I know that the combination of CoQ10, Acetyl L-Carnitine and R Lipoic Acid are necessary to feed the mitochondria to encourage nerve healing especially since I have a history of statin use (I stopped 6 months ago).

I am also hypothyroid and have been on levoxyl 150 mcg for over 10 years. Now I am having problems and just had blood work done and have a tsh of 7.48. I am having swelling of ankles and feet, quick weight gain, severe fatigue. My internist upped my levoxyl to 175 mcg and has already ruled out coronary, liver and kidney problems.

Doing research, I have learned that Lipoic acid use lowers level of thyroid hormones and inhibits T4 to T3 conversion of levoxyl. I have been using the "mito combo" for about 6 months.

Further blood work is being done for the thyroid. My question is if stopping the lipoic acid and just continuing the coQ10 and acetyl l-carnitine will be enough to feed the mitochondria? Is there another supplement I can use that is more thyroid friendly than the lipoic acid?

I have small fiber peripheral neuropathy caused by RA which is currently in medicated remission with Enbrel. I also take gabapentin, fentanyl patches (pain), with lortab for break thru pain. Also take elavil for nerve healing properties and prozac for depression.

Thank you, Cat

There is one study done on rats, only using ALA (the racemic mixture of active and inactive parts) that some thyroid suppression was demonstrated.

No studies have been done on the lower dose r-lipoic at all or any on humans that I have seen yet.

You stated that you stopped taking your thyroid for a while. This would be cold turkey, depriving your body of the hormone when it needed it. And it would take a while to fix that biological effect in the tissues.

This is the study done in 1991 on animals, and has not be replicated or further explored.
http://www.ncbi.nlm.nih.gov/pubmed/1815532

It does show up tho on sites that publish information on supplements. When shown this way out of context, it is not very useful IMO. But it is used for liability reasons.

You can discontinue if you want to see if there is a change. But while you do so, you are still taking the hormone which is changing things daily...so basic effects would not be clear.

It is up to you to decide with your doctor. Just remember, lipoic acid exists in the body, naturally anyway.

Here is a link with more information:
http://en.wikipedia.org/wiki/Lipoic_acid
At the bottom is a medical explanation of the isomers, etc.

A search on this topic on PubMed did not reveal any new information about this potential. Only 9 papers, and only the one I quoted is specific.

Another factor in thyroid hormone use is the carrier proteins. Protein binding is needed to carry the hormone around the body. If the proteins are not present, then the hormone expression decreases. This happens in males, who develop low carrier proteins, due to various reasons including malnutrition. Protein binding carries testosterone for them, and low testosterone results.

This explains protein binding in general:
http://en.wikipedia.org/wiki/Plasma_protein_binding

Here is a detail explaining the thyroglobulin binding involving thyroid:
http://en.wikipedia.org/wiki/Thyroxine-binding_globulin

More details here:
http://emedicine.medscape.com/article/125764-overview
you can join for free to read medscape... easy and quick to do.
They have copyright, so I cannot quote them.
It does state that acquired low thyroglobulin occurs in various disease states, kidney damage/failure, liver failure, Cushing's syndrome, and various protein malnutritions. Albumin is involved so if you are low in albumin, you may be low in this binding protein level also.

I do know that certain drugs can displace thyroid hormone off these proteins. That can get pretty complicated, and a specialist in thyroid function would be the resource to consult for this.

Hi Cat,

I'm not sure whether this is relevant or not as your situation sounds complicated, but I'll throw it out there just in case!

I have hashimotos' thyroiditis (diagnosed in 2006 from positive autoantibodies and ultrasound) but have been euthyroid until now. About a year ago I started taking prescribable l-carnitine and oddly enough the doc who prescribed it wanted me to check TSH levels a month after I started taking it. TSH levels a month later were at 3, which is not bad but a little higher than my usual 0.8-2, so we re-checked three months later and TSH levels came back at 5.8. Now I have to say that while the TSH went up I had no hypothyroid symptoms, ankle oedema or anything, but the doc told me to stop the carnitine asap. I did and lo and behold TSH dropped to a lovely 1.2 within a few months.

