April 4, 2012) I mentioned that I had started on thyroxine 2 weeks before. Rebecca suggested (I am paraphrasing now) that UNTREATED thyroid deficiency rather than treated thyroid deficiency is more likely to be a cause of dry eye. That got me to thinking that maybe my prescribed dosage of thyroxine, 50 mcg a day, was too low. I looked around on the Net for what the normal or typical dosage was and found it to be, for my weight, about 125 mcg per day with 100 mcg - 150 being a typical range of dosages. I had a blood test coming up, so I waited for that, but the day after the blood draw I began taking 2 (100 mcg) of my 50 mcg pills (I had a few extra because I had missed a couple of days).

    Well, I have discovered two things: 1) the blood test showed that 50 mcg per day was NOT bringing my thyroxine up to the proper levels and 2) my eyes feel a LOT better (although they are not back to 100%) now that I am taking 100 mcg per day. My doctor has written to me that he will officially up my thyroxine dosage the next time he speaks to me, but he is not reachable until April 16. In the meantime, I will take a double dose of my original prescription. I hope that finding the right level of this medication will make a strong contribution to making my eyes feel better.

    Thank you so much Rebecca for helping me to think more clearly about this!

  • #2

    As one thyroid disorder patient to another, please be careful with adjusting the thyroid meds yourself. It's really tricky to get the dosage right, even for an endocrinologist, and too much can make you feel very out-of-whack (anxious, agitated or hyper) and stress your heart.

    I've been on Levoxyl for about 6 years. In the beginning it takes several visits for the doc to figure out what level of meds you really need, and the amount you need may change often. It is not based on body weight. The blood tests are necessary for the doc to figure out what you need, but by experience working with you the doc also determines what blood level, within the normal range, makes you feel at your best. It takes about 2 months of being on a dose before your blood levels will reflect how you do at that dose. Then the doc can make an adjustment and wait another 2 months to see if another adjustment is in order.

    Back when I was first diagnosed, I told my GP how frustrating it was to only see the endo every 4 mos, because it would take so long to get up to the right level of medication. So she started testing me and adjusting my dose between endo visits (the endo approved), so my dose could be adjusted every 2 mos.

    If you haven't already, check out side effects and overdose symptoms of the meds on or wikipedia. Also drug and supplement interactions. Some supplements and drugs, like Alpha Lipoic Acid or Calcium, but also many others, can significantly affect the thyroid meds, making them less effective. Side effects and overdose info.

    I hope the thyroid treatment is going to make you feel much better. Good luck with it all.



    • #3
      To add to Mary’s very informative post, taking too much thyroid can affect how your eyes feel just as much as taking too little. One of the many small factors in my dry eye/inflammation improvement was a readjustment of my thyroid meds downward.

      To reiterate Mary’s point, many foods and supplements can affect how your thyroid meds are absorbed in your system. Take thyroid meds first thing in the morning (on an empty stomach) and wait one hour before eating or taking other meds or supplements. The instructions state “one hour before or four hours after” eating or taking any supplements. I believe that includes some fruit juices as well. I take my calcium supplements at dinnertime to make sure they don’t interfere with the absorption of the thyroid medication.

      Some people are not as affected by an increase or decrease in thyroid med doses so doctors don’t always believe us when we tell them how bad we feel if the dose is not perfect for us. I had one primary doc who told me the endocrinologist who trained her told her we could take a whole week’s worth of our thyroid meds in one day and we would be fine that entire week because our levels would even out. I looked at her aghast! I am one of those people who can tell by the middle of the day if I have forgotten to take a dose that morning. (I have one of those little pill boxes with the days of the week on it so I know for sure if that happens).

      Just another note: especially for women, if your hormones change (peri-menopause, menopause, etc.), your thyroid levels can change. That was something that I was not aware of and my doctor did not inform me. I read it on a very informative thyroid website.

      When I had a thyroid level done at my regular yearly check-up, she found that I did not need as much thyroid as I had for the previous 10 years. She adjusted my dose downward and now I am taking 112 mcg instead of 125 mcg. This happened in the middle of my worst few years of ocular inflammation and post-LASIK dry eye and it was one of the many things that helped me improve.



      • #4
        Warren - didn't see your post the other day oopsie. So very glad you're pursuing optimizing your supplement dosage - this can be such a tricky process. I was stable for years but in more recent years I've had ups and downs. In fact reading this is motivating me to get some fresh bloodwork done this spring to see where I'm at (eyes have been bugging me a lot but I've just assumed it's the usual seasonal thing). I'm a little ambivalent on unguided dosage self-regulation. I have worked with naturapaths once or twice who encouraged me to do this (with armour or naturethroid), but I kind of think that was based on how many years I'd been dealing with it and that I had a decent feel for my ups and downs at that time. In any case though I'm glad to hear your eyes are feeling better & wish you the best with really pinning this down. Scout & Mary are great resources on this topic and there's a lot of terrific thyroid info on the web written by patient advocates to help plug the knowledge gaps where the drs aren't providing adequate service.
        Rebecca Petris
        The Dry Eye Foundation


        • #5
          Thanks to everyone who responded about my thyroid med and dry eye. Yes, I am now working with my physician on the thyroid meds; he had moved me up from 50 mcg per day to 75 mcg per day. I have stopped the self-medication, and my eyes are not killing me as much as they were, so I will be patient with the 75 mcg for a while. I understand my physician is doing things by the book (at least from what I can find on hypothyroid websites). My eyes don't seem to feel as good on 75 mcg as on the (self-administered!) 100 mcg, but my doc is very good and has gotten me through a number of other knotty health problems, so I expect he will get me through the hypothyroid as well. I don't want to antagonize him by continuing to self-dose at higher than his prescribed levels. Once the thyroid hormone levels are stabilized, we shall see how my eyes are doing.


          • #6
            Argh! I have been taking alpha-lipoic acid for burning mouth syndrome!

            Thank you Mary! I have been taking alpha-lipoic acid for burning mouth syndrome. I had checked for interactions but for one reason or another never found the interaction with thyroxine! Argh! I will stop taking the alpha-lipoic immediately (it was self prescribed and my burning mouth is gone for now, so hopefully there will be no adverse effects). Once again, I find myself humbly grateful for the help this site has given me. I will keep everyone posted on how my dry eye is effected by this new understanding.


            • #7

              I'm not sure if stopping the ALA right now is the right thing to do, if you were already on it when your blood levels were checked. You may want to put in a phone call to your doc first. From what I hear, it's okay to take ALA if your doctor knows when you are going on it or off it and can look for how it's affecting the thyroxine dose you need. So that's good news, if it turns out you need the ALA for the burning mouth. It may be possible to do both if the doc is aware.