You can't take calcium or eat dairy within 4hrs of thyroid meds and you can't absorb iron foods within 4 hrs of taking calcium or thyroid. Iron and calcium lower absorption of throid. How do people space all this out in day?
timing meds with supplements: You can't take... - Thyroid UK
timing meds with supplements
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Nicole6
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Hello Nicole. I have the same difficulty, especially as I divide my NDT into 2 doses. Sometimes I get the timings wrong and can't leave the recommended timing gaps between my meds and of course eating! So I prioritise with NDT and warfarin and slot supplements in when I can. Sorry, not much help but an acknowledgment of your dilemma.
The half life of T3 is 8hrs max (although I have read other numbers). I take my main NDT between 5 -7 am. This means that my T3 will be minimal by 3pm (when I loose my energy and feel sleepy). I take a second minor dose at noon and have moved my lunch time down to 1:00pm. This way I fulfill the empty stomach requirement and feel wide away beyond supper time - after supper it doesn't matter if I am full of energy or not.
If you are on NDT you don't need to avoid food. It's only levothyroxine that is a problem and not four hours. Honestly, I don't know where some of these rumours come from.
Take levothyroxine when you wake an hour before eating.
I found it best to take at night two hours after eating.
I don't think this is entirely true, but I may be wrong. NDT has T4 just like levothyroxine and taking it on empty stomach is to give either medication the advantage over any other material competing for your stomach acid and subsequent absorption process. If you take it with food in your stomach you will not get the full dose.
If you make your own T4/T3/T2/T1/calcitonin, does your body wait until you haven't eaten? No, didn't think so. The difference is that NDT is natural, plus I chew mine so some is absorbed sublingually.
Wow, that's a complex subject and I think the answer is yes, it does.
We all know that when our T4 and T3 drops the pituitary secretes TSH and causes the thyroid to make more T4 and a little bit of T3. The pituitary acts like a thermostat. However, the pituitary in turn is controlled by the hypothalamus (an organ in the brain) which has the power to switch the pituitary on or off by releasing TSH Releasing Hormone (TRH). In addition to this control the hypothalamus also gathers information about and controls the body's temperature, thirst, hunger, sleep, mood and sex drive. It is quite the microcomputer! Now, since it has information about the body's hunger and thirst status I do not think it would generate the Ts if the body is not receptive to it.
But, look, if it is working for you, stick to it. There are so many variables even the Endos don't understand everything as is evidenced by blog sites like this with thousands of people being mis diagnosed on Levo and other synthetics while NDT (a proven winner) is discouraged. Now multiply those thousands by the number of blog sites and you realize there is a BIG problem. I wish the doctors would read these blogs.
mistydog,
I am on t3 only. My endo just told me to take 25mcg twice a day. He didn't say anything about an empty stomach. He just assumed I knew something. Do you know how to take it? I could just look it up but I went by the 4 hr thing I read in the instructions for Armour., I thought it would be the same.
I'm on NDT so I don't know about T3 but if it is working for you, keep doing it
still get a tight feeling in my neck about 9 hrs after my last dose of t3. It has been 2 weeks since I started the 25mcg at about 4am and 25 at about 11am. I get an ultrasound in4 weeks to the lumpy thyroid. My endo isn't saying anything.. The lumps were there in May and still there 2 wks ago.
Hi
some people take thyroid meds before going to bed. I never stick to correct trimmings it's impossible, especially as I have migraine often and also have to take pain killers. Dont worry too much I've read loads of different articles some say say 30 mins some say 2hrs, 4hrs!! Just space out as much as you can.
good luck
Do painkillers interact with absorption of levo too? I usually take ibuprofen (as it's usually for my joints) most days, rather than paracetamol, so tend to time it with food anyway....good to know though.
You might find that your joint pains are due to under medication of Levo, it was in my case. Get all of your numbers and make sure you are "making" T3 as well as getting T4 from your Levo. Low T3 is the factor which causes the debilitating symptoms.
