I started getting more powder than I previously had done when splitting my 50’s Levo in half, so a while back I bought a 7 day container and added them to it as I show below.
50/100/50/100/50/100/75mcg.
The other day when I saw the doctor about something else I happened to mention my Levo and he said taking them like that could alter blood test results and that I should stick to the 75mcg per day.
Was he right?
Here’s another suggestion, get two 7 day pill pots and load one up at 50/100/50/100/50/100/50 and the other with 100/50/100/50/100/50/100.
You still average out at 75 per day but if you get 50s you don’t need to do any splitting.
Back to the question about splitting tablets. I’ve read someone on here being told not to split tablets, they were asked how do they know what side of the tablet the active ingredient is in. Now to my mind, if the active ingredient isn’t mixed equally throughout a single tablet, how can it be equally spread throughout the tablets in the whole batch. Surely it’s got to be a homogeneous mix before starting to press tablets, otherwise you’d get a proportion of tablets way above/below potency.
Back to splitting tablets of levo in particular. It’s got a half life of roughly a week. So take a 100ug tablet (and for the sake of nice numbers we’re going to assume you absorb every last bit of the active ingredient) if you take no other tablets, after a week you’ll still have 50ug rattling around in your body. After 2 weeks you’ll have 25ug, after 3 weeks you’ll have 12.5ug. So taking 50/100 alternating days really won’t make a difference to taking 75 each day. The only time it might do is if titrating up to a higher dose, so if you’ve been taking 50/day and go up to 100 the next day, the doubling of dose may make you feel jittery/overmedicated until the 50/100 settles at a stable level.
Just my thoughts on the matter.
I rather agree about the distribution of active ingredient in tablets. I think that is is an overblown claim and is said simply because it has not been formally tested.
However, if the evenness is only just good enough for each tablet to be within specification, when you deal with half a tablet, it could fall just out of specification.
We don't know the manufacturing details but if they made, say, 25, 50 and 100 tablets out of the same mixture, then clearly the evenness would be sufficiently good to allow splitting of 100 and 50.
(I am pretty sure that they do NOT make all dosages of a product from the same mixture as tablet sizes do not follow dosage in that way. But quite possible they make two dosages out of the same mixture for some products.)
Splitting tablets is not supported by the UK's MHRA. The primary issues with levothyroxine are uneven split and loss of crumbs in the process.
Additional issues are exposure of the tablet to oxygen, humidity and light - all of which cause deterioration. This is a reason not to prepare many in advance.
(With some other medicines there are numerous other issues which mean splitting is definitely NOT acceptable for them. This is only levothyroxine being discussed.)
Uneven splitting is an issue. The MHRA pretty much refuse to endorse splitting unless it has been shown that they can be split accurately enough.
But the consequence of uneven splitting is, in my view, mis-presented. If you split a 50 and it ends up being 20 and 30, that is uneven. It is not good when we wanted 25 and 25. But it is an awful lot better than going up and down by 50 every single day as appears to be happening without splitting!
Loss of crumbs depends on your technique and care. It is easy to send crumbs flying off and getting lost.
And one make, Aristo Vencamil, is approved for splitting in many countries - but not the UK.
Do not bulk split. If a tablet splits 20 and 30, it is better to take one part today, the other part of the same tablet tomorrow. If you split in bulk, you could get several doses of 20 in succession followed by several doses of 30. If you prepare a 7-day box, split one tablet and put its parts into days 1 and 2, etc.
Personally, I dislike uneven dosing and would far rather split than alternate day dose. But we are all different.
Finally, yes, alternate day dosing will affect blood tests. But without clear evidence, it is unclear by how much. And if they are only testing TSH, it could be insignificant.
Light isn’t a problem because my box is a dense black plastic with 7 separate sections.
It's debatable. Surely it would depend on a lot of factors like whether the blood test was done shortly after taking a 50 or 100ug tablet? Even that might not make much difference. Levo is a different med to other substances that might be affected by alternating a daily dose as it's a storage hormone, not an antibiotic or painkiller for example. If you've been taking levo for some time on that pattern then the blood test results should be reliable. Alternating your dose of levo is common practice and Drs look at more than one blood test over a period of time to help with reliability of results anyway. It's all about consistency. If you randomly took a different dose each day then that would be more problematic.
you would see small difference in Ft4 if you tested 24 hours after 50mcg compared to 24 hours after 100mcg
But TSH would be unaffected
Which brand levo do you prefer
Accord brand, is only available in 50mcg and 100mcg tablets
Mercury Pharma makes 50mcg and 25mcg
If you want 75mcg daily in Accord ……request prescription amended to give enough 50mcg tablets per month at 1 and half tablets per day
I always have Accord now, when I was first diagnosed getting on for a couple of decades ago I started on 50mcg of what was then Actavis, (licence holders of Accord and named as Actavis on my prescriptions) I followed through with them over the years because they suit me. I accept no different types after having an allergic response to a different brand a few years ago. So I get Accord 50’s and had always cut them in half until I decided to make it easier with 50/100 etc.
I can't help there I'm on 100 a.day
Latest Medichecks Results - low FT3 - Dr will refer me to NHS Endo, should I try? Do I need to up my Levo in the meantime?
Managing my own medication
Right or wrong? 
Breathlessness
Endo consultation
