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Old 11-18-18, 06:15 PM
Alliecat Alliecat is offline
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Red face Thyroid cancer and ADHD - can hypothyroidism affect vyvanse effectiveness?

Hi!
I was diagnosed with ADHD as an adult and only recently started taking vyvanse 20mg about a month and a half ago. I absolutely loved it and it seemed to make every single difficulty Iíve had with accomplishing tasks and socializing go away - it was like putting on glasses for the first time.

About a year ago I also found out I had several very quickly growing nodules on my thyroid. My hormones were tested many times over time and they were normal, but my endocrinologist decided surgery was necessary because the nodules were suspicious.

After some issues with insurance I was finally able to have my surgery 2 weeks ago. I wasnít put on thyroid hormones immediately so I quickly started to have horrible hypothyroid symptoms. The noteable things were not being able to stay awake for more than an hour a day, depression, and a HUGE increase in my ADHD symtoms compared to before I started vyvanse (during this time I ran out of my vyvanse so I wasnít taking it for about a week).

I was put on levothyroxine (88 mcg) and got a refil for vyvanse 20 mg in the same day. Iím aware that levothyroxine will take some time to make me feel better but it seems like my vyvanse is barely working at all. I was wondering if anyone knew if this is due to my hypothyroidism or if maybe I just need a higher dose of vyvanse? Any experience and advice with these two drugs or tolerance to vyvanse would be greatly appreciated!!!

Side note: Iím also a little worried about weight gain without a thyroid, which I know levothyroxine should hopefully fix but Iíve heard it still happens. I know I shouldnít be worried about my weight, but will my lack of appetite with vyvanse affect the levothyroxine or help/hurt my metabolism?
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Old 11-19-18, 06:32 AM
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Re: Thyroid cancer and ADHD - can hypothyroidism affect vyvanse effectiveness?

I am no expert on thyroid stuff but it got me thinking... I know that when I was seeing an endochronologist and he found a nodule on my thyroid he has said to me that if it turned out to be something serious I would have to re-evaluate all my meds, specifically the adderall. I take xr adderall but he said that in cases where the thyroid is removed, damaged or cancerous, the ir adderall and ir stimulants work better. I have only his words on that, no scientific proof but maybe that is the issue with the vyvanse. Maybe you need ir release meds multiple times a day instead of something long acting. Especially vyvanse,... that takes like 2 hours to get going anyhow.
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Old 11-19-18, 04:49 PM
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Re: Thyroid cancer and ADHD - can hypothyroidism affect vyvanse effectiveness?

My mother had her thyroid removed, so what little I know comes from that.

But it was clear to me and to her doctors that her hypo condition interfered with her cognitive function.

The challenge-problem in my mother's case ... is that the medicine she was on to treat her hypothyroidism, Synthroid ... stressed her heart ... she was 87 when this all happened ... and had suffered a heart attack 18 years earlier ... and had angioplasty just months earlier ... So her doctor couldn't give her the dose of the higher dose of Synthroid that she thought would be ideal and would help my mother's cognition.

So I would say emphasis for you should probably be on treating the thyroid ... Get thyroid functioning your best ... then find an ADHD medicine that works well ... No ADHD medication can make up for an under-functioning thyroid.

Allow trial and error with the dosing of the thyroid medication as with ADHD drugs. Good luck.
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Old 11-20-18, 12:14 AM
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Re: Thyroid cancer and ADHD - can hypothyroidism affect vyvanse effectiveness?

Quote:
Originally Posted by Alliecat View Post
Hi!
I was diagnosed with ADHD as an adult and only recently started taking vyvanse 20mg about a month and a half ago. I absolutely loved it and it seemed to make every single difficulty Iíve had with accomplishing tasks and socializing go away - it was like putting on glasses for the first time.

About a year ago I also found out I had several very quickly growing nodules on my thyroid. My hormones were tested many times over time and they were normal, but my endocrinologist decided surgery was necessary because the nodules were suspicious.

After some issues with insurance I was finally able to have my surgery 2 weeks ago. I wasnít put on thyroid hormones immediately so I quickly started to have horrible hypothyroid symptoms. The noteable things were not being able to stay awake for more than an hour a day, depression, and a HUGE increase in my ADHD symtoms compared to before I started vyvanse (during this time I ran out of my vyvanse so I wasnít taking it for about a week).

I was put on levothyroxine (88 mcg) and got a refil for vyvanse 20 mg in the same day. Iím aware that levothyroxine will take some time to make me feel better but it seems like my vyvanse is barely working at all. I was wondering if anyone knew if this is due to my hypothyroidism or if maybe I just need a higher dose of vyvanse? Any experience and advice with these two drugs or tolerance to vyvanse would be greatly appreciated!!!

