Lio as fussy as Levo?

[Auders]

Hello lovely people, quick question. I know Levo is very fussy, needs to be taken on empty stomach and needs to be away from other meds. Is Lio as fussy ie can take it nearer foods? Not sure if I read it or dreamt it 🤷‍♀️ thanks 🙏

[FallingInReverse]

discussion in progress!

healthunlocked.com/thyroidu...

I can’t recall/pull up the actual research - but as far as I know there isn’t any research indicating food is an issue with Lio like it is for Levo.

Still up for debate before we nail down a definitive answer and supporting biological/clinical explanation.

Same goes for my understanding for most supplement interactions, but I haven’t deep dived on a detailed conclusion. But Lio absorption pathways are not as fussy as Levothyroxine.

What that means for timing, I wouldn’t say until I did more research. And therefore I still treat Lio like Lio since I can. But I’m sure I don’t have to.

[Auders in reply to FallingInReverse]

Thank you so much. I take mine with Levo first thing in the morning. I do get tired in mid afternoon so I was wondering about taking Levo as normal and perhaps take Lio in one go in the afternoon. Perhaps best thing to do is give it a go? Found the three times a day to fussy and never got the timings right! Thanks again 🤷‍♀️

[FallingInReverse in reply to Auders]

I did 3x split for a while… I hate the complexity, personally.

Then did waking and bedtime.

Did light research on bedtime Lio dose… concluded it was a waste of the Lio boost (for me) and decided on a single dose in the morning .

I either do all upon waking together. But if waking is earlier enough I take Levo first then Lio maybe an hour or so later.

Now my goal is to keep it an hour away from coffee.

There’s no doubt coffee at the very least will speed up your metabolism of the Lio. So I do take care to give it time to absorb and get into my blood before coffee!

I like the idea of Levo when opening my eyes, sometimes I do emails while head still in pillow, then Lio when I get up and start my day going. I have a big refreshing glass of water where I used to have my coffee first, get some sunshine on my face, and then by the time I’m at my desk for work, coffee.

So I feel like I get a few hours of multiple boosts. Vs Levo/Lio all together and coffee an hour later. ☕️

Sometimes I need coffee before Lio, then I’ll take it later in the day well after my coffee.

I guess I just keep my Lio away from coffee !

[Kimkat in reply to FallingInReverse]

I was started on Lio last year by Prof Wass, he suggested I take Levo and Lio together first thing then next Lio in the afternoon, it def stops me having that slump early evening.

[Auders in reply to Kimkat]

Thank you for that, it is the afternoon slump that’s getting me!😕 May try 5mcg first thing with Levo then 5mcg in afternoon. No harm in giving it a try 🙏

[FallingInReverse in reply to Auders]

I used this article to choose my t3 splits… i would do wake up and noon (which eliminated me passing out late afternoon), then at bedtime.

I found the visuals extremely helpful and it definitely worked like that in reality for me too!

thyroidpatients.ca/2020/07/...

[Auders in reply to FallingInReverse]

Thank you so much for the link, it is very very interesting. Will need reading a couple of times before it really sinks in. Definitely think I need to try to split the dose, once again thank you 🙏

[xNorthernLightsx]

I had a total Thyroidectomy as I had Thyroid Cancer. That afternoon, the hospital pharmacist arrived with T3 and just told me to take it 3 times a day - no mention of food, supplements or anything else. I didn’t even know what T3 was. I’d been expecting Levothyroxine.

I figured I’d better take it every 8 hours and took it religiously at 7am, 3 pm and 11 pm. I had it with food as I’d not been told not to. I was taking 20 mcg 3 times a day which is the post Thyca protocol until treatment is complete and scans clear.

I took it for 7 months and was such a happy bunny. Loads of energy, slept like a log and ate what I liked without weight gain.

When the party was over, I was given a weight-calculated dose of Levothyroxine and life was never the same again ……… 🙁

Last time I checked BNF it states that it should be taken 4 hours away from Calcium. No mention of food or other supps

[Auders in reply to xNorthernLightsx]

Thanks so much, hope you well on the way to recovery 🙏

[xNorthernLightsx in reply to Auders]

I am now that I’ve realised that I’m a poor converter and that I need some T3 along with Levothyroxine 😉

[jimh111]

I've never had any problem with liothyronine. I split thr dose and find my bedtime dose helps with deep restorative sleep with dreams "in focus".Liothyronine is a smaller molecule than levothyroxine and rapidly absorbed. At one time patients used to recommend taking liothyronine with food to slow down absorption. I'm not sure it helped but there weren't any reports of problems.

[Auders in reply to jimh111]

Thank you very much for your reply. Taking it at night could been an option if it helps with my dreadful sleep. Seem to have a dip in the afternoon so I could try one in the afternoon and the other at night, will give it a go, once again thank you 🙏

[xNorthernLightsx in reply to jimh111]

I certainly slept very well during some difficult times. When they started ‘messing’ and changed me to Levo, the Endo found it hard to believe that anyone could sleep having taken a dose of 20 mcg at 11 pm..

