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Mary Shomon

Thyroid Patients Need to Be Careful When Taking Weight Loss Drugs Alli / Xenical / Orlistat

By April 30, 2009

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The only FDA-approved over-the-counter weight loss drug is Alli -- which is the brand name for the medication orlistat. (Orlistat in higher dosages is also available by prescription under the brand name Xenical.) Orlistat is a fat-blocking drug, taken with meals to help block some of the fat -- and therefore calories -- from meals, as an aid in losing weight.

In late March, 2009, the FDA approved safety labeling revisions for levothyroxine sodium tablets (i.e., Synthroid, Levoxyl, etc.) to advise of drug interactions with orlistat. Levothyroxine's prescribing information will now include a warning that indicates that use of orlistat may decrease levothyroxine absorption and lead to hypothyroidism, and that clinicians are advised to administer levothyroxine and orlistat at least 4 hours apart and to perform regular evaluations of thyroid function.

Xenical's prescribing information (PDF) has already been revised to reflect the potential interaction between orlistat and levothyroxine. Specifically:

  • Under "Drug Interactions," they have added "Hypothyroidism has been reported in patients treated concomitantly with orlistat and levothyroxine"
  • Under "Adverse Reactions / Other Clinical Studies or Postmarketing Surveillance," they have added, "Hypothyroidism has been reported in patients treated concomitantly with orlistat and levothyroxine."
  • Under "Can I take XENICAL while taking other medications?" they have added "XENICAL and levothyroxine should be taken at least 4 hours apart"
Bottom line: If you're a thyroid patient trying to lose weight -- as many are -- keep in mind that Alli or Xenical may affect absorption of your thyroid medication, and make you more hypothyroid. Take your thyroid medication at least 4 hours apart from your Alli or Xenical. And have your thyroid evaluated more frequently while you're taking the medication, to make sure you don't need a dosage adjustment of your thyroid medication.

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April 30, 2009 at 9:14 pm
(1) Victoria says:

Thanks for that. I take Alli on days I eat more fat than usual – usually just one day a week. But this is good information to know and I will be more careful with it and my thyroid meds.

May 1, 2009 at 8:22 am
(2) Mary G says:

This is only tangentially related, but the same is true for resveratrol, the anti-aging supplement made from the skins of red wine grapes. I started taking it and had an increase in hypothyroid symptoms. I didn’t associate it with affecting the medication initially, but an online search showed that resveratrol raises TSH and lowers T4–not the kind of result I wanted. So I had to stop taking it.
I’m only posting this here because I hope Mary Shoman reads these.

May 1, 2009 at 9:13 am
(3) kcstacy says:

Does the new research address xenical’s affect on Tapazole treatment for Hyperthyroidism? (I’m not finding an answer by googling.)

May 1, 2009 at 9:20 am
(4) Stacey Jones says:

Do you like Thyax?
Do you think it really works and if you take
it, do you stop taking your Armour thyroid

May 1, 2009 at 10:24 am
(5) Vicki says:

I’ve been taking phentermine for the last 9 months and have lost 30 pounds. I got it from my endocrinologist. I’ve had hypothyroidism/Hashimoto’s for the past 13 years. I’ve had a hard time losing weight all those years. You still have to watch what you eat and exercise with phentermine but at least you get some results. Does anyone have any experience with this?

February 13, 2011 at 11:36 am
(6) Aerin says:

Glad I read this I went to an Endocrinologist as well who was a waste of time he didn’t even let me know my new results for my thyroid. I even tried asking him questions about if I should avoid certain foods he told me to go see a nutritionist if I just have questions about food. I will look into this and give it a try more of what I’m looking for is something to suppress my appetite i’m always hungry when I shouldn’t be. Thanks

March 7, 2011 at 7:07 am
(7) Henrietta says:

Aerin, I have a wonderful endocrinologist who explains everything to me clearly. You should get one as well. I am hypothyroid for the past 15 years. When I asked my doctor to prescribe something to assist with weight loss, he was very clear about what was required to have success. I have cut my calorie intake to approximately 1200 to 1400 per day. I exercise with Jillian Michaels 30-day Shred. it works wonderfully. I am now doing Level 2 effectively and muddle through Level 3 together. I will not weigh myself except every 30 days, but I can feel the change in my clothing. My doctor prescribed Phentermine for me, and I tried it. I started on 2/19/2011 and did not like the side effects at first, but I stuck with it and the side effects have stopped. It does suppress my appetite, but a lot of the success has come from my will power to succeed. With hypothyroidism, my weight has crept up from 148 to 180 the last time I weighed, and it has been a horrible time keeping it at bay. But I have decided that this is my year, and nothing will stop me from succeeding – not even me.

May 1, 2009 at 12:52 pm
(8) shade says:

thanks for sharing this info. I just got into the hypo life mid april. I feel like the world is crashing around me. I am always tire and exhausted. My body is just adjusting to my new meds

May 1, 2009 at 2:32 pm
(9) Jane says:

I am 53 and been diagosed with hypo, taking synthroid but are still gaining weight went from 150 to 172 in a couple of months. I am 5 foot 4 inches about 40 pounds overweight. Going to see Doc next week hopefully to change my meds. Any exercises anyone cares to share. Been hypo since June of 08!

