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Isoniazid and thyroid medication

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Isoniazid and Thyroid

I've been on isoniazid for about two and a half months along with 50mg of vitamin B. I also have severe steatohepatitis with macrovesicular ballooning in virtually every cell and some "insignificant" fibrosis but not cirrhosis. I am diabetic and have polyglandular deficiency and high TPOs (anti-thyroid peroxidase autoantibodies-- over 1000 before treatment with synthroid--normal high is 60). On synthroid, they are around 500 and the endocrinologists agree I'm slowly losing my thyroid.

My first liver labs after a month on isoniazid were spectacular, albumin, bilirubin and everything normal while only my ALT was just seven poinst over normal 42 (10-35 U/L). But no one told me that my thyroid was getting bad again, my free T4 at 1.03 ng/dL (0.69-1.55 ng/dL) and my TSH at 2.74 uIU/ml (0.25-5.00 uIU/ml) and they usually like to keep my TSH at 1.8 while I"m on synthroid because I don't feel good otherwise.

I'm feeling really bad now. I have a headache that is crushing on my left side of my head. My hearing seems alright, my body feels like it is itching bad inside, like extreme anxiety and my legs have been getting numb easily, like restless leg syndrome throughout my whole body. My mind runs non-stop and I cant sleep and am seeing black dots.

This happens when MY TPOs (antithyroid antibodies) are very high.

I can't tell if this would have happened anyway since I had a rise before I even started the isoniazid, and can't tell if the mental and physical symptoms, which are somewhat unbearable, it is pretty awful, are something that is from the Isoniazid or from the thyroid.

My question is, does the Isoniazid affect the TPOs and the thyroid and endocrine? Is it possible that this is not a side effect of the isoniazid but somthing with my endocrine maybe made worse by the isoniazid?

I got labs drawn today and left a message with the nurse. I can tell it's my thyroid type thing I had before, but it gets really bad sometimes. I've asked repeatedly if I have hashimotos encephalopathy, but the endos at Mayo said its not even a real disorder and my local docs say they don't know.

So now I have to figure out reasonably what is wrong. For multiple reasons, not the least of which is I may need a liver transplant someday and my adrenals, getting through this therapy is necessary. I don't want my docs to just take me off because they don't want to adjust any other meds, esp. since my thyroid was going up before I took any Isoniazid at all.

If you can help me out with whether isoniazid affects the endocrine or TPOs then it would really help. I also need to know if typically thyroid replacement hormones may need adjusting on isoniazid. I saw something about diabetes but not thyroid. Thanks a million sorry to ramble. Not thinking very well.
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First Helper barbie42
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replied September 18th, 2008
Extremely eHealthy
Hi!
Isoniazid can interact with many different drugs used at the same time, and that happens with Synthroid, too.
Feeling numbness in your legs, is a side effect of using isoniazid, especially because you are predisposed to have peripheral neuropathy, due to diabetes.
This is result of toxic effect of this medicine on peripheral nerves.
On the other side, numbness in legs and hands, along with prickling sensations, is a symptom of hypothyroidism.
Mild serum transaminase elevation isn't a reason to discontinue medication.

Agitation, anxiety and impaired memory are side effects of isoniazid.

Do you see the black dots moving in your field of vision?
Are you experiencing pain with eye movement?
Do you have dull, dim vision?
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replied September 18th, 2008
Yes I have dull dim vision and eye pain but I have had PRK surgery for vision correction and had very scarred corneas prior due to Sjogrens and have dry eyes. My blurred dim vision started over a year ago after being on plaquenil and I feel it has something to do with my nervous system. It started way before being on Isoniazid. It actually isn't worse on Isoniazid. I use restasis drops (cyclosporine) but stopped before therapy and switched to saline and ointment. I'm cutting back on any drug not absolutely needed while on the Isoniazid.

The black spots, sort of shadowy hallucinations usually occur at night, in peripheral fields and is exactly what happened before going on thyroid therapy. It completely went away with proper thyroid supplementation. Now it is back on the isoniazid so I wondered if it was due to the isoniazid affected the synthroid.

