I have just been to occupational health through work and that is what the doctor has recommended.
Is it safe to take all your tablets for the wee... - Thyroid UK
Is it safe to take all your tablets for the week in one day
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mitziboo01
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SeasideSusieRemembering
mitziboo01
I have just been to occupational health through work and that is what the doctor has recommended.
Are you talking about your Levothyroxine?
Can I ask why this has been recommended?
Why would the doctor at occupational health through work be suggesting this rather than your own GP?
What are your thoughts?
It's not unheard of but it's usually done when patients are non-compliant with taking their Levo and it tends to be done at the GP surgery under the supervision of a nurse or a GP.
Thanks for the advice yes I am talking about my Levothyroxine I have been trying at work to keep my shifts to max 12 hours they refused and suspended me in December they arranged a video link meeting yesterday with OH but had to eventually talk to her on the phone. I am going to try to see a doctor at my surgery this week to discuss her flippant behaviour. Any more advice would be great a couple of years ago an OH said thyroid may come under disability/equality but this OH yesterday says its not and working up to 15 hours in the day and a 9 hour rest period would not affect my health. By the way I drive a HGV class 1 lorry.
Your OH department is very wrong and you are covered under the disability act as it’s a lifelong condition. I can’t even imagine doing a 12 hour shift and I certainly wouldn’t want to be driving for 15 hours!
Your shift is 15 hours in total but you can only drive 10 hours of that plus breaks problem is you only have a 9 hour rest break before your next shift by the time you get home have something to eat and the same when you get up again you don't get a lot of sleep and I work at night my shift starts at 22.00 hours
mitziboo01
But why is the OH doctor suggesting you take your Levo once a week? Has she given a reason why that would be better?
This sort of thing really bugs me - sorry, this is not directed at you at all.
Many doctors don't understand hypothyroidism, how it feels, how to treat it, how to interpret blood test results, and don't even realise it's the thyroid hormone results (FT4 and FT3) that are important, etc. This OH doctor, I presume, is not a thyroid expert so why would she know that working up to 15 hours a day with 9 hours rest is not going to affect your health. I would imagine that many people without hypothyroidism could well be affected by those sort of hours on a regular basis.
My thoughts - and I've never taken my Levo once a week, always daily - is that even though it is a storage hormone it is better to even it out and take a steady, similar amount daily rather than possibly shock your body with a big dose once a week. I imagine those who are put on a once weekly routine it must be a last resort when non-compliance is a problem that can't be overcome.
So, getting my teeth into it now! Looking back at your first post on 18th December when you joined the forum (you can see all your previous posts listed on your profile page here: healthunlocked.com/user/mit...
It would seem that you were left on a starter dose of 50mcg for 3 years. You said that your dose had just been increased. Both SlowDragon and I mentioned that it was important to get full thyroid testing along with vitamins and minerals (which play a very important part). So can you tell us:
* What were your test results that prompted the increase in dose?
* Have you had a new test yet because it must be at least 6 weeks now since that increase and a new test is due if it hasn't already been done.
* Did you ask for Vit D, B12, Folate and Ferritin to tested as suggested, along with thyroid antibodies?
I think that you have been undermedicated and were symptomatic because of that.
I think you may also have some low nutrient levels which need addressing.
So that we can help you can you please post all your test results -including the very important reference ranges so that we can interpret them - everything that you have so that we can try and understand this and help you.
SlowDragon gave you links in your second post about hypothyroidism can be regarded as a disability - or rather how the condition affects you. If you are optimally treated then a fairly normal life should be possible, but it's making sure that you are optimally treated that is key, hence us needing to see your test results so that we can, if necessary, point the way forward there.
I don't have any test results my doctor says I am not due a blood test until March.
Ask for previous results. Don't ask your GP, just as the receptionist for a print out of your previous test results, then post them on the forum, along with their reference ranges, and we can help further.
Thank you I will, how are you doing by the way.
Not bad, would have preferred not to have had a fairly difficult extraction of a large double tooth a few days ago after a week of toothache, but that's life 
Can't wait to get back to eating proper food instead of soft stuff, I'm gagging for egg and chips or a Sunday roast!
Egg and chips sounds lovely, I had a double tooth removed about four years ago and it broke of leaving the root it started hurting a year ago and my dentist sent of a request to the hospital I am still waiting for an appointment and I ate at that side this morning and it is throbbing so I know what you are going through
Oh, poor you 
Mine was almost all filling and very little tooth. The dentist had to remove the filling first, then the tooth had two roots so he had to remove it in two parts, I can still hear the crack 😯 but I was very brave, I only cried when I got the bill 😭
I guess the bill is the worst part, my bills at the moment are buying stuff for my puppies. Decided it would be cheaper to buy all the grooming equipment and do them myself. First cut tomorrow, wish me luck hopefully 3 cute puppies tomorrow afternoon.
