Changing time of meditation

[jodary]

Hi, is it possible that by changing the time of your dose of thyroxine from morning to night can affect the absorption giving you effectively a higher dose? I have taken 100mcg early morning 3-4 hours before food for a long long time. My T4 was slightly over range on last blood test in July but I changed the timing and have been taking it when I wake for the loo about midnight. This last week I have been feeling anxious and nauseous. Can feel my heart and have had headaches. Couldn’t sleep last night. I’m going on holiday so have no time to do a medichecks but am wondering whether to leave Levo off for a couple of days and revert back to what my body has been used to.

[helvella Administrator Thyroid UK]

Yes.

But if you change anything, do so extremely cautiously. The difference would be expected to be small. Like a few percent.

So somewhere between 87.5 and 97.5 might be appropriate. Which can be difficult to achieve. But alternate night dosing such as alternating 87.5 and 100 might work for you. I'm not keen on alternating as a rule, but if the dose difference is small, it is probably fine.

[jodary in reply to helvella]

Im pretty worried as I’m going on a 2 week cruise and am not feeling good at all. I think I would prefer to go back to what I was doing previously but was wondering if I skipped just a couple of days as I’ve obviously got enough T4 in my system and then resumed my usual routine whether I can manage to go . Obviously now also feeling a bit anxious about whether I can go but have a couple of days if that change helped symptoms.

[FancyPants54 in reply to jodary]

All change of dose, size or timing, upsets me. Anxiety arrives, I feel unsettled and I often feel really unwell but it only lasts a short time and then settles into the new routine.

If I were you and going on holiday, I'd revert back to your old dosing schedule now. Don't skip any, that's more change for your body to object too. Just go back to taking it when you have been taking it and feeling good.

It won't take long to settle so don't cancel your holiday. Go. Relax and have a good time.

[jodary in reply to FancyPants54]

Thsnk you for your lovely reply, my anxiety is quite bad my symptoms seem the same as being over medicated . I was just wondering as my T4 was over range last time whether to let it drop slightly.

[FancyPants54 in reply to jodary]

If you felt well on your previous dose amount and timing, go back to it. Don't adjust a dose close to a holiday. You can't judge if you feel over medicated or not right now because your benchmark of wellness has been changed when you changed the timing. If you feel good and go on holiday for 2 weeks with slightly elevated FT4, it's not going to be an issue for such a short time. You can try a reduction when you get back home. But I'd test again first, to be sure and test your FT3 at the same time.

[jodary in reply to FancyPants54]

That’s the thing I’m not feeling good at all feels like symptoms of over medication so am looking for a quick fix as it were to get me on holiday and then sort when I get back. Feeling anxious nauseous and jittery . Been feeling off since last week and have only just thought it could be that. Remember reading that a change in time can effectively be a dose increase

[FancyPants54 in reply to jodary]

Do you mean you didn't feel good before you moved your dose? I thought you meant you did feel well but moved it for a blood test and kept it in the new position. Perhaps I got that wrong?

[jodary in reply to FancyPants54]

So I have had over range T4 and low T3 and I wanted to improve my conversion . So I had read in here that absorption is improved by changing to nighttime . So after my last blood test showed high T4 and low T3 still I changed the time . But now I’m feeling over medicated as the symptoms I have match. It didn’t occur to me at first but I think it could be . But unfortunately don’t have time to do a medichecks and would be pointless gp which is why I do my own blood tests

[FancyPants54 in reply to jodary]

But how did you feel with the over range T4 and low T3? Did you feel well enough like that to enjoy your planned holiday?

[jodary in reply to FancyPants54]

I didn’t feel too bad really , I just thought I could feel better still if I improved my conversion. I’ve been trying to improve my vitamins which are in range but could be better. Feeling like this I wish I had left well alone

[Jaydee1507 Administrator in reply to jodary]

It might just be that your low FT3 is affecting you more as time goes on too.

You have said that your FT4 was over range which isnt a good thing. Better to drop Levo and add in some T3. Of course vitamins also come into play and low vitamin levels give us even more adverse symptoms.

Perhaps return to the way you wee taking Levo before and on your return start looking at how you can get some T3 added.

