Levothyroxine woes

[Docbuster]

On levothyroxine for 15yrs now liothironine have read many posts but no mention of foods that block levothyroxine calcium iron mg coffee soya this can cause many problems

[greygoose]

These things are often mentioned, you just haven't looked far enough. Maybe not in that way, but we're always telling people not to eat or drink coffee until one hour at least after taking levo, and to leave four hours before taking calcium, iron, vit D or oestrogen - and I would personally recommend leaving six hours between levo and magnesium. And we're always saying not to consume unfermented soy at all!

You don't have to give up calcium/iron containing foods completely, that would be silly, but to give the levo time to leave the stomach before eating them. It's only if they come into contact in the stomach that there is a problem.

[foxglove in reply to greygoose]

hi greygoose, you mentioned magnesium does this also apply to the magnesium oil spray? Thanks

[greygoose in reply to foxglove]

No, because the oil spray doesn't go into the stomach. It's all about chemicals binding when they meet up in the stomach or the gut, not the actual elements themselves.

[foxglove in reply to greygoose]

Thanks!

[Clutter]

Docbuster,

As Greygoose has said, probably the most frequently given advice on the forum is to take thyroid medication away from food, drink, medication and supplements.

I advise:

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, magnesium and oestrogen.

If a member says s/he is eating soy or soya I advise against it unless it is fermented.

[AlasdairM in reply to Clutter]

Remember the "2 hours after food & drink" is an advisory; some meals may occupy your stomach for much longer. You are aim is an empty and low acid stomach to maximise absorption.

Your local qualified pharmacist is far better informed than almost any GP and many offer private advice sessions fee-free.

[Louv]

To avoid problems, I take my Levo at night, usually 10-11pm, and take all of my supplements in the morning, this way I’m not in danger of mixing things and I don’t drink anything with milk in it after 7pm. I have noticed a big difference in how I feel and was able to drop 25mcs of my levo after a few months of this new regime, before I was having my first coffee of the day within 10 minutes of taking my meds!

[Danielj1]

The levo at night vs supplements in the morning works really well I agree

[Hidden in reply to Danielj1]

I think this article explains why very well:

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

Interesting...I wish I had known about this years ago, when first put on T4...maybe I'm being overly optimistic, but I cannot help but think that maybe that would have worked well enough for me not to have to turn to NDT. I like NDT, it's not that, but there have been lots of problems with various reformulations, making some brands work less well, there have been availability problems as well in recent years, plus it's incredibly expensive and not reimbursed by health insurance...thank God for Thai NDT, although I always worry about customs confiscating the shipment...I have been thinking lately: "I wish I was one of those people with hypothyroidism who do perfectly fine on T4 only"...it would be too simplistic to tell myself that taking T4 at bedtime, instead of in the morning, would have made such a remarkable difference, but maybe it would be worth a try nonetheless...

[Nanaedake in reply to Hidden]

Well, until 2015, levothyroxine in the UK was riddled with problems too. It's still not perfect and any reformulation is likely to cause problems for patients. If you want to understand about levothyroxine production you can read the 2013 MHRA report into quality and clinical considerations of levothyroxine. Similar reports from Australia and New Zealand available on the internet.

gov.uk/government/publicati...

[Hidden in reply to Nanaedake]

Interesting!

[Hidden in reply to Hidden]

I tried this way taking Levo at night and it made no difference to me, however, it's a good idea to try out something that works for others and you could be the lucky one.

[Hidden]

Just out of curiosity: how long between taking your evening dose of T4 and your last meal? What if you occasionally eat later than usual? Do you always wait X number of hours...?

[Kipsy in reply to Hidden]

Hidden I take T4 at night 2hrs after eating. If I eat later than usual, I try to stay up the requisite 2 hrs but it's hard! If we're out at someone's house & it's getting late, I don't have pudding or cheese just so that I can take the T4 before I fall asleep! I've never managed to leave more than 2 hours between eating & bed but I do seem to absorb the T4 ok.

[Hidden in reply to Kipsy]

Thanks, that sounds reassuring! What about other meds you take at night; in my case, Utrogestan ten nights per month, and the occasional melatonin pill...will they decrease the absorption of T4?

Two hours really sounds so much more realistic long term than four...glad to hear it seems to be working for you!

[helvella Administrator in reply to Hidden]

anna69,

I suspect the ideal is always to eat at the same time - and leave the same gap.

The real world, however, gets in the way of that. So the second-best is always to leave the same gap.

I doubt it would make much difference if, very occasionally, you leave it longer (e.g. take when you wake, or in the night), or even a little earlier and therefore a little closer to food.

I have always taken mine at bed-time (except blood test days).

[Hidden in reply to helvella]

OK, so when your blood test is due the next morning, you take T4 in the morning the previous day, thus leaving 24 hours between meds and labs?

[helvella Administrator in reply to Hidden]

I just don't take last night's bed-time dose until after the blood draw. I take the tablet(s) with me and swallow immediately afterwards!

This is the one time I really don't take much care about delaying coffee or whatever.