May 1, 2009 at 6:42 pm
(10) Michelle says:

I am 35 years old and have been hypo for over 10 years, it took me about a year and a half to start feeling better taking my meds, during that time I lost alot of weight about 40lbs, but over the course of time I have gained it back by changing nothing, I still exercise the same and eat the same way my Dr. has checked me several times and can’t understand why this is happening, then a couple weeks ago I found out that I am going through premature menepause and that has something to do with it.My husband says I look fine but I don’t like it at all, so if anyone has any advice on weight loss please send it my way. mlsmiss20@AOL.COM. Thanks

May 2, 2009 at 1:48 am
(11) Sumintra Gounder says:

I’m 35years old with 2 little kids. I’ve had hypo for 6 years and still trying to fight it.Has had ups and downs inspite of medication as the medication itself have been an issue. Only 3 weeks ago started having carpel tunnel syndrome, not pleaseant, seems lie problems not ending.

May 2, 2009 at 3:35 pm
(12) Dave says:

Before you people take synthetic drugs for weight lose please look into vitamin/mineral deficiencies and especially eviromental toxicities.
Most likely it is a combination of all three.
On top of it Alli will make those deficiencies worse. I used to work at a “health store” and met some people that began to feel terrible on that Alli garbage.

May 4, 2009 at 6:14 pm
(13) Amber says:

Does Alli also have that effect if you take your Armour subliqually?

May 6, 2009 at 1:24 pm
(14) anne beszant says:

I have been taking Orlistat for a year. Initially it had a great effect, so much so that my GP didn’t believe that I wasn’t doing something else. But latterly it has had no effect. Can anyone suggest anything?

July 16, 2009 at 1:34 pm
(15) Judi says:

I was sooooo pleased to read this. I started taking Xenical-was eating 900 calories and walking 2 miles every day with the dog and wasn’t losing weight. I’ve just realised that i’ve got all my hypo symptoms back, bad tempered, legs like lead, no cramp etc. I’m going to stop the Xenical and do it the hard way!

February 14, 2010 at 3:31 pm
(16) Jennifer says:

Thanks for the info…it was a big help!!!

April 11, 2011 at 8:25 am
(17) Jackie says:

I became hypothyroid 10 years ago after initially being hyperthyroid. Wow. What a change. Within the first year, I gained 50 lbs and hated all the symptoms associated with being hypothyroid. I’ve been on low fat and low carb diets since then and lost 100 lbs and gained it back and then some. I wanted to try Alli, hoping this would be my savior. The first month I lost 10 lbs and have lost nothing during my second month. I will keep it up till my new bottle of Alli is gone. After that, if I see no results, I will stop and just keep up the low fat diet. I’ve wondered, too, if having had my gallbladder out has had any effect with the Alli?
I, too, did the Phentermine for 3 months and loved the fact I had no desire to eat whatsoever. The first pill to ever suppress my appetite. But, the side effects left me jittery, unable to sleep at night and blood pooling into my extremities. I lost a lot of weight but it all came back after stopping use of it and I felt it hindered me in the long road. The side effects continued for months after stopping it.

August 8, 2012 at 8:06 pm
(18) Robyn Toronto says:

I used the Lady Soma Detox product since 2005. I had to lose about 15-20 lbs to get ready for my sisters wedding and The Swedish Diet (while taking the Lady Soma Detox) helped me to lose 21 lbs in only 4 weeks…I not only lost lbs and the scale but oh my goodness…I LOST BODYFAT as well…..

I did use the Detox product and I am thrilled! I am looking to order 4 more bottles to maintain my weight loss now.

September 17, 2013 at 8:02 pm
(19) http://revolynweightloss.com/ says:

Hi just wanted to give you a brief heads up and let you know a few of the pictures aren’t loading
correctly. I’m not sure why but I think its a linking issue.
I’ve tried it in two different internet browsers and both show the same outcome.

October 11, 2013 at 2:55 pm
(20) LYNDA says:

Where can I buy the Lady Somo Detox

November 2, 2013 at 12:39 pm
(21) Joan says:

Starting Alli today. Need to lose a good 50 lbs. 5’2″ and 53 yrs old. I take Levothyroxin for hypothyroidism. Exercise is limited as I need a knee replacement. I do aquatic exercise, but walking any distance is tough. Doctor told me to try Alli first and we’ll discuss phentermine at my next visit. The extra weight on my knee isn’t good and now my feet have started hurting too. Hoping this helps me.

March 9, 2014 at 2:40 pm
(22) vidya says:

Hi! I’m 37 years old and now Hypothyroid now and have been for a couple of years now. I was hyperthyroidism first when I was in my 20′s . Then I had tried phentermine and lost weight then when I stopped gained it back. Now I have gained so much weight til I feel depressed. Any suggestions on how to lose weight. Should I start back on the phentermine? Help please!

March 9, 2014 at 2:45 pm
(23) Vidya says:

Hi, I’m a 37 year old and once had hyperthyroidism and now I’m hypothyroid. And have been for years now. I was once taking phentermine and lost weight then it stopped. I gain so much weight over a course of time til it’s depressing. Wondering what to do now any suggestions?

March 27, 2014 at 11:18 pm
(24) Dida says:

Here’s my dilemma. I am 57, had hypo-thyroidism for 30 years, I also have FSH muscular dystrophy in my shoulders and upper back now. I am also taking levo. and two anti-depressants that help me not only gain weight, but keep it on. I would love to try Lady Somo and Alli. I just need to know where I would get this Lady somo.

Thanks for everyone elses’s input!

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