To this day I'm not sure if l-carnitine had anything to do with what happened or with thyroid function in general or if this was just a fluke or maybe something that happens to people who already have thyroiditis, but thought I'd mention it since you're taking l-carnitine too...

Hope you feel better soon! :-)

Ziggy

I looked for papers on PubMed for this, and did not find anything to show this effect. I didn't read every single one, but the first few pages only show improvements in thyroid function when carnitine is used.

mrsD, thank you for all the information and links you provided. The studies were done with much higher levels than my measly 100 mg/day. The protein binding info is fascinating and shows just how complicated thyroid issues can be especially when you throw autoimmune diseases into it. My mom went from hypothyroid (she didn't mention Hashimoto's) to Graves disease complete with the buldging eyes before they ended up destroying her thyroid with the radioactive cocktail.

My neurologist decided yesterday to lower my gabapentin (even though I have been on it 6 years without edema problems) and increase my lasix to 40mg and potassium. I went searching before my appointment about the acytl l-carnitine and coQ10. The carnitine info states it also affects hypothyroid negatively but is great for hyperthroid. Studies done used doses of 2000 to 4000mg per day (I take 500). Results iffy also here. The biggest who knows comes with info on coQ10 (ubiquinol). So I asked him what about my supplements. He said what about them? Oh, great, another doctor who doesn't pay attention to vitamins/supplements. Except B-12. I let him know what I had found out about my "mito combo" and he said well maybe I should stop those for now until the cause of my edema and lo thyroid symptoms have been found. I had already decided before I saw him that I would do that. Excuse me, Doc, Pay ME for the office visit!

And you are correct, mrsD, to bring up my 67 days of not taking my levoxyl before resuming it and then upping the dose. That complicates my situation as to how much damage was caused during my cold turkey phase and how long it would take to correct that until a true thyroid level could be established with my increased dosage. Also as to how long I would feel crappy and if that is due to a true new Hypo condition.

I had gone to my neuro appointment wanting him to lower my fentanyl since I get short of breath every time I lay down with my legs elevated. My pain was under control and I was going to ask him anyway to lower this drug. Also, regardless of the edema, I wanted to lower my gabapentin since pain undercontrol and feeling a bit overdrugged lately. So Fentanyl is now 100 mcg/hr every 48 hours and Gabapentin is now 1200mg 3 times per day. Hopefully I will find pain still under control. Dr is prepared to raise anything if I go back to level 10 pain.

Thank you, for your time and effort....Cat

Hi, Ziggy, Thank you for telling me you experience with the L-Carnitine. It may not have been a fluke as when I started researching that supplement I came away with POSSIBLE great for hyper but not ok for hypothyroidism (even in a euthyroid condition). But the information is real iffy.

No real thanks to my neurologist, but I have decided to stop my "mito cocktail" of r lipoic acid, acetyl l-carnitine and coQ-10 until I can find out what is going on with my thyroid and edema.

May I ask where you apply your fentanyl patch?

I had a patient putting it on his chest, and he had problems too.
He said he felt like his heart was racing all the time.

He eventually went off fentanyl completely and did Suboxone instead.

Helloooo!

Another thing I remember, is reading on the Juvenon website (my mum was on this briefly a couple of years ago) about a possible (not proven though by any means) interference of carnitine and thyroid hormones. I have no idea what dose they were talking about though or what kind of intereference and really have not researched the matter at all...

I hope the mito cocktail cessation, the fentanyl lowering and the increased lasix will bring some relief re the swelling...!

Ziggy

more on carnitine:

http://www.umm.edu/altmed/articles/c...e-l-000291.htm

http://lpi.oregonstate.edu/infocente...uts/carnitine/

nothing about causing hypothyroidism at either resource or here:


http://www.drhoffman.com/page.cfm/607

This link to Juvenon says, so far no reported problems with Juvenon in patients taking thyroid hormone:
http://juvenon.com/jhj/vol4no05.htm

Thanks Mrs D!

Must have a fluke then!!!!

Ziggy