Is it possible to split levothyroxine into a mo... - Thyroid UK
Is it possible to split levothyroxine into a morning and afternoon dose rather than all in one go?
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you can do this, whether it will make any difference it is unlikely (not impossible, unlikely), as T4 is long acting, it builds up in your body over weeks not hours then plateaus and you taking your pill you just top up the current 'steady' level going round your body.
If were to stop the levo/T4 then most people may not feel any difference for at least a couple of day or even longer, for me it was 5 days for example (am on T3 now not on levo anymore).
I second NBD's comments, Levo is not a 'quick-fix' medication, although some people do say they can feel it 'kick in' an hour or two after taking it, most people find that it takes far longer - days - to have any effect. Thus it does seem a bit pointless taking it in split doses - plus, it makes it more difficult to take it the required time apart from food and other meds.
That said, we're all different - if you try it and you feel better, why not?
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I can't find a suitable graph! But the peak level of Free T4 in the blood usually occurs around two hours after taking a levothyroxine tablet. Some people notice this; others do not. Similarly some people notice hitting the bottom FT4 level somewhat before they are due their next dose; others don't.
I have often thought that I can notice something within a few minutes of taking my tablet - but it is so very difficult to be sure. I am absolutely sure I can notice a higher level an hour or two after taking it.
One problem with split dosing is that it gets ever more difficult to maintain a gap between those doses and food, supplements, drinks (other than water), and other medicines.
Rod
True about needing to space out the meds. The problem is I get very low around 1.30 and I have blamed this on lunch, skipping lunch , sugar, whatever, so I wondered if there was a dip there that I could relate to t4 levels. It happens most days but not every day. When it happens I actually physically need to lie down and try to sleep!
Feeling sleepy straight after lunch is normal for almost everyone I think, not just people with thyroid problems. It is part of the normal circadian rhythm and is one of the reasons why so many cultures have a siesta after lunch. It will almost certainly help you if you never miss lunch, and if you avoided simple sugars during lunch. Try having a lunch (and a breakfast!) which is Low GI so you don't have big spikes in blood sugar followed by huge dips where blood sugar drops dramatically.
I usually take my levo at night, but if I forget for any reason I will then split the dose the next day, half in the morning and half at night, just to keep the supply coming.
I think, as with all medication, it is an individual thing. My body processes meds very quickly. MST morphine are supposed to last 12 hrs but only lasts 6 max with me. I've had to split my levothyroxine as I was having a major evening dip. My daughter really noticed how odd I was later in the day....brain fog kicking in!!! I've also noticed it works better if I take with food. If you can see/feel any differences try taking the dose split. It's up to you. Good luck
I'm considering splitting my dose. I take one dose at night and swear the affects kick in about 7 a.m along with my waking up cycle. Then I am really low by late p.m. Not dissimilar to my experience taking ndt but less obvious.
Splitting your dose can help if you have adrenal fatigue or low cortisol. If you take a big hit once daily it can effect your cortisol and make it suddenly drop too low. Giving you weakness. It’s all a balance. Thyroxine is your exertion and cortisol is your strength. If you exert too much with weak adrenals they won’t be able to keep up and you will feel very weak and crash.
Please post any updates, if you decide to split, I get very sluggish and sleepy after lunch too, wondering if I should split it.