Good luck with that! I decided a long time ago that scissors, my dog and I weren't a good combination so I pay a groomer ✂️🐩🐾
helvellaAdministratorThyroid UK
I'd have been tempted to ask the Occupational Health doctor if they would willingly take a whole week dose of levothyroxine on one go?
They would probably say that they don't need it, so of course not.
If on Monday, you would normally take, say, 100 (just to keep the numbers simple), you would be expected to take 700. That is 600 that you don't (yet) need.
However you play about with things, like not taking any for three days before taking 700, you will be on a regime which goes from low to high and back - by a large margin.
SeasideSusie has answered very well.
I am going to wait for her report to come to me and take it to my doctor.
What was her reason for this ridiculous advice?
Or, wearing my cynic's hat.... her motive!
"...working up to 15 hours in the day and a 9 hour rest period would not affect my health. By the way I drive a HGV class 1 lorry."
Has this woman even considered the safety aspect of her advice...it seems not!
When were you diagnosed?
What dose are you prescribed? You are probably under medicated.
Did she refer to your GP/medical notes?
Thyroid disease, if not correctly treated, is a life threatening condition and a reason that we are entitled to free prescriptions. It is a disability!
Her ignorance is only exceeded by her arrogance....just my opinion!
This sort of advice makes me furious!
Diagnosed in 2016, was on 50mg until December last year now on 75mg. She said she doesn't need to contact my doctor and her bad report will probably get me dismissed from my job of 13 years, bad doctor and very bad manager who risks peoples lives.
Bloods MUST be tested 6-8 weeks after EACH dose increase in levothyroxine
75mcg is only one step up from starter dose of levothyroxine. Most people require somewhere between 100mcg to200mcg levothyroxine daily
See GP and request thyroid and vitamin testing NOW
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Ask GP to test vitamin levels and thyroid antibodies
You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
thyroiduk.org.uk/tuk/testin...
For thyroid including antibodies and vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )
monitormyhealth.org.uk/thyr...
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all primary hypothyroidism in Uk is due to Hashimoto's.
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 is in top third of range and FT3 at least half way through range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
nhs.uk/medicines/levothyrox...
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
It is HIGHLY LIKELY THAT YOU NEED FURTHER INCREASE IN LEVOTHYROXINE
Get bloods tested via GP or privately ASAP
Going to try to see a doctor this week.
I'm so sorry that you've been treated in such a disgraceful manner.
Being left on 50mcg for so long is appalling, 50mcg is a starter dose and should have been re-tested after 6 weeks followed by an increase.....and so on until your symptoms were relieved. Do you feel well on 75mcg., you most probably need another increase.
Can you discuss this debacle with your GP as soon as possible
Will her poor decision have an impact on your ability to find a new job....if so you need to get it reviewed/overturned. Do you have a Union to which you can turn?
You need to have a full panel thyroid test done... now!
There are far too many badly informed medics and consequently far too many sick patients!
You have a double whammy....manager and medic!
Wishing you the strength to fight this injustice....and to win.
Thanks I will keep you updated on what happens
Very important to test vitamin levels as you have been left so under medicated on far too small a dose of levothyroxine for far too long
NICE guidelines
cks.nice.org.uk/hypothyroid...
The initial recommended dose is:
For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.
This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.
If they try to sanction you or sack you (as thyroid problem are covered by the disability laws), you are in a good position to take them to a tribunal. Try to keep recordings and notes and get a witness. The Safety implications are horrifying
I have kept all records and have already spoke to ACAS as I have been employed by the company for 13 years and as I have said in my investigation meeting and disciplinary meeting I take safety very serious shame my manager doesn't.
The fact that we may look and appear 'healthy' they cannot see what's going on in our bodies at all.
These ignorant people you wouldn't wish hypo on them but being treated like you are, one would definitely want them to develop it.
Others' advice re your dose I'd take note of. It is very unusual to have such a low dose and I think you should take a look at how your doctor has been treating you.
Is your TSH 1 or below, is your Free T4 and Free T3 in the upper part of the ranges.
Are you aware to leave a gap of 24hours between last dose of levo and test and take it afterwards?
Many doctors seem to believe that taking note of the TSH level alone (TSH being from the pituitary gland - not thyroid gland) is fine and if it is within a range believe you're on a sufficient dose.
.
They should, occasionally, give you a whole Thyroid Test which is:
TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.
TSH should be 1 or lower and FT4 and FT3 in the upper part of the ranges.
