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TIMING OF MEDS

Hi,

    A question was posted on the board a few days ago about timing of meds.  It concerned feeling good in the morning, taking the meds in the morning and then feeling bad a few hours after and the whole rest of the day.  Then feeling better at night.  I have had this experience too - anyone else?  This is concerning Synthroid.

Thanks,
Liz1900
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Avatar universal
Hello,
This has been a very interesting thread.
My internal medicine doctor seems to be very knowledgeable. He says Hashimotos is very common in our city! (Izmir, Turkey)
After my fibroids were removed we needed to reduce the meds. I am down to 75 mcg of synthroid 5 days a week and 100 two days a week. That was his suggestion. To get to this point (which for the last 2 weeks has felt pretty good) i went through a few weeks of just 75 mcg and had lots of hypo symptoms and then some days in a row on 100 and got hyper symptoms. I found that even though i am only taking T4 my body reacts within hours to what i take.
I found that splitting the 100 helps me feel a boost in the afternoon AS WELL AS not feel jumpy at night.
Also, when figuring out when to take 100, if i felt jumpy one night, i didn't take 100 the next day. I've ended up splitting up the 100 dose to M/F.. instead of Sat/Sun as he recommended, because i found it too strong for me back to back.
Although i've learned not to vary more than 25 mcg within a 3 week period, i do think that from day to day it can go back an forth on those 25 mcgs depending on symptoms.. somewhat... so i listen to my body. But i'm also trying to stick to the plan of 5 / 2 that my doc said. But this is also after he initially told me to take 100 and i was having horrible hyper symptoms. So i got him to reduce it and now we are all happy.
I will get my TSH tested in a couple weeks. Am feeling great, however.
My doc aims for 1.0 or a little less.
Alexandra
Helpful - 0
338303 tn?1211319843
Just had a visit with my endo today and he said all the problems we are having is either from to low or to high a TSH.  I must have scared him because he is letting me adjust my Levoxly as to how I feel.   I am just hoping that my TSH has dropped into the single numbers from 17  6 weeks ago.  He wants me to get to about 5.0 and then fine tune from there.  Your TSH might be too low for you.  He did tell me that the older we get the TSH range isn't all that important.  I do question that though.  I will be asking my internist about that at my next appointment with him next month.  Good luck with your appointment tomorrow and hope you get some answers.

Kathy
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Avatar universal
Kathy,

   Wow - sounds like me between my ordeal when the Armour turned on me or my body on it in Dec 2007.  First it was like I was on some type of speed with heart palpitations for 3 months and then went to being almost "dead" on the couch since I started Synthroid.  I didn't know that Synthroid had Lactose, but I have never had a problem with that.  Of course, I have never had any problems from thyroid, but I do now.  I have always been drug sensitive and I probably am like you and have a hard time adjusting.  I think this is going to be a waiting game all the way around from what I have read.  These boards have been a blessing to me too as I really didn't know much about thyroid since my problems were solved years ago and I didn't have them until Dec.  When you don't have a problem you aren't spending your days on the internet researching...you have a life!!!!!  Right now I have no life at all and I was always so busy.  It hurts to think about it - but I am trying not to right now.  Well, I took that whole pill this morning - not sure - but I don't think I feel as bad now - but the lousy feeling lasted all morning.

I had the non-sleeping problem when I first started Synthroid.  Now I go to bed and if I don't go to sleep within 30 minutes, I take a half a zanax - cause the more I am awake - I get anxious and can't stand it.....

Keep me posted on how you are and I will do the same.
It helps knowing you aren't imagining things when you learn that others have the same things - although it don't cure us - it does relieve some of that feeling like you wonder what in the heck is going on.

Best to you,
Liz
Helpful - 0
338303 tn?1211319843
Levoyxl is a named brand.  Do you have a problem with lactose and if so do you know that Synthroid has it in it.  I am taking 69 MCG but I was told that I should be at about 94 MCG.  I take hald of an 88 at 7:00 am and then I take 25 at 1:00 pm. I was told not to increase yet till I go back to the endo on May 20 th.