Side note: Iím also a little worried about weight gain without a thyroid, which I know levothyroxine should hopefully fix but Iíve heard it still happens. I know I shouldnít be worried about my weight, but will my lack of appetite with vyvanse affect the levothyroxine or help/hurt my metabolism?
I've been on Synthroid (Levothyroxine) 25 mcg a day for years now, and get regular (every few months) blood tests to make sure my hormone levels are in the proper range. I haven't had any problems with it, and I take Vyvanse as well (with the same near-miraculous effects on my ADHD symptoms). I think you'll be just fine as long as you check your levels every few months.
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Old 11-21-18, 07:30 AM
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Re: Thyroid cancer and ADHD - can hypothyroidism affect vyvanse effectiveness?

I don't have thyroid cancer but I have subclinical hypothyroidism (potentially hashimotos subject to further testing) and I find that Concerta works fine for me, but it doesn't relieve the tiredness much.

I'm hopefully switching to elvanse/vyvanse soon and then I'll be able to share my experience.

I'm not sure about weight gain, I still have a thyroid but I am hypo most of the time and don't have problems gaining weight. My ADHD meds don't affect my appetite much but for most people they suppress hunger in which case they might help you not gain weight.
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Old 11-26-18, 04:15 PM
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Re: Thyroid cancer and ADHD - can hypothyroidism affect vyvanse effectiveness?

Quote:
Originally Posted by Alliecat View Post
Hi!
I was diagnosed with ADHD as an adult and only recently started taking vyvanse 20mg about a month and a half ago. I absolutely loved it and it seemed to make every single difficulty Iíve had with accomplishing tasks and socializing go away - it was like putting on glasses for the first time.

About a year ago I also found out I had several very quickly growing nodules on my thyroid. My hormones were tested many times over time and they were normal, but my endocrinologist decided surgery was necessary because the nodules were suspicious.

After some issues with insurance I was finally able to have my surgery 2 weeks ago. I wasnít put on thyroid hormones immediately so I quickly started to have horrible hypothyroid symptoms. The noteable things were not being able to stay awake for more than an hour a day, depression, and a HUGE increase in my ADHD symtoms compared to before I started vyvanse (during this time I ran out of my vyvanse so I wasnít taking it for about a week).

I was put on levothyroxine (88 mcg) and got a refil for vyvanse 20 mg in the same day. Iím aware that levothyroxine will take some time to make me feel better but it seems like my vyvanse is barely working at all. I was wondering if anyone knew if this is due to my hypothyroidism or if maybe I just need a higher dose of vyvanse? Any experience and advice with these two drugs or tolerance to vyvanse would be greatly appreciated!!!

Side note: Iím also a little worried about weight gain without a thyroid, which I know levothyroxine should hopefully fix but Iíve heard it still happens. I know I shouldnít be worried about my weight, but will my lack of appetite with vyvanse affect the levothyroxine or help/hurt my metabolism?
In a word, yes. Stimulants aren't just affected by - or affect themselves - the "big three" neurotransmitters: serotonin, noradrenaline and (most potently) dopamine. I found this out the hard way when diagnosed with late onset-severe asthma that had an obstruction present. As I am allergic to almost all asthma medicine on the market and I would be so ill my life was at risk, I had no choice but to begin taking Prednisone for many months. It utterly decimated my previous regime of 50mg 2x a day of Vyvanse that worked well. I exercised 6-7 days a week, felt fabulous in my mid-30's and could usually trust my brain to work better.

Enter Prednisone. 70mg of Vyvanse, I laid down and slept 8 hours. Stunned. Concerned, my doctor added 150mg Wellbutrin to the mix. Well, at least now I can complete a grocery list or balance my checkbook before that siesta. A second 70mg Vyvanse dose allows me to go out to the store, do a load of laundry and if I'm lucky, cook a meal. The fatigue and lack of concentration, the loss of all motivation, focus or quick reaction time- horrifying.

While I would say it's one of the most under-discussed issues in medicine, how well your thyroid is functioning, whether levels of cortisol are normal (below normal and you're more tired- my primary issue from Prednisone), and if there is excessive serotoninic activity in the brain (as seen in some medical testing done on people with Chronic Fatigue Syndrome). This excess serotonin to dopamine ratio can occur naturally, though medication or through medical conditions. People who put on excess weight and feel lethargic on an antidepressant SSRI (such as Zoloft) are theorized to perhaps be too serotonin heavy. Please don't ask me why doctors then like to add something like an antipsychotic instead of maybe switching to Wellbutrin of adding a stim...whatever. Just don't go to the doctor and let them wave away your fatigue while waving an SSRI script in front of your face.

If you're a woman, guess what?! Even more fun! Still menstruating, I noticed a huge difference in every single cycle between the first two weeks and last two weeks of the month. I thought fibromyalgia had given me brain fog. Ha! Dr. Jekyll and Ms. Hyde was I. No amount of protein, drinking water, cutting out anything like sugar, etc., made a dent. Perimenopause is equally joyful.

