I have tried searching through the threads to find the answer to this but seemingly can’t work it out myself!
I have to take Levothyroxine 75mg so I take that at 6am every morning and wait for at least an hour before eating and two hours for my bladder medication.
My GP has advised I have to take Ferrous Fumarate twice daily 210mg - which I take with Vitamin C. But when is the best times to take it if I have to take it twice? To leave enough time between medications.
I also have to take a B12 complex which includes 1000mcg Mythelfolate and 1000mcg B12.
I have been prescribed 1000IU per day of Vitamin D for severe deficiency (I don’t think this is enough per day to overcome the deficiency I have but still) - I take this with Vitamin K.
What kind of regime should I be aiming for for optimal absorption please?
Thanks again
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GeekyMummy
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The usual recommendation when taking levothyroxine is to wait 4 hours between it and vitamins/minerals/other medications. If you find this problematic you could switch to taking levo at bedtime, as long as you've last eaten about 3 hours previously. Food interferes with the uptake of thyroid hormones.
This is an excerpt:
If you are hypothyroid and taking a prescription thyroid hormone replacement drug, you may not be aware of the many rules that need to be followed when taking your medication. Something you may not know is how your other medications, vitamins, supplement, and even food choices are interfering wither thyroid medication.
If you are taking thyroid medication, hopefully your doctor or pharmacist has already shared with you the most important things to remember:
Take on an empty stomach first thing in the morning
Wait one hour before eating breakfast
Take it at the same time each day
Never miss a dose
Don’t take your thyroid medication at the same time as your coffee (coffee may lower the absorption of your thyroid medication)(1,2,3)
and
Many medications, supplements, and foods are important to avoid or not consume within three to six hours of taking your thyroid medication. These interfere with the the body’s ability to absorb and utilize thyroid medication effectively. When an interference of absorption happens, serious things can occur. You may become under-medicated or even over-medicated depending on the substance causing the interference. So, which substances cause an absorption issue?
A good rule of thumb you could use is to take vitamins earlier in the day and minerals later in the day.
If you are taking Levo at 6am and bladder medication at 8am, then one timetable that might work is :
B12 Complex, Vitamin D and Vitamin K between 10am and noon.
Then take iron and vitamin C at 4pm and bedtime.
Regarding the dose of your vitamin D, if you are severely deficient I would agree that 1000 iU per day is not enough. Vitamin D in a range of doses up to 10000 iU is easily sourced online on sites like Amazon.
Note that people should be taking vitamin K2, not vitamin K1 as a co-factor with vitamin D. Magnesium is required as well.
If you read SeasideSusie's posts on supplementing vitamins and minerals you'll find plenty of info on the subject.
Hi, I also take my Levothyroxine and at 6am and leave 2 hours between taking anything else upon my Endocrinologists advice. He also advised me to take vitamin D 1000mu and a Vitamin B complex to help with my constant tiredness (it doesn't help but hey ho) I'm guessing it is best to leave as long a gap between taking supplements and you thyroxine as possible so not to hinder the absorption of the Thyroxine. I hope this helps, its just repeating what my specialist advised me to do
I have been taking Levothyroxine for @ 6 years since I had my thyroid removed due to Graves.Three years ago I started taking minerals and vitamins on advice from a doctor. I take them as follows and according to his advice;
Levothyroxine @ 5 (I am an early riser)
Breakfast @ 7 immediately followed by a multi vitamin and fish oils washed down with a large glass of water, followed by sub-lingual b12
Lunch @ 12.30 followed by Vit C and iron
Supper @ 6.30 followed by fish oils/d3/calcium
I also follow a paleo type diet (a la Dr Myhill), and this change to my diet has shown improved absorption of all supplements.
Despite my initial suspicion, supplementation has changed my life. I think it is important to take supplements with food - that is when your gut is set up to absorb them - and I think it is important to observe the minimum 1 hour window between Levothyroxine and anything else; but as you see, I give a big gap between taking Levo and taking iron and calcium - which I understand is important for absorption/conversion issues.
I wish you all the best sorting this out; it takes time.
