What the heck does this mean?

suzieq · Post by **suzieq** » Thu Oct 15, 2015 8:45 am

Hi all,

I'm taking Budesonide EC for this recent flare of CC, I'm alternating 3 pills, 2 pills, it's going ok. I needed to refill my prescription and there's a snafu with the insurance company. Hopefully it gets straighten out before I run out of it.

I have a bunch of medical problems going on: hypothyroidism, CC, Osteoporosis, Fibromyalgia to name of few. The pharmacy gave me a print out of the insurance company rejection of the renewal with a clinical review message that reads "Budesonide ER Oral Capsule Extended Release 24 Hour 3 MG should be used cautiously in Hypothyroidism, which is a proxy medical condition based on the use of Levothyroxine Sodium Oral Tablet 75 MCG". I have been taking Levothyroxine since 2009, diagnosed with CC in 2011, is the Levothyroxine causing the CC?

Thanks,
Susanne

Post by **tex** » Thu Oct 15, 2015 9:21 am

Hi Susanne,

No, it's not likely that the Levothyroxine is affecting your CC. The insurance company is almost surely referring to the fact that corticosteroids are known to affect adrenal function, which in turn can affect the thyroid. This relationship involves a functioning and feedback dependency that's known as the hypothalamic–pituitary–adrenal axis (HPA or HTPA axis). But since there is also a functioning and feedback system that involves the hypothalamus and the pituitary gland and the thyroid, known as the hypothalamic–pituitary–thyroid axis (HPT axis for short), that implies that a drug that affects adrenal functioning can also affect thyroid functioning. Whether or not any particular drug actually has that implied effect, very likely depends on the details of each individual case.

That's why there are doctors in the first place. Physicians should be making treatment decisions of this type, not insurance companies. Insurance companies are out of line when they try to usurp medical privileges. Insurance companies typically employ lawyers, rather than doctors, to make such self-serving decisions.

Tex

suzieq · Post by **suzieq** » Thu Oct 15, 2015 10:39 am

Tex,

Thank you for the explanation. Drs. have given me meds in the past that didn't do well with the meds I was already taking, even though I informed them of what I was already taking.

The insurance snafu has to do with healthcare.gov. I believe I have it straighten out. While I appreciate getting affordable insurance since my husband retired, having to deal with healthcare.gov has been a total nightmare. The current snafu is a result of "too many cooks spoil the soup" if you know what I mean.

Thanks again.

Susanne

DebE13 · Post by **DebE13** » Mon Oct 26, 2015 6:19 pm

I've been taking low doses of entocort since 2011. I've been taking both levothyroxine since 2013. My MC has had no change.

Sorry to hear you are having such frustrations with your insurance and I hope it works out soon. Can your doctor call the insurance company and put them in their place?

I had a similiar experience in getting my thyroid meds from the pharmacy. They didn't want to give me the manufacturer I requested (no bad fillers for me) and told me they made less money if I were to use that company. I contacted my insurance company and they set them straight. They still regularly try to substitute different manufacturer's but I now call to verify before I pick it up.

Sometimes you have to be direct and tell them what you need and not let up. Sadly, sometimes it's a battle of wills.

suzieq · Post by **suzieq** » Wed Oct 28, 2015 9:33 am

Hi,

I finally got my medication from the pharmacy. Things got messed up because of Healthcare.gov and I owed the insurance company part of the new premium, which I paid that day and the pharmacy was then able to fill them for the copay and not what they really cost.

I don't know however if the thyroid medication or my generic Flexiril are safe, they are from a different manufacturer than where I had them filled in NJ. I will have to check them out.

I am 1 1/2 weeks on 2 Entocort pills a day and I'm getting clogged up and uncomfortable. Tomorrow I'm going to start alternating 1 pill then back to 2 pills for a couple of weeks and see how it goes.

Thanks,
Susanne

suzieq · Post by **suzieq** » Wed Oct 28, 2015 10:45 am

Hi,

I checked a list online, I don't think some of my meds are gf. They are:

Cyclobenzaprine 10 mg - KVK-Tech Inc.
Levothyroxine 75 mcg - Mylan
Diazepam 5 mg - Teva

I couldn't even find Budesonide on the list, they are Mylan.

I had checked them out when I lived in NJ, I used Walgreens, the brands were ok. Here in North Carolina I use Rite Aide.

Susanne

Zizzle · Post by **Zizzle** » Wed Oct 28, 2015 10:56 am

Regarding the interactions, after years of "normal" thyroid function (at least that's what the blood tests said), I had to take prednisone for 2 years. After I weaned off, my thyroid function was clearly lower than before the prednisone, so I'm now on a low dose of Armour Thyroid.

Low T3 Syndrome probably explains my case, because my T4 was normal and TSH barely elevated, but I had T3 issues. Gotta love autoimmune inflammation!

http://chriskresser.com/inflammation-strikes-again/

http://emedicine.medscape.com/article/118651-overview

Post by **tex** » Wed Oct 28, 2015 2:25 pm

Susanne,

The Levothyroxine is OK, but the Cyclobenzaprine and the Diazepam both contain lactose. In the Diazepam the lactose is in the form of anhydrous lactose.

Tex