Getting thyroid hormones down

[Gcart]

Can anyone help.. I have a congenital problem that causes a very narrow trachea which is getting more exaggerated with age.

Eating solid food seems ok but strangely taking tablets , even with copious amounts of water stick and cause lots of throat clearing, or trying to. Plus I seem to feel it stuck there just about 1/3 way down

I worry about the thyroid meds , as empty stomach with water, is the best way .

I am going to have to use some food to cause the dynamic effect , which doesn’t seem to have the same problem

Any suggestions ? Can hormones be obsorbed before getting to the stomach?

Sorry to be a pain thanks

[jimh111]

You could crush them and put in some water and perhaps add a little more water to ensure you get it all. Or with a little food, light meals have little effect. Your next blood test will confirm you are absorbing it.

(edited to correct typos).

[Gcart in reply to jimh111]

Ok thanks for that , very reassuring.

[jimh111 in reply to Gcart]

You could also contact the licence holder who will probably have a helpline number on the leaflet with the tablets. Note they will be described as the licence holder rather than the manufacturer who may be a different company.

[helvella Administrator in reply to jimh111]

Look at EMC!

medicines.org.uk/emc/search...

The Patient Information Leaflets for levothyroxine tablets used to advise dispersing the tablet in water for children and others who have difficulty swallowing. As in this for Actavis:

When applicable:

Tablets are to be disintegrated in some water (10 to 15ml) and the resultant suspension, which must be prepared freshly as required, is to be administered with some more liquid (5 to 10ml).

But now, for Mercury Pharma (Concordia), the advice has changed:

In children under 5 years of age, the administration of whole tablets is not recommended. It is also not recommended that tablets are crushed and dispersed in water or other liquids, owing to limited solubility which could lead to dosing inaccuracy. In this age group it is preferable to administer an approved oral solution of levothyroxine

I suspect the advice will be updated to use a proper liquid product when next updated.

[jimh111 in reply to helvella]

Concordia advice has changed!!! As many of us know Concordia is ripping off the NHS by currently charging £246.69 for 28 liothyronine tablets that cost a few pounds in Europe. They are being investigated by the Competition and Markets Authority. For administering small doses of liothronine they advise crushing and dispersing in water, swallowing part of the dispersion and throwing away the rest. This generates much more profit than splitting tablets that cost £8.81 each. True, liothyronine is slightly more soluble than levothyroxine.

Their comment about dosing inaccuracy is nonsense, if the tablet is crushed and the whole solution swallowed then all the tablet will be swallowed, especially if a little water is added to swallow any small remaining bits. This couldn't be because levothyroxine 100 mcg tablets cost £0.96 for 28 and levothyroxine solution is £164.88 for 20 x 100 mcg shots? Concordia wouldn't try to cheat the NHS would they?

Helvella, this is very helpful, it confirms levothyroxine tablets can be crushed and taken in a little water. This makes sense, as long as you swallow nearly all of the tablet it doesn't matter is it is crushed, it might even help with absorption.

[helvella Administrator in reply to jimh111]

I agree that it is ridiculous.

Further, I know that levothyroxine and liothyronine are differently soluble, but I can't help thinking that if dispersing and then measuring a fraction is good enough for liothyronine, then dispersing and taking the whole lot (as you describe) must be good enough for levothyroxine.

[Gcart in reply to helvella]

Thank you very much for all your input . I tried T3 last night and it seemed to be fine Thanks again.

[Pig4u]

I take Thyroxine in liquid form so perhaps ask your Dr for that