Forgot to take my Levo!!

[Diyena]

I forgot to take my levothyroxine this morning! so think I might take them tonight before bedtime instead and see how that time works for me. The question being when I have my next blood tests in 4 weeks, ( in the morning) do I miss the night time one prior or still take it?

[Jefner]

I would leave a clear 24hrs from meds before having bloods done hon. How are you doing?

[Diyena in reply to Jefner]

I'm actually doing great! I feel nearly normal ( if I ever was such a thing) since upping to 75mcg and my massive Vit d doses. I'm also taking vitC, iron, b12, b complex.

[Jefner in reply to Diyena]

that's brilliant hon, really pleased for you. I am still at the bottom fighting my way up again. Not just Hashi's, now my adrenals are shot and I am under the wing of a nutritionist, just completed my 2 day detox and on a strict diet for the next 14 days

[humanbean]

If you usually take levo at night time...

The day before a blood draw, don't take any levo. The day of the blood draw, arrange it to be as early as possible. Take levo immediately after the blood draw, and then again at night time as usual.

Bear in mind that some people only take their levo once a week. It isn't time critical.

[marsaday]

I take mine at bedtime and so if i get a blood test i will ask for it to be done later in the day if that is allowed. I know they like bloods to be done in the morning, but i reckon they would find an afternoon appointment if needed.

[Jazzw in reply to marsaday]

The thing to take into account with afternoon blood draws though is that TSH will be at its lowest in the afternoon, so if you're hoping for a dose increase you're less likely to get one if you have a doctor who only believes in TSH readings. TSH readings are at their highest first thing in the morning.

[marsaday]

I don't think that is true. TSH increases through the day and is highest when we go to sleep. We then make the T4 in this period of sleep for the next day. T4 is then highest in our system in the morning and so TSH will be at its lowest.

I may be wrong, but this is how i understand the hormone cycle works for thyroid.

[humanbean in reply to marsaday]

Free Triiodothyronine Has a Distinct Circadian Rhythm That Is Delayed but Parallels Thyrotropin Levels

press.endocrine.org/doi/pdf...

If you look at the graphs on page 2 of the above link you will see that TSH and FT3 are highest in the middle of the night. But since people don't get blood taken for routine testing in the middle of the night we have to get it done at the highest point for TSH during the working day. And that is as early as possible in the morning.

[marsaday]

So i am correct in that TSH is highest as we go to bed and then into the night.

Looking at the TSH graph though shows the TSH is 1.9 at 9am and 1.4 at 3pm, so not a huge difference. Essentially the TSH is in the same ballpark area. So i would say getting the blood test in the morning is not that crucial.

Would a doc change meds or prescribe if the TSH was 5 at 9am but 4 at 3pm ? I doubt their prescribing would differ that much.

[Jazzw in reply to marsaday]

It might make all the difference in the world, actually. I've had to persuade a doctor to prescribe medication for their so-called borderline results in the past., and that one number difference proved pivotal.

Anyway, apologies for writing "highest" rather than "higher". I was on a train and was more interested in getting the point across that an afternoon blood draw might give misleading results than accuracy.