# Which (nonthyroid) meds to stop taking before labs



## BrynneTM (Mar 12, 2014)

I was diagnosed with subclinical hypothyroid 2-3 years ago and haven't started any treatment yet. My last labs were in 2012 and recently I've thought I might be symptomatic, so I figured I should get some new labs to see what's been going on. It occurred to me that many of my medications might have been masking or contributing to my thyroid related issues (either syptoms or in lab results). These are the labs I've had done and what meds I was taking daily at the time...

2009 - Adderall & low-dose estrogen/progestin birth control

TSH-High Sensitivity: 5.46 (0.36 - 3.74)

1 week later - Same meds 

TSH-High Sensitivity: 3.61 (0.36 - 3.74)

Free T4: 1.02 (0.8 - 1.8)

6 months later - Same meds 

TSH: 5.25 (0.50 - 4.50)

2010 - Flonase nasal spray (corticosteroid), Astelin nasal spray (antihistamine), Adderall, & birth control

TSH: 8.38 (0.50 - 4.50)

Free T4: 1.4 (0.8 - 1.8)

Thyroperoxidase Ab was 0 (0-100)

2012 - Same meds as 2010, plus I had a cortisone shot 2 weeks prior to blood work

TSH: 2.28 (0.50 - 4.50)

Free T4: 1.3 (0.8 - 1.8)

I haven't been taking birth control for the past 4 months, but I'm still taking Adderall, Flonase, and Astelin daily. None of these are life-saving and I can start and stop without major health risks (aside from the annoyance of allergy and ADHD symptoms). Can anyone tell me how these meds might have affected my results and if I should stop taking any/all of them before getting new labs done?

In 2012, could that cortisone shot still have been affecting my TSH levels 2 weeks after the injection?


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## Lovlkn (Dec 20, 2009)

Because your TSH is on the high side the next test to consider is the FT-4 which is below 50% of range for most of your labs. I feel if you were in the upper 75% of range your TSH might fall.

How do you feel?


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## BrynneTM (Mar 12, 2014)

How are you calculating 50% of range? I thought the midpoint was 1.2 but since you said I'm below 50% of range for most FT4 tests, maybe I don't understand what that means. Do you think any of the meds I mentioned could be affecting my FT4?

I suppose I feel more anhedonic and lethargic than usual, even when taking Adderall. A lot of the other hypo symptoms are things I've experienced my whole life, so it's hard to say. I can definitively say that in the past few months, my hair texture has changed and has become more dry and brittle. My dry skin has been significant enough that I went to a dermatologist in 2009, which I had kind of forgotten about until I recently got access to my electronic medical records. Was diagnosed with Pityriasis alba (whatever that is). It think I'm cold all of time, especially hands and feet, but that one is so hard to measure because I don't know how other people experience cold. My weight is stable, but recently lost a little, I assumed from stopping birth control.

I asked my GP for a new lab order, so once I get the results, I was going to email the GP some questions and ask if I should schedule with her or just see an endocrinologist. I don't need a referral, so maybe I should just skip to endo? I do like my GP.


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## jenny v (May 6, 2012)

So your most recent labs were done in 2012? Have you done anything more recently? If not, I think you need to do labs again since it's been 2 years.


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## BrynneTM (Mar 12, 2014)

Right, most recent labs were in 2012. My doctor just put in an order, so I can go get the lab work done tomorrow, but I'm wondering if I should stop taking any of my prescriptions for longer than a day if they might be impacting my results.


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## jenny v (May 6, 2012)

I am not 100% sure, but I don't think stopping anything for a day is going to affect your results. If anything, I would stay on them so you have the same drugs in your system as the last two times you did labs. It's a good basis for comparison. Do you know which tests your doctor ordered?


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## BrynneTM (Mar 12, 2014)

I think my lab order is just for TSH, but I'm not positive, so I need to clarify with the doc. It just says "Thyroid testing algorithm." I was planning to be assertive and tell her which tests I want, but now I feel kind of weird doing that. Last time she talked to me I didn't know anything about what tests she ordered or what they meant and it seems like doctors hate it when you google stuff and then want whatever you found to dictate treatment, so I'm kind of chickening out.


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