MY TSH had been at 1.8 for over a year now or more since I've been on synthroid. In March it had gone up to the 2.7 but I didn't start Isoniazid till June, so it was already going up and the endo said it would as my thyroid kind of slowly dies.

Thanks for letting me know about the synthroid being affected by the isoniazid so I can make sure the endo knows. My synthroid likely needs to be raised, but it could go back down, since my thyroid is so unstable and it depends on my autoantibody loads, it can go up and down like crazy and be irritating. I wish they'd just take it out, but they don't want to since it works halfway still. Usually it is stable, but the isoniazid is a strong drug.

Yes the black dots or irregular patches move in my field of vision. Sometimes they look like hands or arms, or a cat jumping or just something not explainable. The mind tries to make sense of them. There is some anxiety with the "shadow men" because you have to keep reminding yourself that it's just light and shadow play, but it startles you a little before your intellect can kick in and deal with it.

My vision looks like I have eye ointment in all the time with some dimness, but that is old. I have to get back to the eye doc, I have a referral sheet for my next visit so maybe this is the time. I want to get my thyroid results soon, I should have them tomorrow or Monday, and it will have my liver too, and then I can call the endocrinologist and the eye doc and have the results.

I have found relief cutting out red meat from my diet and avoiding the foods on the tyramine list and have ordered some high quality whey protein vitamin powder to provide good nutrition to cut back on meat just to give my liver a break. I'm also eating probiotic yogurt which has been shown to be as effective as lactulase in recent studies and helps my gi. So hopefully with diet modifications, even someone like me who has real problems with drug metabolism due to severe steatohepatitis can make it through therapy.

Avoiding meat has been surprisingly helpful. and the aged cheese. Smoothies are working good, and much smaller portions of regular food.

Thanks for your help on everything.

Yeah sometimes my legs tremble or are numb or tingly, but it isn't every night or even long lasting, so I'm not so worried about it.

I've got dizziness, a feeling like I inhaled fumes or something at times, but it isn't constant. Increasing my klonopin from 1mg at night to 1.5 mg has helped with anxiety and some of the neuropathy. Taking my vicodin ( I take one pill split in half in two doses) earlier in the day, not morning and night, helps too.

I take B6 50mg and get half the daily requirement in the whey mix.

I hope I get my latest labs soon. I am allowed to let my liver function tests go five times normal before I have to go off Isoniazid. We agreed that some fibrosis is worth getting through the therapy and will likely mend once I'm finished.

Thanks so much for your answer on the syntroid and also the glucophage. Sorry so rambling, I'm like a puppy, all over the place lately. In a way, its nice to have so much more energy than normal. I have been much more active and during the days. I take my isoniazid at dinner time and have the worst effects during bedtime during the first few hours after I take it.

I won't alter my dose, but just FYI, my mother asked if it might be better for someone like me with a bad liver to split the tablet in half and take one in the morning and one at night, to lessen the effects. Does anyone ever take it like that?
It might be easier on my liver, though I take four pills in the morning and to take another, I would have to space it out well.