When I had joint pains my GP sent me to the "arthropod" who said I had arthritis and wanted me to take pills for it. I had so much pain I couldn't walk around my supermarket without pushing around a cart to lean on, I felt 100 years old. I didn't take the stupid pills because I "felt" something was wrong with the whole deal . When later I switched from Levo to NDT (for the T3) all of my joint pains disappeared within an hour and I can now run when necessary (like across the road). There are so many terrible things mono therapy of T4 will cause you, read up on it then probably get another doctor since s/he wasn't aware of this side and very common symptom.
Thanks for that, but it is unlikely, as my T4 and T3 are both optimal (T4 could be a couple of points higher, but that would probably send my T3 over range). Saying that, the endo I have seen (who prescribed The T3 - I have conversion probs) told me to experiment as I was still not feeling well at our last, and final, meeting. So I have actually added 50mcg extra T4 every other day for past 2 months....still not feeling great though, so I'm going to try T3 only when I run out of T4. Hope something makes me less tired!
Anyway, simialrly to you, the doctor has referred me to the hospital to look at my bones for the joint probs (not until October though, so a little time to experiment).
I'm also dosing up with iron and B12, as these were in middle or lower part of range when tested 3 months ago. Also taking Omegas as endo said some people feel better taking these.
This is just anecdotal but it is on topic and worth saying.
After I had been to that "Arthropod" and I wouldn't take the pills, I begged for and got an MRI - just because something didn't seem right. He looked at the MRI and he said, "Look, are you convinced now, you have bone on bone arthritis!"
And you know something, that was BALONEY. My knees are normal now, I just don't know how so much mis information and errors get perpetuated. Maybe they are just too busy. Maybe he was just looking at the MRI - I couldn't see b on b anyway, but I'd never seen one before. Maybe I should have just looked for my name on the screen!
I take my Levo & T3 with Vit C first thing on waking.
Have some sups with breakfadpt but don't take calcium until lunchtime.
Then have second dose of T3 about 3pm.
Then rest of sups with dinner.
Zinc & 5HTP at bedtime on an empty stomach.
F
Both chemists and doctors have told me it is 4 hours
I take my thyroid meds at bedtime and my other medications during the day spaced out accordingly. I find this the easiest way to do it 😊
I asked the chemist if it matters taking levothyroxine at night and she said that it could keep you awake?
I find this a real pain! Why can`t Levothyroxine come in patches like HRT?
I spoke with the chemist, he said leave 30 minutes before food. But if I had been doing it differently then to carry on that way.
I take my thyroid meds last thing at night on an empty stomach. They seem to absorb much better that way too.
The two supplements shouldn't be too hard to schedule this way.
t3 can keep you awake. I started setting my alarm for 4 am , breakfast at 8 with calcium, mag and multi-vitamin/mineral. 2nd dose of t3 about 1130. Lunch at noon. Lunch is low iron and calcium. at 4pm take calcium /mag. High iron dinner at bout about 8pm. no dairy at all. 1/4-1/2 cup sauerkraut 3 times a week for GI bacteria. That's the plan anyway. Hope I can stick with this. I'm not converting t4 to t3 and I'm reading that a lot of that is in the intestinal bacteria. So I'm reading about food combining. You read a lot of conflicting information on what you can combine.
Don't forget you don't necessarily have to take every supplement every day - if you have limited "supplement slots" in the day you could maybe alternate different supplements from one day to the next to avoid taking ones that interfere with each other's absorption together.
I have osteoporosis and take calcium at breakfast and before bed, as this is recommended to offset bone density loss that happens mostly during the night. So I have to take my levo between 2 and 5 am, which John Lowe apparently advised his patients to do. I'm also taking Nutri Thyroid, which has to be taken with a meal, so I take that with my lunch, but I don't know whether any foods/sups interfere with that.
I tried taking Levo at night and was totally unable to get to sleep, now I take it in the morning and I am sleeping well again. We are all different - you have to try different times of taking to see what fits in with you.