When I went for oncology check ups my FT3 was always about 7 (when they did bloods at midday). Well over range, but I had no tremor, no palps or any other symptoms of being overmedicated. The oncologist ignored it as the aim was to keep my TSH suppressed.

It only became an issue when treatment was finished over 7 months later and I was changed to Levo. When I felt very ill and asked to be returned to the Liothyronine dose I was told I was endangering my health. It didn’t go down too well when I asked why, if that was the case, they’d been endangering my health for 7 months 🤐

[Transalp in reply to xNorthernLightsx]

I had a thyroidectomy when living in the US and ended up on a mix of Levo and some NDT (Armour). I moved back to the UK and stayed on the same mix for the next 7 years with the NHS, one day I went to order my usual 3-month supply on the NHS app and the NDT was missing - I queried it with the Dr surgery and they said I didn't need it - no blood test for the previous 2 years, no discussion with the patient, just cancelled. I complained in writing and was told it was for my safety - which makes one wonder why they were happy for me to be "unsafe" for the previous 7 years. I realised then that I couldn't trust the NHS with my health.

[xNorthernLightsx in reply to Transalp]

I’m sorry to hear this but not surprised. With the NHS you get what you’re given. The concept of evidence-based medicine seems to have escaped them. The sooner they admit that most prescribing is done on the basis of cost, the better. This applies to all conditions

We have to be advocates for our own health and forums such as this are our lifeline.

I hope you’re now able to manage your own health and are getting the NDT you need.

[Transalp in reply to xNorthernLightsx]

Yes, in reality it was 100% cost-based and they didn't even have the decency to speak to me before cancelling it.

I was already doing my own private blood tests and all it did was motivate me to source my own T3 online to self-medicate. I now manage my NHS T4 with self-sourced T3 and private blood tests with the odd RMR test as another check from a different direction.

I don't bother reminding the NHS that they should be doing periodic blood tests and they don't book them - if they did they'd likely get upset at the reduced TSH and I don't need the hassle.

[xNorthernLightsx in reply to Transalp]

I’m glad you’ve sorted things and don’t have to involve the GP/NHS at all.

I take NDT and my GP is aware. However, it’s not on my medical record and being an inpatient in hospital is a nightmare. I just hide my NDT and self medicate without them knowing. The problem with that is when routine bloods give a TFT with suppressed TSH, the interrogation begins and you have to have “the discussion”. I’m afraid I’ve now reached the point where I say that the NHS don’t prescribe my medication so they’re not going to engage me in a lot of ill informed garbage about my test results. It usually works - but they did once write on my discharge notes that I’m “hyperthyroid as a result of self sourced medication”. Pft 😬

[SlowDragon Ambassador]

I split my T3 as 4 x 5mcg

I get 20mcg tablet prescribed. Cut roughly into 1/4’s with sharp craft scalpel….and mop up any crumbs with damp finger

Doses 6.30am (alarm and go back to sleep) 11.30am, 5.30pm and 11pm

Generally I try to leave 30 mins between taking and food or drink

But occasionally it clashes ……and might only be 5-10mins

Doesn’t seem to make much difference

I also now split my Levo ……half at 6.30am and half at 11pm

[Kimkat in reply to SlowDragon]

Does taking your Levo and Lio at night not give you an energy boost? I was always under the impression that T3 was the action hormone .

[FallingInReverse in reply to Kimkat]

jimh111 mentions above about t3 at night helping with restorative sleep.

When I was first prescribed I was told 5 upon waking and 5 upon bedtime.

Then at some point I switched to 2.5 waking, 2.5 noon (helped with the afternoon nap/slump) and then 5 at bedtime.

Then, I researched exactly what you mentioned - this idea I was “wasting” the t3 energy boost while sleeping.

I then switched to 5 am and 5 some time between noon-2.

jimh111 I never was able to find any research/info that explained why taking it at night made sense re to body chemistry/cellular processes. Do u have any or is it just trial and error?

[tattybogle in reply to FallingInReverse]

natural fT3 levels (in people without thyroid disease) are at their peak overnight as are natural fT4 levels ...i'll find you a picture ......

[Kimkat in reply to FallingInReverse]

I’m just going by what my private endo said, he recommended morning and early afternoon but as it’s the “action” hormone it makes sense to me, However my sleep has improved and I take mine around 2/3pm.

[tattybogle in reply to FallingInReverse]

here you go FIR : thyroidpatients.ca/2020/07/... dosing-t3-circadian-rhythm/

thyroidpatients.ca/2020/07/... circadian-rhythms-tsh-f4-f3/

[SlowDragon Ambassador in reply to Kimkat]

I find 5mcg T3 at bedtime gives really good sleep

Discovered by accident …..initially I was on 2 x 5mcg waking and mid afternoon

When 3rd dose added …..when doing blood test next day …..I moved last dose to 9pm ……was so much better

So I subsequently tried bedtime

Doesn’t suit everyone

Endo always said last dose latest 6pm

Levothyroxine, many members find it more convenient to take at bedtime…..possibly more effective/better absorption

I had been taking levothyroxine at bedtime for decades

[Kimkat in reply to SlowDragon]

Thats really interesting, just might give it a try, I can always change back but I do sleep more soundly now with less disturbances.