When do you take your thyroid medicine?

[onedaybaby]

Hi,

I have recently started taking Thyroxine and after a quick bit of research, I understand that it should be taken at the same time each day and ideally in the morning with a glass of water.

Thats's fine, but the confusing bit is in relation to when to eat and what to eat. At the moment, I am waking at 5am to take the tablet, going back to sleep and then have a banana or cereal bar at 8am.

I would prefer a bowl of porridge but by all accounts, milk causes a problem with it being absorbed.

I have read that some people take it when they go to bed, which would suit me better.

I would be really interested in when you take it and if you do anything special with food etc.

could you use rice milk to make your porridge - or another milk substitute?

Why the waking at 5am to take it and not taking the medication as you wake?

I wasn't aware of any problems with milk and thyroid medication and I'm surprised it would have an effect if you are leaving time between taking your medication and having breakfast (as opposed to taking the medication with milk). But I'm not a doctor, so take advice on this.

Normally, I take my thyroid medication as soon as I wake (on bedside table with drink ready to go) but leave about an hour before breakfast. I nearly always have cereal with milk.

During pregnancy I've changed my habits as I had a lot of sickness and nausea and wanted to take my medication at the time least likely to make it quickly reappear. So for the moment, I take it last thing at night. I also take my pregnancy vitamins at the same time, which isn't really the best thing to do (they can interfere too) but its the easiest way for me to remember to take everything and keep it all down. I'm satisfied as long as my blood results keep coming back fine.

I'd have thought that as the dosage is based on blood results it should reflect what your body is actually making use of. I might be wrong about that, but it seems to me that if my body wasn't getting enough then my blood results would reflect that.

I think waking up at 5am just to take your medication if you normally breakfast at 8am is a bit excessive... who suggested you do that?

I thought you just needed to wait 30mins to 1hr before breakfast.

Even if calcium does interfere, it is surely unlikely to interfere after 3 hours?

If you still want to be cautious, then maybe decide which bothers you most - waking up at 5am just to take your tablets, or not having porridge for breakfast and get rid of the one that you find most inconvient. i.e. either wake up at 5am and have the milky breakfast you like at 8am or wake up at 7am and have a non-milky breakfast.

I go on whether I'm getting symptoms of my thyroid problem or not, and on my blood results. If I'm feeling fine and my bloods are fine, does it matter if I have cereal for breakfast?

I take mine in the morning with water when I wake up. I have breakfast (a cereal bar) about an hour later on the way to work.

My understanding is that food and vit supplements can interfere with it if they contain calcium or iron, but not otherwise. So you shouldn't really need to leave 3 hours before having a cereal bar or banana. But you should leave as long as poss before eating eg milk or eggs or multivit supplements.

this link might be helpful?

oh blimey I've been taking thyroxine for 13 years and didn't know you were supposed to avoid milk - I take mine about 10 minutes, with a milky coffee, before having my cereal each morning .

My levels are always fairly OK - within reason - they only get buggered up when I forget to take it/run out of prescription etc...

Same as DottyDot - I get up, come down to have breakfast but firstly take a swig of orange juice with my tablet, and then 10-15mins later I'll sit down to eat cereal, toast or whatever.

I do take the tablet at around 7am each morning, sometimes I'm a bit late, but normally 7ish.

I'm 'borderline' so I teeter close to OK/not OK all the time on the reference range....

I wonder if those who have milk shortly after, are actually taking more thyroxine than they need to, to "compensate" for the blocking effect of calcium?

or the whole calcium concern could be wrong

well that's possible - I do take slightly over my dose anyway and get told off from time to time by my GP but feel better when I take a bit more than I'm supposed to.

I have taken thyroxine for about thirteen years and always take it at lunchtime, with either a drink of water or my redbush tea. I used to take other medication at breakfast and I didn't want to take it all together, so lunchtime seemed the best time. I have never heard this thing about milk interfering with it. I occasionally forget it, but just take it then when I remember and my doctor said not to worry if I ended up taking double in one day, as long as I didn't take it all at the same time (I take 150 mcg a day).

I still remember how I felt the very first time I took it - I started off on 75mcg a day - it was almost as if I had taken something to give me a high.

I have it first thing - probably about 30-45 minutes before my cuppa and then I have breakfast another 45 minutes after that.
I have heard that it should be s ahort while before eating, not heard about the drinking milk bit.

I understood it needed to be taken on an empty stomach at least 30 mins and preferably 60 before eating or drinking anything else.

When I was taking it I used to take it when I woke up in the night, usually 3.30 - 4.00 am and then go back to bed.

It should not be taken within 4 hours of calcium or iron meds.

This is all stuff that your doctor won't tell you.

