Type 1 Diabetes, Hypo treatment & thyroxine

[LECJ]

Who else here is Type 1 Diabetic?

Question pls re taking your thyroxine and being hypo so needing to eat

I usually take the Levothyroxine when I wake up but this morning as quite often happens I was super low (1.7mmol) so lucozade and breakfast later I’m wondering when the heck to take the thyroxine as obv I now have food in my tummy 🤦‍♀️

[SlowDragon Administrator]

You can take levothyroxine at bedtime. Can be more convenient and perhaps more effective too

verywellhealth.com/best-tim...

This morning, just take Levo 2 hours after eating and minimum of an hour before next meal

[Gambit62 in reply to SlowDragon]

SlowDragon, just wanted to draw your attention to the fact that an evening dose may not be the best option in this case. Many diabetics need to eat smaller amounts more frequently to keep blood sugars under control. Taking a dose in the evening could potentially result in a longer period without food increasing the likelihood of low blood sugars.

This is an instance where the normal protocols re empty stomach may not actually be in the best interests of the patient.

LECJ, I would suggest speaking to the pharmacist first - they are more likely to be aware of or able to get easy access to information about why dosing recommendations are the way they are and hence more likely to have an understanding of when variations from general practice may be more appropriate and what the effect of those variations could be on dosing levels. They can also alert the GP and that may be more effective than trying to speak to (or write to) the GP on your own.

[Gambit62]

as I understand it the main reason for going with levo on an empty stomach is that this ensures the right stomach acidity for it to be best absorbed, so it results in the lowest dosage required. However, we are all individuals and if you have problems with regular hypos or low blood sugar meaning that you need to eat earlier it might well be better to not go with taking it on an empty stomach and taking it a shorter period after food. This will probably mean that you need to up your dosage. I would suggest that you discuss this with your GP/pharmacist, ie

there isn't anything fundamental that means levo absolutely needs to be taken on an empty stomach, just that this results in it being absorbed best. Probably more important that you are consistently taking the levo in the same circumstances so the absorption from a dose is consistent.

Levo is a medication that is retained in the blood for quite a long period.

Your priority in the instance that you are hypoglycemic will always be dealing with the hypoglycemia first as the time-scales on damage caused by hypoglycemia is almost immediate.

[LECJ in reply to Gambit62]

Thank you that’s a really interesting idea - I’ll speak to the pharmacist - I wonder thinking on what you said that perhaps just on the occasions of a hypo tje doctors could advise on a slightly higher levo dosage to take account of the unfortunately having had to eat

[Gambit62 in reply to LECJ]

because levo has quite a long half life in the body it would be extremely difficult to judge what change might be needed - if you need to switch would be better to switch to a different regime entirely that doesn't means levo is being taken under the same circumstances and dose is steadier.

To be honest missing one dose or even absorbing less of one dose now and then is unlikely to make any difference to people though there may be the odd exception. I missed a dose last weekend because of a huge migraine and not particularly worried about that.