Anyone who split levothyroxine?

[lisan1]

Anyone who split their levothyroxine during the day? How do you split and did it affect your TSH and if so did tsh increase or decrease?

[Lalatoot]

Lisan . I have always split my t4 into 2 or 3 daily doses. I don't think splitting the dose affects tsh directly but it can affect ft4 and ft3.

[lisan1 in reply to Lalatoot]

Thanks! Did it affect yours? If so how?

How do you take yours?

[Lalatoot in reply to lisan1]

I don't know how it has affected my ft4 and ft3 personally as I have never taken it in one daily dose. The endo I was seeing when I had RAI and became hypo suggested increasing by taking a second dose as I felt unwell when I started on levo. I was very very hypo at this point.I take my doses first thing and bedtime. At one stage I did also take a dose at 4pm but it interfered with my tea and cake routine and I didn't feel any different.

There is a theory that a split dose can improve conversion for some. The body has a safeguard mechanism where if ft4 gets too high it starts to make less t3 and more reverse t3 to stop ft3 becoming too high. Nobody can tell you your individual cut off level but the theory is that for some the spike of a full daily levo dose entering the system can put their ft4 temporarily over their limit causing the body to downregulate t3 conversion. By splitting the daily dose the t4 spike is not so high and dose not trigger the poorer conversion.

[Cavapoochonowner in reply to Lalatoot]

I might try that myself although like you I have quite rigid meal times and also take proprananol 3x a day for migraines.I might give it a go to try and help my conversion.Thankyou

[tattybogle]

i take 50mcg about 7 a.m, and 62.5mcg at about 10.30 /11 p.m ( dose 112.5mcg daily)

It just seems logical to me to try and replicate the levels of fT4 we would get from our own thyroid rather more closely than having a huge dump of it all at once .

naturally fT4 is a bit higher before we wake up .. the TSH reaches it's highest around the middle of the night/ very early a.m. and the fT4 level reaches it's highest a few hrs after this ( because the thyroid is stimulated by the TSH)

so we naturally have our highest fT4 levels a couple of hrs before we get up, and then a steady amount is drip fed in for the rest of the day .

So if we take a full daily dose of levo just before breakfast ,and it then takes an hour or so to get absorbed into the blood .. we have the lowest levels for a couple of hours before we wake.... which is totally unnatural.

I have no idea what effect this difference might make to how the body functions .. but i've decided to give it the benefit of the doubt and let it have a higher level over night and a more even level through the day ,,, just in case it's doing something useful with it while i'm asleep.

i can't say for sure if it has any effect on my TSH because i only test annually and my levels tend to be all over the shop for no obvious reason.

i did think it had made my TSH a little higher eg 0.05 up to 1 ish , but i'm really not sure .. i thought i was , but now i'm not.

But i've felt better overall since splitting it like this for the last 2/3 yrs , and several yrs ago i used to split it 7 am and about 2pm .. which i also thought made me feel a bit better... so i'm continuing even though i'm not sure if it really has any effect , cos i don't want to rock the boat .

[lisan1 in reply to tattybogle]

When do you take last dose before a test?

[Lalatoot in reply to lisan1]

I take 50mcg levo around 6am and another 50mcg levo around 10pm. The largest gap I have between doses is 16hours roughly. So the lowest level of ft4 gets to in my normal day is at 16hours after a dose. I therefore leave a gap of 16 hours between last dose of levo and blood test so I am measuring my ft4 at the lowest level it gets to in my daily routine.

[lisan1 in reply to Lalatoot]

Would it make sense to take levo at 7am and 7pm if away from food or is it better to take just before bed. Which in any case might be easier anyway

[Lalatoot in reply to lisan1]

It is whatever suits you and your routine. I take mine getting up and bedtime as that suits me and leaves the day free for food and any supplements. It makes it easy to take magnesium which needs to be 4 hours away from levo.

[lisan1 in reply to Lalatoot]

Thank you ever so much! May I ask what your TSH, ft3 and ft4 are?

[Lalatoot in reply to lisan1]

Lisan I now also take t3 so my blood results are not on levo only. On levo only TSH was under range, ft4 was at 60% and ft3 was at 17%. I do not have an autoimmune thyroid condition and I was originally hyper so my results really don't apply to other hypos.

[tattybogle in reply to lisan1]

if i was testing at 9am i would just bring my last dose forward a couple of hours to 9pm. to get a consistent 12 hr gap.

however, i always test at about 12 pm( lunchtime) , so i don't change my timing of last dose, i still take it at bedtime .

[Batty1]

I split my meds and it hasn’t effected anything about my labs.

[McPammy]

I split my levothyroxine dose easily as I’m taking liquid form. I take 34mcg at noon and a further 34mcg at 5pm. I found splitting my dose stopped spikes that were making me feel overwhelmed on a full dose. My TSH increased slightly when I started splitting my dose from being slightly over medicated to just within range. Importantly I felt much better not having t4 spikes. I also take t3 liothyronine two doses 5mcg a day. For me splitting gives me a smoother reliable feeling. Don’t think my body handles one dose per day very well. I’m not sure why though.