Medication Absorption
lisemcl
Posts: 9 Member
I had read in an earlier thread that levothyoxine should be taken on an empty stomach, 2 hours before or after food and 4 hours after any vitamin supplements. How do people manage this in practice? Firstly - I had no idea, my GP never mentioned it, but more practically, I usually take my medication as soon as I get up and I don't think I could wait 2 hours for breakfast. Any advice would be great!
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My pharmacist told me 1 hr before food or 2 hrs after. Dr never mentioned it. My mother takes hers first thing in morning but doesn't worry about when she eats. Neither her pharmacist nor Dr told her any differently. My son has to take his in morning or he can't sleep. I think as long as you take it same time every day, & find when (1-2 hr food) works for you is best. My body lets me know if I've forgotten or left it later in day (headaches).0
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I take mine as soon as I get into bed at night - as a rule I don't eat anything past two hours before bed which Endo said is fine for me. I found taking it at night helps me sleep better. I take T3 in the morning as soon as I wake up an hour before food.0
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My endocrinologist and pharmacist both told me to take Synthroid (levothyroxine) & Cytomel (liothyronine) 2 hours after eating or drinking anything but water & 4 hours after taking any supplements—including vitamins, minerals, and fiber. Having those in your stomach will reduce the absorption of your meds.
A full glass of water is better than just a few sips.
The meds leave your stomach within about half an hour. Many people wait a full hour just to be sure, but there's no reason to wait any longer than that.
I take my Synthroid & first dose of Cytomel when I wake. I leave the pills & a glass of water at my bedside so if I wake in the night I take my meds. Then I can immediately eat & drink in the morning.
Cytomel has a short half-life, so it must be taken several times a day. My endo says I can wait as little as 15 minutes after the other doses if I'm really hungry.0 -
My gp and chemist told me to take my levothyroxine 1 hour before eating or 3 after or 5 after a multivitamin.
I take mine in the morning, shower, get ready etc. and kill and hour for breakfast. I take my allergy pill and probiotic in the morning but the rest of my pills after dinner.
I agree that the best thing to do is to take it constantly. Although it does react with some foods, if it's consistent, than I think (note I'm not a doctor) that it would help cancel out any issue with absorption and dosage. At least that's how I've been taking it.
Side note- I'm a little horrified that there is so much inconsistency.0 -
duckykissy wrote: »Side note- I'm a little horrified that there is so much inconsistency.
Here's what the manufacturer says: https://www.synthroid.comSome medications or supplements can make SYNTHROID less effective if taken at the same time, so it's best to take SYNTHROID 4 hours before or after you take these things. Some examples are iron products, calcium supplements, or antacids.
Take SYNTHROID as a single dose, preferably on an empty stomach, one-half to one hour before breakfast. SYNTHROID absorption is increased on an empty stomach.
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I started levothyroxine in January. My doctor told me to take it before bed and the pharmacist seemed surprised but just said "Oh okay, I guess that could work." I try to wait 1/2 an hour after dinner before I take it but honestly I'm not extremely consistent with how empty my stomach is- I just try not to forget about it and usually am too tired/lazy to drink a whole glass of water (since that usually makes me wake up in the middle of the night to use the restroom). My TSH level was 80.15 at the beginning, then after a month of 88mcg doses it read at 2.64 which my doctor told me is now normal. I was in the hospital for an unrelated issue in February (pulmonary embolism) and the nurses said they give their patients the same meds 1/2 an hour before/after a meal.
My mom is taking Synthroid also but her doctor told her 1/2- 1 hour before breakfast so the poor woman wakes up at 4AM(!!!), takes her meds, then goes back to bed because she's afraid of forgetting. I think it's silly, but whatever works for her I guess.0 -
It is a little disturbing how variable the information out there is! I take mine before I get in the shower and don't eat/drink until I'm done getting ready for the day, which takes about 1/2 hour. This has worked for me, as I rarely eat anything for breakfast and rather have a big cup of tea (with some honey and cream, so there is calcium/calories there).
My endo also told me to never, EVER take your thyroid meds at the same time as another hormone. For example, I was taking birth control and levo at the exact same time and he was horrified! I now take my levo in the morning and the pill at night. I used to be bad about forgetting one or the other, but now it's just routine.0 -
Taking birth control daily while being on thyroid treatment change the way the thyroid treatment works. Quote from Thyroid UK food and drugs leaflet.
"Oestrogen - any oestrogen raises the levels although thyroid activity is unchanged. This could make your levels look within the normal range, whereas they are really below it. Oestrogen provides more of the transport protein, making the hormone inactive. After starting on any oestrogen therapy, a woman should always have TSH tested to see if the oestrogen is having an impact on overall TSH and thyroid function and might require a dosage adjustment".
HRT is not without issue either. "Prempak C/premanin etc - made from mares urine and interferers with thyroid availability.
Add sweetcorn is now on the "list of foods which can cause problems" and as maize starch is used as filler/binders for many pills not to mention widely used by the food industry as a thickener for sauces as well as reducing the need for "fat" in low calorie foods knowing what you are eating becomes increasingly difficult.
