Hi
I just wondered if the medicine in the Levothyroxine tablets was equally distributed.
I was told to break my tablets by one doctor and then warned against it (saying the medicine was not equally distributed).
Can anyone please advise on this point.
Many thanks 
Doesn't matter one way or the other. If you take one half of the pill you break today and the other half tomorrow, it doesn't matter. T4 has such a long half life, taking a little bit more today and a little bit less tomorrow makes no difference. Some people, who are poor at taking their meds every day, are told to take the whole week's worth of T4 at one time.
I would be really worried about taking nearly 700 T4 at one time that would be a huge dose .... I thought if I missed a dose one day I was not supposed to double up the next day.
A while ago I linked to an excellent endocrinologist's essay about patients who don't absorb T4 well and how he gives them hundreds of mcg per day just to have them at normal blood levels. But that most endos would suspect that these people were not compliant. He wrote that patients with compliance issues are asked to take all the T4 in one dose once per week.
A while ago I linked to an excellent endocrinologist's essay about patients who don't absorb T4 well and how he gives them hundreds of mcg per day just to have them at normal blood levels. But that most endos would suspect that these people were not compliant. He wrote that patients with compliance issues are asked to take all the T4 in one dose once per week.
I have been told by pharmacies not to cut tablets but I have to cut T3, as it comes in one strength only under the NHS. I make sure I use the same cut tablet until it is finished and do not hop about between different cut up tablets. I figure that this way, I shall get all the potency at some point. As a matter of interest, why do you need to cut Levo, as it comes in so many sizes?
Hi
When I get Hypo symptoms I prefer to increase my Levo by 12.5 (splitting a 25 tablet). My needs seem to fluctuate with activity and perhaps approaching menopausal variations.
Going to try adding T3 instead, too.
Can you get 25 mg in levothyroxine??
I was told that the minimum is 50 and you can’t get less than that.
I take 50 but have recently started cutting in half.
25 microgram levothyroxine tablets do exist.
12 (or 12.5) microgram levothyroxine tablets also exist.
But they are only available in some countries, and some makes.
In the UK, both 25 and 12.5 microgram tablets are available, but only from some companies. And 12.5 microgram tablets are relatively expensive.
I don't know where you are!
This document might be of some interest:
dropbox.com/s/cag4qidukqeb8...
Oh thank you.I am in the uk.
Lots of people do break/cut their tablets.
We have seen suggestions that manufacturers advise against doing so because the active ingredient may not be evenly distributed. However if you are careful to avoid losing any crumbs, and take the first half one day, the second half the next day, I doubt the difference is significant for levothyroxine. After all, the alternative will likely be to go for alternate day dosing which would be a much greater day to day variation.
Ironically, some people have reported pharmacies splitting batches of tablets. That would be worse because you could end up taking the big "half" of every tablet day after day!
If the manufacturers care about it that much, let them release 10 or 12.5 microgram tablets!
Some makes (e.g. the USA product Levoxyl - but no UK make) are actually designed to be easy to break.
Rather than splitting the tablet, I take 100mcg on one day and 125 on the next. I have to put them in a weekly pill box though as otherwise I forget what dose I've taken the day before!
Yes, I need to work out my dose as 100 seems ok for a while but then, it seems with activity, I get hypo.
I've decided to keep a diary and work it out myself based on how I feel as I'm sick of the doctors and all the incompetence I've been through this year (all in earlier posts).
I read some threads on here that seemed very cautious about dose changes but your suggestion would suit me better.
Thanks a lot
When I start a new pack, I get a sharpie pen and write the initials of the day on the blister, Sa,S,M,T etc I don't know if this system might work for you? Writing Sa,M,W,F etc on one then, Su,T,Th etc on the other?
I know it sounds pathetic, but this is the only way I can remember for sure if I've taken my tablet!
Sounds pretty good to me! It's so easy to forget and we have to be organised with our condition...
Thanks for the reply
Of course it all depends on us remembering what day of the week it is ha ha!!
Actually on a more serious note, I've just reread your post - and the very reason I joined this forum was because I enjoy sport but I do find activity can really knock me for six and it can take days to recover if I push myself. I never managed to find anything on this, but I am convinced that because we cannot control our metabolic rate, we don't manage sport so well. I seem to be okay once my fitness levels are up, but getting them there is doubly hard.
Hi
If you look at some of my earlier posts, I asked about exertion and got some really interesting replies. There's also a link to a study with athletes that monitored the depletion of thyroxine and how the thyroid replenishes it as and when it is needed.
I went hypo again this summer due to extremely increased activity and now feel I need to respond to symptoms a lot quicker....or even break a 25 tablet during increased activity.
Also, in 'Stop the Thyroid Madness', the author states that those taking Natural desiccated thyroid need to increase it during times of exertion...which reflects my experience on T4. I suppose it depends on your blood storage of T4 and how efficiently it can be replaced...
Hi Ruby, I'm a runner. Apparently, we can take longer to recover from training and are more susceptible to symptoms of over training.
I found this article really interesting: scienceofrunning.com/2013/0...
I also find I need to be careful on long runs with energy intake as we're more susceptible to hypoglycaemia too.
Many thanks - I'll check that out. I used to run, but have also been into swimming and cycling over the years - but never triathlon I broke my pelvis skiing last year so have taken ages trying to get a bit of fitness back.