I have the same problems that you do and it drives me crazy. The worst is the dizzy feeling. I can feel fine when I get up but about 10:00 I start to feel horrible. I then take 25 at 1 and it is the same thing over again. I too feel better at night.  I had mentioned this to my endo and he just says I am one of the very few people that have a hard time adjusting to the medications. Personally I think he is an idiot and I even told him so.  

I first started out on the generic levo at 100MCG and after a month I just wanted to die I felt so bad.  I don't think I had a muscle that didn't hurt and I got maybe 2 hours sleep a night.  I was a real mess. I then started going to an endo and he gave me Synthroid and after 1 50 MCG pill I ended up at the er thinking I was having a heart attack.  I had to get my Internist to change my script to Levoyxl in Dec. and between him and myself we have been working to get this under control and my numbers down.  

I have also been to suppossedly top thyroid docs in D.C. and all I was told to just suck it up and deal with the pain. Needless to say they will never see me again. They told me nothing I didn't already know.  I have learned more from different forums than my endo knows. and he is a "SPECIALIST".  

Hope we can all start to feel better soon.

Kathy
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Avatar universal
Kathy,

   To clarify - I am taking the 50 mg of zinc and 200 MCG. of selenium, but I am cutting them in half and taking half in the at lunch and half around 9:00 P. M. - especially if you are splitting your Levo.  My friend's sister took 50 mg  ZINC in the morning and at night and 100 MCG of selenium morning and night.  I looked up dosages on the internet and they are all different - but these amounts are not too high if it doesn't bother you.  When you feel bad you will try almost anything - I am surey ou know that.

Let me know,
Liz
Helpful - 0
Avatar universal
To:  Squirley777

Hi,

   Thanks for the input.  I am trying again to take the whole thing.  I am on .88 now, but I think the doctor will have to increase it because I sure don't feel anywhere near normal.
I haven't asked the doctor about it, but it he increases it - I will probably have more adjustment problems. I will try this for a few days - today so far I don't feel any worse than I did when taking half - so we will see.  Usually as the day goes on - I feel better - but don't know why.  Do you have this too?  How did you feel when you took the whole dose.  What dose are you on?  I am on Synthroid.  Is Levo the generic or a different med?  I try to fight it in the morning and then it seems to go away - some, but I never, ever have felt normal.  I was on Armour for so long and getting T3.  But when that caused problems after all those years - the doctor switched me and then I have a whole new set of problems which are terrible.

Regarding the selenium and zinc.  I have looked it up on the internet and also a friend's sister had success with it.  I asked my doctor and he said to try it just so I don't take it at the same time as Synthroid.  With taking the medicine in half, it has been more of a challenge to take the Synthroid on an empty stomach, but I worked it out.  I took half the Synthroid early...then had breakfast.  At lunch I took my vitamins including the selenium and zinc and then didn't eat for about 5 hours until an hour before dinner - took Synthroid then had dinner.  I have been also splitting the zinc and selenium as I didn't know how they would effect me and have been taking the other half around 9:00 at night.  Probably don't have to do that.  Anyway, I looked up dosages on the internet and found several different amounts and checked with my friend's sister to find out what she took.  I don't want to take too much - but right now I am taking 50 mg of zinc and 200 MCG (NOTE MCG) of selenium.  That is how the dosage came.  My friend's sister is taking another 50 mg of zinc - but I haven't tried it yet.  It is supposed to help with the conversion of T4 to T3 and my T3 is low.  I go for blookwork next week and doctor on May 21st.  I think the vitamins helped me and they seemed to work rather quickly - I started last Wednesday and Friday afternoon I felt a tiny bit better-  but that could be my dosage stabilizing - who knows.  Let me know if you try it.  

Also on the Expert Forum Dr. Lupo said the only supplement he might recommend is Selenium - that was a recent post there.

Good luck and let me know if you try it.  My TSH is 1.65 - but I am not sure what is a good number and the numbers don't mean much if you feel awful.

