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Do you skip your thyroid meds on lab days?
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Do you skip your thyroid meds on lab days?

I went for my labwork today. Hopefully, I will get my meds raised because I still feel hypo.

My endo's nurse told me not to take my Synthroid before my lab this morning. I thought that was weird, but I took my Synthroid after labwork.

The lab tech said that I would not get an accurate reading.  Should it make that big of a difference since I have been consistend with my Synthroid for the past three months?

Any thoughts?

Thanks!
:) Tamra
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608 Comments Post a Comment
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1013194_tn?1296463081
I have not skipped mine when i have my bloods done, but im seeing here that a lot of ppl do, i haven't yet been told to but im thinking maybe i should:)
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Avatar_f_tn
I have always skipped my dosage the day of my labs.. I had labs done today actually and skipped on it.. I think that as long as you have been consistent with it for the last 3 months then it shouldn't make a huge difference taking it or not for 1 day...  
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1013194_tn?1296463081
So do you take it at all that day of you labs?
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Avatar_f_tn
I probably should have but because i ate breakfast and had coffee i skipped on it completely.. I've had exceptions where i skipped for the day but not very often at all.. I only did today because i wanted to eat and drink my coffee after my appointment haha.. but usually i'll schedule my labs for first thing in the morning and then take my meds afterward..
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1013194_tn?1296463081
Lol ok, well i think i would be wanting my breaky and coffee as well:)) I read on my instructions if you miss one it wont make any difference if you miss three days it will..Dawn
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231441_tn?1333896366
hi,

i always take it after, not before the labs. particularly as i take dessicated.

your dr's nurse is right. should not take the med before the test. levels may appear high because of the just absorbed dose.

Agree with dawn too that missing 1 day not a big deal - though repeatedly missing days will....
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231441_tn?1333896366
hi,

i always take it after, not before the labs. particularly as i take dessicated.

your dr's nurse is right. should not take the med before the test. levels may appear high because of the just absorbed dose.

Agree with dawn too that missing 1 day not a big deal - though repeatedly missing days will....
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Avatar_f_tn
Thanks all! I think the guy at the lab had no idea what he was saying. He's not an endo. I assumed the nurse gave me orders from my doctor, and he seems to know a lot about thyroid.

My last endo didn't tell me to skip my meds, but she didn't seem to know SQUAT about thyroid.  That's why I switched.

:) Tamra
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499534_tn?1328707778
I have a fantastic Endo who is a Thyroid Specialist.....and he always reminds me  to NOT take my thyroid meds before my labs. I always take them with me and pop them after my bloodwork is finished.
It will give a false flood of hormone in your system if you take it before.  :)
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Avatar_f_tn
I do the same as Laura.
I take my T4 with me but dont take it until blood is drawn.
I usually take a bottle of water with me and take the T4 med in the waiting room After bloods drawn.
By then I am usually 'hanging out' for the T4 med lol.
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1013194_tn?1296463081
Why dont all doctors inform you of this:( my last blood showed i was a little high in T4....20.7- range (10.0-19.0) said do you feel hyper, as i didn't he said it was prob because i had my meds an hour before i went, he still didn't say dont take it before you come..
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649848_tn?1357751184
I do the same as Laura and Deb -- take my T4 med right after the blood draw.  I'm also on cytomel, so absolutely don't want THAT dosage in my system BEFORE the test.....I take a bottle of water to drink with my med and I also take along my coffee mug -- that 30 minutes goes faster than you think..........

My doctors have not told me anything either -- it's just a habit from years of having other types of blood work -- they always say not to take med before fasting blood work......except heart/blood pressure med.
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607546_tn?1222302744
I did ask my general Doctor because I forgot to ask the Endo. He said unless I get my synthoid put in an IV directly in my blood stream it does not matter if I take it before the blood draw. Now that I'm on Nature throid I do wait until after. I would listen to the girls on the forum they know more than most Doctors!!!
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Avatar_f_tn
I had a bottle of water and my Synthroid in my purse. After bloodwork, I took it out and the lab tech said I should have taken it before the bloodwork. What does he know????