So nice to know I'm not the only one!
Fascinating read - and what I suspected! I have just skimmed it for now, but definitely worth a good read - thank you.
My levels have been changed so much over the last 6 months. I don't have a thyroid gland, so make no hormone myself. When I was younger I used to chop and change doses, and had no idea at all how wrong that was. Now I alternate 125 and 100 with 112.5 on a Wed and its a nuisance halving the pills as here in Uk we only have 100, 50 and 25. Perhaps I need to find a pill cutter as I find it very difficult halving the 25 pill evenly. I never thought of using the other half the following week!
I don't have a thyroid either so I'm totally dependent on the medication. Trying to find the right dosage on my now as the doctors have been so appalling! So glad I found this forum..
As most tablet presses the manufacturers use are gravity fed followed by compression there is no guarantee that the active would be evenly distributed but it would only be a minimal difference between both halves.
You might well be right - but the comment about unevenness I referred to came from one of the UK manufacturers. (Drat - can't remember which one!)
Rod
Oh i don't doubt it they are covering their backs really. I work for a company that manufactures tablets (veterinary not human) and i know it can't be guaranteed that it is evenly distributed the tablet presses and bulk powder mixers are just not that accurate all they can guarantee (through laboratory testing) is that the strenght it says on the pack is what is in one tablet.
From experience across a 500kg bulk mix there is about a 10%-20% variation in distribution weve never tested distribution in a tablet I'm not sure its possible
After being fine on 150mcg for years and years (no thyroid after TT) it all seemed to go pear-shaped. Then I was on 125mcg which was too much after a while, then alternate 125 and 100mcg. Now (worked this out for myself) I take 125 Mon, Tues 100, Wed 112.5 (I cut a tablet in half) Thurs 100, Frid 125 and Sat and Sun 100mcg. Is there a less complicated way? Alternate doesn't work out obviously on account of uneven no of days in the week. This seems to work ok but of course the other half of the tablet I cut in two isn't used again until the following week. May I also ask which is the original Levothyroxine and which are the generic ones. I am trying to get meds which are as pure as possible, without all the fillers. I feel quite energetic, no cold hands and feet, but I don't always sleep well (takes me hours to 'drop off' and now and then can be a bit full-on (overmedicated I think) I also swim 50 lengths front crawl twice a week and do yoga class twice a week, because I want to preserve my bones having had a hip replacement due to loss of calcium (didn't know about Vit D importance), had carpal tunnel (better since yoga class). Looking at a few supplements now but its a minefield as no-one wants to be 'rattling'. So grateful for this site, I have learned such a lot.
Hi
I'm in the process of working my own dose out after a number of TSH tests and hypo symptoms. I thought I'd over-exerted and gone hypo in the summer but I've just dropped again so am concluding that I need a bigger dose (dry skin, muscle aches, irritability etc).
How did you work your own dose out? Did it take long?
I'm keeping a diary with dosage and symptoms at the moment.
Trial and error actually. .. best wishes.
Hi
When you say that you worked your dose out by 'trial and 'error', was that with a doctor over every 4-6 weeks or alone?
Nadine
Alone, before I knew about this great forum and also the risks of switching from one doseage to another.
You could change to a much simpler way of doing things. Ignore days of the week. Take 100, 100, 125. And keep repeating that pattern. Over a period of four weeks, you would have taken only 25mcg less than on your current regime!
It won't be easy to read, but I will paste what I mean below. The first number is your current pattern, the second number is my simplified version.
Mon125100
Tue100100
Wed112.5125
Thu100100
Fri125100
Sat100125
Sun100100
Mon125100
Tue100125
Wed112.5100
Thu100100
Fri125125
Sat100100
Sun100100
Mon125125
Tue100100
Wed112.5100
Thu100125
Fri125100
Sat100100
Sun100125
Mon125100
Tue100100
Wed112.5125
Thu100100
Fri125100
Sat100125
Sun100100
Total30503025
Rod
Thank you it is so kind of you to type that all out. Wonder if it would make any difference having 25mcg less over that period... I seem to be just about fine on the present (complicatede) dosage.
Could always take one extra 25mcg tablet every four weeks/month? E.g. the first day of each month on which you would normally have taken 100.
I read about some tests on cutting tabs and accuracy of it. The accuracy of cutting is the problem not the tablets ingredient distribution itself but it was concluded that the levo was slow release so the slight differentials were insignificant over time.
i know this is not a good idea but i realized that i have an increase in TSH from 1.00 to 4.00 but my specialist told me to stick with the same 100mcg. my TG also changed from 0.00 to 0.02 so what i did just now, i cut my 100mcg and took the 1st half 4 hours after my first 100mcg, will take the other half tomorrow with my original 100mcg. yes, without my specialist telling me to do so. so i was thinking of looking for another specialist who is very keen with the dosage/TSH.
not sure if its just that i gained weight even before i had my TT i dont feel any side effects or issue like others have (issues not sure if its because of my weight before i had my TT, fatigue, lethargic, less energy, weight unchanged despite the workout and lean diet)
i need to have normal levels for the next 6 months as i have started working out (with whey protein intake after 9 hours of levo) else i may find it useless to workout having a 4.00 TSH level.
Cutting Accord tablet
Cutting Levo tablets 
cutting tablets into quarters
can I cut tablet in half? 
