Meds Interactions

[DylanA]

Hi

I currently take Levothyroxine, Ramipril, Rosuvastatin, Iron supplements and vitamin D.

Can anyone advise how long after or before Levo the others can be taken. I currently take Ramipril and Rosuvastatin early morning with a coffee. Levo at least 30mins later… iron with my breakfast (30 mins after Levo) then the vitamin D with my evening meal.

Is it easier to take everything first thing then Levo on its own at bedtime. Oh I also take antihistamines which I take lunchtime to be away from other meds but would rather take them in the morning.

Thanks all

[SlowDragon Administrator]

Levothyroxine needs to be at least 4 hours away from iron

And iron at least 2 hours away from any other supplements or medications

Suggest you move levothyroxine to bedtime

And iron to lunchtime

Retest thyroid levels 6-8 weeks after changing

How much levothyroxine are you currently taking

What were most recent thyroid results

High cholesterol perhaps suggests thyroid not adequately treated or being affected by other medications and supplements too close to levothyroxine

Essential to test, folate, ferritin and B12 at least annually

And ideally test vitamin D twice year

How much vitamin D are you taking

Recommended that all thyroid blood tests early morning, ideally just before 9am and 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

bluehorizonbloodtests.co.uk...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

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

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[DylanA in reply to SlowDragon]

Hi. Currently taking 100mg Levo and 2000iu Vit D

TSH 1.03 mU/L range 0.3-4.2

T4 14.9pmol/L range 9-19

[SlowDragon Administrator in reply to DylanA]

Just testing TSH and Ft4 is completely inadequate

Most important result is Ft3

Essential to test vitamin levels at least annually

Important that vitamin levels are optimal for good conversion of Ft4 to Ft3

was test done early morning and last dose levothyroxine 24 hours before test

FT4: 14.9 pmol/l (Range 9 - 19)

Ft4 59.00% through range

[SlowDragon Administrator in reply to DylanA]

Vitamin B12. 138-652. Result 190 pmol/L

Folate vitamin B9: 7-46.4 result 8.7 nmol/L

Obviously need to be improving extremely low B12 and folate

[DylanA in reply to SlowDragon]

sorry I am a bit confused. So if I take ramipril, Rosuvastatin and anti histamine in morning (5.30am). Iron at lunchtime (12oclock), levothyroxine at bedtime (8pm), when can I take my vitamin D?

[SlowDragon Administrator in reply to DylanA]

Take vitamin D in the morning.

And vitamin B complex and B12 in morning after breakfast

Retest folate, B12 and ferritin at least annually

Test vitamin D twice yearly

Retest thyroid and vitamin levels 8 weeks after changing how you take your levothyroxine

Come back with new post once you get results

[SlowDragon Administrator]

previous post

healthunlocked.com/thyroidu...

Shows very poor conversion rate of Levothyroxine (Ft4) to active hormone (ft3)

Extremely low B12 and folate

Have you now had testing for Pernicious Anaemia

If not insist that’s done ASAP before starting on B12 injections or B12 daily supplements

And week after starting B12 …..adding separate vitamin B complex

High antibodies

Have you had coeliac blood test done

Are you now on absolutely strictly gluten free diet

If not get that organised asap too

Approx 5% Hashimoto’s patients are coeliac but further 80% find strictly gluten free diet necessary or essential. The only way to know if that includes you, is to try it