Thyroid UK
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Seeing Endo today. Have I to take Levothyroxine before

Hi

I am seeing the Endo today but not while 4pm, I will be having a blood test. I have read before don't take Levothyroxine before hand. I usually take about 7am or sometimes 4 or 5am if I get up earlier to go to Loo. Have I to take the Levo or not. I have hunger pangs already. I know I've also read about fasting before blood test also but I can't go while after 4pm without anything to eat 😧 Blood test will probably be about 5pm so in that case I wouldn't be taking Levo while about 5.15 ish that's very close to morning after where I will prob take between 4 and 7am

I'm also going armed with a box of T3 to see if he will trial me on it also

17 Replies
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Miss your dose this morning and have your breakfast and take levo after your appointment with Endo.

Levo has long half-life so you should be o.k. Take levo after test as long as you've last eaten protein about 2 to 3 hours previously.

Some take a full week's levo once a week.

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Oh I I've never heard about eating protein before

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Usually we take levo when we get up and wait an hour before eating.

If we take levo at any other time, if we've eaten protein and due to our metabolism being low, our digestion can be affected as well. Someone without hypo will digest quicker than us due to us most probably having low stomach acid rather than normal/high. If we complain about stomach issues doctors usually give us something for 'high acid' as symptoms are so similar to low acid but if hypo we might have to take digestive enzymes to help dissolve food in stomach.

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Blood tests are better early in the morning and yes, no levo and fasting, only water. I wouldn't have the test so late, not if you want the doctor to see you need better treatment. Can't you change it? Your bloods may suggest you are being treated fine, so why would he want to change the treatment? Unfortunately, most doctors treat according to the blood tests and not symptoms. I assume you feel ill, which is why you want to try t3? Test results in range won't help you.

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Hi no it's abit late to change it it now I think.

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I disagree with the previous two posts! I'd take the levothyroxine in the morning, it's long before a 4 pm appointment and will not influence the assay. I take my levothyroxine three minutes before breakfast, but I know some people need to wait an hour to ensure good absorption. (Wait an hour! I'd starve. I'd take it at night instead). There's no need to fast for the blood test, if it did make any difference to the result it would be marginal. There's no point in punishing yourself just to try and fiddle a miniscule rise in TSH, eat plenty and be in good shape to deal with endcrinologists. A good doctor can't carry out a proper physical assessement if the patient is fainting from hunger.

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Yeah! Like he's even going to look at her! Probably won't even raise his eyes from his computer screen!

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He was fantastic!!!!!! So please I took the T3 with me. He lowered my T4 and introduced the T3 😀

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Well, that's wonderful! I'm so glad I was wrong. :)

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I'd change your blood draw to a morning appointment as TSH level will fall lower as the day progresses, it drops quite substantially as shown in the following research paper, and so if your Endo puts a lot of importance on TSH then the outcome of his recommendation may be different:

naturalmedicinejournal.com/...

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TSH peaks in the early hours of the morning, around 2 am to 4 am. It then gradually falls until after midday. If you measure TSH early morning you are taking a measurement somewhere on the slope, you will get different results from day to day. Taking the blood later in the day gives a more reliable result that you can use for comparison, say three months later. It does mean that if the doctor only sees TSH they see a lower figure and you will need to point out that TSH is higher at different times of the day.

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Thankyou Jimh111

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If you take levo with food it interferes with the uptake of thyroid hormones. It is also a possibility the doctor will reduce your dose.

This is an excerpt from a scientific study.

The average TSH at the start of the study was 1.7. The TSH level was higher when levothyroxine was taken during breakfast (TSH 2.9) as compared with group who waited 30-60 minutes before taking levothyroxine (TSH 1.9). Patient preference was assessed at the end of the study and 41% preferred taking levothyroxine and waiting, 33% preferred taking the levothyroxine with breakfast and 26% indicated no preference.

WHAT ARE THE IMPLICATIONS OF THIS STUDY?

This study shows that the absorption of levothyroxine is indeed decreased when taking the hormone with breakfast. Despite an increase in TSH while taking the hormone with breakfast, the TSH remained within the normal range. Thus, while taking levothyroxine with breakfast could be an alternative regimen for patients who have difficulties taking the hormone on an empty stomach, this regimen is more likely to cause variability in the TSH level. It is still advised that patients with a history of thyroid cancer, those who are pregnant or those who are very sensitive to changes in their TSH level need to likely wait 30–60 minutes prior to taking there levothyroxine.

thyroid.org/patient-thyroid...

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It depends what your endo is going to test, and what he actually looks at. If he's obsessed by the TSH, then that is going to be really low at 5 pm, anyway, so eating isn't going to make much difference. Your TSH will be low.

Taking your levo just before the test will only affect the FT4. But, as there will be such a long gap, it probably won't make much difference.

What we usually advise is having your TSH early in the morning - when the TSH is highest - and fasting over night - which will probably make a significant difference to the TSH. And taking your levo after the blood draw, to avoid the spike in blood levels up to six hours after taking it. But, having your test at 5 pm, none of that really matters. It's doubtful it would change the out-come. :(

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I fell back asleep and only just woken up. This happens every day but I usually take the Levo when wake.. So I've not taken it and I've not eaten. I made a mess of that one didn't i

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Well, you'd better eat. As I said, it's not going to make much difference to a TSH taken at 6 pm. But you could hold off taking the levo until after the blood draw. That won't hurt.

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I'm so glad I went to my appointment armed with T3

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