Does anyone divide their synthroid up into 2 doses? Is this a possibility? my tolerance to all thyroid meds is terrible even at low doses- about 2.5 hours after taking med I am too revved up, severe anxiety, agitation and some days down right angry! This lasts for about 3 hours then I settle down. I Have tried NDT, and also t3 , but this was even worse as the t3 was way too stimulating ( ata tiny dose).
I’ve Had countless tests and other than low Vit D and thyroid numbers being a bit off all else is fine ( I’m on vacation so don’t have blood tests handy) .I Just wondered if it’s possible to divide my dose- if it might lessen these horrible side effects- my husband is getting pretty fed up with my erratic moods😢 and can’t say I don’t blame him- I can’t stand myself when I feel so mean and wound up. I know Synthroid has a long half life unlike t3. I appreciAte your thoughts on this.
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jjyankee
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I don't think there is any reason not to divide the dose - except your ability to maintain separation between Synthroid (or, of course, any other levothyroxine product) and food, drink, supplements and medicines which might interfere with absorption.
In my mind, small and frequent doses would be closer to a working thyroid so should be better!
Thanks so much for taking the time to respond. Yeah, I do know I'd have to be aware of food, drinks, other meds, etc. which is quite a pain in itself- I sooooo hate this illness! I don't know, it almost feels like my body just metabolizes these meds too fast or something. My doctor's don't take me seriously and/or have no answers. I know t3 meds can be taken in multiple doses because their half life is short but not sure how that works out with Synthroid.
I have always taken mine as 2 or 3 doses. My consultant recommended it as I couldn't tolerate a high dose. I have taken doses at 6am and bedtime and I currently take doses at 6am, 4pm ish and bedtime. I take t3 so have split my t4 doses into 3 to take at the same time as the t3.
I take 100mg Synthyroid and 10mg cytomel so I had my doctor prescribe 50mg (synthyroid) so I could take 2 doses instead on 1.
I take them about 5 hours apart give or take Im not persnickety about taking the second dose as long as I leave enough hours before I take my other meds.
Try splitting pills and decide based on your needs when to take them.
Have you looked into if you have adrenal issues it might be causing some of your symptoms you can order the tests online or work with a holistic doctor
Yes of course you can! Taking it all in one go is a kind of convenience for the doctors prescribing (to ensure compliance) and for patients to take it simply and easily and consistently without worrying about variation in absorption due to state of digestion and food or drugs that affect absorption.
Having said that, the healthy human thyroid secretes t4 in little bursts continually with the pattern over each 24HRS being relatively stable. Some of these unphysiologically large doses we are prescribed may cause side effects and almost certainly will reduce cellular conversion rates of t4 to t3, which is what it’s all about!
I’m like you and very sensitive to all the thyroid replacement options and I know from my own blood tests that more frequent smaller doses of levothyroxine appear to give better free t3 levels especially if I’m not taking exogenous t3. I was taking 125 mcg levothyroxine in three doses with 3x2mcgof liothyronine on retiring on waking and at midday.
That worked ok, far better than a single 125mcg dose of levothyroxine which made me feel too ill to sustain it. There are those , here and in the medical profession who will ridicule this and argue the science doesn’t support it but they are either insensitive or have never taken it to know! Moreover, the science has simply not looked at wider issues of well-being under thyroid replacement regimes and so personal experience is of far more weight and value than being influenced solely by scientific data based on a very small range of biological monitoring criteria.
The potential for me in split dose levothyroxine is quite promising based on my experience and reading of the literature. I am now trying 6x25mcg levothyroxine and no liothyronine to see if I can manage without that expensive and contentious drug! It’s a bit of a bind yes but after 6 weeks so far so good. I take the levothyroxine whenever I like but try to keep about 4 hours between doses and don’t worry about absorption- the blood test will reveal the net effect. My first 6wk blood test showed an excess of ft4 (25pmol/l) and 4.9 ft3 which is slightly less than when was taking liothyronine, but not by much.
The only downside now, apart from the vast number of levothyroxine pill blister packs I need, seems to be that I do not feel quite as well as I did with an optimal levothyroxine and liothyronine combination and I do not know how long I would tolerate this but it may be a matter of simply getting used to it.
The critical takeaway point is that I have been able to push my conversion of T4 to T3 to normal levels using T4 alone. The only way I have been able to do this is to take a large T4 replacement split evenly throughout every 24-hour period. Whether this is sustainable in the long term remains to be seen. But as ever I would say we are all unique and if we are not comfortable or feeling well on the standard prescription methodology we should not be afraid to experiment for ourselves taking care of all the usual risk factors.
