timing of medications

[bikebabe]

hiya - am getting confused about when to take all my meds and supplements throughout the day other then to leave 1hr after taking thyroxine and not having calcium tab within 4hrs of thyroxine. Does it matter when I have the rest or are there optimal times to take these meds/supplements. I wondered if anyone can advise. These are the full list:

Levothyroxine

Symbicort puffer

Palbociclib

Letrozole

Calcium tabs

Vit d3

Vit k

Thorne b complex

Glucosamine / chondroitin

Many thanks (in hopeful anticipation)

[greygoose]

Levo should be taken on an empty stomach, two hours after food or one hour before. And, at least two hours away from any other medication or supplements. Four hours away from calcium, vit D, magnesium, iron and oestrogen.

Why are you taking calcium? That's not a good thing to take unless you absolutely have to. Calcium supplements are not easily absorbed and tend to build up in the blood and soft tissues, causing problems. Taking vit D will increase your absorption of calcium from food, anyway, so it would be easy to over-dose on it. But, you should be taking magnesium with vit D, as the two work together.

[bikebabe in reply to greygoose]

Hello grey goose

The calcium is because of the monthly denosumab that stops my bones breaking down too fast from breast spinal secondaries. It just about keeps blood calcium at minimum level of 2.2. I will retest magnesium but it seemed ok last time.

[greygoose in reply to bikebabe]

Testing for magnesium is unreliable. And, it doesn't matter if you take too much because excess is excreted. But, if you don't take magnesium when taking vit D, the vit D will leave you magnesium deficient - no matter what a blood test says.

[Hookie01 in reply to greygoose]

Hi Grey goose, sorry, but i am a bit confused. I thought having too much magnesium in your body is bad for you? We don't excrete the excess, would you not have to take diuretics, water pills, calcium to reduce high magnesium? I thought high magnesium caused lots of symptoms? Nausea, vomiting , stomach cramps, muscle weakness or maybe i am getting confused?

[FAB-jellybean in reply to Hookie01]

Hi Hookie01 , your comment spurred me to check this out. Healthline (see link below) quote the American Office of Dietary Supplements. Magnesium is excreted by the kidneys in urine and is only an issue if you have inefficient kidney function or you take greater than 350mg in supplements daily. It can cause a laxative effect and as such is used in huge doses in some laxatives, and some forms of magnesium supplements are more likely to do that. Personally I have taken both magnesium malate and magnesium glycinate and I haven't had any issues with them at all. However, without supplementation, my levels are way below the minimum level and I suffer from horrendous muscle cramps. I was away for a month during the summer and decided to run an experiment of taking no additional supplements (usually D3, K2, Mg, B Comp, C, Iron, Zinc & Selenium) having taken them fairly consistently for about 5 years. I knew I was coming back to get them tested and wanted to see what my body would do without them. As well as bottoming out on my magnesium, my Vit D levels were on the lower side of normal despite spending a month in the sun. So my low magnesium appears to have affected my Vit D levels, which fits with needing to take both Magnesium and Vit D3 (along with K2) together.

healthline.com/health/food-...

[Spangle15 in reply to FAB-jellybean]

Hi FAB-jellybean

Can I ask if you get your zinc and selenium tested privately?

Thanks

[FAB-jellybean in reply to Spangle15]

Spangle15 I haven't had zinc and selenium tested. Medichecks do a selenium only test but I haven't been able to afford that yet and I'm not sure that it's very accurate. Not sure at all about zinc testing. I take a low dose supplement that has both zinc and selenium: 15mg of zinc citrate (~5mg elemental zinc) which supplements my diet without going near the recommended daily dosage is typically 15–30 mg of elemental zinc. Too much zinc interferes with copper levels. The selenium is 200 mcg sodium selenite anhydrous which gives around 90 mcg elemental selenium. According to the NIH we need around 55mcg daily and not to exceed the tolerable intake level of 400 mcg of selenium. Selenium is needed for proper endocrine, CV and immune function and studies have shown that Vit C can affect absorption, so to take them at least 2 hours apart. Healthline website also states that signs of too much selenium include a garlic-like odor on your breath and a metallic taste in your mouth. Selenium intake in the diet comes from grains and is dependent on the grains growing on selenium rich soil. Optimal serum levels of selenium is 70-90mcg/L so I'm quite happy to keep taking the 90mcg daily without worrying too much about needing to test to ensure I'm not overdoing it.

That was quite a long reply to a simple question so apologies if it was a simple answer you were looking for. In my travels looking for correct information to ensure I was getting the numbers right, I found the following paper quite interesting. It looks at the role of Zinc, magnesium and selenium in depression; something I've got personally got experience of. Could also help explain the link the between undermedication of thyroid hormones and depression symptoms in hypothyroid patients.

Zinc, Magnesium, Selenium and Depression: A Review of the Evidence, Potential Mechanisms and Implications ncbi.nlm.nih.gov/pmc/articl...

[Spangle15 in reply to FAB-jellybean]

Thank you so much, I really appreciate the thorough answer.

[greygoose in reply to FAB-jellybean]

It's magnesium citrate that has the laxative effect - it's the citrate (vit C) that does it, not the magnesium itself.

[Hookie01 in reply to FAB-jellybean]

thanks FAB-jellybean (great name btw)

I've clearly got the wrong end of the stick when I read up on it. All this is so bloody confusing. My results always say I'm high in magnesium so have been to scared to take it cos I've read what I posted above

[greygoose in reply to Hookie01]

Why would taking calcium reduce high magnesium? I think you're muddling it up with something else. I've never had those symptoms from taking high doses of magnesium.

[Hookie01 in reply to greygoose]

its just something I read. Looks like maybe I have read it wrong. It's why I have avoided magnesium because my levels always come out high. I get so bloody confused, its a minefield out there isn't it

[greygoose in reply to Hookie01]

It is. And, it's not helped by the fact that a lot of people write a lot of rubbish. The difficulty is sorting the wheat from the chaff. But, you develop a sort of sixth sense about whether something seems logical or not.

Blood tests for magnesium are not reliable. You could be deficient even if your blood test says you have too much. So, ignore blood tests - or don't even bother doing them! - and just take magnesium. You'll feel all the better for it.

[Hookie01 in reply to greygoose]

Thank you greygoose, appreciate the help. I will get there one day

[greygoose in reply to Hookie01]

You're welcome.

[bikebabe in reply to greygoose]

I think my original request re timings got a bit hijacked but think the answer is thyroxine at least 1hr before breakfast, palbo /letrazole and Thorne b complex and vit k at least 2hrs after thyroxine ie late morning or lunchtime, and everything else at least 4hrs after thyroxine ie with tea - vit d, calcium, magnesium, glucosamine. Does that sound ok?

[greygoose in reply to bikebabe]

That sounds fine.

[SlowDragon Administrator]

Do you normally take levothyroxine waking or bedtime?

Is vitamin D mouth spray?

When has GP advised you take Palbociclib and Letrozole

[bikebabe in reply to SlowDragon]

hi slow dragon

Usually take thyroxine when wake up ie 8am and calcium before I sleep. No time set for palbo, only that it’s taken with. Same 2hr window each day with or without food. Vit d3 are liquid pearls - didn’t get on with the spray as it doesn’t last long.

[SlowDragon Administrator in reply to bikebabe]

You could try an alarm at 6am….take levothyroxine then. Go back to sleep

Then can get up and take vitamin B complex after breakfast

Vitamin D with lunch

Not taking magnesium?