Advise please

[Gillw1978]

I take liquid levothyroxine I’ve just been told I’m vitamin d deficient am I able to take the vitamin d at the same time?

Tia

[SlowDragon Administrator]

Never ever take anything at same time as levothyroxine

All levothyroxine is extremely fussy and must be taken on empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

Vitamin D tablets that you swallow must be minimum of Four hours away from levothyroxine

Vitamin D mouth spray, at least an hour away

How low is vitamin D and has GP prescribed, if yes how much vitamin D have they prescribed

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

[TRbo in reply to SlowDragon]

Does the same apply with ndt and vitamins, also does coffee affect it

[SlowDragon Administrator in reply to TRbo]

No vitamins at same time as levothyroxine or coffee

Vitamin D, iron, magnesium all need to be four hours away from levothyroxine

Generally seems accepted that it’s ok to take NDT and levothyroxine at same time

[TRbo in reply to SlowDragon]

Sorry I meant is it ok to take vitamins and coffee within an hour of taking ndt

[SlowDragon Administrator in reply to TRbo]

Don’t know about coffee ....but probably not

Definitely not vitamins

[Gillw1978]

Doctors haven’t prescribed just told me to get some from the pharmacy xx

[shaws Administrator in reply to Gillw1978]

I believe that it has been agreed that cheaper medications we need can now be sourced through a chemist/pharmacist ourselves.

The following is an excerpt from link below:-

Don’t always use a prescription

The cost of a prescription is charged at a flat rate of £9 per item (£9.15 from April), which applies no matter the type of medication you order.

But if you’re prescribed over the counter medication like painkillers or eczema creams it may be cheaper to buy them outright than paying £8.80 for a prescription given to you by your doctor.

A 500ml tub of Aqueous cream, for example, is £3.59 at Boots, so using a prescription could leave you out of pocket.

lovemoney.com/guides/63226/...

[Anthea55 in reply to shaws]

Just to say that it is now known that Aqueous Cream should be avoided as it contains SLS (sodium lauryl sulfate) and can cause a rash. Two links -

"BBC Two - Trust Me, I'm a Doctor - Are my wash products damaging my skin?"

bbc.co.uk/programmes/articl...

"Eczema cream that could be making your skin worse"

dailymail.co.uk/health/arti...

[Miffie in reply to Anthea55]

From Gov.uk :-Article date: March 2013

Aqueous cream is a widely used product topically applied as an emollient for the symptomatic relief of dry skin conditions such as atopic eczema, and as a soap-substitute for skin washing.

Although aqueous cream is useful as a leave-on emollient in a substantial proportion of patients with eczema, it is known that in some patients, especially in children, it can cause skin reactions, such as stinging, burning, itching and redness.

In light of new information from the published literature all data on the benefits and risks of aqueous cream, particularly when used in children with eczema, have been recently reviewed in the UK.

Paediatric clinical guidelines from NICE and the National Eczema Society have reported that aqueous cream may be associated with skin reactions, such as burning, stinging, itching and redness, when used as a leave-on emollient but not when used as a wash product. The difference in the irritation potential in some patients may be related to the contact time with the skin, as soap substitutes are largely removed in the washing process.

So it’s been known for several years.

[Anthea55 in reply to Miffie]

Thanks, Miffie, It's not just aqueous cream to be avoided, but anything which includes SLS. And it's not just children, adults too.

It still isn't widely known by medics. My chiropodist offered to put it on my feet after treatment until I asked what he was using, so I explained the problem. I've now sent him links about it so he is aware. I went to a dermatologist who didn't seem to have heard of it - I didn't go back!

[SlowDragon Administrator in reply to Gillw1978]

So what was actual vitamin D result

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

2 good videos on magnesium

healthunlocked.com/thyroidu...

[SeasideSusie Remembering]

Gillw1978

Officially Vit D Deficiency is <25nmol/L. I think in some areas it may still be <30nmol/L.

If it's <25nmol/L then your GP should follow NICE Clinical Knowledge Summary and prescribe loading doses of D3 on prescription.

What is your level?

If you are in England and have a diagnosis of hypothyroidism then prescriptions are free.

If you are in Scotland, Wales or N. Ireland prescriptions are free for everyone.

[Gillw1978 in reply to SeasideSusie]

I tried to edit it to add a pic of results and think it has created a new post xx

[SeasideSusie Remembering in reply to Gillw1978]

Post with result: healthunlocked.com/thyroidu...

Gillw1978

So your level is 26nmol/L and your print out shows <30 = consistent with deficiency. Therefore your GP should prescribe the loading doses. If you want to go down this route then show your GP the following but point out that in your area it says deficiency is less than 30nmol/L so you come into that category as stated on your print out:

NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d...

(click on Management > Scenario:Management)

"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.

* Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

If you prefer you can treat yourself following the guidelines above for the loading doses.

Once the loading doses have been completed you will need a reduced amount so you should make sure that you are retested after you have finished the loading doses so that you know how much you should then take going forward. If your GP wont retest then you should do this yourself with a private test.

Most doctors, if they continue prescribing, only give 800iu daily which isn't enough. If GP wont retest then do this privately (link below) and post your new result at the time for members to suggest a new dose to bring your level up to what's recommended by the The Vit D Society/Grassroots Health - which is 100-150nmol/L - and then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3.

D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

For D3 I like Doctor's Best softgels which contain only D3 and extra virgin olive oil, they are a small, easy to swallow softgel and budget friendly. Some people like BetterYou Oral Spray although it does have a lot of excipients.

For Vit K2-MK7 I like Vegavero or Vitabay, very tiny tablets.

Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

[Imaaan]

I wrote a reply on the other thread and tried to send it, unknowingly that it was closed. Already wrote it out and didn't want to lose it so I took a snapshot.

[Imaaan in reply to Imaaan]

Second portion is below

[Prothero]

Do you mean same time of day? Big no, should be spaced apart. I have very sensitive gut so have to apply strictly to the rules!

[Countrykitten]

Vit D is fat soluble so it's best to take it with a meal containing some fat. I usually have mine with dinner. Only take Levothyroxine on an empty stomach and nothing else for at least an hour. There is plenty of guidance on this site.

[JackiePooh]

I agree with others here, don’t take anything with your thyroid medicine but I have learned that you should take vitamin D with foods containing fat.