Boots Pharmasist

[miglet54]

I remembered an occasional a few years ago whilst collecting my prescription from Boots. The pharmacist interviewed me as a matter of course. I advised her that I regularly forgot to take my hormone and meds. She suggested using a dosette box. Her advice was to take my 2 Codeine, 2 Omeprazol 100 Thyroxine 1 Calcichew all at once then refill the box. I said that I might be inclined to take them again later in the day as I am scatty. But the worst part now that you good people have educated me is that there wasn't a peep out of he regarding the correct way to take my Thyroxine.

[helvella Administrator]

Have always assumed this is exactly what happens to anyone who gets their medicines in a prepared pack. This is very common and almost always includes several medicines together.

[CCSP-27]

I'm still not sure !

When is the optimum time to take Thyroxine ?

[SlowDragon Administrator in reply to CCSP-27]

thyroxine should always be taken on an empty stomach and then nothing apart from water for at least an hour after. (No coffee or tea)

Many take on waking, but can be more convenient and recent research, suggests perhaps is more effective taken at bedtime. (Must be at least two hours after eating)

Quite a few take in middle of night

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

archinte.jamanetwork.com/ar...

Long research article - final conclusion 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 quality of life to occur."

[Teada]

I take mine at night before I go to bed even though it is advised to take it in the morning. I was getting an upset stomach from taking the thyroxine at the same time as food.

Speaking as someone who works in pharmacy and spends all day packing those pre-packed dosettes, the medication is generally put it either as prescribed or as we (as trained individuals) know it is best taken. However, if the patient states a preferred time for taking a particular medication, we can pack the dosette to their preference, assuming it won't be detrimental to their well being.

[bluebug in reply to Teada]

Aren't pharmacists aware of drug interactions? The ones near me have ended up reporting locums to the practices due their strange prescribing habits.

[Teada in reply to bluebug]

Yes, pharmacists are aware of interactions between medications and where I work if an interaction is thrown up by our system when we label prescriptions it has to be referred to the pharmacist. However in my experience Levothyroxine is mainly prescribed by the G.P. for use in the morning.

[helvella Administrator in reply to Teada]

Trouble is, no GP has ever said when I should take my levothyroxine - certainly never written anything. So it must be left to default to, I assume, what the manufacturers put on their Patient Information Leaflets.

I have told more than one GP that I actually take it at bed-time, but they have almost entirely ignored that in the sort-of "it really doesn't matter and anyway haven't got time to pick up on that" way of acknowledging something.

[Debsoxford]

What about dividing them into labelled egg cups I do mine every night ready for the next day. I also have a couple.to suck and get 1 pack of those.in.the car.which.reminds me to take them

Good luck

[Soneram]

I take my thyroxine at 6am and my calcichew two hours after as was told by pharmist in hospital the calcichew stops the thyroxine working if you take at same time

[BadHare]

Pharm-ass-ist?

My friends' hubby takes his T4 with breakfast yoghurt, & I think he has a coffee, too. His endocrinologist told him to do so.

Sigh...

[Summer64]

Why not have a days of the week box like I do. That way you know if you've taken them or not. I was recently in hospital and got my meds when it suited them. One doctor even said it wouldn't hurt to miss a day as they came so late. I don't think they are educated in this at all.

[Binkie]

All my best advice on how to take my meds has come from fellow sufferers. It is a nightmare to learn and some of my buddies have spread sheets. My drs have on the whole been useless, bless them.

I easily forget stuff and often have to be reminded and get back to basics

[elaine2447 in reply to Binkie]

From what I understand nationwide and my own experience, "bless" them is not quite the word I would use!!!

[Binkie in reply to elaine2447]

or me but i was being polite lol x

[BonnieT]

Yes. I've been told to take my thyroid meds with a lot of water an hour before any food. I usually get up early, take the pill, and go back to sleep for another hour, then get my toast and coffee. I've been told that coffee without milk and sugar is ok to have within that hour, but I still wait.

[helvella Administrator in reply to BonnieT]

A glass of water - rather than "a lot" of water - in my view.

[miglet54 in reply to helvella]

I suppose a glass might be a lot to some people. Very few people drink sufficient fluid.

[Pepekins in reply to helvella]

I am unsure if it makes much difference. When I had my thyroid gland removed 16 years ago I was told to take 150mcg. No-one said how or when exactly, so I took 50 mcg three times a day with food. Worked fine. Then years down the line my endo said, why not take it all at once, so i did first thing in the morning with water followed soon after with a cup of tea. I usually wait an hr before eating but now and then I don't and it still is ok. I would like to try taking in the eve but wonder if it would make my insomnia worse!!

[BonnieT in reply to BonnieT]

I always have a bottle of water on my night table. I drink about half of it with my pill vs a few sips to swallow it as I used to.

[helvella Administrator in reply to BonnieT]

Which I agree is very sensible.

[Glynisrose]

Take thyroxine on an e,pty stomach away from other meds.

[fibrolinda]

I have a dosage box that can be set for up to four doses a day. Mine is for four with an alarm that goes off to tell me its time for that dose. It turns around in the circular box when the alarm goes off to the dose for that set time so you can have different Meds etc. each time. Its a simple piece of kit but brilliant, no over or under medicating since getting it and no missed doses, no matter how distracted I am. I got it from the council care department but have seen them in disabled aid shops and Lloyds chemists.

[LAHs]

Here is a question on a similar theme. I was in hospital once and had one overnight stay. The woman in the bed next to mine had an intravenous drip being set up. The nurse was explaining to the woman that she was getting this, that and the other and it included an antacid and her thyroid medication. I called over the nurse and mentioned that you shouldn't take antacids at the same time as thyroid meds. The nurse (who was very friendly and not offended) said she was not aware of that but was interested, and thought about it for a minute. She said that maybe if they are intravenous it doesn't matter. Does any one know if that is true?

[helvella Administrator in reply to LAHs]

It is the interaction within the gut that is the first point of interaction so it is probably the only thing that has even been looked at.

We do see some interactions with medicines occur elsewhere (e.g. the effects of soya certainly occur in the rest of the body), but it isn't clear to me that the timing is an issue.

[BonnieT]

[milliemack]

One of the side effects is severe dizziness which I am experiencing for the past 3 months. anybody else have dizziness??

[Raventhorpe in reply to milliemack]

I get dizziness if under medicated,and can take some time to go once on right dose of levo. I only realised I was taking levo in wrong way when I read on here .I was taking levo with omeprazole just before i had breakfast, now I don't take omeprazole at all , take cider vinegar and lemon juice instead.a and I set my alarm 1hour before I get up and have levo with a glass of water.