I'm sure glad I listened to my new endo's nurse. The last endo said nothing about this and my TSH measured 1.2. She was afraid to push my meds, even though I felt VERY hypo. She was the doc who treated TSH, not the frees, so she was CLUELESS anyway. I now wonder if my TSH had dropped because of the Synthroid I'd just taken.

:) Tamra
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964127_tn?1252379062
I don't take mine until after labs either!
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Avatar_f_tn
I have been told that it would not make a difference one way or the other if you take it or not before lab work. I have never been told not to take it.

Now if you miss more than 2-3 days in a row it would.
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649848_tn?1357751184
Maybe with just a T4 med, it wouldn't make that much difference, but it will with a T3 med, such as cytomel or a T4/T3 combo because the T3 goes directly to work.....I guess I'd rather be safe than sorry.........
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1144849_tn?1395458766
This is a good question .. I was not sure either so I asked my doctor so that I will know when I go in for labs soon. I am on Methimazole and the doctor said to stop taking it 3 days before labs.

McMillan
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798555_tn?1292791151
The time a doctor insisted I do an "unscheduled'  lab blood draw right after an appointment with him, screwed up the consistency with all my previous labs. It read higher than I usually like (I like higher free T3 to begin with) on the frees, and he wanted to lower my dose.  I gave him the 'symptom' speech and he left my dose alone. I had another lab weeks later consistent with my previous labs. So, yes meds two hour before without a doubt, messed up my lab results.

Inconsistent test times are not worth it. Need to compare apples to apples. Any  inconstant scientific test in any other industry would be tossed out the window.

**BUT- Years ago on T4 only, I took my med in the morning , 6 AM before labs but CONSISTANTLY had lab work at 4 PM, always. I think you can spread the time frame out on only T4.**

But for a MORNING lab, like others, I would not take my meds again beforehand, T4 or combo.

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Avatar_f_tn
My endo, the fourth one after quite a search, knows a lot about thyroid disease. Initially, I had asked the forum if it was normal to wait to take the thryoid meds until after bloodwork, because my endo's nurse had told me to hold off on the meds. After the labs I spoke with my endo, and he does advise all of his patients to wait until after bloodwork to take meds.

Which means that if the lab opens at eight, no coffee or food until nine!

Blah!

But my FT4 was a 1.0 when I'd skipped the meds. My FT4 was also a 1.0 a month earlier on .25 mcg less hormone. So if you are wanting a bump, it is to your advantage to wait on taking the meds until after the bloodwork.  

:) Tamra
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798555_tn?1292791151
Ha!........"So if you are wanting a bump, it is to your advantage to wait on taking the meds until after the bloodwork."

Thats funny! My exact thoughts too, but I didnt want to push the fact that we sometimes have to be 'sneaky' with uninformed docs just to get optimal!  Why do we have to do this #@?#!! ,     errrrrrr!

LOL
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793305_tn?1303671818
This is very interesting...I guess my dr's have never said to or not to, but I am on T4 only.  I would think you would want to take it and keep your levels consistent, might it not drop if you don't take it?  I never miss taking my meds.  I take it like clock work every morning at 5 a.m.  
So next time...I'll ask.  : )
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Avatar_f_tn
I didn't suggest to skip the med entirely. Just get your labs in the morning and take the T4 after your labs.

:) Tamra
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Avatar_f_tn
Luckily, I don't have to be sneaky with my new endo because he treats my symptoms. If only all doctors would be like him. He's getting close to retirement age, which scares the heck out of me.

:) Tamra
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907968_tn?1292625804
  I would assume it all depends on the specific lab doing the work(?) but do you know if it is procedure to have the time of day the blood was drawn on the lab paperwork handed to your Dr?  I know I took all my med.s at the usual time but I don't remember if I took the ten minute drive to the lab right after or if I waited til late afternoon.  If it is usual practice then I'll contact my Dr and find out the time.
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798555_tn?1292791151
Yes, I too just found a doc that treats by symptom and will go with dessicated (what I need). He is an MD but does not accept insurance and could retire now if he wanted.

