Table of ContentsView AllTable of ContentsHeart HealthDrug InteractionsAlternatives
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Table of Contents
Heart Health
Drug Interactions
Alternatives
Decongestants can pose a risk to people living with a thyroid disorder, such as an overactive thyroid (hyperthyroidism) or an underactive thyroid (hypothyroidism).
This article explains why some decongestants should be avoided and why it’s important to discuss medication use with your healthcare provider before taking them.
Verywell / Emily Roberts
Decongestants and Heart Health
The catch is, this effect isn’t limited to nasal passages: Blood vessels throughout the body are affected, which can be dangerous for someone with a thyroid condition. That’s because both hyperthyroidism and hypothyroidism can affect the heart and circulatory system.
Pseudoephedrine can strain an already overtaxed heart or further increase high blood pressure, worsening two common issues related to hyperthyroidism.
The decongestant most likely to be problematic is pseudoephedrine, which is sold not only as a single-ingredient medication, but is found in multi-symptom cold, flu, andallergy remediesas well.(Note that because pseudoephedrine has been used illegally to make methamphetamine, it is sold from behind the pharmacy counter.)
These decongestants show up in many products, and some brands have products that contain both ingredients. It’s important to read labels so that you know what you’re taking.
These lists represent a small sample of the many OTC medications that have pseudoephedrine or phenylephrine, alone or in combination with other ingredients.
Common Medications With PsuedoephedrineAdvil Cold and SinusAlavert Allergy and Sinus D-12Aleve-D Sinus and ColdAllegra-DClaritin-DMucinex DSudafed 12/24 HourSudafed CongestionTheraflu Max-D Severe Cold and FluTylenol Sinus Severe Congestion DaytimeCommon Medications With PhenylephrineActifed Cold and AllergyAdvil Congestion ReliefAlka-Seltzer PlusBenedryl-D Allergy Plus SinusExcedrin Sinus HeadacheRobitussin Cough and Cold CFSudafed PETherafluTriaminicTylenol Allergy MultisymptomVicks DayQuil
Common Medications With PsuedoephedrineAdvil Cold and SinusAlavert Allergy and Sinus D-12Aleve-D Sinus and ColdAllegra-DClaritin-DMucinex DSudafed 12/24 HourSudafed CongestionTheraflu Max-D Severe Cold and FluTylenol Sinus Severe Congestion Daytime
Advil Cold and Sinus
Alavert Allergy and Sinus D-12
Aleve-D Sinus and Cold
Allegra-D
Claritin-D
Mucinex D
Sudafed 12/24 Hour
Sudafed Congestion
Theraflu Max-D Severe Cold and Flu
Tylenol Sinus Severe Congestion Daytime
Common Medications With PhenylephrineActifed Cold and AllergyAdvil Congestion ReliefAlka-Seltzer PlusBenedryl-D Allergy Plus SinusExcedrin Sinus HeadacheRobitussin Cough and Cold CFSudafed PETherafluTriaminicTylenol Allergy MultisymptomVicks DayQuil
Actifed Cold and Allergy
Advil Congestion Relief
Alka-Seltzer Plus
Benedryl-D Allergy Plus Sinus
Excedrin Sinus Headache
Robitussin Cough and Cold CF
Sudafed PE
Theraflu
Triaminic
Tylenol Allergy Multisymptom
Vicks DayQuil
Phenylephrine is also an active ingredient in somenasal spraysfor treating congestion. Although the drug is targeted at blood vessels in the lining of the nose, experts don’t know for sure that it won’t affect vessels throughout the body.
You should check with your healthcare provider before using a nasal spray (such as Neo-Synephrine) if you have hyperthyroidism. The same may be true for nasal sprays containingoxymetazoline. These include:
Nasal Sprays Types and How to Use Them
Interactions With Thyroid Medications
Hypothyroidism is managed with a synthetic form ofthyroxine(T4) called levothyroxine, available under the brand names Synthroid or Levothroid.
People may be at increased risk of cardiovascular side effects if they take pseudoephedrine or phenylephrine and levothyroxine. This could be especially dangerous for someone who has preexisting heart disease.
Regardless of the type of thyroid disorder you have, whether you take medication to treat it, or happen to have a heart condition as well, it’s best to err on the side of caution before taking a decongestant for a cold or flu and speak with your healthcare provider.
An Overview of Levothyroxine
Alternatives to Decongestants
People living with a thyroid condition have options to relieve nasal congestion from a cold or flu without medication. You can:
Acupunctureand acupressure may also help to relieve congestion.
If none of these strategies work, check with your healthcare provider to find out if there are other ways to get relief.
Summary
Some decongestants can pose a risk to people living with certain health conditions, including a thyroid disorder. This is because ingredients in over-the-counter (OTC) products, like pseudoephedrine, can affect the heart and blood vessels. Some products also may interact with your thyroid drugs.
Be sure to discuss the use of any OTC medication with your healthcare provider before you try them. You also may wish to consider natural remedies, like using a humidifier, before you try a nasal decongestant drug.