Very interesting post. Do you bother with all the gaps we are told are essential between food and drink? I find that the hardest thing to deal with. I feel like a sick person having to handle that aspect. I'm much better if the alarm goes off and I just swallow the pill and carry on.
I might try this. I'm fine taking 125mcg all at once first thing, but my conversion isn't good and I can't seem to improve my T3 level no matter how much Levo I take. Do you think it necessary to split the dose exactly the same each time? And how do you manage a blood test? Do you just skip your meds for a 24hr period?
I try to avoid swilling the levothyroxine tabs with coffee
Seriously, I will take them with food or near food but I do try and leave a bigger gap between levothyroxine and coffee or high fibre meals but any reduction of dose because of decreased absorption can be offset by increasing the overall dose. For example if I was taking a sufficient dose of 125 in one fasted dose at 6am an hour before anything else I might try increasing to 150mcg if the doses were taken throughout the day. I suspect that the extra 25 may be too much but it’s trial and error to establish our optimal dose anyway so we could try different dose and timing regimes and test the three blood levels accordingly - then be consistent with our dosing pattern once we establish acceptable blood levels for whatever dose regime we preferred. I guess the value of this is a trade off between the ease and consistency of a single dose at a set time every day with reliable fasted state conditions and any benefit we may get in better t4-t3 conversion and reduced side effects......
I also wonder whether it’s possible to listen to our bodies and dose levothyroxine whenever we feel it’s running low, much like developing an ear for a particular hunger, like knowing when we need carbs or protein. I guess there’s a risk of over medication if we confuse signals between body and brain but if we know the safe upper limit of levothyroxine and don’t exceed that we could perhaps freely experiment with ad lib dosing over 24HRS. Doing all this also requires a good record of what we have done, a symptom diary and maybe even a food diary linked to periodic blood tests to establish a reliable regime.
As far as blood test timing goes I take it the same time every time and that is about 11pm just before any thyroid meds on retiring. This is one of the major advantages of DIY home fingerprick testing along with control of which TFTs we choose (ft3 ft4 and tsh), two damn good reasons to free ourselves from reliance on nhs testing. Even if we did this every 2 months it’s only the equivalent of £20/month which isn’t so bad in relation the grief some of us can suffer from out of whack thyroid medications.
Thanks so much for taking the time to write such an in depth reply- I can't imagine taking 125mcg of levo- I'm taking 50 and that sends me off the rails. So I am going to try splitting the dose in 2 and of if that helps I'll try small increases (doc wants me to increase to 75 before being tested again). I tried t3 and even at minute doses it made me feel like I was on steroids-sooooo revved up and downright ugly.
Yes it’s powerful stuff! And most of the doctors seem to grossly underestimated this. Possibly because some people can take quite big doses with almost no apparent effect! However for those of us that are sensitive to it, and there is nothing wrong with us in that, even 25 µg can have disturbing affects. When I was first diagnosed, 50 µg every day for two weeks made me feel so unwell I opted to be hypothyroid instead! Of course the eventual consequence of that is coma and death if whatever is left of our thyroid conks out completely.
I struggled for years with taking anything like the prescribed dose of levothyroxine and have only managed to take as much as I do now by increasing it almost imperceptibly over several years and using natural desiccated thyroid or synthetic liothyronine to stop me being catastrophically hypothyroid. I do think the medical profession at large treat this issue far too simplistically and I would bet that most if not all of them have never experienced the effects let alone had to rely on the drugs. Unfortunately we probably have to find our own way with this and I find that only by keeping a detailed symptom diary and dose record together with very frequent blood testing have I been able to get my head round it and even now I am still not as well as I was before levothyroxine!
You know you could quite possibly cut your 50 µg pills into two or even more portions and without losing any of it, split that accordingly perhaps before going to bed and before getting up in the morning. I used to find that taking most of it at night helped me sleep through some of the side-effects and, perhaps bizarrely, taking half a dose of normal antihistamine not only helped me sleep but seem to ameliorate the side effects. Please remember I’m not a doctor I’m just passing on my own experiences anecdotally.
I did split my pill this morning- still felt wired and really irritable a few hours after taking it (25mcg Synthroid). I don't know, it just feels like my body finds all of these meds toxic.I've tried so many different meds, different combos, different dosages. I've read a pile of books- have a super open minded integrative doctor but I also saw an endocrinologist (he was useless). I'm so tired of trying to figure this all out. I really appreciate you sharing your experience- thanks for that- it's comforting to know that so many others have the same challenges.
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Now I’m confused. 
Test Results : Balance T4/T3?
6/7 weeks into 50mcg Levothyroxine and have constant anxiety & rapid Heart rate. 