The younger doctors I have met have been TSH and synthetic t4 brainwashed.

This, unfortunately, makes a big difference if I move someday. Not to many stay here forever. There needs to be a better doc list than the one on About Thyroid.

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Avatar_f_tn
Unfortunately, where I live we have the second highest diabetes rate in the country, so we have too many endos that specialize in only diabetes.

I wonder if we could start a list of recommended endos on this forum. I noticed that the About Thyroid site lists my mom's endo, and she only treats TSH. She also said that Hashi antibodies don't mean a thing, and that they could come and go from day to day; therefore, treating Hashi is the same as treating hypothyroidism. I wish someone would explain this theory to MY antibodies.

:) Tamra
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393685_tn?1325870933
yes... yes and YES - I skip prior to testing.
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Avatar_m_tn
I take it right after the blood test !!
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Avatar_n_tn
i recently had to have a cardiac procedure, which turned out great and blood work was done at the hospital and my unsymphathetic primary care got a copy of the lab.  i had a tsh of .64 and free t4 of .97. and i am on 75mcg and i am finally feeling normallllll and finallyn after 6 months of trying am losing weight! now the doc is saying he wants a blood test because he thinks i should decrease back to 50 mcg, which i felt absolutely crappy on and tired as hell. he doesn't treat symptoms, just numbers.  i also have a endo who bumped me to 75mcg from 50, and she will retest in 3 months to make sure i stay in the 1.7 tsh range, arghhhhhhhhhh...my cardiologist agrees i need to be on the higher dose, but tells me to have the endo discuss it with the primary. im so upset...i feel so good on 75mcg, have expressed so to the primary.
now the bases of my inquiry...can i skip 1 day before the lab and the morning of the lab and will this change my lab so it looks "better" to my primary? its a damn shame we have to fight and struggle with these drs, to agree!!!!
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1157646_tn?1343970728
My endo never told me anything about meds on lab days.....it was only the day before the last lot of labs I with my dad to an appt with a dr (not a endo!! ) and he said for me to not to take the T4 till afterwards....

Why didnt my endo say this - is it still debatable whether it should be taken or not or did my endo not tell me something important and could all my previous blood work be not 100% reliable???  
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Avatar_f_tn
Some doctors recommend not taking T4 meds before bloodwork, others say to take them.  The really important thing is to be CONSISTENT...either always take them before labs or never take them before labs.  It's also important to have blood drawn at approximately the same time of day each time you have labwork since there are some circadian variations.

I think it's best to take meds or not according to what the doctor ORDERING the tests tells you to do.  That way, in addition to being consistent with yourself, you are giving him lab work consistent with what he is used to seeing with other patients...we don't want to confuse him either.

Since T4 takes time to build  (and therefore also to leave) in your system, skipping your T4 meds until a few hours later than usual is not going to affect your levels appreciably.  T3 meds are a different story and should not be taken before labs.
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Avatar_f_tn
Endos tell you nothing usually...only when the Bill is due! lol

Opps soz..joking with you lol xxx
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649848_tn?1357751184
Good one Deb -- and so true for most of them.  They sure aren't going to forget about the bill............lol
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1157646_tn?1343970728
lol....but Im starting to agree with you Deb!!  My GP is being more useful than my endo!!
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Avatar_f_tn
Same here..my Endo got fired after the 2nd appointment. The first was for RAI, the 2nd was for followup.
I have worked with my GP ever since.
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1157646_tn?1343970728
Well, I saw my endo once before surgery and he reccommended a FNA so I had that, went back to him then he recommended surgery because the results came back non conclusive.  Saw him again in the pre-op area of the hospital, saw him for follow up and at the 3 month follow up basically he said he doesnt need to see me again unless I have issues....that was after he doubled my dose....useless!!  

He didnt even tell me the T4 med had to be taken on an empty stomach...that was the GP....he told me nothing, he gave me a script and said take this...damn dr's!!
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Avatar_f_tn
You are LEARNING Nat lol !
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1157646_tn?1343970728
lol....yep, im getting there!!!  Im learning quite quickly - i got no other choice but to learn quick!!!
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