Keep in touch,
Liz
Helpful - 0
338303 tn?1211319843
I take my Levoyxl at 2 different times being that I have the same problem as you and it makes no difference.  I was told by my doctor to try it this way since I have alot of problems when upping my dosage.  This has been going on for 2 years and I am still trying to get my TSH in range. As of 4 weeks ago it had come down to 16 and that is from 27 with a starting number of 100.  What dosage of selenium and zinc do you take. I had thought about taking it but am not sure how much to try.

Thanks,
Kathy
Helpful - 0
Avatar universal
To all,

     I am trying to take my whole thyroid dosage at once this morning to see how I feel.  I tried splitting it for about 5 days and know how I feel from that.  I am hoping that it is stabilizing a little and I can take it without feeling too weird.  Feeling weird has become commonplace and that is not good.  I took it about three hours ago and don't feel any different than when I took half yet.  Hoping I don't as it will be much easier than trying to have an empty stomach at a certain time.  Just like those of you who mentioned having wine before bed and how that influences taking it at night.

    Also I started the selenium and zinc last Wednesday and on Friday I started feeling a bit better - so hoping the combination of things is helping some.  Still not anywhere near normal and hoping my labs next week and doctor's appointment week after will show something - I think he will have to increase and then it is another waiting game which seems to be the whole story of thyroid.  Not bad if you don't feel bad - but when you do - it is torture and I am sure you all know what I mean.

Thanks,
Liz
Helpful - 0
280485 tn?1249013844
Sorry for the link disappearing.  I thought the thread disappeared origonally because of fan's postings, but it must be a problem to post that particular link in here.  If you need more info, send me a PM.
Helpful - 0
213044 tn?1236527460
Some people report having trouble sleeping when taking Synthroid at night. some people have no problem with it.

There has been at least one study done that suggested taking it at night was a more natural rythem for the body, the Circadian rythm or something.

I don't know.

Splitting you pill shouldn't be a problem. your still getting the same dose. Your body is using the pill you took two weeks ago as well as the one you took yesterday, so I don't see an issue.  

Any hypo symptoms you have could be coming from the hypo or from the drug. If you look up the side affects for whatever you're taking, they list every symptom of hypothyroidism as a possible side affect.

My guess is that is because their trial patients had hypothyroidism, but it can give you some of those symptoms.

The other possibility is you may still be suffering the effects of being Hypo. It takes a long time for some of the symptoms to go away.

Your thyroid med is giving you T4. Some of it is bound by protiens that make it unusable. Most of it, in fact. That is why you want a free T4 test. It measures the active, usable hormone in your blood. Not the bound, useless stuff.

T4 is converted to T3 in your Liver and Kidneys. It converts at a rate faster than it is needed, and the excess T3 is bound by a protien that makes it unusable, just like with your T4.

Your body also converts some of the T4 to reverse T3, if it thinks it is producing too much T3. Don't ask me why, because it makes no sense to me. But then I didn't make this marvel of a shell we carry around.

So you need a Free T3 test, because it is the acurate measure of how much usable T3 you have in your blood, without counting the junk.  
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Avatar universal
Hi again all,

Forgot to add this:

To AR - I have thought about taking the Synthroid at night, but don't want to do that without doctor's OK.  Wondered if it would keep you awake at night?  I had terrible sleeping problems when I first changed to Synthroid....a bit better now but I wake up more than I ever did and now get up earlier than ever.

PEP88 - Thanks for the article - I think I may have read that before - interesting.

Stella - I don't know about the splitting - but I feel better doing it.  I am going to give it a try taking it all at once in the next day or so and see how I feel.  I have been splitting it for about 4 days and I am not sure what is helping but I do feel a bit better.  I am thinking several things:  1.  Perhaps the dosage is kicking in a little because the doctor's office said 21-28 days to see how the dosage would be and today is day 21.
2.  I am splitting the pill.  3.  Last Wednesday I added selenium and zinc upon info I read on the internet, advice from a friend whose sister tried it, and OK from my doctor.  Whatever it is - I do feel some better which compared to feeling like I was dying makes me feel like I am semi-normal and I know I am not really feeling that well.