I leave my thyroxine by my bed. When I get up in the night for a bathroom visit, I take the tablets. By the time I get up and am ready for my breakfast and other meds, usually more than four hours have passed.
I don't always manage this and do frequently take my meds too close to having taken others, but I have been doing this for over 20 years, and come to no harm. Blood tests are always OK.
Em xx
I do exactly the same thing. I am half asleep for the bathroom visit/thx pill-take(NDT) so I hardly notice anything, it's all automatic and I don't think about it during the day at all. - Oh and I feel great, with no complaints.
i take my thyroid tables just after i get up and hr before food i only drink water for an hr as well after ive taken them
Like several people on here, I have 5 slots in the day: At waking, with breakfast an hour + later, with lunch, 2 hours after lunch, then at bedtime.
When i first started taking the "with food" set I had to start setting an alarm to make sure I had lunch. Before that I would have only really had breakfast and supper. It's hard to squeeze it all in if you've got fatigue that means you're only awake for a short day. I'm now up for about 10 hours, but it has been much less at times. I guess you just have to set an alarm during your "night" to take one of the batches.
I take levothyroxine (125mg) as soon as I wake, then liothyronine (20mg) 1/2hr later. 1/2 to 1 hour after that I have breakfast with Omega 3/6/9 sup, at lunch I take B Complex and B12, then I take Iron & Vit C with my tea/dinner in the evening (or sometimes I forget and have it at bedtime). I take all my Vit D sups once or twice a week since they have a long half life. Fairly new to this and not sure the sups are helping, but I'll give it a while longer before giving them up.
I've heard about lots of time gaps, but general consensus seems to be meds 1 hour before food, Iron at least 4 hours after.....saying that, my dad is on levo and takes it with his breakfast & coffee and is fine!
Hi Nicole, it is difficult to find good information about this because the only real information I found was this:
Calcium supplements, particularly calcium carbonate, interfere with your body's ability to absorb thyroid hormone. In 2001, researchers with the Veterans Affairs Greater Los Angeles Health Care System measured thyroid hormone levels in seven study volunteers when levothyroxine, a common thyroid medication, was given both alone and with 2 g of calcium carbonate. When the subjects took levothyroxine by itself, they had absorbed 83.7 percent of the hormone after two hours, but taking the medication with calcium carbonate reduced absorption levels to 57.9 percent.
I also think the minerals are very hard to break down and demineralize unless you have enough acid so taking it before your hormone may definitely interfere, but if you take your hormone first, I don't think it needs four hours or even two hours to pass through the stomach. I don't know why they don't consider that. I don't think that research study is very helpful if it only sampled taking both pills together.
For what it is worth, I feel my NDT hit my blood stream about 1/2 hour after I have taken the pill. It's like drinking cold water on a hot day, you feel it trickling through all your veins.
I have had to take thyroxine for 40 years and just recently stumbled on all these dos and don'ts so all the rules I haven't followed. I take my thyroxine first thing but sometimes I have breakfast at the same time which is usually oats and milky coffees to follow with a multi A-Z supplement. What should I expect from doing this?
I've got a friend who has always taken hers with coffee. I think her dose is rather high, and that nights be because its been adjusted to take that into account.
If think the best thing to do is make sure you do the same very day. It's supposed to reduce absorption by about 30% but I think that's a big simplification. So you don't want your dose jumping that muchall the time. It will probably be stopping your body getting settled.
Lack of efficient absorption.
I take my supplements (multivitamin, Magnesium, Calcium, Biotin, Zinc, Vit E, Evening Primrose Oil, Biosil, Sea Buckthorn Seed Oil) with breakfast, along with my first dose of Plaquenil (I have lupus and Sjogren's). I take iron and vitamin C at noon or 1:00pm. I take levothyroxine and my second dose of Plaquenil at 4:00 or 5:00pm along with D3 and some crackers.