Be prepared to fight for higher doses of your ADD medication as well as having to take it more frequently. Vyvanse never did give me even eight hours at my peak of health and fitness. It became about half of that post-asthma and -Prednisone. This is my experience and may not be yours, but a serious issue like hypothyroidism or severe asthma drains the body already. Medications or other interventions to treat these other conditions usually adds to the drama. Prednisone doesn't play nice with anybody, apparently.

I don't want to say there is no hope. I highly suggest you look up your own condition's articles related to neurotransmitters or hormones on PubMed and hypothyroidism's main page on Wikipedia. I would suggest reading Wikipedia's article on Chronic Fatigue Syndrome as if has some theoretically important acknowledgement of the detrimental effects of low dopamine. Hypothyroidism would seem to me a likely diagnosis for a similar issue. Stuff will often catch my eye and help me decipher the mystery that doctors almost always neglect to talk about. IF they even understand these subtle nuances. YOU are going to have to become the no. 1 most (informally) educated member of your medical team, advocate, well-read arbitrator.

I highly recommend printing out articles with good citations and scientific evidence to back up your needs, before bringing them to your doctor(s) and asking for more medication. Keep a detailed journal for a few weeks of when you take your medication, if and when it kicks in, how long it (doesn't) work, what you ate, drank, were able to do that day requiring mental and or focus - especially if your stim absolutely failed you - and how much sleep you're getting. I know it's probably a pain to do but it's hard(er) for a Dr. to argue with cold, hard facts based out his own community- or with your own logical approach to this.

I truly wish you the best. Things like this throw a big monkey wrench in our routine and dosage and such but I believe that there is an answer for you, at least in part.

Please keep in mind that I am not a medical professional, just a full-time patient. Feel free to PM me if there is any assistance I can offer further.
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Old 11-26-18, 04:28 PM
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Re: Thyroid cancer and ADHD - can hypothyroidism affect vyvanse effectiveness?

Lizzie are you in the US? I ask because I am surprised that your doc didnt consider adderall, adderall xr or an adderall booster dose.
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Old 11-26-18, 05:12 PM
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Re: Thyroid cancer and ADHD - can hypothyroidism affect vyvanse effectiveness?

Quote:
Originally Posted by sarahsweets View Post
Lizzie are you in the US? I ask because I am surprised that your doc didnt consider adderall, adderall xr or an adderall booster dose.
Hello there. I am in the U.S., and my kindly doctor (one of the few gems) was willing to do anything to help. He did in fact allow me to try a few different doses of Adderall XR and IR. Unfortunately, I'm one of the (few?) people who do great on Vyvanse but terrible on Adderall in all forms and dosages. Headaches from hell, absolutely no help with my ADD, fatigue worse than if I was taking nothing, serious anger issues when wearing off (not normal or cool!)...

I was truly stunned as I didn't think there would be that kind of totally negative reaction. I was extremely careful with diet as I know Adderall is more sensitive to acidic stuff/excess carbs than Vyvanse. I drink plenty of water anyway, but of course I made it a point to stay hydrated. I tried Adderall a second time about 18 months later...had exact same reaction, except even more acute loss of cognition, focus, concentration. Couldn't believe it and was quite bummed--Adderall's a lot cheaper under my insurance. The first time I gave it 6-8 weeks before my fiancť said to stop it because he couldn't take my attitude and anger without cause night after night...and he was right, it wasn't pretty. Vyvanse has a comedown that sucks, too. But I'm more weepy or sad, not ready to thrash around. The second time I lasted about the same amount on it, but I should have dropped it much sooner. Stims generally don't take that long to be determined the winner, although getting the dosage & scheduling right is a different story...

I would certainly recommend one try each of the different stimulant options out there as well as consider an alternative or add-on like Wellbutrin, IF your doctor agrees. Realistically, you may have to try many different meds in varying dosages and schedules and try to do so OVER TIME, lest you would like the DEA and AFT banging down your door at 2 a.m. No seriously, I'd say give a new drug/dosage 3-4 full weeks (8 weeks for non-stim drug classes) in order to see if the side effects abate and the therapeutic effects hit. Sarah, any adjustments to that time allowance you would suggest? I know you have those stats down to a freaking science.

I realize this sounds like an eternity when you've been sick and just want your darn pre-illness life back...but there are no shortcuts. And it may never be quite the same. The body and brain are going to change and age for each of us. Each time we experience a serious illness, injury, psychologically upsetting occasion, or a change of life deeply involving hormones (pregnancy, menopause, vasectomy), there are possibilities of medication no longer working as it used to, or at all. Try not to reach backward to what used to be, but instead focus on a fresh start and rebuilding from here. I say that you've got to be able to move forward without the things you had in the past because you may run into a time when you can no longer take a certain medication at all. It can be as simple as aspirin (moi) or an old standby Rx that was once your saving grace.
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