Thank you everybody for all your replies and insight in to the supplementation time lines etc. Apologies for the delay in response, I have been in hospital having an operation.
I think I’ve found taking my Levothyroxine at 6, then I eat at around 8am then take my B12 complex (includes Folate rather than Folic acid) at 10am. At 12 I now take Vit D, K2 and Magnesium. And at 4pm vitamin C and iron and treat again at 8pm before bed.
It’s difficult because the GP’s don’t agree with all the different ins and outs they say 30 minutes is enough between Levo and any other medication, food/drink and caffeine. It’s like talking to a wall sometimes.
Now I’m a bit worried because I’ve seemingly developed these really WEIRD internal shakes... it’s like a total upper body shaking or vibration and it keeps waking me up out of my sleep, I also have a neck tremor on the left which I’ve had a couple of years but now people are noticing it. Think I’m falling to bits!
I'm sorry you have been in hospital and hope you are on the way to recovery.
If we are hypo recovery is not quick unfortunately but we can help ourselves by asking questions from the forum and the majority on it have recovered by not following the guidelines laid down by the BTA or BTF.
One doctor said that they way we are diagnosed/medicated nowadays will cause a Parlous Situation for everyone who has hypo and also for those who remain undiagnosed or given too low a dose.
Most of the information/advice comes from members with hypo through self-awareness i.e. you are told by doctors and endocrinologists, this and that and wonder why we are feeling worse - not improving - body isn't working as it did but are assured by the medical profession that our bloods are 'fine' and in normal range but they are completely unaware that our TSH is to be 1 or lower - not within range which is fine for diagnosing alone.
They are unaware that it is T3 which allows us to recover our health, relieve pain, diminish clinical symptoms but doctors will still insist our bloods are 'fine' or 'normal' or nothing to do with hypothyroidism, so out come the prescriptions for antidepressants (for complaining too much), pain relief (diagnose Fibro due to pain or CFS if fatigued) they rarely check FT4 and FT3and do not ensure that both FT4 and FT3 are optimal so decide its all in our mind.
Levothyroxine should convert to sufficient T3 but it has to be optimum but some cannot get well on levo no matter how much the Associations state that is all that will be prescribed.
They also provide, usually, too low a dose to keep numbers in range and we suffer. People are signed off as too ill to function (GPs/Endos believe our complaints are psychosomatic) so according to them its all in our minds. Doctors don't ensure that all vitamins/minerals are optimal. Some of the numbers posted by members are well below ranges.
Many of us finally realise that there has to be info somewhere and come upon our forum. With responses they realise that the doctors are mainly wrong, poorly trained in dysfunctions of the thyroid gland and all emphasis being on the TSH and T4.
If you want to respond to a collective of names you don't have to respond individually and to do so you put an @ and then put the first few letter of name and a selection appears below and select the one you want and it appears as GeekyMummy and so on so all can read and they will also be alerted that there's a response and saves you some time. .
The medical profession are poorly trained and the insistence in the UK that we aren't to be diagnosed until TSH is 10 is barbaric and in other countries we are diagnosed around 3+.
I’m due for my stitches out and bandages off this Friday, thanks for your well wishes.
I’ve noticed I’ve been helping my Mum as well. I feel so bad for my Mum, her thyroid has been above 7 since 2002 and they only started treating her when it reached 11 in 2012.. it’s appalling. They’ve never even tested her vitamin levels AND she’s had Rhumatoid Arthritis for 14 years since she was 36 which warrants vitamin/mineral testing alone.
I have read so much on Thyroid/Hashimoto’s etc. I was wondering about T3 because they’ve given me a blood bag for yet again just TSH. It’s becoming pointless asking for T3,T4 alongside it. I am told it doesn’t matter but I strongly believe it does. I’ve done everything in my power to help myself and my mum to start to get better or as much as we both can. I must admit since silencing the doctor with what I have learnt from all of you she had no choice but to test my vitamins, albeit she’s issued a measly dose of Vit D so I’m supplementing my self based on guidelines from the internet and my test results, I am starting to feel less aches and pains and less fatigue. But we shouldn’t have to struggle.
