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Medications usually contain other products besides the active ingredients to help them. Fillers are inactive ingredients that play an important role in ensuring the drug is consistent and reproducible. They also help your body absorb the medication more efficiently. The amount of active ingredients is often too small to be contained in a pill or capsule, so fillers also help make the drug manageable in size. But sometimes, these ingredients cause sensitivities or even allergic reactions. Here’s what you should know about having an allergy to the thyroid medication you take for hypothyroidism.
People often use allergy and sensitivity interchangeably. But these are two very different responses that need defining.
An allergy is a reaction to something outside of your body that triggers an immune response. Usually, an allergy results from an immunoglobulin E (IgE) mediated reaction. IgE’s are antibodies that cause your body to react when exposed to an allergen immediately. This immediate immune response causes histamine to be released, which can lead to several severe symptoms, including:
- Hives and itching
- Airway constriction, wheezing, and shortness of breath
- Vomiting and diarrhea
This type of reaction can sometimes lead to anaphylaxis, which can be life-threatening and requires immediate medical attention.
A sensitivity is also sometimes called an intolerance. This type of response from the body is usually because your body cannot break down specific proteins in foods or additives in medicine. Typically, people develop a sensitivity if they:
- Do not have the proper enzymes to break down particular proteins, such as the lactase enzyme necessary to break down lactose,
- Are sensitive to caffeine and other chemicals used in pharmaceuticals, or
- They are sensitive to sugars that are naturally in certain types of food.
The most common types of sensitivities occur with food. Not surprisingly, most of the symptoms associated with a sensitivity occur in your digestive system. These symptoms include:
“True allergies” to foods and chemical products are rare, but sensitivities are relatively common. Yet, the symptoms of either can be concerning and may lead you to seek a firm diagnosis.
Allergy testing is one of the best ways to determine if you have an allergy or not. People can get allergy testing for various things, including foods, animals, pollens, dust, mold, and drugs.
There are several different ways to test for allergies:
A scratch test is performed on your back. An allergy doctor will determine what needs to be tested based on your concerns and will apply a little serum with the allergen inside it with a small prick on your back. The prick is just light enough to alert the immune system that damage has occurred and sends immune cells to investigate and heal. If you have an allergy to the serum in that specific area, you will develop a wheal that becomes red, itchy, and inflamed. Your allergist will measure the size of the reaction to determine how allergic you are to the item in question.
Sometimes, allergists apply a patch on your back with chemicals or ingredients you suspect may be triggering symptoms. The type of reaction detected by a patch test is a little bit different than an IgE-mediated reaction. However, it can help identify if you are sensitive to certain chemicals found in medications, cosmetics, and common household goods you are exposed to regularly (like laundry detergent).
Allergists also can do blood tests. However, this type of testing is not often used to detect medication allergies, as the research on this testing is limited and is not always accurate.
Thyroid medication usually makes people with hypothyroidism feel better as it replaces the thyroid hormones they are missing. Still, sometimes people can have sensitivities to this medication and rarely allergic reactions. Sensitivities and allergic reactions are generally due to the filler used in these medications.
The filler ingredients vary based on the brand you take. Common filler ingredients in common T4 medications include:
In rare cases, people can have a true drug allergy to T4 medications. However, it is more likely that you can be sensitive to something in the medicine that causes symptoms like bloating, diarrhea, cramping, and headaches.
Identifying a drug sensitivity can be challenging, whereas an allergy is more straightforward given the severity of the symptoms. If you suspect you cannot tolerate your thyroid medication, try to keep a daily journal of your symptoms. Track when you take all of your medications, the foods you eat, and anything else that may be relevant.
Take your journal to your thyroid doctor and share your concerns and findings. Making a diagnosis of a drug sensitivity or allergy requires a thorough history of your symptoms, so a journal can be a valuable tool for your doctor.
Your doctor may offer several diagnostic tools to help figure out the cause of your symptoms, including:
- A lactulose breath test
- An elimination diet
- Allergy testing (patch test, or less commonly a blood test)
- A tTG-IgA test (Tissue Transglutaminase IgA antibody) to test for celiac disease
Although switching your thyroid medication brands is usually discouraged, your doctor may try you on a different medication if you struggle with some of the ingredients in your medicine. For example, if you have a lactose sensitivity, you may need to switch to a medication like Tirosint, a levothyroxine brand free of acacia and lactose.
Some people may also benefit from natural desiccated thyroid, which has fewer inactive ingredients.
A note from Paloma Health
Are you worried about a possible allergy or sensitivity to your thyroid medication? Chat with a trusted Paloma Health thyroid doctor to find the best thyroid treatment plan personalized for you.