Swallowing difficulty, have to chew meds.

[grumpyold]

About a year ago, I began getting my thyroid meds stuck in my throat. All my other meds, vits and minerals, being much larger, seem to go down ok, as they seem to have sufficient "weight" behind them. My magnesium capsule is the size of a suppository 🤣 and I can swallow that without a problem. It's just the tiny T4 and T3. No matter how much water I take to help "whoosh" them through, they still won't go down properly.

So, for the last few months, I have been chewing them into a paste, before swallowing them and this has been working well. I know they are meant to be swallowed whole, but try as I might, I just cannot get them down now. If I do try, they get stuck in my gullet and I get a chalky fizzy taste like heartburn or indigestion so I know they are still there and I can sort of feel them in my throat.

The only other way I could get them to go down would be to "push" them by eating a biscuit afterwards or something similar, but of course I NEVER eat within an hour of taking them.

As I don't seem to have a choice about not swallowing whole now, does anyone know the implications long term of chewing them into a paste? ( I have seen info which states that they can be crushed for children.) Is there a significant difference between a crushed and a chewed tablet?

( I was referred for an endoscopy and a barium swallow.....no reason for my problem was found.)

Any opinions / advice would be gratefully received, as always. Thankyou.

[TiggerMe]

Perhaps the answer is to pop them in a capsule ( you can buy empty ones) which are a better shape to swallow, I agree that tablet shapes don't go down as easily and lactose free ones do tend to dissolve in your mouth

[grumpyold in reply to TiggerMe]

That's a brilliant idea. I'll definitely get some. Thankyou for quick reply!

[TiggerMe in reply to grumpyold]

🤗

[helvella Administrator Thyroid UK]

In the time before any liquid levothyroxine products were available in the UK, the Patient Information Leaflets would say something like, if you can't swallow them, mix with a little water, stir until dispersed, drink.

(I think they were primarily considering children too young to swallow tablets. But there was no age restriction implied!)

I'm sure that this process isn't perfect - for a start, you really need to swill the glass with some more water and drink that to ensure as little as possible remains at the bottom. But I have no doubt it is a reasonable approach.

I wouldn't use a capsule. We've had too many members seemingly react to some some capsules. And they cost!

[grumpyold in reply to helvella]

Thankyou.

[RedApple Administrator]

I don't think chewing them is an issue, as long as you swish your mouth with water, and swallow well enough that it all goes down your throat. Years ago, I recall there was a US brand (levoxyl I think), that almost exploded in the mouth as soon as it made contact with saliva. The brand was recalled for reformulation, but only because the 'exploding' caused issues for some people, not because the dissolution itself was a problem.

[grumpyold in reply to RedApple]

Ah, that's great. Thankyou.The "pulp" goes down fine with the water I take. Sounds like it's OK to carry on as I have been then. 👍

[Anthea55]

Some of us take our thyroid meds with food.

[RedApple Administrator in reply to Anthea55]

Levothyroxine?

[Anthea55 in reply to RedApple]

Yes, both Levo and Lio

I was advised to do this by Dr Peatfield, author of 'Your Thyroid and how to keep it healthy'. It's also recommended by Dr Myhill who is an advisor to Thyroid UK, see this page from her website

drmyhill.co.uk/wiki/Thyroid...

I have been doing this for several years and I find that it is much easier to fit into everyday life and so it is less likely to be forgotten. The important thing is to be consistent.

[FallingInReverse in reply to Anthea55]

I see how those experts indeed say take it with food, but what’s the biology/chemistry of how they justify avoiding food interactions and blockers?

Or is it just a trick to not forget and assuming whatever blocking the food does is fine because it’s consistent?

[RedApple Administrator in reply to Anthea55]

I would be concerned about having to be consistent with the foods you take it with. And what if you aren't able to eat for some reason... 'nil by mouth', upset tummy, or having to miss a meal for some other reason.

I think taking thyroid meds without food is easier than worrying about what you do or don't eat when you take them.