Splitting dose times

Hi all, just a quick question. Those of you who take your thyroid twice daily, when do you take it an hour before meal or two hours after?

I'm taking NDT and noticed a major fatigue at 5pm every day...at what time do you think would be best for the second dose to combat this? I'm wondering if I cut my dose and take half in the am and half in the evening, or is my body just needing more of the dose I'm on. I'm sorry if I can't explain this right :(

18 Replies

  • Leilany, try splitting dose and take the 2nd dose 60-90 minutes before your 5pm slump. If it doesn't help you may need to increase dose. I take morning meds when I wake but I don't have breakfast so it's hours before I eat. Bedtime dose I try to take 2 hours after eating but a snack does sometimes get in the way.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thanks clutter:)

  • I split my NDT into 3 doses,

    one when I get up probably nearly an hour before breakfast,

    another end of morning but at least half an hour before lunch,

    and the other between 4 and 5pm.

    That way keeps topping up the active T3 in the NDT.

  • Thanks! How much are you taking? Just outbid curiosity. I just started 60mg np thyroid, but I have to wait 4 weeks to see if I need an increase. How long is shelf life for t3? I heard it was 8 hours

  • I'm on 1 and 3/4 grains of NatureThroid which seems to be the same strength as NP Thyroid (according to ThyroidUK website).

    My first dose is 3/4 and the other 2 are 1/2s. I buy the 1/2 grain size pills so it's not as complicated as it might sound!

    The T3 will go up as it gets absorbed and then gradually go down so the later doses top it up a bit. You may have to experiment to see what timings work for you.

  • Yes I will def see what works thanks! Were you on synthetic before? If so how much? I'm wondering because my doctor thinks that 60 (1 grain) is equivalent to 88mcg in synthroid, that's what I was taking before. We will see if I need more next draw though

  • My Doc told me that NatureThroid 65 is equivalent to 100mcg of Synthroid. I just had my dose raised I know take 65 in the a.m. and 65 in the afternoon. Also has anyone had a problem with itching from NatureThroid???

  • That is what is usually stated on the websites of manufacturers of desiccated thyroid.

    The general view of people who have converted seems to be that the 1 grain = 100 micrograms has been chosen as a safe conversion. If you change from levothyroxine to desiccated thyroid at that ratio, you won't be likely to overdose. But you will probably have to increase your desiccated thyroid dose a bit as you gain experience.

    The "real" conversion seems to end up nearer 1 grain = 75 micrograms - but does vary from one person to another.

    Warning: If you were converting from desiccated thyroid to levothyroxine then the 1 grain = 100 micrograms conversion factor could see you significantly over-dosed.

    ҉ helvella ɐllǝʌlǝɥ ҉ helvella ɐllǝʌlǝɥ ҉ helvella ɐllǝʌlǝɥ ҉ helvella ɐllǝʌlǝɥ ҉

    Disclaimer: I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • I don't know much about Synthroid (I'm in UK). Google for Synthroid conversion chart. It seems your doc is about right, but that's only to get you started. As I understand it, Synthroid is levothyroxine and only contains T4 but NDT contains T4 and T3 so the way your body reacts may be different.

    You may find this link helpful


  • What do the instructions say on the leaflet of your tablet? I thought the dose is once per day. I do know, however, that some split doses.

    I don't see the reason for splitting doses of any thyroid hormones. First you cannot get on with 'living' and forget you've got a health issue. You've to find a 'window' sometime during the the day, i.e. 2 hours (maybe 2.5 hrs) after eating and about 1 hour afterwards. I doubt this could be 'exact' every day. So I think lives would revolve around being 'hypo' remembering to take the tablet - and times might well vary.

    Would it be difficult to 'titrate' a dose gradually upwards till you feel good? Say, for instance, you start on 1 gr. and a few weeks later add 1/4, etc etc.


  • Good advice Shaws. I have titrated upwards twice now to the point where I feel good. The first time I was shot down by my doc who said, "Oh, your TSH is too low I am going to reduce your dose!" My TSH has been non existent for eight years (and my bone density improved and I have not had one palpitation nor fast pulse). The second time is the present, and this time (with a different doc) there is no way I am changing my dose and I don't give a flying fig what my TSH is at, it can be minus 72 for all I care, I feel great and that's the way it's going to stay.

  • I am the same, one a.m. dose and I haven't had any of the ill-effects I had with levo, thankfuly.

  • Instead of worrying about taking it before or after food can NDT be taken under the tongue or chewed?

  • Hi Leilany,

    Yes, I have been wondering about that. I have been experimenting with doing the "under the tongue" way but I noticed that a large amount of saliva slides down the throat, presumably carrying a large dose of the NDT with it. So I guess you do get some absorbed but you get a lot entering the stomach - and therefore wasted if the stomach is not empty.

    We were always told to drink lots of water with Levo so that it doesn't stick in the throat and get absorbed by the esophagus lining - which could ultimately cause an ulcer. So does this also apply to the under part of the tongue?

    Anyone know about this?

  • As far as I know thyroid hormones are too large a molecule to be used sublingually. Therefore, you might not be getting the dose you think you're taking:-

    To explore the issue further, Geri Rybacki, Executive Director of the Coalition for Better Thyroid Care and I both talked to a variety of doctors, drug companies and other experts, to get a sense of the professional perspective on the issue.

    The consensus? The active ingredients in thyroid medication have molecules that are so large that it is difficult for them to pass through the mucous membranes.

    Most of the dissolved/crushed medication ends up swallowed, and moves through the digestive system in the usual way. Other factors also affect sublingual absorption, including oral pH, and salivary enzymes.

    Thyroid expert Kenneth Woliner, MD in Boca Raton, Florida said that some medications are designed to be taken sublingually -- for example, drugs that need to be fast-acting, and when where seconds count (like nitroglycerine, used to treat angina and heart attacks) -- and have a molecular structure that lends itself to sublingual absorption.


  • Thanks Shaws!

    I have wondered about that for a long time. I used to have a friend who had once had a heart attack and showed me where he kept his nitroglycerine in the remote event that he should have another (he did not). He instructed me to break it/pour it? under his tongue. I have read (here) that quite a number of people take thyroid sub lingually and wondered if it worked the same way. Thank you so much for clearing this up.

  • See the link I've given below.

  • Article really interesting. I think I am going to keep taking the Armour in the classical way (1 hr before breakfast etc.) but I think I will chew it up a bit first before I swill it down with lots of water - this way it will give it an even better chance of being absorbed by the gut and not having any residual undigested lumps getting excreted.

    Gosh, I didn't know there was so much to the simple act of taking a pill.

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