Does anyone take thyroid sublingually?

[StokeGabriel]

If so, what brand or type do you find works, any comments on doing it this way? Thank you.

[greygoose]

Thyroid hormone tablets are designed to be swallowed. The molecules are too large to pass the mucus membrane/blood barrier. What's more, as the hormones are bound to sodium, they need stomach acid to unbind them.

If you try taking them sublingually, all that will happen is that the tablet will dissolve and the hormone will float around in your mouth until swallowed, risking coming into contact with something that will compromise its absorption.

[Spareribs]

I thought same as GG (hi!) however was watching a Dr Myhill video recommending to put it under your tongue, tried night time Levo dose - probably swallowed it... anyone else tried it?

[greygoose in reply to Spareribs]

Hi Spareribs.

We've had quite a few posts on here where people talk about taking thyroid hormone sublingually, and the usual result is that their labs suggest poor absorption. Even if they don't, there doesn't appear to be any advantage to taking it that way. You just get hormone-rich saliva! 🤣🤣🤣

[StokeGabriel in reply to greygoose]

Thank you very much for your responses!👍

[greygoose in reply to StokeGabriel]

You're welcome.

[StokeGabriel in reply to Spareribs]

Thank you I'm interested in the video, any links? 👍

[HeartWoman]

I have a friend who tried for sometime to get her levels up. Her endo finally had her chew them and it works. I have no idea why that worked as opposed to just swallowing them.

[helvella Administrator Thyroid UK in reply to HeartWoman]

It will almost certainly vary by make.

The USA make Levoxyl expands extremely rapidly the moment it gets damp, let alone properly wet. (So rapidly the instructions were amended to insist on taking with a glass of water to avoid the possibility of choking it they got stuck in the throat.)

But the reason they are like this is that the "old" formulation of Levoxyl failed to disintegrate and disperse. (Hasn't been available for well over twenty years.) And chewing might well have made a big difference.

(I chose Levoxyl to illustrate this as it is the extreme case, and I know the storyline!)

I doubt it would be any better chewing than mixing the tablet with water and swallowing the result.

From personal experience, both Wockhardt and Aristo (Vencamil) seem to started dissolving very quickly.

[jgelliss in reply to helvella]

Yes your right Helvella. Good choice Levoxyl. I dose with it. And taking it with lots of water is important otherwise as you said it feels like it's stock in the throat.

[StokeGabriel in reply to helvella]

Interesting, thanks

[heathermr]

I take all of my T3 sublingually as I take it in small portions during the day. There are quite a few of us on here that take our T3 this way but not T4. I take Cytomel which dissolves rapidly and tastelessly and I can feel working within 10minutes as the brain fog clears and I start to get warm. My biochemist husband tells me that the idea of T3 being too big is not true, after all cells in the mouth are no different from those in the gut. The sodium element of T3 drops off as it enters the blood stream as all ions are normally carried separately in the blood. I know that this method of taking T3 works and is very convenient when taking doses throughout the day without having to wait an hour for it to absorb. Another thought is that some of the T3 could be digested too far in the stomach and as a result become blocked by other gut juices.My suggestion is to try taking your T3 both ways and see what works for you.

Heather

[radd]

StokeGabriel,

Welcome to our forum.

There are various thoughts on taking thyroid meds sublingually and conflicting advice even amongst the more knowledgable. Regarding synthetic thyroid meds, doctors such Dr Myhill and Dr Kenneth Blanchard both suggest taking thyroid meds sublingually.

Regarding NDT the thyroglobulin that the hormones are attached to requires degradation before thyroid hormone can be released, and when placed under the tongue it is claimed the molecules are too big. However, tpauk (although old info now) have always advised for Erfa to be taken ‘between your gums and cheek.’ They also claim swallowing brings stomach acid into contact with the Calcitonin that diminishes it. Some used to claim Acella’s NP Thyroid should be taken sublingually but all other NDT’s should be swallowed as have too much fibre in the hard casing.

When we take meds, as long as it is absorbed, it means we suddenly have a lot in the blood stream. In a healthy thyroid most T3 is converted at tissue level from T4, giving the cells opportunity to decide on the level through deiodinase action. Tania Smith says T3 taken sublingually poses a risk of too fast absorption and the resulting peaks raising higher than the usual norm results in less duration.

And just to complicate it further I have also read that sublingual relates to the sublingual gland under the tongue where more saliva liquifies and absorbs faster., and the buccal gland is in the mucus membrane lining the cheeks with less saliva so absorption is slower and therefore more suited for T3 administration.

I think its an individual choice as we all find what works best for ourselves. I have always swallowed my meds with water and chewed them up when out and caught without water, but haven’t taken any sublingually although I know some members do very successfully.

What meds are you taking?

[StokeGabriel in reply to radd]

Thank you very much for this, really interesting, I may need to came back to you again on this

[tattybogle]

i found this awhile ago ....and it does show 'improved' absorption when taken sublingually BUT it's very important to note they were looking at people with very very poor intestinal absorption ('refractory' ~ meaning their absorption from taking tablets normally was so bad that TSH remains high even on large doses of Levo ) .

so it was an improvement over 'very bad' gastrointestinal absorption.... (it's NOT saying it's an improvement for most of us , because they weren't comparing it to people with ok intestinal absorption).

endocrine-abstracts.org/ea/...

Endocrine Abstracts (2021) 77 LB59 | DOI: 10.1530/endoabs.77.LB59

Study of the efficacy of sublingual route administration of levothyroxine Na nablets vs oral route in cases with refractory primary hypothyroidism

Mina Michael Nesim , Yara Mohamed Eid , Manal Mohamed Abu Shady , Salah Huessein El Halawany & Gehad Soliman El Shamy

"Conclusion: Our study revealed that sublingual levothyroxine Na tablet may be more effective than oral levothyroxine tablets in controlling TSH levels in refractory hypothyroidism and sublingual levothyroxine Na tablets may overcome some absorption problems of oral levothyroxine tablets. Autoimmune gastritis should be taken into consideration as an additional factor influencing the daily requirement of levothyroxine Na."

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A collection if interesting studies with lots of detail about absorption:

healthunlocked.com/thyroidu.... where-and-how-is-levo-absorbed-....-a-collection-of-information.