Can I take my 112mg levothyroxine first thing in the morning and at the same time as my 5mg Felodipine? (Blood pressure tablets)

[Rezzar]

Hi everyone, I usually take my levothyroxine on its own at about midnight. However, I possibly now need to take sleep aid tablets at night, so I am thinking of changing times and taking my levothyroxine first thing in the morning instead. However, first thing in the morning I have to take my high blood pressure tablets (Felodipine).

So my question is can I take levothyroxine and Felodipine together? I hope this makes sense, my brain is a bit blurred due to lack of sleep!

[Lalatoot]

To get the most out of levothyroxine it needs to be taken on its own with water on an empty stomach and 2 hours away from supplements or other meds.

[Rezzar in reply to Lalatoot]

Thank you for that, I shall stick to taking it on its own.

[bingobingo in reply to Lalatoot]

I have been taking all my medical together for years. I was never told to take levothyroxine by itself, just not to eat until 1 hour after

[Rezzar in reply to bingobingo]

Thank you

[SlowDragon Administrator]

Levothyroxine needs taking on its own minimum 2 hours away from any other medications, or you risk poor absorption

What are your most recent thyroid and vitamin results

Perhaps dose levothyroxine or vitamins need improving

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)

Recommended on here that all thyroid blood tests early morning, ideally before 9am last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[Rezzar in reply to SlowDragon]

Thank you so much for your informative reply. My latest blood test was taken at 8.30 am on 08.02.2021. (I delayed my levothyroxine until after the blood draw)

Vit D 72nmol/L. (76-250 nmol /L)

TSH. 0.53miu/L. (0.35-4.78 miu/L)

cholesterol 5.5 mmol

T4 14.8 pmol/L. (10-20 pmol/L)

T3 4 pmol /L. (3.5-6.5 pmol/L)

Vit B12. 442 ng/L. (200-900 ng/L)

Folate. 10.8 ug/L. (2-17 ug/L)

Everything was stated as normal except for Vit D and I am now taking more Vit D.

My next blood test is booked for in 2 weeks time.

Sadly in April last year I fell, whilst out running, and ended up in A/E with dangerously high blood pressure! I haven’t really felt right since then. I am very jittery and my nerves are on edge. I find it hard to switch off my head and get to sleep at night.

I reduced my levothyroxine (with doctors consent) from 125 to 112.5mg (5 weeks ago) as I thought this may reduce my nervousness. So far I have felt no change.

[SlowDragon Administrator in reply to Rezzar]

FT4: 14.8 pmol/l (Range 10 - 20)

Ft4 only 48.00% through range

FT3: 4 pmol/l (Range 3.5 - 6.5)

Ft3 only 16.67% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

Suggests under medicated

Most people when adequately treated will have Ft4 at least 60% through range and will need Ft3 at least 50% through range

These results were from before reducing dose further

Anxiety and insomnia are common hypothyroid symptoms

High blood pressure also hypothyroid symptom

B12 and vitamin D could be a little higher

Vitamin D at least around 80nmol and around 100nmol maybe better

B12 at least over 500

You need ferritin tested (and iron if ferritin is low)

[Rezzar in reply to SlowDragon]

Oh that is so helpful and interesting, thank you so much. So in all probability I should increase my dose after my blood test. Just another question, I am now 64 years old, will my requirement for levothyroxine increase or decrease as I get older?

[SlowDragon Administrator in reply to Rezzar]

Dose levothyroxine Unlikely to decrease much, if at all

Vitamin levels tend to drop as we get older due to reduced stomach acid leading to poor nutrient absorption and low vitamin levels as direct result

Extremely important to maintain OPTIMAL vitamin levels for levothyroxine to work well

Test FULL Thyroid and vitamins once year ….privately via Medichecks or Blue horizon if GP refuses

[Sewsewer]

Good morning RezzarI am new to taking thyroxine so have been looking into it carefully over the last couple of weeks. I also take Amlodopine for high blood pressure. In my research I came across a suggestion that it may be better to take blood pressure pills before bed so that they have the most impact on your resting blood pressure. Others who know more than me may know whether or not this is good advice - but I have followed it, and take my thyroxine in the morning and Amlodopine at night.

I have a friend on thyroxine who says it kept her awake so she switched to taking it in the morning, which helped.

[Rezzar in reply to Sewsewer]

Thank you so much Sewsewer, I have just had a chat with my GP who agrees with what you say. So from now on I shall take my blood pressure tablet in the evening and my levothyroxine first thing in the morning. My GP suggests that the crux of all my problems: insomnia, nervousness and anxiety, could be caused by my hypothyroidism.. so she wants to see what my levels are and has therefore brought my blood test earlier to next Monday, but sadly the only time they have is 11.20am. But I need to get myself sorted out; , after another night of no sleep I am just not functioning properly, I have no enthusiasm or zest for life!

[Sewsewer in reply to Rezzar]

Great to hear that your GP is so keen to investigate! I’d check in with one of the experts about having the blood test so late in the morning - it might do more harm that good in the medium-to-long term to get an inaccurate result. As far as I understand it, the later in the morning the test is done, the lower your TSH will be, due to natural rhythms. If you and your GP are looking for evidence that you TSH is too high, causing your hypo symptoms, then you would probably be better off waiting for an early morning appointment.

[Rezzar in reply to Sewsewer]

Thank you Sewsewer I shall stick to this appointment as it’s all been organised for me now ( and I don’t want to be an awkward patient). But I am thinking of taking a home medicheck test if the results from Mondays test look dubious. I shall just take one day at a time.

[Rocky]

I have always taken my blood pressure tablet Amlodipine at the same time as my Levothyroxine as advised by my GP and Pharmacist. I have recently been put on Liothyronine by my private Endocrinologist, and asked him about taking my tablets at the same time as my blood pressure tablet. He told me to take my Levothyroxine and Liothyronine first, and then wait half an hour to take my blood pressure tablet.

[Rezzar in reply to Rocky]

Thank you for that Rocky