This schedule doesn't affect my sleep, hasn't caused any weight gain nor has any meds interference.
When I was taking T3 (I stopped a few months ago since it was determined that I didn't need T3 and I do much better on Levo alone), I was taking the T3 in the morning with everything else at breakfast.
I know my method is contrary to what many of you do. I see a private endo here in the states (Dr. Kenneth Blanchard) and his experience has been when patients follow the schedule I am on, they don't gain weight like folks are prone to do when they start on thyroid meds. All I know is that it works for me.
To keep everything straight, I have my meds/supps in pill minders and also have reminder alerts/alarms set on my iPhone.
What I do to remember to take my meds on time is to set the alarm on my phone and indicate which med to take...it works well most of the time...although I was at a movie yesterday afternoon and my alarm went off...which was not cool...but I just went to the lobby and took my meds...that is what works for me
Nicole, it's okay to take thyroid meds an hour before, or two hours after, food and drink, including dairy. 2 hours away from most meds and supplements and 4 hours away from iron and calcium supplements, vitD and oestrogen.
I hadn't realised the four hour rule applied to vitamin D! Will have to add that to the night time supplements list.
Sarah, vitD is best taken with food, ideally the fattiest meal of the day, for maximum absorption.
Hi Clutter - only just seen this (one year on!), does this also hold with taking Magnesium Glycinate or Magnesium Malate supps do you know? Would it need to be two or four hours after the Levo for that too? Thanks.
Clarabelle17,
I'm sure I've read magnesium should be taken 4 hours away from Levothyroxine.
I didn't know this. For the last 3 years I've taken my Levothyroxine in the morning and ate cereal with milk pretty much straight after. I don't feel any different but then to be honest I don't feel any difference with how I felt before being prescribed Levothyroxine 3 years ago.
And you shouldn't take iodine within 2 hours of vitamin C either... Well we just try to do it.. most important is your thyroxine so take that one first thing.. then take any calcium at lunchtime... eat a high protein breakfast with eggs so don't need iron supplementation and avoid dairy altogether (and gluten) forever.. That's what I do.. some people actually prefer to take their thryroxine at night.. and if you're on T3 there is research on circadian rythms that mean you should take it at 3am or something daft.. Basically it's hard.. and you might forget, so get the thyroxine nailed, don't forget that and don't stress if you miss one day of something else... we all get in a pickle sometimes or have working days away where it just isn't possible.
I was told you can eat with t3 meds but NOT with NDT,
you do need to wait 4 hours to take vitamins or 30-60 min after eating and treat it the same way as synthetic t4 if you want it t absorb appropriately .....because if you change and eat with it, then you will be the person that gets hypo or your dose increased and if you are not consistent...in eating or not, then you can travel between hyper and hypo after dosed increased due to eating etc.....
leaving water beside your bed and taking it before you get out of bed and then 2nd dose 3pm.....mid afternoon but not later so it wont keep you up at night
jacr,T3 meds also bind with the proteins in food and drink. ALL thyoid replacement should be taken away from food etc.
The European Thyroid Association recommend the largest dose of T3 is taken at night as it will more closely mimic natural circadian rhythms where FT3 is highest between 2-3am. I take my 2nd dose at bedtime. Many patients find T3 at night improves sleep.
in reply to Clutter
It's interesting you mention taking T3 at night. I've recently started taking 3/4 of a grain of Armour at around 11.30pm (instead of taking it on a morning) and have noticed I wake up feeling much more human and refreshed!! Long may it last.
Clutter in reply to
EpicSwan, T3 is out of the serum around 6 hours after last dose, so last dose at 2 or 3pm is a helluva wait for the next morning dose. Once FT3 levels are good people are less conscious of T3 wearing off and may be able to manage on once daily dosing, although I prefer the gentler peaks of 2 x daily dosing.
in reply to Clutter
Clutter, Yeah that's what I was doing at those timings you post and waking up shattered around 5-6am. I have noticed I do feel quite knackered with brainfog around about now (6pm) until I take the Armour (11.30pm), which goes with what you're saying.
