I have seen the answer to this question in the past but cannot now find it again.
I have just heard from the GP that my thyroid function has declined and that I need to increase from 75 -100 mg of Levothyroxine .I am reluctant to do this as I know I have been here before and after a couple of months' stay of execution' it righted itself. We agreed that I would wait a couple of months before another test. She questioned when I was taking the thyroxine and stressed it should be first thing in the morning not at bedtime which is what I have been doing since GCA. I have been taking Pred first thing in the morning (EC now 3 mg). Both drugs seem to need an empty stomach. How do others manage the timings of it all? I assume they need to be taken with a gap between them. If I take the pred in the night would I need food as a stomach protector even though the tablets are EC? GP had no answers
All this led me to thinking about how one tells whether fatigue and lethargy is down to underactive thyroid or adrenal insufficiency or even old age? I don't imagine that there's an answer to that
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Noraflorence
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i take levothyroxine on empty stomach as soon as i wake up, and prednisolone an hour later with food. My blood tests have been ok for the thyroxine so that seems to work.
The pharmacist at my GP surgery rang me and told me to leave at least 3 hours between taking thyroxin and vitamin D. I now take thyroxin around 5.30 am. Hope you are feeling better
And WHY does she insist that it MUST be in the morning? I think she may be a bit out of date - the studies showing it was OK, in fact advantageous, were about 15 years ago!
If you're prescribed levothyroxine, you should take it at the same time every day. It's usually recommended that you take your tablet (or tablets) in the morning, although some people prefer to take them at night."
Several papers mention the problem of polypharmacy and getting it all fitted in in the 24 hours and it really can be a problem, especially if you have medications that must be taken separately from others. At one point I had to take stuff at 5 separate times in the day and it mattered about some being exact!! I had alarms set on my phone - and still would switch it off and forget the tablets!
If you are on EC pred, theoretically you don't need any stomach protection, especially at such a low dose. Depends on the person. Ordinary pred should be taken with food but some people have found that taking EC pred with food slows its absorption which since it takes ages anyway is a bit of a pain (pun intended!). However, since EC pred takes about 4 hours to get into the system, it lends itself to dosing at bedtime - and is there waiting for the inflammatory substances first thing in the morning.
As for your last paragrah - er, pass ... You are quite right - how on earth do you tell?
wow thank you for all the links which I have tried to absorb ! However having a small brain and not a scientific one my take away messages are that it is essential to take it at the same time each day and on an empty stomach. By bedtime my stomach is probably not empty so shall revert to first thing for the thyroxine. I may think about doing the pred at bedtime instead in the hope that a full stomach will not impair the efficacy
I have never heard of polypharmacy but it is self explanatory. Going away from home is a nightmare and now have a bag full of medication . Who would have thought it would come to this.?
The links were really for your GP's benefit! The NHS page is rather simpler.
I suppose it depends what time you have your evening meal - 3 hours is the usual interval before taking medication "on an empty stomach" so since you are using EC pred, you could take either the pred OR the thyroid meds before bed
Thank you I shall keep the info up my sleeve for the next 'debate'with the GP. It is helpful to understand what constitutes/defines an empty stomach. I somehow thought it was an overnight lack of food.
Almost all the papers I have seen agree that 3-4 hours after a meal is fine. Most things that instruct you to take them BEFORE food are assuming you don't eat every hour or so!!
I take mine at night 125mg level are allways fine.
Pharmacies has a fit when thay do meds review. .But GP fine for some patients he said that are non compliant with meds he says they come into surgery and given
I take 75mg Levo first thing on an empty stomach then my Pred immediately after breakfast around an hour later. I have been on 75mg Levo for several years now and thus regime hasn't upset it at all. Even with an Omeprazole somewhere between the two.
Thank you Wildlifephotographer. I too have been on 75 mg for several years and dismayed to find that I may need to up it. I think I have become a bit hit and miss in my routines with Levo and certainly not been rigorous on taking it on an empty stomach. Perhaps with a new routine I can avoid an increase. Fingers crossed
I always took mine in the morning before I was on prednisolone. So now I take them at bedtime. If you look on the Thyroid group on here, which is just as active as this one, they recommend night time as the best time. I would do what suits you and not concern yourself with what the GP is saying.
Thank you. PMR pro sent several links to research to say that night time was perfectly acceptable. I will see how it all works out for me and what actually suits me. Where do you find the thyroid grou[p Is it on Health Unlcocked?
I am on 75mg Thyroxine, 20mg Omeprazole and 3 mg of Pred. I understand that Omeprazole, caffeine and milk interfere with the absorption of Thyroxine. I did find that Omeprazole taken too close to the thyroxine made me feel hypothyroid. So my regime is:
Thyroxine on an empty stomach any time after 4.30am
Omeprazole on an empty stomach no less than 40 mins after the Thyroxine
Breakfast
Pred near the end of breakfast and at least 30 mins after the Omeprazole.
I put my thyroxine and omeprazole on a saucer beside my bed every night so I can swallow them without waking up too much to wrestle them out of the packet. It works!
I have been taking 100mg thyroxine since in my early 40’s, always first thing before breakfast. I take Pred - at present 9mg, but this has yo-yoed after having breakfast. I have had PMR since early 2021. I don’t take a stomach protector as they did not agree with me. This regime works for me. . ( am 75 now) I have never had a problem with thyroxine and have always been grateful one tiny pill does the trick. I don’t like having PMR though!!
Thyroid meds need empty stomach - Pred definitely should be taken on a full stomach. So I take my Thyroid stuff at least an hour before breakfast and Pred as I finish. Pred is inclined to upset the stomach lining hence - eating first. Some people do take pred early with a little yogurt. Thyroid meds need to be taken well away from Iron supplements and should only be taken with water. I hope this helps.
Thank you Pippa45 as I have EC Pred it may be not essential to have it after food as PMRpro says. However the thyroxine needs an empty stomach which I did not know until the last day or two thanks to people here. Now to implement the new regime.
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