Does splitting levo dose throughout the day help?

I usually take my pitiful dose of levo in the morning. I know its not enough as I'm having a flare up of symptoms and everything is unsettled again. Latest bloods clearly show I'm now undermedicated. My body does seem to respond well to levo. Last night, my cramps were keeping me awake, so I took an extra 25 levo and within an hour, the cramps had eased. My late night top-up of levo seemed to help my muscle cramps - do others take night-time top-ups and does it help?

27 Replies

  • Taking levo of a night helps quite a few people. The body can absorb the levo better when the stomach is empty. Muscle cramps can also be a sign of low magnesium - have you ever had this tested?

    Why are you undermedicated? and whats your GP doing about this?

    Moggie x

  • Thank you for getting back to me.

    I'm concerned that as my levo dose is so low, I'll 'run out' if I take it all at night, and syptoms over the long school day will get even worse by PM.

    I've not been tested for magnesium - and when I went back to one GP last year about cramps, as well as other issues, was told I was 'imagining symptoms'... I think they won't test for anything unless forced. (Cost cutting?)

    I started taking a vitamin/mineral supplement recently.

    My dose has just been increased to 50 (TSH nearly 20 range 0.35-5.5) so I'm going to give it another week and then go and insist I see a different GP and make sure they listen.


  • A dose of 50mcg is too low - it is a starting dose - if you are having symptoms and it is not even lasting 24 hours.

    Your TSH is still to high, he should aim for a TSH of 1 or below.

    This is a link and I know levo suits you but the point here is about a low dose of thyroid meds. Cursor to question dated November 28, 2003

    Also ask for B12, Vit D, folate, ferritin and iron if you haven't already had them.

    Make an appointment now and request an increase otherwise you could get more problems arising from a low dose. It has to be enough to alleviate your symptoms and reduce your TSH, of course it is gradual and you should have a blood test about every 4 to 6 weeks till you get to an optimum dose.

  • Thank you - I will follow your advice. I've been on the verge of tears at school over the past few weeks in the afternoon and I'm now sick of being fobbed off by the NHS because they want to keep costs as low as possible.

  • Levo cost about £1.30 per MONTH.

  • I'm shocked it is so cheap. The more I learn about the NHS and the treatment of this condition, the more appalled I am. But there's also a financial gain to my surgery to keep diagnosing 'depression/stress' which they can almost guarantee if they continue to undermedicate, since I'e found out that depression earns them more 'points' than simply increasing the dose of hypothyroidism and treating me correctly. If I had more energy I'd be livid!

  • They could easily add some T3 if people are still complaining - they wont - or reluctant: this is an extract of Dr Toft's advice (ex President of the British Thyroid Assoc)

    Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

  • I will look further into this if I can. My first issue now seems to be finding a GP at my surgery who will increase my current out-of-range TSH (since that's what they focus on), and my returned symptoms.

  • Sorry to be a pain - but I can't access the link as it's not available any longer. :(

  • Try again, it is an archived site and it worked for me just now.

  • Thank you - can access it now.

  • Odd, works for me. The original site is offline, but the link Shaws posted is to the archived site.

  • Thank you - can access it now.

  • When I told the Doctor about my leg cramps She suggested quinine which was totally useless as it did not give any relief. I was telling someone about my night cramps in my legs and he told me magnesium would do it and it has.

  • Thank you Polly. You could well be right, and I will find out more. Even better if this can be corrected with food. I'll find out about foods with high magnesium content. Do you treat yours with tablets or eating magnesium rich food?

  • I use tablets I know its another tablet but its better that the pain of cramp.

  • I don't know why but if I eat one banana a day, the cramps are much improved.

    When I told my doctor this, he laughed at me. Then again, he laughed at me when I told him I was not getting enough thyroxine...

  • Bananas are high in Magnesium but they also have a lot of sugar. I am a diabetic and find they spike my BG so I avoid them.

  • Fair point.

    I was given Quinine but they made my tinnitus almost unbearable. Not having a sugar problem, it is the ideal solution for me.

  • God no wonder you are feeling ill. Let me explain simply how levo works in case you need it explained.

    Levo (T4) is stored in the body and, hopefully, will then be turned into T3, which is the hormone that our body needs to function - from hair and nails to muscles and brain.