Poor you, I would be recoding the dates times and contents of these meetings. Medication wise continue as you are and only take advice from your local doctor or endocrinologist. Meanwhile I hope you are quietly updating your cv and feeling around for another job. This way you can iron out the terms of your employment before you begin. Goodluck xxx
I have been employed by the company for 13 years just have a bad manager at present and I will fight it too the bitter end as employers should take peoples health into consideration.
Of course, sorry I see what you mean. It’s maybe it’s different when you’ve been there such a long time and have friends there and things x
I actually thought the min rest between shifts was 11 hours. Id there some reason why she thinks you d be exempt? Does she have no idea what your working day is like?
I could go on here, like : Is she actually qualified?
You can reduce your rest to 9 hours 3 times between 2 weekly rest periods but what I am saying if I have max 12 shift it allows me 12 hours rest and that means I can have a good sleep, exercise and a healthy diet. I also work night shift which is harder on you my shift starts at 22.00 hours 5 nights per week.
Found it (eventually). That s harsh!
That and then that brings in a whole new level of people who know nothing about thyroid issues. I see you are getting help from the legal point of view. Good luck (for your health and the H&S of all of us).
talk to a local law clinic who offer free employment advice, about whether you can take action for discrimination or bullying. acas are also sometimes able to assist. keep notes of conversations, dates, comments of this type etc. take a colleague or union representative to take notes at any meetings.
visit your GP for supporting letter ( if they are supportive) and print off a leaflet from thyroid uk explaining your illness. keep a note of when you submit this, to who and their response.
employment claims are difficult because of 2 year in service limitations on claims ( except for discrimination i think) but with the right advice and evidence you may be able to take this further
I have spoken to ACAS and they say I have a good case as I have been employed 13 years with the company, my union are backing me all the way and at the moment I have had part investigation to be continued but they decided to go straight to disciplinary and now the disciplinary manager has postponed it to investigate the investigation and now my disciplinary meeting is rescheduled for the 13th of this month.
So it strikes me that if you say to your work that their shift patterns are making you sick, and you have any diagnosed medical condition that this is affecting (classified disability or not) and they suspend you for it, they're discriminating. I'd consider speaking to an external legal advisor about this. This advice and attitude brings the words constructive dismissal to mind...
I had never heard of such a regimen in many years of these forums. So of course I googled it. Came up with this: google.co.uk/amp/s/www.endo... when I took T4 a brand change could send me loopy so there is no way I’d take seven pills at once. The paper actually says it was ok but there was strong opposition to the idea from some very eminent endos. Last thing you need is stress. Stay calm. Don’t let them grind you down.
This is appalling! I would either write to your MP or send a email telling them your story. I have done this and my MP is going to put my case to Matt Hancock and I am still hopeful that something might happen to change the way thyroid patients are treated in the UK. Also why don't you contact your local paper to see if they are interested in publishing your story?
Wow, I'm sorry to hear about your troubles with work. I can only work 12 hours a week due to bad fatigue and have had to fight to get universal credit. I've found these posts very helpful too. I've been on 50 levo thyroxin since I was diagnosed 7 years ago. I'm in the process of requesting my blood results from GP so I can post them on here to get help to understand them. I'm also wondering if I have B12 deficiency.
All the best with work and your gp.
Hey, I believe that 50mcg is only a starter dose. I’d encourage you to get your results and post on here as it sounds as though you might be under medicated!
Thanks cazmania7 I have put in a request form for my blood results at my gps today, but was told it could take up to 30 days for me to get them. I'm wondering if I should go see my gp in the meantime and ask for my levo to be increased due to my on going fatigue. Or ask to be referred to a endocrinologist?
Why will it take up to 30 days? That seems a very long time. You could always do a private blood test which takes days. I went for one with Medichecks on Friday and they emailed me yesterday to tell me they have received my sample and will contact me when my results are ready to view online.
Thanks Lora7again. May I ask what will you do with your results?
Thanks
I have just posted them on here for members to advise me
Well after being on this forum and knowing how unhelpful my Drs can be, if I were you I’d get my own blood kit sent to see for myself what my bloods are doing then take it from there.
If you ask for an increase now they may just say no as you are in range. Depends what your Dr is like.
I’ve heard you have a right to an endo referral but I asked my Dr and they just said No.
Knowledge is power. I’d order a blue horizon blood kit. Arrange for a nurse to take your blood (my surgery does it £30) and send it off to see for yourself what you need. Good luck! Hopefully you’ll just need more levo and you’ll be right as rain
Thanks cazmania7. Can I ask what do you do with the results from the blue horizon test kit when you have them? Take them to your gp?
Thanks.
No way! Lol I post them on here for advice first. I now self medicate. I’m still sick but I have more hope now and instinctively feel I’m on the right path to better health
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