NDT - swallow or suck -does it make a difference to dosage?

[Hypopotamus]

My brain never seems to stop coming up with more questions, and I was wondering if taking NDT subingually means that you get more of the active ingredients into your system, and therefore means that you get a higher dosage than if you swallow a tablet, and then have any problems absorbing the active ingredients through the gut.

I was taking ERFA sublingually, but switched to Thiroid which I found worked better although I was swallowing it. I have just started to try the same dose but sublingually to see what happens (if anything).

Does anybody have any thoughts on this issue?

[gabkad]

Hypo, thyroid hormone replacement medication is supposed to be swallowed with water on an empty stomach. You can mince it up between your front teeth before you swallow it and maybe smaller particles are absorbed faster this way, but sublingual is not an accepted or recommended way of taking this medication.

[Hypopotamus in reply to gabkad]

That's interesting gabkad as I know from reading these forums (and others) that many of us have taken it under the tongue. ERFA (before it was 'changed') worked perfectly well for me that way.

[gabkad in reply to Hypopotamus]

Sticking it under your tongue just means it dissolves slowly and you swallow it eventually.

[Hypopotamus in reply to gabkad]

I thought that it was absorbed directly into the bloodstream via the mouth. I can see that some of it will dissolve in saliva, and then be swallowed.

[Hidden in reply to Hypopotamus]

A study showed (can't find reference) that sublingual method for NDT doesn't work and like gabkad says you just dissolve it in saliva and eventually swallow it. This process may help absorption in the digestive system.

[Clutter in reply to Hypopotamus]

Hypopotamus, the T4 and T3 molecules are supposedly too large to be absorbed sublingually.

[Rudegirl]

I take thiroyd.. I take my morning dose with water & my next dose sublingual due to work breaks & food!!

[Hypopotamus in reply to Rudegirl]

It is convenient if you need to take a dose and don't have access to a glass of water.

[sandi]

I take my Erfa sublingually. I have experimented swallowing it with water but after a few days begin to feel more hypo. I assumed I must have a problem absorbing it from my stomach and as I have always taken it sublingually and hence my dosage was arrived at based on that method. Am reluctant to change now - is there really a problem with taking it sublingual?

[helvella Administrator in reply to sandi]

Until someone, somewhere does some proper research we will remain in ignorance of what really happens. Maybe the rate at which T4 and/or T3 rise and fall is different? Maybe the total amounts of T4 and T3 absorbed are slightly different? Maybe one (of T4 and T3) is absorbed faster, the other slower?

In my book, it is as you say, where you end up that matters. With better understanding we might be able to see why one method could be better than the other but until then, whatever works for you.

[Hypopotamus in reply to helvella]

Very true Rod. I was only saying to a Type 1 diabetic yesterday, that having a simple blood test that we could do would probably answer a lot of questions about dosing for hypothyroidism.

[Hidden in reply to Hypopotamus]

The problem with having a simple blood test for hypothyroidism is that thyroxine levels take 6-8 weeks to reach a peak serum level. Can you imagine the amount of people overmedicating if they were measuring FT4 & FT3 a few times a day? And then taking more medication? Also the circadian rhythm of T4 and TSH means levels vary during day and night. It is a good idea if used wisely.

[helvella Administrator in reply to Hidden]

Frequent testing AND understanding are required hand in glove with each other.

I suspect that at least some diabetics are concerned that the Hb1ac test, and its interpretation, are being as woefully handled as TSH...

[Glynisrose]

I chew mine!! Taken sublingually is better as you lose about a third of meds by swallowing.