levothyroxine and RLS

[meyer]

I'm new here and am looking for information about taking levothyroxine . I have read that it is contraindicated for RLS but I'm looking for some confirmation, especially in a journal article, so I can discuss this with my neurologist. The Mayo Clinic 2021 paper discussed some medications but not levothyroxine. I would like to take Cytomel and lower my levothyroxine dose in preparation for decreasing my Requip. Ultimately I would like to be off the Requip before I must deal with augmentation. I know this will be a hard argument so I want to be well-armed with clinical data. Any help would be appreciated.

[Yankiwi]

I had my thyroid removed about 16 years ago and have had rls a lot longer.
There's never been a problem with taking levothyroxine but because I take oral iron tablets I take my levothyroxine in the middle of the night so they do not confilct.
I took ropinerole for many years, never taking a high dose but cut back due to beginnings of augmentation and finally stopped taking any a few months ago. I take two 60mg tablets of codeine each night and 900mg gabapentin.

[Rustsmith]

I took levothyroxine for several years and never had any issue with my RLS. The only issue that I know of is the one that Yankiwi mentioned, namely that both levothyroxine and iron supplements must be taken on an empty stomach, but they cannot be taken at the same time since they interact and this makes both meds ineffective.

[ViewsAskew]

No issues here taking it. I always take it on an empty stomach when I first wake up.

[badnights]

I would like to take Cytomel and lower my levothyroxine dose in preparation for decreasing my Requip.

Kudos for wanting to avoid augmentation. Do you have any signs that you might be augmented already? What dose of Requip are you on and how long have you been on it?

Why do you want to lower the levothyroxine before you lower the Requip? I don't see why you would need to.
As the others have said, it's just the timing of the iron you have to watch out for.

[Frunobulax]

I'm new here and am looking for information about taking levothyroxine . I have read that it is contraindicated for RLS

I found this one here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882550/

Haven't read it in detail, but it seems rather speculative to me. It's possible that hyperthyroidism is associated with RLS (high thyroid activity/low TSH), but this doesn't mean causation. In any case L-Thyroxine is given for people who have hypothyroidisim (low thyroid activity/high TSH) to normalize the thyroid hormone levels.

Personally, I have seen a slight increase of RLS symptoms after starting iodine, which might in theory activate the thyroid. However, it's quite unclear where my thyroid function stands: I had symptoms of severe hypothyroidism for several years, yet my TSH was always low (0.5 to 0., close to hyperthyroidism. After starting iodine last December my TSH went from ~0.6 to 3.6 within 9 months (without a change in symptoms), which leads me to believe that all of this medical literature (which pretty much always uses TSH as indicator of thyroid function) is somewhat questionable...

Oh yes, I recently started taking L-Thyroxine, which didn't change my RLS symptoms at all.

[meyer]

Thanks for the feedback. I'm on Cytomel now instead of the levothyroxine and am decreasing my dosage of the Requip by 0.25mg at one time without too much symptom breakthrough. I'm only on 1.25mg total per day but have been on this dose for 6 years and want to be off. My oral iron has been increased to 650 mg at bedtime and I'm hopeful about getting off the Requip without too much difficulty.
I don't take the iron at the same time as the Cytomel and I take the iron with orange juice.

[meyer]

to very belatedly answer very logical questions here:
I have read that levothyroxine along with several depression medications and some antipsychotics are contraindicated with rls(J Clin Sleep Med.2010 Feb 15;6(1):79-83 Pharmacologically induced/exacerbated restless leg syndrome, periodic limb movements of sleep...........) Sorry, I' m not too facile with computer-ese so don't know how to footnote
I want to get off the Requip completely
I am taking 650 mg of iron at bedtime with orange juice , an increase from 325 mg about 45 days ago.
I think I am feeling the results of the discontinuation of the levothyroxine (also 45 days or so ago) because the decreasing of the Requip, by 0.125 mg every 2 weeks, is going well, with minimal breakthrough.
I also take 200 mg of Gabapentin 4 times a day.
I am scheduled for a ferritin level in another month. My current level is 45. I'm hopeful that will be higher.
Thanks for all the responses and support