[Hidden in reply to helvella]

I could not agree more

[Hidden]

PS. The reason I'm asking is because I'm considering going back on T4 only long enough for my TSH to normalise, which would make doctors happy...if I do that, I'd want to optimise its effectiveness, and it seems taking T4 at night makes it work better for many. But I recall reading somewhere that you should leave at least four hours between your last meal and taking T4 at night, and I'm not sure that will always be possible for me...

[shaws Administrator in reply to Hidden]

I think if your meal contained protein it should be a gap (I've read about 3 hours) due to our digestive system being slower than those without hypo. I know of one doctor who took his dose in the middle of the night so there would be no interference with food.

healthline.com/health/how-l...

[Clutter in reply to Hidden]

Anna69,

Men's stomachs empty in 90 minutes, women's stomach's empty in 2 hours. So 2 hours after eating/milky drink should be ample to be taking Levothyroxine on an empty stomach.

[redsissy in reply to Hidden]

I too, take mine in the middle of the night

[Danielj1]

I have not noticed it has made the slightest. Difference to me

T4 option involves some hard work to deliver the right outcomes - high reliance on supplements and diet to achieve a high conversion to T3

This journey is very poorly explained by the profession - some brilliant stuff on some of the US websites has proved invaluable ...there is some trial and error but after a few months I think i am much closer to longer term solution

[Hidden in reply to Danielj1]

Would you mind sharing it with us...?

[Danielj1]

Most important of anything BAR NONE is giving up PUFA and replace veggie oils with coconut oil across frying eg use butter on toast

Beyond that a combination of :

Black cumin seed oil - recently startedUse of plenty of sea salt

Hydrolysed collagen powder with orange juice

Loads of black coffee

Very pure kelp

Zinc/copper/selenium /Magnesium

Various vitamins

High carb diet with plenty of fish - sadly a number of years of marathon running on low carb / high fat is what I think caused recent damage

I still need to add dried beef liver capsules and these are arriving from USA this week

I claim no credit for any of these ideas - I closely follow dr ray peat ideas and forefront health. A book I read last week callled perfect health diet is also very similar and explains it well with loads of research.

The biggest problem with this journey is being able to quickly discount the 101 “blind alleys” eg probiotics, apple cider vinegar, digestive enzymes that are often expensive and for me over hyped.

The biggest issue with what is now becoming a massive industry in “thyroid self help cures” is there is enough vital stuff that is being debated over meaning you have to take a very personalised view on what you think your own needs are

In that category I would put for me kelp, strong black coffee, OJ and black cumin seed oil. ...

Even if everyone debates all or none of the above the great thing about this website is to open up the debate ..

I am learning a lot from reading everyone s ideas here

[redsissy in reply to Danielj1]

What is PUFA?

[Hidden in reply to redsissy]

butterbeliever.com/what-is-...

[Danielj1]

I am not fully there but T3 is trending right up on regular monitoring - I still need to get TSH to the lowest level and have added black cumin seed oil

I am not able to up dose of Thyroxine ...

[SueAndHerZoo]

Anyone notice a spike or crash in their TSH levels after adopting a low-carb way of eating? When I gave up gluten I had my blood drawn about 2 months later and it had spiked from my normal .8 to 6.87! We, of course, increased my Synthroid slightly and I had blood drawn again and now it's plummeted to .7. For four weeks I've been eating very low carb so I wonder if my TSH is going to keep fluctuating until it gets used to my new way of eating.

[Danielj1 in reply to SueAndHerZoo]

forefronthealth.com/low-car...

Been there done this sadly to my cost - will never do so again. Very very risky for me anyway ....

[SueAndHerZoo in reply to Danielj1]

Did what that was costly to your health - low carb?

[Danielj1 in reply to SueAndHerZoo]

I think it has had a bad impact on my thyroid....felt better with a higher carb lower fat diet

[SueAndHerZoo in reply to Danielj1]

Oh, OK.... that's possible. I don't have a thyroid anymore so I'm not sure it's going to do me any harm.... I will just have to tweak my Synthroid accordingly. I know that I always felt better eating low carb so decided to go back to it. We all just need to listen to our bodies.

[Caze in reply to Danielj1]

So what about people like me who have Candida and are following a low carb diet? I also have adrenal fatigue and I am sure I read that a low carb diet is hard on the adrenals - stuck between a rock and a hard place.

[Catseyes235]

Personally I gave an all things in moderation policy. Cabbage is supposed to suppress thyroid activity but you'd have to eat so much cabbage for it to have an effect you'd probably have other side effects and be unpleasant to live with! I've been on Levi for 36 years with a few initial tweaks to get dosage right. You don't mention what problems you are experiencing though and that would help thanks.

[Danielj1]

It’ s not just been high carb but the right carbs -eg potatos not brown rice/pasta

Where was all that stuff from years ago about glycemic index etc

It takes huge mental adjustment ...I am not sure how you resolve Candida at the same time - does gluten free help? Is OJ allowed - what options are there to reduce eostrogen levels to assist the thyroid process ?

[Eddie83]

The standard advice (which I have seen multiple places) is: take your levo one hour before eating/drinking, or two hours after eating/drinking. Water excepted of course.

[Hidden]

Hi. Would it be best to take levy before bed?