Advice on taking Levo with Diclofenac, vits and minerals

Hi peeps So I'll be starting Levo (25 mcg) next week and wondered the best time of day for me to take it. I've read lots of advice on here but I have an added issue of taking Diclofenac for chronic back pain. Diclofenac must be taken with food to protect the stomach. I take 3 doses per day, or sometimes just two, depending how I feel, the first is usually around 6.30 a.m. with food, then a second dose at lunch time, the third at dinner time.

I need to figure out when I can take Levo, Diclofenac and my other vits/minerals so nothing cancels out anything else!

If I take Levo with water on waking (around 6.00 a.m., then wait 1 hr to have Diclofenac with food, would that be OK? I believe I can manage any pain for that hour with heat if need be). Then I can continue on as normal, although I may end up taking just two Diclofenac as I don't want to have to eat mid-afternoon.

The alternative is to take Levo at bedtime but I can see that being more problematic juggling things round.

Any advice?

[Clutter]

Jadzhia,

For maximum absorption Levothyroxine should be taken with water 1 hour before or 2 hours after food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

Most people will find symptoms resolve after their TSH drops to around 1.0 with FT4 in the upper range but symptoms can lag a couple of months behind good biochemistry.

thyroiduk.org.uk/tuk/about_...

[Hidden in reply to Clutter]

Thanks Clutter That would mean I'd need to wait at least 2 hrs before taking Diclofenac which might be too difficult for me. I can easily take all my vits/minerals at lunch time, so then maybe I could take Levo last thing before bed. I eat around 7.30-7.45 pm so I could take it at 9.45 pm I suppose, although not ideal as I'll be going to the loo more than once in the night I fear! (I already go once as it is).

[Clutter in reply to Hidden]

Jadzhia,

Some people take Levothyroxine when they make a night time loo trip.

[Hidden in reply to Clutter]

Yes so I read! Trouble is, what if it's one of those rare nights I sleep through? Then what? Yes I do over-think these things.

[greygoose in reply to Hidden]

Why not take it when you go to the loo in the night? But, I dont see why taking your levo at night would make you go to the loo more often.

[Hidden in reply to greygoose]

Well taking it with a full glass of water would surely mean more fluid filling up my bladder? As I replied to Clutter above, what happens if it's a rare night I sleep right through? Does happen occasionally. Then I've missed my Levo dose slot. And yes I do over-worry about these things, I know!

[greygoose in reply to Hidden]

The water doesn't drop down straight into your bladder, it has to go through a lot of processes, first. It probably wouldn't reach your bladder until the morning.

If you miss a dose because you sleep through, don't worry, you could take two tablets the next night. It won't make much difference.

[Hidden in reply to greygoose]

LOL greygoose! I do know that. But I find I need to go within an hour of drinking. But good to know I could just double up the dose, that would solve the problem.

[SlowDragon Administrator]

Lots of us find it actually works better at night

verywell.com/should-i-take-...

archinte.jamanetwork.com/ar...

Long research article - final concluding paragraph below

"In conclusion, bedtime intake of levothyroxine in our study significantly improved thyroid hormone levels. This may be explained by better gastrointestinal bioavailability at night or by less uptake interference by food or medications. As shown in this study, bedtime administration is more convenient for many patients. Clinicians should inform their patients about the possibility of taking levothyroxine at bedtime. A prolonged period of bedtime levothyroxine therapy may be required for a change in QOL to occur."

[Hidden in reply to SlowDragon]

That's very interesting, thank you! Was going to ask what is QOL but I figure it's Quality Of Life!