Thanks so much. You are such a help. I feel better and know what I need to do. I have two endos, one at Mayo and one close to home. Sometimes the one close to home isn't as responsive as the one at Mayo, so I needed to know kind of what direction to go. Thanks again.
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replied May 1st, 2009
isoniazid & body blowing up
I just started taking isoniazid about 4 weeks ago and I feel like I'm going to kill someone. I skipped my period. That's never happened to me in my life. I know exactly when I'm going to get it right down to the hour. My hands are so bloated right now I can't close them. My face huge and I've gained 8 pounds. Everything on me is bloated. It's as if someone is blowing me up with a bicycle air pump. I can't stand this anymore. I can't think straight. I'm going crazy it feels like.Can I take something else instead? The doctor said this medication shouldn't do this to me so maybe I am just losing my mind?
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replied January 27th, 2012
I know this is probably very late. I just started the isoniazid. I have been experiencing very different changes in mood. I'm very irritated, anxious and I just feel generally 'emotional'. It's driving me nuts and I've just started doing a search to see if this is common. I'm also feeling the bloating thing.
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replied May 1st, 2009
You need to see your doc right away and if you can't get help there, then find another doc or call the health dept and talk to a TB nurse there. I have a really bad liver and thyroid/multiple hormone problems and I didn't get that bad. It can be hard on the kidneys andliver, both cause swelling. The psychosis got bad with me when it reached the most toxic level, about 6 mos into my 9 month treatment. I felt the same way I felt on interferon for a few days, went on some steroids and it went away. Without the steroids, I don't know how I would have done. I was ready to check in somewhere. I am not a doctor butwas told it stimulates the adrenal glands, which can make you have good energy or bad energy--like anxiety vs. excitement. I take klonopin, so increasing my klonopin is allowed for me and also helped get me through. I would get in with a doc right away, if your doc isn't taking it seriously in your opinion, ask him why he seems not concerned. If you get no help, seek out a second opinion. At least, they should be able to do some bloodwork. If you have to, go to an ER if it gets unbearable. You have the presence of mind to connect your bad feelings with the drug, the ER should be able to help. It is a very very strong drug. Poison control can help you, they have an 800 number in every phone book in the front bythe emergency numbers if you really have trouble, they will help you. The real experts are often the TB nurses and docs at your county health dept if in the US as they see people on it all the time. They will often talk to you on the phone and really helped me get through. I hope you feel better and get some medical treatment for the anxiety and swelling.
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replied July 4th, 2009
Isoniazid posion
Hi, a doctor put me on is isoniazid because i started working at a hospital and was told i have latent tb. About a month on isoniazid i got a severe case of hives and was taken off the medication. My question is will i have long term side effects i need to worry about. I my liver damaged after only a month on this toxic? Thanks
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replied September 30th, 2009
the same happened to me as well,they put me on Isoniazid and after 2 months we found out my liver was abnormal,when i start the treatment liver blood test was 35 and after 2 months treatment went up to 1034 which is dangerouse and now i have been taken off the treatment.no it shouldnt be a long term side effetcs as long as yo stoped taken them.
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replied February 8th, 2010
Isoniazid posion
Hi, I had the same thing as Rikan. Took the medicine for only one month and has skin rash. I am very worried. How bad my liver would damage after only a month on this toxic and how long will it take for the toxic to be out of my body? Thanks.
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replied October 21st, 2010
INH side effects with other meds
Hi I am on Lopressor for my high blood pressure, Tikosyn for heart afib/aflutter, throid meds for a throid syndrone, and tromadol i think i spelled that right for spinal pain, I had a fussion a few years agao. Now I have LTB, I started on INH for a month and hand swelling in my legs, feet, hands, severe abdominal pain, headache that felt like my eyes were coming out of my head, and hearing loss, and i think i was more crumpy than usually. I stopped the meds for a month all the sysptoms stopped. any suggestions on which med to switch to, or maybe not taking one at all. I think INH is messing around with my other meds. My heart was under control for 6 months, then when I was on the INH I had poor ryhtem stips now I off it the stips are fine.
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replied December 24th, 2013
Isoniazid--an awful cure!
I have been taking Isoniazid for 6.5 months. I HATE it! Anxiety--oh yes! Impaired memory is getting worse and worse every month! Kidneys hurt on and off for days at a time (have had kidney stones previously). Liver hurts (below right rib) fairly regularly--no previous liver issues. Gained weight and fight to keep it off. Can't get my blood sugar below 200. Some days, very sick at my stomach. But the one thing that is persistent is the soft stool/diarrhea. And it is awful! I can't hold it when I'm out in public, and I have to rush to the restroom. I've thrown away numerous underwear in public restrooms. I'm sick at my stomach most days, and it isn't getting better. Headaches are increasing, and I had been free of headaches for years (after a car accident). But these seem to be headaches similar to a poisoning--like you feel the day after you recover from too much alcohol or from food poisoning--sort of like a mini-migraine. I've had one for five days straight now. I have considered quitting it repeatedly, and I see why people quit it. It is bad and getting worse, and you need to take it for 9 months to have the greatest likelihood of getting tb out of your system. After nearly 7 months, the effects are getting worse and stronger and most insistent and persistent. I'm seeing a doctor, a psych and a counselor--all to deal with getting and trying to cure tb. I hate this medication, and it is my plan to never take it again!
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