What’s more.... because I had a very traumatic experience in my past that left me with anxiety at the time. If ever I mention how I feel it’s put down to anxiety when I’m not anxious, even after I self diagnosed with the medichecks private full thyroid test and took my results in to the doctors and finally they said I had Hashimoto’s. They still tell me everything else is anxiety with depression.... I’m 100% not depressed. So I see exactly where you are coming from!
Thanks for the info on responding collectively... it confused me to do that so it makes sense now lol.
An example is... I went to the GP last night because I’d spoke to my Mum on the phone and she said she was worried because of what I was describing... the inner shaking/tremors during sleep.. the GP literally said to me ‘what do you want me to do for you exactly?’...... and my best friend was in the room (due to me in a wheelchair at the min) and had to bite her lip. So I said well you tell me because I’ve only come to double check that nothings wrong with me. Then said it can be anything from anxiety to learnt behaviour.... how do you learn to have INNER tremors whilst sleeping? I mean seriously. So she basically said keep taking your vitamins and it should pass. Told me to go back in 6 months.
I think unless the medical profession ups it’s game we are slightly doomed. But then again with all the government cuts I can’t see that happening anytime soon.
We have to self-medicate due to the snooty comments by some who are 'supposed' to be healers!
For me (not everyone has the same affect) T3 was magical, just added to T4 it made a huge difference and then I tried several NDTS too. I had severe palps since starting levo and cardiologist was also puzzled, but when I too T3 only I have had none since. My assumption is that my body didn't like the T4. I am on T3 only now and am symptom free.
Funny you should mention that. I’ve had palpitations quite badly and my mum who is on a higher dose of Levothyroxine than me also has them. We’ve always been told it’s the Hashimoto’s and being Hypo that cause it.. typical.
Do you purchase T3 yourself or does your endo or GP prescribe it?
I did get prescribed but I now buy my own since the Supplier of T3 to the NHS ran out of stocks a couple of years ago and GP wouldn't prescribe on a 'named-patient' basis for the other non-licenced T3 which they could have done.
GeekyMummy Good piece today in Guardian about new journal publication about vitamin D and RA: "A study led by the University of Birmingham compared the ability of immune cells in blood from inflamed joints in people with rheumatoid arthritis to respond to the so-called sunshine vitamin.
The experts found tissue that was not diseased responded well to vitamin D, suggesting it could be effective at preventing the onset of rheumatoid arthritis, which affects more than 400,000 people in the UK.
The vitamin proved much less effective once the disorder was established, suggesting much higher doses may be needed in combination with other anti-inflammatories such as steroids."
I am really hoping that’s what happens with me because I really don’t want to end up with RA as well, I’ve watched it ravish my Nan and my Mum and it’s so horrible.
My Vit D was at 17.8ng when converted from nmol I think she said, by the GP... yet she only offered me 800IU once a day.
So I’m currently taking 35,000IU per week at 5,000IU per say gel capsules.
Interesting read, very interesting thank you ITTFIALMCTT
Psoriatic arthritis for me and < 5 - 8ng or roughly 12-20nmol/L (amending it is complicated for me by a genetic disease with systemic effects) so I am likewise interested for personal reasons. I'm still severely deficient but being less severely deficient, has made a huge difference to the functioning of my hands.
Hi. Have you ever thought about taking your levothyroxine before bed (three hours away from food) rather than in the morning. I changed a few weeks ago and it’s much better. Means I can get up, have a cuppa, breakfast and then take my vitamins straight away. It may not be for everyone but it’s helped me out tremendously
Yes I did try that for about a week, but I seem to feel better if I take Early morning as the baby has me awake from 5.30am anyway, and I don’t feel like eating breakfast straight away. Also don’t drink any form of caffeine so it seems to fit me well
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I've edited it now.
What vitamin D dose do you take? 
What vitamins and supplements does everyone take?
Hypothyroid + Vitamin D/ amount to Take when Deficient 
What's the best time of day to take vitamins and supplements?
What vitamins are you taking?
