Perseverance paid off !

[ChickieBaker]

Hello.I just wanted to say that if you need Levothyroxine and your doctor refuses, keep trying. I approached my 'named' doctor when my TSH was hovering around 4.70 - 5.00 but my antibodies were well out of range. Her comments were " oh we don't treat until your TSH gets to 10" and " we don't treat Hashimotos" 🤬🤬 I then saw a different doctor several months later and she put me on Levo for a 3 month trial after I showed her a litany of symptoms. Of course my TSH went down to 1.7. She then consulted with the Endo who refused to let me continue on the Levo. Having joined this forum and read so many useful stories and received some great advice I armed myself with all my blood test results ( both NHS and private ), the NICE guidelines and the information from the NHS website and asked yet another doctor at my surgery. He said yes to the Levo 🎉🎊 I'm starting back at 75mg with a blood test in 8 weeks. My question is, I've read some studies that taking the Levo at bedtime is better because it absorbs well. I tend to wake up and have a cup of tea straight away which of course I can't do if I take it in the morning. Any thoughts as to taking it at night ?? Thanks ☺️

[jimh111]

Well done! Taking levothyroxine at night is fine and it avoids a lot of problems as most people don't have a large meal with double espresso at bedtime.

[ChickieBaker in reply to jimh111]

Hi. How long between dinner and meditation do you know ? Thanks.

[jimh111 in reply to ChickieBaker]

You can meditate straight after dinner but I would allow about three hours before taking thyroid medication! A small reduction in absorption doesn't matter as your dose will simply be a little higher. We store around ten days worth of thyroxine so day to day variations don't have much effect.

[Sneedle]

Hi there,we don't treat Hashimotos

What do you understand that to mean?! A genuine question.

You definitely persevered and a big well done for that.

I take mine when I wake around 4 or 5 am but that might not be of use!

[ChickieBaker in reply to Sneedle]

Hi. I couldn't believe it when she spun me that line. At the time I wasn't as educated about this subject as I am now. Had I been I might have responded by asking why she thought that an auto immune disease shouldn't be treated 🤬 I have no idea why she was dead against giving me the Levo but am very grateful that having seen 3 doctors from my surgery I finally found one that understood the issue and was more than happy to give me the Levo long term ☺️

[SlowDragon Administrator]

Well done

Starting on 75mcg may be too much initially

Assuming it’s a 75mcg tablet…..first 3-4 weeks suggest you start on half tablet per day before increasing to 75mcg daily

Also only brand that makes 75mcg is Teva

Be aware that Teva doesn’t suit lots of people

If you want different brand

Most easily available (and often most easily tolerated) are Mercury Pharma or Accord

Mercury Pharma make 25mcg, 50mcg and 100mcg tablets 

Mercury Pharma also boxed as Eltroxin. Both often listed by company name on pharmacy database - Advanz

Accord only make 50mcg and 100mcg tablets. Accord is also boxed as Almus via Boots, 

Wockhardt is very well tolerated, but only available in 25mcg tablets. Some people remain on Wockhardt, taking their daily dose as a number of tablets 

Lactose free brands - currently Teva or Vencamil only

Teva makes 25mcg, 50mcg, 75mcg and 100mcg

Many patients do NOT get on well with Teva brand of Levothyroxine.

Teva is lactose free.But Teva contains mannitol as a filler instead of lactose, which seems to be possible cause of problems. Mannitol seems to upset many people, it changes gut biome 

Teva is the only brand that makes 75mcg tablet.

So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

But for some people (often if lactose intolerant), Teva is by far the best option

Aristo (currently 100mcg only) is lactose free and mannitol free.

March 2023 - Aristo now called Vencamil

healthunlocked.com/thyroidu...

List of different brands available in U.K.

thyroiduk.org/if-you-are-hy...

Posts that mention Teva

healthunlocked.com/search/p...

Teva poll

healthunlocked.com/thyroidu...

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Government guidelines for GP in support of patients if you find it difficult/impossible to change brands

gov.uk/drug-safety-update/l...

If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Discussed here too

healthunlocked.com/thyroidu...

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[ChickieBaker in reply to SlowDragon]

Thanks for all that info. Looks like I'll be taking it in the morning as I have to take magnesium at night to help me sleep. Guess I'll have to wait for my morning cuppa 😩 I was on 75mg when I was last taking it so that's what the doctor suggested I go back to ? I could start with 50 I guess.

[SlowDragon Administrator in reply to ChickieBaker]

oh well if previously been on 75mcg start at that dose

You can take magnesium 4 hours before bed and take levothyroxine at bedtime

[ChickieBaker in reply to SlowDragon]

Will the magnesium still help me sleep if I take it 4 hours before bed ??

[SlowDragon Administrator in reply to ChickieBaker]

Well I find it just as effective

[goingholiday in reply to ChickieBaker]

I take my levo at bedtime and use a magnesium spray early evening or bedtime. That way it doesn’t interfere with levo absorption….. and I do sleep well 😊

[Singwell in reply to ChickieBaker]

In case it helps. A few of us who get up for a nightly wee take their levothyroxine then. Dependent on you remembering though. I nearly went back to sleep last night without taking mine. But, for me, this strategy works really well together with the rest of my medication regime.

[Noelnoel in reply to ChickieBaker]

When I switched to bedtime dosing I simply took my magnesium slightly earlier in the evening to create a 4 hour gap and it still helped but you’ll likely find sleep will improve once established on thyroid replacement. I was a tough to crack insomniac of 22 years before that but since treatment I sleep so much better. The difference is incredible

[ClareP5]

Well done for persevering

[waveylines]

Well done.... You finally found a reasonable doctor in the practise. I'd defo stick with seeing that one!! The ignorance surrounding Hashi is breath taking tbh....

[ainslie]

Was it Churchill or Einstein that said that nothing can take the place of persistence

[helvella Administrator Thyroid UK in reply to ainslie]

Or Calvin Coolidge?

“Nothing in this world can take the place of persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan 'Press On!' has solved and always will solve the problems of the human race.”

goodreads.com/quotes/2749-n...

(No - I did not know that!)

[ainslie in reply to helvella]

Fantastic, thankyou , this is getting off topic but allegedly Jason Donovan said “prepare or prepare to fail”, hopefully you can correct me on that one too 😀