Clutter in reply to
EpicSwan, fiddle with your dosing and timings. Something around 4pm should help the 6pm slump with a little less at 11.30pm.
in reply to Clutter
Clutter, I will have a fiddle with dosage and timing. I do find it quite hard on a night time as I take vits/minerals usually around 6-7pm and leave 4 hours either side. Not sure if I need to leave as much time though.
Well...this is all news to me! I take all mine together about 30 mins b4 breakfast! Levo, vit D, calcium, multi vit , water tablet and something else I've forgotten! No doctor has ever advised me about timing! Have just been diagnosed with Poly Rheumatica so now they are talking steroids which I am fighting against! Anyone know of any alternatives?
Same as me Content1. I have had no such advice by my gp or specialist about timing my meds/food or which foods to avoid as a whole. I was just told to take them first thing in the morning. I think that SilverAvocado was right when she said just keep everything the same.
if you do take with vitamins....calcium etc.....then most likely you are not getting your whole dosage aborbed in your system and therefore you will start to get body aches etc or hypo symptoms....also don't take the morning before blood test and take blood test 8am with water only.....If you google your medicine info sheet online, it will tell you not to take with vitamins, calcium, iron,vit d
etc because they block absorption of the pill.
I am following the suggestions made by Mary Shomon (take all hormones at bedtime) and/or Paul Robinson (use T3CM: take hormones during the night). I am on a T3+T4=15+75 program, and since my T3 dose isn't huge, taking it once a day works fine. (Although the late John Lowe supposedly took a T3 dose of 150mcg one time per day - hard to believe!) I imagine you could use one dose per day with NDT too, depending on how you respond to T3. However, if you are not deep into recovery - that is, if you haven't reached full wellness - then once/day might not work. If you are deep into recovery, which I am, then you can take one dose per day and you won't feel noticeably different after taking it.
I'm assuming you are not on T3-only. While I was on T3-only, doing 5*12.5mcg doses per day, it was super difficult. I purchased a watch that had multiple alarm settings so I could remind myself via wrist vibrations. And I wasn't using iron while on T3-only.
I've just started on a supplement regime this week as I am deficient in various things. I take my 125 levo at bedtime and have been taking iron and vitamin C, Vitamin D, B12 and B complex first thing. Does that sound ok? All very complex!
I take my meds first thing followed by breakfast, coffee and a multivitamin without problems Vic198
This is just a passing thought:
So many people are saying that "I am not a good converter of T4 to T3" that it makes me wonder if it is the pill that is not "breakdownable" - or the reverse, the pill degenerates before it hits the peripheral organ (say the liver) so that when the patient deiodinases it to T3, the result is not T3 - close, but it is not the molecule that our cell receptors will accept.
It would be interesting to find out if one manufacturer makes this mistake in the synthesis of it's T4. It could be that one manufacturer doesn't break down yet another has weak bonds which disintegrate too soon. It would be quite difficult to gather the data for this analysis.
Whichever it is, they haven't got it quite right yet.
That's an interesting idea but I tried Naturethroid and Armour. I don't know how my endo came to that conclusion but I'm on cytomel only anyway.
LAH, there is evidence to show that some patients cannot convert sufficient T3 on Levothyroxine only. It's nothing to do with how the tablets break down.
endocrineconnections.com/co...
thyroiduk.org.uk/tuk/TUK_PD...
ncbi.nlm.nih.gov/pubmed/191...
Wow, thanks Clutter. I have read them all and printed the first two out so that I can study them. It is very encouraging that research is being done on this conversion problem. I was also glad to read that post surgery patients will "normally" have low TSH and low T3, so trying to cut back on T4 via whichever pill you take will just exacerbate the low T3 and therefore low feeling of well being because you will have less source material to work with.
You have kept me busy for the next two days, they are fascinating reports full of info. Thanks.
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