Endo says take all Levo together?: Hi I’ve been... - Thyroid UK

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Endo says take all Levo together?

Flecmac profile image
19 Replies

Hi I’ve been taking a split dose of Levo with my split dose of Liothyronine for a few years. My Endo has now said that Levo should be taken all together. I’m not sure what to do. Any idea how I could change to once a day without over medicating?

Thank you. ☺️

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Flecmac
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19 Replies
jimh111 profile image
jimh111

It will make no difference whether you take one or two doses of levothyroxine daily. If they are having to prescribe more tablets for twice daily dosing going to once daily would give a small cost saving.

marsaday profile image
marsaday in reply tojimh111

Stick yo your current system. Use a Stanley blade to cut tablets if needed. I have moved to T4 2 times per 24h. It has made a huge difference to my health - all positive.

Flecmac profile image
Flecmac in reply tomarsaday

To be honest, splitting hasn’t made any positive difference.

Shelleyblue profile image
Shelleyblue in reply tomarsaday

That's interesting to hear about the splitting gof levothyroxine dose. I have tried doing once a day and twice a day levothyroxine dosing. I do now only have one a day dose of levothyroxine and 4 split doses of my T3 meds. May i ask : Which brands do you have ?? :)

marsaday profile image
marsaday in reply toShelleyblue

just levothyroxine I think. From the NHS. I don't get the teva brand, as that was not so good.

Flecmac profile image
Flecmac in reply tojimh111

No not prescribing more tablets so no saving.

Buddy195 profile image
Buddy195Administrator

if your dosing regime works for you, I would stick with it. The timing of medication is very much a personal choice.

helvella profile image
helvellaAdministrator

Did your endo tell you why he thinks you should do this? Seems to me the absolute basics of patient care require him to justify his advice to you.

Bear in mind, there are medicines like desiccated thyroid and Novothyral which are often taken in two doses. And, because they contain both T4 and T3, there is no way of separating them.

Flecmac profile image
Flecmac in reply tohelvella

They just said no need or benefit by splitting Levo and it should be taken in one dose.

SlowDragon profile image
SlowDragonAdministrator in reply toFlecmac

If you never noticed any improvement…..try single dose

Do you normally take waking and bedtime

Try taking full dose at bedtime

Can be more effective …..certainly more convenient than taking in morning

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

Links re possibly more effective taken at bedtime

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

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….so that last dose is 24 hours before 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

Do you always get same brand levothyroxine at each prescription?

Flecmac profile image
Flecmac in reply toSlowDragon

Yes always.

McPammy profile image
McPammy

I split my T4 levothyroxine dose into two. I also split my T3 liothyronine dose into two. If I take either in one daily dose I feel it’s too much of a spike. Naturally the body would never make either hormone in one hit a day. I would stick to splitting if you are symptom free and levels good. I’m symptom free with good levels. Prior to splitting I wasn’t symptom free.

SlowDragon profile image
SlowDragonAdministrator in reply toMcPammy

McPammy

But you are on liquid Levo …..which is absorbed much quicker than tablets

McPammy profile image
McPammy in reply toSlowDragon

But I was on tablet form levothyroxine for 11 years prior to switching to liquid. I have experience of both tablets and liquid. And yes, you are correct liquid does absorb much quicker it seems than tablets.

Lilian15 profile image
Lilian15

I have been taking mine (150mg T4 and 50mg T3) together in the morning when I get up for the past 23 years. After slowly starting the T3 a few times a day - under a doctors supervision, once I got to the dose that was optimal for me, I just took it all at once in the morning. No problems. I believe the late great Dr. Skinner said they could be taken once a day. There may be people who are a bit more sensitive, I am just relating my experience for my body.

buddy99 profile image
buddy99

"If it ain't broken, don't fix it." I have no idea why your endo said that, but if it has served you well so far, I would not change a thing.

Flecmac profile image
Flecmac

splitting hasn’t made any difference.

Jazzw profile image
Jazzw in reply toFlecmac

Then in your situation, I would just revert straight back to taking it all in one dose. I know you’re probably concerned about having a big “hit” of Levo if you do that, but it’s actually got a long half life and you almost certainly won’t even notice the switch.

If you are worried, perhaps because you know you’re sensitive to medication changes, then you could gradually shorten the gap between the two half doses—so instead of it being 12 hours between doses say, you make it 10 hours. And the next day 8 hours, then next day 6 hours, the day after than 4 hours… and by that point you’d definitely be fine to take the whole dose in one go.

Flecmac profile image
Flecmac in reply toJazzw

Many thanks, very helpful! ☺️

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