How to split thyroid erfa in two doses?

[AliasWillow]

Good morning, I have been taking thyroid erfa for more than a year now. It has helped a lot. Higher body temperature, higher pulse, no more constipation, no more cold chills, very good free T3 levels (5+), no more heart palpitations. However, I am still very tired and it gets me the most around lunch time or just after. I can’t not function without a nap. I also crave for sugar all afternoon and I have more belly fat. I read and heard that spitting the dose in two takes could help. I would love your advice on how to do that. I currently take 97,5 mg at 7 am in the morning. Can I split it 60/37,5? When would I take the second dose? How many hours away from the prior food intake and the food intake afterwards ? Many thanks !

[pennyannie]

Hello AliasWillow :

Your current dose appears to be working well as is -

maybe it's not about splitting but adding in an additional afternoon dose ?

It's difficult to know without seeing some blood test results / ranges and the time lag from last dose to fasting blood draw.

Some people dose once a day - others build up their dose AM & PM evenly - some find they seem to need just a small top up hours later - I tried a PM dose but wasn't aware of any benefits :

It's recommended to take thyroid hormone replacement on an empty stomach and wait around an hour before eating or drinking anything other than water -

how long it actually takes for your food to be processed through your body - giving you this empty stomach - is anyone's guess.

Are you maintaining your core strength of ferritin, folate, B12 and vitamin D at optimal levels ?

I dose once a day and have around a 15 minute nap most afternoons - but then I'm 77 and likely with a very different life style than your good self - and I 'm in bed by 10 pm and take my dose at around 2.00 am in the morning at a toilet break - and up again by around 5/6 am.

[AliasWillow in reply to pennyannie]

Dear pennyannie, thank you very much for your insights. I think I will start with trying a small top up in the afternoon and see if that helps. My ferritin, B12 and folate are optimal. My vit D levels were very low (15) but I managed with supplementation to get to 40 within a couple of weeks (which has helped a lot already with tiredness ) and it should still improve as I continue vit D supplementation. I do not mind my nap (it’s also a moment of peace for my brain) but I am studying to become a teacher and will have to be regularly following or giving a class in the afternoon. For the moment, that’s very hard for me. I am trying to get to bed by 10 pm as it indeed helps a lot. The past month, I did not succeed much with that and will focus a bit more on that too. Thank you for your help ! All the best.