Good morning everyone, What are the benefits of taking Thyroid meds a night?

[Kitten-whiskers]

Thank You

[helvella Administrator Thyroid UK]

Well worth having a read through the comments on this TUK poll:

healthunlocked.com/thyroidu...

I take mine at bed-time - always have.

Rod

[Kitten-whiskers in reply to helvella]

Hello Rod,

Their is no information on the link.

It would seem taking it at night would make more sense as it would fit in with the bodies natural clock, it is only because of the adrenals I haven't tried it sooner.

Thank you

[helvella Administrator Thyroid UK in reply to Kitten-whiskers]

As I have voted, I see something a bit different to you. However, when I go there on another computer (and so I am not logged in) I see:

When do you take your thyroid medication?

Immediately on waking

During the morning

Lunchtime

During the afternoon

During the evening

At bedtime

Twice a day

More than twice a day

Vote View results and responses

You need to click on the link at the bottom that I have underlined above. There are over 170 comments.

Rod

[Kitten-whiskers in reply to helvella]

Hello Rod, I tried it on a different computer and it works - Thank you very much

[Clutter in reply to Kitten-whiskers]

Just tried and voted. Link is working, Kitten-Whiskers. I've tried both and didn't find any difference but I'm less likely to forget to take a dose if I take in the morning. I do occasionally forget the 2nd T3 dose I take at night.

[Kitten-whiskers in reply to Clutter]

Hello Clutter,

Link is working on my vista laptop - thank you.

Do you think their is any benefit in taking the Liquid T4 in divided doses? I ask because it stays in the body for seven days.

Thank you

[Clutter in reply to Kitten-whiskers]

Kitten-Whiskers, I think it should be taken as directed. How much have you been prescribed?

[Kitten-whiskers in reply to Clutter]

The doc said it would be 25mcg daily - their is no way I could take that amount daily or any amount really

[Clutter in reply to Kitten-whiskers]

KW, there aren't fillers in liquid thyroxine so you may not have the reactions you experienced with tablets. I'm afraid the only way to see if it will help you is to try it.

[Kitten-whiskers in reply to Clutter]

Hello Clutter,

I do agree completely but with all the terrible sympoms Thyroid medication causes me I am to frightened to go along with the every day scenario. I did try the westhyroid pure which never had the fillers in but the end result was the same. I do think my stomach problems are causing the medication not to be taken up properly, so from the liquid point of view I maybe able to take more.

I haven't had any Thyroid medication since the 01st of July.

Best wishes

[Clutter in reply to Kitten-whiskers]

KW, I know how frightened you are of suffering adverse reactions but if your surgery agrees to prescribe it you'll have to try it to see whether it will help you. You could discuss with your pharmacist whether taking fewer drops than the prescribed dose is advisable.

[Kitten-whiskers in reply to Clutter]

will do, thank you Clutter

[gabkad]

Kitten-whiskers, levo is absorbed in the jejunum. The pill has to make it past the stomach and duodenum first. Best case scenario (apparently) is that 80% of the medication is absorbed at this location. I just read this recently in an article about surgery on hypothyroid patients. It would appear that absorption varies between individuals and also if there is food consumed with the medication.

This is why people on this forum recommend that you take the pill with a full glass of water on an empty stomach in the morning and wait for 1/2 to 1 hour prior to eating breakfast. The volume of water will wake up the digestive tract and result in movement which will move the pill to where it will be most effectively absorbed.

If you take the pill at bedtime, you have to ensure that you have not eaten for a few hours. This way, during the night, the pill will move down into the jejunum. Digestive tract movement slows during sleep so the medication will have more time in contact with the jejunum tissues to maximize absorption.

Various disease states such as Celiac disease, Crohn's and small intestinal bacterial overgrowth etc. will affect how levo is absorbed in the jejunum. This is why Clutter recommends that people try a gluten free diet and see if they feel better and absorb their medication more effectively. Any condition that upsets the functioning or anatomy of the jejunum will have an adverse effect on absorption.

A study done in Italy showed that taking levo with coffee reduces absorption by 30%. I don't know by how much absorption is reduced by calcium containing foods or by iron but these also have a huge impact.

T3 is a salt. Food does not impair absorption which is why T3 can be taken multiple times per day with no reduction in effect.

[gabkad in reply to gabkad]

Oh yeah, forgot: it takes several hours for a dose of levo to be absorbed. So taking it at night is probably a really good idea since adding food on top of the dose even if it's an hour afterwards, might reduce absorption.

[Kitten-whiskers in reply to gabkad]

Thank you Gabkad, lots of fantastic information. I have stomach problems and absorbing the medication is a real issue for me, so I think I will try it at night with a glass of water. I took it in the morning because of my adrenals but that hasn't worked. I am hoping to be allowed to trial the Liquid T4 but the surgery is still deciding if I am allowed it. Thanks very much (lovely kitty your holding)

[gabkad in reply to Kitten-whiskers]

She's my 'boss'.

[Kitten-whiskers in reply to gabkad]

absolutely, my cat is also the boss

[helvella Administrator Thyroid UK in reply to gabkad]

gabkad,

T4 (as the medicine) is a salt. But food most definitely can impair its absorption.

Levothyroxine sodium is the sodium salt of the levo isomer of the thyroid hormone thyroxine.

fda.gov/Drugs/DrugSafety/Po...

I get the feeling that adequate research simply has not been done on the impact of food in general, and specific foods in particular, on T3. Certainly it appears to be less affected than levothyroxine but I am suspicious that at least some foods impair absorption.

Rod

[gabkad in reply to helvella]

Rod, that is a bummer because I am taking Cytomel every 8 hours and the middle of the day dose is not usually on an empty stomach. Thanks for letting me know. I'll have to figure out something to schedule meals. There is no data on what percentage of T3 is absorbed under 'ideal' circumstances. Unlike with T4.

It makes sense though what you do by taking it at bedtime. Slower transit time during sleep will help to ensure maximum absorption. My work schedule makes leaving several hours between the evening meal and bedtime difficult to take levo this way.

[helvella Administrator Thyroid UK in reply to gabkad]

Whenever I have tried to find information, I end up realising that most of the information is simply extrapolated from levothyroxine - or based purely on the assumption that there isn't an issue because no-one has reported an issue! Absolutely useless as a basis of any form of decision making.

There is some information on typical absorption - but cannot remember where. It was a higher percentage than with T4 but still less than 100%.

Rod

[Hidden]

I have coeliac and pancreatic exocrine insufficiency. I take ndt with food because i figure that the creon will help it be absorbed

[gabkad in reply to Hidden]

Bluedaffodil, I think the most important thing about dosage and blood levels is that circumstances need to be consistent. If what you are doing works for you then it's the right thing to do. What is 'creon'?

[Hidden]

Creon is the medication for pancreatic exocrine insufficiency. It contains enzyms so that you can digest your food/

[Hidden in reply to Hidden]

How do you get a diagnosis for this? I also have Celiac and I feel I do not digest very well.