I have just been diagnosed with hypothyroidism and will start taking thyroxine tomorrow morning. I usually wake at 6.30 and will take then. NHS and endocrinology guidance says wait half an hour before having any food and drink, but I notice this forum advises an hour. I’m not worried about eating anything but do like a couple of cups of tea to get me going. Would de caff black tea be ok?
Thanks
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Bluesew
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Can you move the other tablets to slightly earlier? Otherwise you need to delay drinking anything other than water for an hour after Levo in the morning.
As you have an autoimmune disease already it’s highly likely your hypothyroidism is also autoimmune
Have you had thyroid antibodies and vitamin levels tested yet
If not, get these included at next blood test
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test 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
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime or in middle of night
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
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
I wake up to go toilet between 3-4, I take mine then. Otherwise my alarm goes off to take it early and I can go back to sleep if desired. That works best for me.
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