[jodary in reply to Jaydee1507]

I have no clue how to get T3 safely, I don’t think I could afford a private Endo and my GP once many years ago agreed to send me to an nhs one who wasn’t very nice and said my blood tests were fine. I didn’t know anything then , have been on thyroxine for about 40 years now . Didn’t even know then about taking it away from food

[Jaydee1507 Administrator in reply to jodary]

Roseway pharmacy offer a prescribing service. £50 for the consultation + cost of T3 which is very reasonable. Ask for Thybon Henning 20mcg which you can cut up to tailor to your dose.

Get private bloods run before your appointment. Also ensure key vitamins are at optimal levels.

See link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...

There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

[jodary in reply to Jaydee1507]

Thank you ! My vitamins aren’t at optimal level yet so will work on that

[FancyPants54 in reply to Jaydee1507]

But not when she's about to go on a cruise. She needs to step back to where she felt "not bad at all" for now. Review when she's back home again.

[FancyPants54 in reply to jodary]

This is why I keep saying go back to what you were taking before you changed it and have your holiday. You should then review it again when you get home and come up with a plan. But for now it's project Save the Holiday!

[jodary in reply to FancyPants54]

Oh god yes ! I’m so scared I’m going to have to tell my husband I can’t go it’s making me anxious. A vicious circle, thank you so much

[FancyPants54 in reply to jodary]

You can go. Just try to take things easy beforehand and rest up and be calm. Once on board it's a floating hotel so you won't have anything to do and can lay about all day in your cabin if you want too.

[jodary in reply to FancyPants54]

🥰thank you x

[helvella Administrator Thyroid UK in reply to jodary]

I've not been in that position - as I've always taken mine at bed-time.

You might be right about skipping to achieve a drop but without experience, I wouldn't like to advise either way.

My comment was really about the longer term. It would be very easy to drop slightly too much.

[jodary in reply to helvella]

Thank you it’s so helpful to talk to someone Been awake all night worrying

[helvella Administrator Thyroid UK in reply to jodary]

And that is a very bad state to be in.

Poor sleep for any reason is bad enough - and, if it is worry, that makes it even more difficult to cope with.

Try to marry up being in control and making your decisions based on what you think and feel - along with being thoughtful and reasonably cautious.

For example, maybe skip one dose. Then another in a few days?

Maybe take half a tablet for a few nights?

And remember that mild overdose, in the shorter term like days, weeks, even months, is common and is rarely serious. Unpleasant and definitely to be avoided but not, in itself, a major issue.

[jodary in reply to helvella]

Thank you , very unpleasant symptoms atm, feel like cancelling the holiday but it’s a lot of money to lose and my husband suffers. But as I feel at the moment I couldn’t go, I have a few days but that’s all

[FancyPants54 in reply to helvella]

Bob, did you answer a different question to the OP's question here? Because the OP is asking about dose times and your reply is about dose size? Just seems like the wrong answer for the question?

[helvella Administrator Thyroid UK in reply to FancyPants54]

If jodary had been stable on a morning dose, changed to a bed-time/night dose, and feels over-dosed, then it very likely is a dose issue.

The improved absorption having the same effect as a dose increase. And this has been reported in research as well as by members.

Some people feel that bed-time dosing affects their sleep, etc., which would indeed have likely been a dose time issue. But, in this case, I interpreted the issue as being on too high a dose - even if the tablet is identical it has become too high due to better absorption.

[FancyPants54 in reply to helvella]

That's better. I think it just needed a bit more explanation to understand your response in relation to the question.

Personally taking it at night or in the morning doesn't make any difference. I've been taking it at night for some time now as an experiment. But because I want to do a blood test I switched it round to morning again and I'm no different (blood test has been delayed for various reasons so I've been back to morning dose for about 2 weeks) and I'm going to keep it there as it's less disruptive and there's no benefit. I like some T3 at bedtime if anything. That does give me nice sleep. But I'm on NDT now so don't do that at present.

The main aim right now for the OP is to go back to feeling well enough to enjoy her cruise, so going back to original dose time seems like the best idea and leave fiddling with dose size until she returns if she want's to try it again. Cruises aren't cheap holidays to just cancel at the last minute.

[helvella Administrator Thyroid UK in reply to FancyPants54]

But currently being slightly over, returning to original dose, alone, might not be enough to feel well by start of cruise.

And I was trying to consider if she is on the cruise and has to cope, fiddling might be her only option.