11 Popular Natural Remedies for the Common Cold
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Abdullah B, Abdul Latiff AH, Manuel AM, Mohamed Jamli F, Dalip Singh HS, Ismail IH,et al.Pharmacological Management of Allergic Rhinitis: A Consensus Statement from the Malaysian Society of Allergy and Immunology.J Asthma Allergy. 2022 Aug 2;15:983-1003. doi:10.2147/JAA.S374346.Harvard Medical School Harvard Health Publishing.Don’t let decongestants squeeze your heart.Razvi S, Jabbar A, Pingitore A, et al.Thyroid hormones and cardiovascular function and diseases.Journal of the American College of Cardiology. 2018;71(16):1781-1796. doi:10.1016/j.jacc.2018.02.045Sur DK, Plesa ML.Treatment of allergic rhinitis.American Family Physician. 2015;92(11):985-92.MedlinePlus.Oxymetazoline nasal spray.Sharma M, Gupta A, Prasad R.A review on herbs, spices and functional food used in diseases.International Journal of Research and Review. 2017; 4(1):103-108.Lei RL, Lin WC, Lin CC, et.al.Effects of Acupressure on Symptoms Relief and Improving Sleep Quality in Pediatric Patients With Allergic Rhinitis.[published online ahead of print, 2020 Apr 1].Holist Nurs Pract. 2020;10.1097/HNP.0000000000000377. doi:10.1097/HNP.0000000000000377
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Abdullah B, Abdul Latiff AH, Manuel AM, Mohamed Jamli F, Dalip Singh HS, Ismail IH,et al.Pharmacological Management of Allergic Rhinitis: A Consensus Statement from the Malaysian Society of Allergy and Immunology.J Asthma Allergy. 2022 Aug 2;15:983-1003. doi:10.2147/JAA.S374346.Harvard Medical School Harvard Health Publishing.Don’t let decongestants squeeze your heart.Razvi S, Jabbar A, Pingitore A, et al.Thyroid hormones and cardiovascular function and diseases.Journal of the American College of Cardiology. 2018;71(16):1781-1796. doi:10.1016/j.jacc.2018.02.045Sur DK, Plesa ML.Treatment of allergic rhinitis.American Family Physician. 2015;92(11):985-92.MedlinePlus.Oxymetazoline nasal spray.Sharma M, Gupta A, Prasad R.A review on herbs, spices and functional food used in diseases.International Journal of Research and Review. 2017; 4(1):103-108.Lei RL, Lin WC, Lin CC, et.al.Effects of Acupressure on Symptoms Relief and Improving Sleep Quality in Pediatric Patients With Allergic Rhinitis.[published online ahead of print, 2020 Apr 1].Holist Nurs Pract. 2020;10.1097/HNP.0000000000000377. doi:10.1097/HNP.0000000000000377
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Abdullah B, Abdul Latiff AH, Manuel AM, Mohamed Jamli F, Dalip Singh HS, Ismail IH,et al.Pharmacological Management of Allergic Rhinitis: A Consensus Statement from the Malaysian Society of Allergy and Immunology.J Asthma Allergy. 2022 Aug 2;15:983-1003. doi:10.2147/JAA.S374346.Harvard Medical School Harvard Health Publishing.Don’t let decongestants squeeze your heart.Razvi S, Jabbar A, Pingitore A, et al.Thyroid hormones and cardiovascular function and diseases.Journal of the American College of Cardiology. 2018;71(16):1781-1796. doi:10.1016/j.jacc.2018.02.045Sur DK, Plesa ML.Treatment of allergic rhinitis.American Family Physician. 2015;92(11):985-92.MedlinePlus.Oxymetazoline nasal spray.Sharma M, Gupta A, Prasad R.A review on herbs, spices and functional food used in diseases.International Journal of Research and Review. 2017; 4(1):103-108.Lei RL, Lin WC, Lin CC, et.al.Effects of Acupressure on Symptoms Relief and Improving Sleep Quality in Pediatric Patients With Allergic Rhinitis.[published online ahead of print, 2020 Apr 1].Holist Nurs Pract. 2020;10.1097/HNP.0000000000000377. doi:10.1097/HNP.0000000000000377
Abdullah B, Abdul Latiff AH, Manuel AM, Mohamed Jamli F, Dalip Singh HS, Ismail IH,et al.Pharmacological Management of Allergic Rhinitis: A Consensus Statement from the Malaysian Society of Allergy and Immunology.J Asthma Allergy. 2022 Aug 2;15:983-1003. doi:10.2147/JAA.S374346.
Harvard Medical School Harvard Health Publishing.Don’t let decongestants squeeze your heart.
Razvi S, Jabbar A, Pingitore A, et al.Thyroid hormones and cardiovascular function and diseases.Journal of the American College of Cardiology. 2018;71(16):1781-1796. doi:10.1016/j.jacc.2018.02.045
Sur DK, Plesa ML.Treatment of allergic rhinitis.American Family Physician. 2015;92(11):985-92.
MedlinePlus.Oxymetazoline nasal spray.
Sharma M, Gupta A, Prasad R.A review on herbs, spices and functional food used in diseases.International Journal of Research and Review. 2017; 4(1):103-108.
Lei RL, Lin WC, Lin CC, et.al.Effects of Acupressure on Symptoms Relief and Improving Sleep Quality in Pediatric Patients With Allergic Rhinitis.[published online ahead of print, 2020 Apr 1].Holist Nurs Pract. 2020;10.1097/HNP.0000000000000377. doi:10.1097/HNP.0000000000000377
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