So, right now - I am afraid to make any changes - but I will try taking the whole thing again - just to see.  Just hate to think of feeling weird all day instead of just a little while.  Of couse, perhaps with the other things I mentioned above - that isn't it.

Will keep you all posted,
Liz
Helpful - 0
Avatar universal
Hi all,

    Thanks for all the input.

Have a couple of questions:

1.  Would you say that weird symptoms like muscle pain - abdomen, stomach, legs, was a result of the hypo condition or side effects of medication?

2.  Could someone give me a quick explanation of Free T3 and Free T4 so I can converse intelligently with my doctor next visit?  If I am on Synthroid a T4 hormone - is a Free T3 blood test that of what my thyroid is making or what is being converted?  Is there a difference?   Is Free T4 blood test then what my thyroid is making?  This is confusing to me.

3.  If my dosage is changed is it likely I will go through weird symptoms again if I am getting close to being stabilized?

Thanks,
Liz
Helpful - 0
393685 tn?1425812522
Liz I am not sure that splitting Synthroid is good. From what I know Synthroid is a T4 only and only inbound. It takes the body the time to convert that to free then to convert the free t4 into free T3. The natural T3 then will move through your system and give you the "keeping up with the day". feeling. If your conversion is slower, which sounds like the case - your body is not making the appropriate Free T3 early enough to get the day going.

Here is - what I feel could be your two choices. I know you are happy on Synthroid so moving the meds to a different time may help - or introducing a T3 Cytomel may be an option.  

Helpful - 0
280485 tn?1249013844
I think you were looking for this link that got wiped out because of some trouble on the board.  I requested it and ChitChat sent it to me.  Liz, didn't I send it to you?  Anyway, here it is: http://****.about.com

I was considering this myself as it seems to take forever for the Synthroid to kick in, then I'm up late at night.  But I'm with AR, I want to have a glass of wine or two before bedtime every once and a while, and that would just throw everything off.  I'm still in "consideration" mode and that's why I requested the link.  For myself and Liz1900.
Helpful - 0
213044 tn?1236527460
I'm not stbilized yet. I had RAI to ablate my gland in January, and we are playing the dosage game.

I just went from 100mcg to 75 mcg a few days ago. That didn't make me very happy, but I suppose the initial dose was too high.

I take my Synthroid between 6:00 and 6:30 in the morning. Then I eat and take toprol XL and Alprazolam about 8:00.

Saying I feel good when I get up is an exageration, but by 8:00 I often feel BAD, and it doesn't really improve until after supper. It get's a little better later in the morning, but not much.

When I get up I am tired and bloated and in pain until I have a few visits to the bathroom. But by 8:00, I feel weak, and taking a shower is work. I feel out of breath and my heart bothers me, but I figure that is because the Toprol has worn off from the day before.

I nap in the afternoon, and get up sore and yucky feeling. After supper is about the best time of day, but I think for me it is half psychological, because my work day is over. The frustration and guilt of not working is over until the next morning.

Maybe taking at night would be better for you and I. I've thought about it, but I like to have a glass of wine or two before bed once in a while, and I like to snack toward bedtime.

I'm not going to stop eating after supper just so I can take my Synthroid at night. At least I don't want to. I may be forced to if the mornings keep going like they do. I'll wait six months and see if I can get to a stable situation first, and then see what I feel like.  
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Avatar universal
Forgot one question in response to you saying you had same reaction.  Do you feel bad all day?  What other symptoms do you have?  I have been trying to take 1/2 of the tablet at 6:00 A. M. and then after lunch I don't eat anything for about 6 hours and taking the other half then - it seems to help some - I think.  I feel lightheaded too.

Liz
Helpful - 0
Avatar universal
Hi,

   How long have you been on Synthroid and at what dose?  I have read that the symptoms we have are from not being stabilized which I know I am not - at least not yet.  So it seems weird that it would happen after taking the meds - although I don't feel that great before.

   I have to tell my doctor on my next appointment.in about three weeks.  Have you ever talked to your doctor about it?

Liz
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213044 tn?1236527460
I get the same reaction.
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