when is the best time to take your medication, morning or evening?

[NATALIEDW67]

i have just been given medication for over active thyroid, the label says one tablet daily.

[helvella Administrator Thyroid UK]

I assume Carbimazole?

There is a problem with one tablet daily. Carbimazole has a short half-life. It takes effect quickly, but it also fades quickly. By 24 hours after your daily dose, it will be having little effect.

The end result is that your thyroid hormone levels can, instead of reducing, end up getting topped up every day.

For this reason, it is common to start Carbimazole as two, or even three, doses a day, spread as evenly as possible.

However, if you are only mildly hyperthyroid, it might be OK.

After controlling thyroid hormone levels, many can cut the dose and take it once a day. Which is, of course, easier.

You don't mention your dose. If, as I suspect, it is 20 milligrams, they could instead have prescribed four 5 milligram tablets. That would allow split dosing.

If only one dose, I'm not sure it matters at all when you take it. Just be consistent in your timing.

Also, I always encourage anyone starting Carbimazole to read the Patient Information Leaflet - start to finish - several times. There is important information to take in.

[NATALIEDW67 in reply to helvella]

Hi Helvella

Yes it is Carbimazole and it is 20mg. Do you think it would be worth splitting the tablet in half? I could ask the GP but it is very hard to get through to them.

Many thanks

[helvella Administrator Thyroid UK in reply to NATALIEDW67]

Most carbimazole tablets in the UK, even if they have a score or break line, are expressly not to be split. They can be broken in order to facilitate swallowing but not to divide the dose.

The doctor should know better and should have prescribed more appropriately. This is the standard instruction:

Adults

The initial dose is in the range 20 mg to 60 mg, taken as two to three divided doses. The dose should be titrated against thyroid function until the patient is euthyroid in order to reduce the risk of over-treatment and resultant hypothyroidism.

medicines.org.uk/emc/produc...

(It might be that splitting is accurate enough. But the official documentation rules - not the opinions of individuals.)

[Lalatoot]

Natalie do you mean OVER active and is the medication carbimazole?Normally carbimazole is taken in several doses throughout the day.

Did you know that hypothyroid UNDER active can begin with a phase that mimics over active? Not all doctors are aware of this and we have seen a few folks on here who have been wrongly diagnosed and given the wrong medication. Sorry I don't mean to scare you.

So we can give you the best advice can you ask the surgery for a print out of your results. These should be TSH, ft4, ft3 and antibodies. If you pop your results up on here along with the ranges (numbers in brackets after your result) then we can help.

[NATALIEDW67 in reply to Lalatoot]

Thank you I will ask for them.

[Mommie in reply to Lalatoot]

If I gave you my numbers could you help me. I am very confused as to if I need meds.

[helvella Administrator Thyroid UK in reply to Mommie]

I'm sure you'll get some replies. But please do a brand new post to keep your issues separate from those of NATALIEDW67 being discussed in this thread.

Write button

[helvella Administrator Thyroid UK in reply to helvella]

Or What's your question? if no Write button.

Write new post

[Mommie in reply to helvella]

Thank you

[Mommie in reply to Mommie]

I am new and do not know how to do that.

[humanbean in reply to Mommie]

Go to this link :

healthunlocked.com/thyroidu...

Give a title to your post and then write your question in the bigger box.

Once you're happy with what you've written then click on Post.

[PurpleNails Administrator]

Was it definitely over active or under active thyroid?

If hyperthyroid the medication can be taken when ever is convenient. Anti-thyroid medication can also be taken with or without food, unlike replacement hormone which has to be taken on its own.

What’s more important with carbimazole? or PTU? is it’s taken consistently. ie as close to same time every day as possible.

It’s safe to take in 1 dose but usually beneficial to take 2x or 3x a day. Or split the daily dose initially, this prevents the thyroid being able to produce between doses.

What have you been given & what dose? Eg 10mg 60mg?

What is the cause of your hyperthyroid? Very important to know the reason as it can be transient & medics don’t always check and assume all hyper is continuous and prescribe antithyroid.

Propranolol often prescribed if hyperthyroid, was this suggested?

Keep & reread the PIL patient information leaflet. The chemist MUST supply the manufacturers ingredients and information. There can be mild and severe side affects you must be vigilant for.

What are your symptoms?

Do you have a repeat thyroid function test scheduled? This should be about 6 weeks after starting medication.

Do you have access or copies to results? We can help explain them if you post.

You need

TSH.

FT4

FT3

TPO & TG antibodies

TSI & or TRab MUST be tested if graves suspected

Folate

Ferritin

B12

Vitamin D.

[NATALIEDW67 in reply to PurpleNails]

Thank you. It is over active thyroid caus d by me taking and then being told to stop taking amadona (not spelt right). I have been prescribed 20mg of carbomozide (not spelt right sorry) I have only just got the tablets. Maybe I should split the tablet in half and take it morning and evening.

Many thanks

[SeasideSusie Remembering in reply to NATALIEDW67]

NATALIEEDW67

Do you mean Amiodarone? Apparently it has a high iodine content and can cause alterations in thyroid hormone levels. It can cause hypOthyroidism and, less commonly, hypERthyroidism.

[NATALIEDW67 in reply to SeasideSusie]

Yes it was Amiodarone. I am hoping things will calm down . 🤞

[helvella Administrator Thyroid UK in reply to NATALIEDW67]

Amiodarone?

Mild Amiodarone Induced Thyrotoxicosis may spontaneously resolve in about 20% of the cases. Type 1 AIT should be treated with high doses of methimazole (20-60 mg/day) or propylthiouracil (400-600 mg/day) to block the synthesis of thyroid hormones

(Methimazole is almost the same as carbimazole.)

Hard going - just letting you know where I got the paragraph I quoted above. Don't feel you are expected to read it, or understand it all if you do read it.

Amiodarone Induced Thyrotoxicosis

ncbi.nlm.nih.gov/books/NBK2...

[PurpleNails Administrator in reply to NATALIEDW67]

I started on 20mg daily dose but was given 10mg to take 2x a day.

I’ve had many adjustments since, and I have to admit - To save getting a new prescription & wasting pills I have sometimes used a pill cutter to half the pills. This hasn’t been a problem, but I’ve been on very low, single daily doses by that stage. It does say they shouldn’t be split and are meant to be swallowed whole.

That’s tough - that Amiodarone has induced thyroid issues. Was it picked up quickly?

[NATALIEDW67 in reply to PurpleNails]

Thank you. Unfortunately it only occured once I stopped the tablets. Hopefully it will sort it self out quickly. Have not got any symptoms. Was picked up in routine blood test.

[PurpleNails Administrator in reply to NATALIEDW67]

If you do not have symptoms it may be that it’s your TSH low & your thyroid hormone are not abnormally high. It would be unusual for abnormal thyroid levels not to cause symptoms. Especially if FT4 or FT3 levels rise suddenly, symptoms are usually very obvious.

Once you have your results we can help explain more.

[NATALIEDW67 in reply to PurpleNails]

Thank you

[NATALIEDW67]

Thank you. It is all mind blowing

[PurpleNails Administrator]

This is a useful link on carbimazole

nhs.uk/medicines/carbimazole/

[NATALIEDW67 in reply to PurpleNails]

Thank you