(Sweet corn is also on foods with higher salicylate level. salicylate is a toxin produced by many plants to protect themselves from moulds and mildews which is known to medics and is why aspirin has a dose above which it becomes life threatening).0 -
I have to get up in the middle of the night anyway...so I leave it handy. Its a habit now and I can do it without even waking to a full yawn.0
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I wake at 5:30, take my L-Thyroxine and go back to sleep. Breakfast is usual around 7. Having a longer break ( I used to wait half an hour before ) made a big difference for me.0
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My endo says that if I wanted to take my meds at bedtime I would have to make sure it is about 3 hours after my last meal.0
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I take my Thyroxine at least 2hrs after my last meal at night, as recommended by my endo. Its all very confusing0
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Taking birth control daily while being on thyroid treatment change the way the thyroid treatment works. Quote from Thyroid UK food and drugs leaflet.
"Oestrogen - any oestrogen raises the levels although thyroid activity is unchanged. This could make your levels look within the normal range, whereas they are really below it. Oestrogen provides more of the transport protein, making the hormone inactive. After starting on any oestrogen therapy, a woman should always have TSH tested to see if the oestrogen is having an impact on overall TSH and thyroid function and might require a dosage adjustment".
This is very interesting... i'm on Microgynon pill, and my T4 always shows in range but TSH is high... basically asking me for more thyroxine. That said I have no thyroid (TT in Aug 2013), so not sure how that would effect things.0 -
What this seems to be saying to me, is that, the testing system shows a patient as having potentially good results but in fact they need more medication to really be where the doctor thinks they are.
As an ordinary person needing to find my own answers, I really feel for any TT patient. It seems as if no consideration is given to your, what I would consider to be your postoperative, additional needs. If you have no thyroid how do you make t4. I assume you only have those you take in the form of a pill at whatever dose you are given. (T2 is created in the ovaries, and may be the consequence of recycling or preparation for elimination, I wonder if one t2 colliding with another t2 might they create a t4 and the merry go round starts again, but I don't know.)
In the Thyroid UK leaflet talking about Hypothyroidism, on page 8, they quote the words of a Dr Anthony Toft from an article in Pulse Magazine, the magazine for doctors. He is or was a consultant endocrinologist in Edinburgh, Scotland, UK. He was at some stage a former President of the Royal College of Physicians and President of the British Thyroid Association. (I did not find his dates).....................................................................................
He says,
"the appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range -0.2 to 0.5 m U/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated - 18 - 22 p mol/l. Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum t4 will be elevated at around 24 - 28 pmol/l.
This 'exogenous sub-clinical Hyperthyroidism' is not dangerous as long as serum t3 is unequivocally normal - that is, serum total around t3 1.7nmol/l(reference range 1.0 - 2.2 nmol/l"
This in formation is probably more useful outside the UK and Europe because doctors are probably more constrained here. I am finding the booklets make interesting, thought provoking reading which others may too. (Thyroid UK is available on line. The information pack is available outside the UK though it costs more. I may have seen, if requested on line it may be provided electronically)
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Thanks for all the advice. Haven't been feeling great recently, but recently restarted on the pill and I have been taking them together! I will stop that immediately.0
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My endocrinologist told me to just be consistent. He can work around interferences with absorption as long as I am consistent everyday. As a rule, I take my multivitamin (with iron) in the am (on the days my throat isn't dry from snoring all night) and I take my synthroid right before I go to bed at night (since I'm more likely to remember this dose - I put my synthroid here bc it's more important than my multivitamin).0
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lisemcl. Please don't stop taking care. My intention in posting was to alert whoever needed to know of the potential of this situation, to see if their medics would be helpful. greenj05 seems to have found someone who understands interactions.0
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Depends greatly on what else the patient is on. I take 200/175 alt day at 0500. At about 0600 I drink 16oz water and eat breakfast around 0700-0800. This works for me, but it is the only medication I take. For most healthy people 1 hr before the first meal is fine.
If people took a multivitamin ~ 30 mins afterwards this would be fine.0 -
If people took a multivitamin ~ 30 mins afterwards this would be fine.
Do you mean to say that the body can process/absorb the calcium and other vitamins that interfere with thyroid replacement if the multivitamin is taken 30 mins before the thyroid med? I have always understood that we need several hours between multivitamins/calcium supplement and thyroid to avoid absorption difficulties whether the vitamin is taken before or after the thyroid meds....please clarify.
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Synthroid & Cytomel clear the stomach in approximately 30 minutes, after which time it's safe to eat, drink, or take supplements.0
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indianarose2 wrote: »
If people took a multivitamin ~ 30 mins afterwards this would be fine.
Do you mean to say that the body can process/absorb the calcium and other vitamins that interfere with thyroid replacement if the multivitamin is taken 30 mins before the thyroid med? I have always understood that we need several hours between multivitamins/calcium supplement and thyroid to avoid absorption difficulties whether the vitamin is taken before or after the thyroid meds....please clarify.
Other way around - Synthroid prior to multivitamins. Multivitamins can take hours to fully absorb/uptake depending on the molecule. Calcium doesn't so much interfere, than run a parallel pathway to T4.0
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