D

My consultant has just suggested that I change to taking thyroxine at bedtime, mainly cos I'm veggie so have more soya in my diet than a carnivore would. Soya apparently messes with how thyroxine is absorbed. I've not noticed a difference yet tho.

I can see the benefit in taking it at night, so it will be working by the time you wake up. I generally take it at about 7.30 and feel pretty crap before about 9.30am.

I know it has a really long half-life anyway, so I don't expect it makes too much difference really but maybe worth trying it a different way. I do try to avoid milky drinks and and cereal for about an hour after, but thats not hard as I'm still half-asleep and don't feel like eating!

7.30am

With my breakfast...milky porridge!

I totally agree that waking up at 5am to take the tablet, then going back to sleep until 7 is ridiculous. I really struggle in the mornings to wake up, but funnily enough, have no problem taking the tablet at 5

According to the leaflet with the Levothyroxine tablets, it says: "...take your tablets with a glass of water, preferably before breakfast."

My "research" includes:

Should you take your thyroid medication at night?

"Every thyroid patient has heard the advice that for best results, we should take our medication first thing in the morning, on an empty stomach, and wait at least 30 minutes to an hour before eating. (And also, that we should wait at least three to four hours before taking calcium or iron, which can interfere with thyroid hormone absorption.)"

It then goes on to suggest the benefits of taking it at night.

"Taking medication at bedtime instead of in the morning could have major implications for many thyroid patients.
First, it?s easier, as you don?t have to worry about when to eat breakfast.
Second, it?s easier to avoid medications, supplements and foods, like calcium, iron, and high-fiber foods that can interfere with thyroid medication absorption.
Third, coffee drinkers would not have to wait until an hour after their medication to enjoy their first cup.
Fourth, it might offer some improvement in symptoms to people who are just not getting optimal absorption by taking thyroid medication during the day."

Foods & supplements that can interfere

"In particular, iron from food or iron pills, and calcium from food or calcium supplements can keep your full dose of thyroid medicine from being absorbed.

Instead of changing your diet, the best way to keep your thyroid treatment stable is to take your thyroid pill at a time separate from your mealtime. Take your daily pill one hour before eating or at least two hours after eating. This will ensure you get your full dose."

The general consensus does seem to be that you should wait at least an hour before eating, and several hours before things like caffeine, calcium (milk) and vitamin supplements with iron in it.

We tend to eat late (after 8 pm) and I'm not sure I could guarantee I haven't eaten for 4 hours before going to be bed. However, I could make more of an effort to eat earlier so breakfast and sleep isn't interrupted.

The link that minipie posted also includes:

"Calcium, iron, and soy-based formulas will bind with thyroxine and prevent it from being absorbed. So if you are taking any form of levothyroxine (Synthroid, Unithroid, etc.), do not take any calcium- or iron-containing foods or supplements within four hours of taking the levothyroxine. This means avoiding milk and yoghurt ? two classic breakfast foods. It also means avoiding eggs and baked beans, which are surprisingly high in iron. (But eggs are also rich in iodine, so they are a brilliant food to pick for lunch, once you've safely converted any thyroxine tablets from T4 to T3)."

dh just asked why I don't take the tablet at 4am then I can eat what ever I want at breakfast time!

The best result for eaking out that last ummph from my miserable 75mg(stubborn gp)was to change to a fluoride free toothpaste.
I noticed a difference on day one changing to a fluoride free option.
Some whitening toothpastes have massive doses of fluoride that wipe out levothyroxine, far more than a milky cuppa.

I keep posting this nugget of information on thyroid threads because it really did make a big difference for me and is such a simple thing to do, switch toothpaste for something like BioRepair(available at boots).

'Give up drinking tea altogether', I don't think so!

I was talking to a pharmacist about swopping my thyroxine to a night dose, she said it was a good idea as I wasn't sure if it was helping along my morning sickness, as it happens this has all but cleared up now and I just know I would forget to take it at night.

I take it whenever I wake up in the night/early morning, bit like you, op
The evening thing is not fully researched as yet (according to clinical knowledge summaries in any case which mentions the problems with the research paper you mention) but my problem is late night snacking!
I don't think you need to wait so long for your porridge though - it's more the calcium supplements a lot of us are on (or the iron - which you can't take near the calcium or thyroxin either)
Did you get your bloods tested for vit deficiencies btw?

My GP has just warned me about this Thyroid drugs not working well

Toothbrush, thanks so much for that link!

I had to ask to swap my Teva 100mcg tablets last year, as I felt they weren't working at all. My Gp thought I was making it up and the pharmacy didn't seem interested, both implying that I was being a bit of a hypochondriac, although I was able to get a replacement, but now having read that I'm sure that was why I felt so awful!

I would also really recommend thyroid uk or tpa for info on thyroid and updates on probs with meds

I would also really recommend thyroid uk or tpa for info on thyroid and updates on probs with meds