Dissolve Levothyroxine in water?

[Foodie23]

I’ve had the worst time swallowing this medication. I’ve tried everything I can from drinking water first, then guzzling a bunch of water with the pill. It keeps getting stuck in my throat and causes me anxiety.

Has anyone been told by their doctor they can dissolve it in a small amount of water? It seems to disperse/dissolve quite easily and has solved my problem. I’m just not sure if it will affect absorption. I’d ask my doctor, but she’s nearly impossible to get ahold of outside my appointments.

Thank you.

[Aurealis]

Hi Foodie23, I wonder what brand you have as the coating on the tablet may vary. I don’t take Levo anymore but I used to avoid mixing it with water. I’d avoid putting it into a dry mouth or one with water in. Just used to swallow it with saliva then drink plenty of water. If mouth is dry I’d use a small amount of chocolate but I know advice now is to separate Levo from food, however if you do the same every time, it will matter less, you just might need to settle on a slightly higher dose, if it makes any difference.

[helvella in reply to Aurealis]

You are right to question whether a coating could make a difference. But none of the UK levothyroxine tablets is coated.

The Patient Information Leaflets used to suggest dispersing the crushed tablet in water for young children. I see they have now changed that advice to recommending an oral solution (i.e. liquid levothyroxine).

The Summary of Product Characteristics documents say:

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.

medicines.org.uk/emc/produc...

I am not at all convinced that this is a reason to avoid dispersing tablets - so long as you make sure the glass is emptied - and maybe swilled round with a bit more water?

[Foodie23 in reply to helvella]

Thank you for sharing this. Yes, that’s exactly what I’ve been doing. From that language, it seems that’s alright. I’ll do my best to confirm with my doctor after the holiday.

[helvella in reply to Foodie23]

Don't hold your breath expecting an informed answer. You might be lucky...

[shaws in reply to Foodie23]

We have to swallow the tablet with a full glass of water on an empty stomach. so It might be difficult to dissolve but I would assume if your stomach is empty before and after swallowing the tablet in water and wait an hour anyway so that levo is not affected by food etc. your body will still benefit.

When you get your next blood test, then I would expect your blood test results to be improved.

I am not medically qualified.

[Hidden]

In the short term you might get an answer from the pharmacist.

[Foodie23 in reply to Hidden]

Great idea, I’ll try that for sure!

[danym in reply to Foodie23]

foodie what did your dr say, i was thinking of dissolving mine in water as well.

[Foodie23 in reply to danym]

The pharmacist said it was fine and my levels were stable taking it that way. However, I switched brands and haven’t had any more trouble. The brand I couldn’t swallow was TEVA. Their pills were 2x the size of my new ones and the coating was different.

Good luck!

[danym in reply to Foodie23]

that it a levo pill right?

[Foodie23 in reply to danym]

Yes.

[G2G2]

Try it in a tsp of apple sauce.

[ShootingStars]

Levothyroxine is absorbed in your small intestine, specifically in your jejunum and illium. Diluting Levothyroxine in water is pretty much what happens to it when you swallow it with water and when it's on it's way to your jejunum and illium. Levo is always taken with water only on an empty stomach. You can drink as much water as you'd like during those 60 minutes where you sustain from eating any food, coffee, or other drinks as you wait for your medication to be absorbed. By the time your levo pill gets from your mouth to jejunum and then illium in your small intestine where it is absorbed, it has been diluted by the water used to swallow it, as well as by the contents of your stomach.

I have always chewed my Levothyroxine and Liothyronine and then drank a bunch of water as I wait out the 60 minutes before I can drink coffee and eat food. Chewing up my meds and drinking 20 ounces or more of water definitely dilutes it almost immediately as it leaves my mouth. I've done it this way for years and my levels are consistently in the optimal part of the range. I have years worth of test results that were often done every 6 weeks showing my consistent levels, so consuming it this wait definitely has not interfered with absorption.

[ZippyAppletush in reply to ShootingStars]

Always chew mine too! 😁

[Ellie-Louise in reply to ZippyAppletush]

What does it taste like?

[helvella in reply to Ellie-Louise]

To me, the taste depends almost entirely on the make. Wockhardt is intensely sweet. Mercury Pharma is quite salty. Actavis is nothing much.

I don't crunch and chew but I often taste the tablet as I put it on my tongue then drink water to swallow it.

[Ellie-Louise in reply to helvella]

I might try it tonight then. Thank you helvella.

Mind you, Actavis is so small that it might end up filling a tooth! Lol

[ZippyAppletush in reply to Ellie-Louise]

Hi Ellie-Louise, thanks for your post. As with helvella, it does depend on brands, but the taste of any has never been unpleasant and as they are small tablets they are gone quickly and no real aftertaste.

[Unhole]

Hi Foodie...you don’t say how long you’ve been on the meds?...it’s just that when I first started I could neither get them out of the packet or swallow them!...my hands were so tight and weak I’d pop them out of the pack the night before then struggle to swallow them like you. I will say that I don’t need to do either now. Regarding the swallowing...lack of thyroxine adversely affects smooth muscle..the oesophagus is smooth muscle...now I’m on the right dose my body’s smooth muscle function has improved massively...just a thought....good luck and good health

[Hidden]

If crushed or dissolved, would the stomach acid destroy some of the Levo before it be absorbed? You would still probably get some, but maybe not the full dose you need.

Yes, checking with the pharmacist is the best advice. And if the answer is no, and you really can't swallow it, ask the doctor to prescribe liquid instead.

I like the apple sauce suggestion too. Or jam. Or peanut butter... The possibilities are endless!

[helvella in reply to Hidden]

If you had seen what happens to Levoxyl when it gets even damp, you would not have asked that! It seems almost to explode. There is an FDA warning because if it puffs up in the throat it could be dangerous. There is no way it can even reach your stomach without disintegrating.

Levothyroxine is almost insoluble in acidic solutions, such as stomach acid. It is when it passes from the stomach in the alkaline environment that it can dissolve and get absorbed.

[Zezee]

Try elevating your other hand above your shoulder blade while putting Levo.in mouth ...been doing this with all meds for years ..opens your gullet like you see sword swallower doing..truly reliable I believe....

[Sus64]

I felt the same way with my NDT so I now chew the pill and let it dissolve in saliva, then wash the liquefied pill down with a glass of water.