    So it doesn't really matter when you take your levo as it isn't used straight away but is stored away for when you do need it. If you take your levo regularly your body will never run out as it lasts up to 6 weeks in your body. You can even miss a dose without it effecting you in any big way.

    There are many things that will stop your body absorbing the levo so you must be careful WHEN you take it. It needs to be taken well away from food or drink (except water), nowhere near suppliments (about 4 hrs apart) or the contraceptive pill, iron or milk. For these reasons many people take their levo last thing at night, they will often say that taking it of a night makes them feel a lot better.

    To make sure your levo is working properly certain vitamins need to be just right and these are

    B12, VitD, ferritin, folates and iron so your GP should be testing for these.

    So my answer to your original question of splitting your levo would be that it wouldn't make any difference as your body will never run out of levo as long as you take it daily.

    Sorry if I have told you wat you already know but thought it might help.

    Moggie x

  • Thank you - I'd worked out most of this by being on this site for the past few months. So even if undermedicated, the top-up I'm taking can't really be making a difference in the few hours after taking it? Am I clutching at straws?


  • Hi liz,no wonder you feel rough on 50mcg of levo.My endo told my GP to start me on 100.He said 50 would be fine initially if you we're a little old lady or had heart problems.

  • Hi Ian. I'm not (yet) a little old lady ('tho feel it most of the time) and as far as I'm aware I have no heart probs! I'll bear this in mind next time I go to see my GP.

  • No not entirely - this is a stange illness and, although it shouldn't make a difference, maybe in your case it does. If it works for you keep doing it but I would be more concerned of my TSH being 20 and my GP not doing enough to get it down.

    Sorry it took a while to reply but I'm at work and my boss is about.

    Moggie x

  • Don't get busted Moggie! ;)

    I am concerned about my TSH of 20 and after 2 months of reading as much as possible on ThyroidUK, I will be visiting my GP at my next visit with a lot of questions.

    This visit is due end of next week.

    The top-up is only to keep me going for a few more days.

    I've decided to give the recent increase in dose the 4 weeks to do its best. If I go back now, I'm sure the GP will say - its not enough time - go away and give it 4 weeks...


  • I'm always getting

    Was your first thyroid test reading 20 or is it 20 now you have been on 25mcg's levo for a while?

    If I were you I would start asking for ALL your blood test results and keep them in a folder as you never know when you will need them. I took my folder along to my endo appt this week and they came in mighty handy when he was looking at his screen and trying to tell me something different. It is also worth getting copies of blood tests so that you can post them on this site to see what others think of them.

    Yes you are right about giving the dose at least four weeks otherwise the GP will say exactly that "not enough time".

    Moggie x

  • Hi

    hehehe! I'm guessing you're home now so you're safe!

    TSH was just over 10 when I was given 25 levo. Refused increase at 5.36 last March as I was considered 'normal' and I was basically told I had psychological issues. I was too ill at the time to fight it. Although I had a 'feeling' I was being fobbed off, I also didn't know any better and thinking I was on my own with this, decided to make the best of it and tried to help myself with nutrition/exercise, and getting on with it etc. Things settled but I had very little stamina and weight was still creeping up on a wholesome veggie diet. I started to do as much research on the internet as I could.

    One year on, I joined ThyroidUK and know sooooo much better! I realised that although I had improved so much since 2011 with some treatment, there was still a long way to go and much more that could be done.

    Last bloods (Feb 2013) were TSH just under 20. GP told me to increase to 50 levo a day. Taking the advice regularly posted on here I got all my test results two weeks ago and they are in a folder. To get my test results I had a bit of a battle with the medical centre - and the GP tried to diminish the importance they put on the test readings. He got quite a ticking off since last year EVERYTHING depended on the test results and they weren't interested in my symptoms!

    I now no longer trust my centre at all and will be keeping everything, checking everything and telling them what I want instead of letting them tell me.

    And the next GP who tells me 'weight gain is not connected to your thyroid issue' is going to get another ticking off! :D

    I posted my blood results on here and had some useful advice :)

    My legs and hands starting cramping again today - getting worse as the PM went on. Went to bed at 5pm - got worse, so took another 25 levo an hour and half ago - cramps are easing again - I'm sure there's a link although probably because I'm still undermedicated.

    Sorry for the essay and thank you for reading. xxx

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