how to take thyroxin

[dillydally1]

hi, does it matter if I take my thyroxin after breakfast. I know some say before. is the thyroxin less effective if I take after breakfast.

when do you take yours. thanks

[shaws Administrator]

The recommendation, to get the best out of levothyroxine, is to take it either first thing when you get up with one glass of water and wait about an hour before eating. Food interferes with the uptake of the hormones, so you wont get the full benefit if your stomach isn't empty.

You can also take it at bedtime as long as you've last eaten about 2-3 hours before.

Blood tests should always be the earliest possible, fasting and allow 24 hours gap between last dose of levo and test and take afterwards. If bedtime dosing, miss this and take after test and take at bedtime as usual too.

[dillydally1 in reply to shaws]

many thanks for your reply. i have found it very helpful.

[Raventhorpe]

Hi Dilly-dally you need to take thyroxine on an empty stomach an hour before breakfast with just a glass of water or you can take at bedtime but need to not have eaten for at least two hours before. If you take with food it affects the absorption. I put my alarm on for an hour before I get up then just take tab and go back to bed for an hour this works well for me x

[dillydally1 in reply to Raventhorpe]

thanks, I've found your advice helpful x

[jimh111]

I take mine a few minutes before my breakfast, porridge or ceareal. It may reduce absorption by a few percent but as long as you are consistent it won't matter as your dose will be titrated accordingly. Avoid having coffee when taking thyroid medication as coffee has a big effect on absorption. I think the best option is to take it at bedtime, not many people eat a large meal or have coffee at bedtime.

[dillydally1 in reply to jimh111]

will try taking it night. thanks x

[Ruthi in reply to dillydally1]

Don't forget that its not just food but also drinks that can affect it.

[Ruthi in reply to jimh111]

Actually that is not entirely true. Even though you can achieve what appears to be the same blood levels by taking more but with food, the effect and the extent to which it is converted to active hormone is very different.

Different elements in food will bind to the thyroxine, or affect the way in which it is processed.

It started with my hypothyroid dog. We had always been told to give his thyroxine with food, and his T4 levels (the normal measure for dogs, who metabolise their T4 25 times as fast as we do) were good. But after an operation on his back his hair failed to grow back even after a year. We were then advised that he should have had his thyroxine an hour before food and the dose split, and within two weeks his hair was growing back. His T4 levels were also much higher, and we eventually settled on a dose half of that he had been on before.

Then, given how well he had responded I decided to move my thyroid meds to the same time as the dog. Until then I had been taking it with breakfast. I felt heaps better, and again was able to cut my dose considerably to achieve the same blood levels.

So the advice is most certainly to take it an hour before or at least two hours after food, drinks with caffeine or milk or anything else, really.

[helvella Administrator Thyroid UK in reply to Ruthi]

How is your coat now?

I always think about the times when you cannot continue with the same regime. For example, on holiday, when travelling, staying with others, or feeling unwell with something else. Most of us have to put up with some variability in our lives.

[Ruthi in reply to helvella]

Sadly the lovely Seamus died last year - but he had three years of a lovely dense coat on his back, albeit a different colour to before his op!

Yes, of course we have some variability. But once the medication is properly in your system then it seems not to matter, it does its job. Otherwise, given its long half life, T4 would be impossible as a medicine because we have to eat sometime! I must admit that when travelling/staying away etc I go to some lengths to make sure that there is at least half an hour between my pills and breakfast - and if that means skipping breakfast so be it.

If you are on levothyroxine then most people could safely take a double dose next day - there has even been suggestion that once a week would be enough. A few people seem to be able to feel it, though, so its always going to be trial and error. Because I am on NDT that wouldn't work for me, the T3 in a week's supply would send me totally hyper. But I seem just fine taking it in the morning.

[helvella Administrator Thyroid UK in reply to Ruthi]

That's sad.

I notice my levothyroxine. If I miss a dose, for example for a blood test, I notice even though it is just a few hours late. It is a very long time since I missed a dose, but when I did, I certainly took a few days to get back on to my usual self.

For that reason, I would run from anything other than daily dosing.

[Ruthi in reply to helvella]

I still miss Seamus. He was a huge character, despite being the world's most unlucky dog when it came to matters of health. Only ten when he died.

I don't even notice if I miss a dose of NDT! But I suspect that I am monumentally unobservant when it comes to my own state of health.

I think we are all so different - and that is the trap the doctors fall into. They imagine that since we all have the same system, we should all operate in the same way. Mini car of Aston Martin, the same remedy should apply to all.

[Clutter]

Dillydally1,

You can take it any time of day or night as long as it is 1 hour before food and drink or 2 hours after food and drink, 2 hours away from other medication and supplements and, 4 hours away from iron, calcium, vitamin D and oestrogen.

[dotti]

Years ago before i knew any better i took my Levo and then had breakfast straight away, now i wait at least an hour before eating or drinking.

Dotti

[Emmyloug]

I always take mine at night as part of my bedtime routine... helps me remember to take it (take Thyroxine, brush teeth) and also adds in consistency of time as I tend to go to bed at the same time each day.

The other benefit of night time dosing is that I can then take my vitamins and supplements first thing in the morning without having to worry about leaving enough time after Thyroxine.