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is it really necessary to take thyroid meds same time every day?
I read that you should take your thyroid medicine the same time every day. now Im sure this is so sthat you get a consistent supply without a lapse in the medicine your body gets. However, I am on armour and I started splitting my doses into thirds so I have a more consistent supply of energy from the T3 threw out the day. Hers what im wondering tho, if T4 accumulates in your body and is converted as needed, and t3 is instantly active and available and only lasts 9 hours tops but anywhere from 4-6 on average, Im wondering is it REALLY necessary to take it at the EXACT same time every day? if your labs and th level show great numbers then couldent you take it "within" the same time each day. I have different work hours so I wake up at different times, and I sometimes take my spit dose of thyroid meds at different times during the day, however there all within a hour or 2 of the usual time, I just gie or take depending on my energy level. before you comment, what sound scientific evidence is their that taking it at the same time every day is the most effective way?
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No, it's not necessary to take it at the same time every day.  Whatever works for you is acceptable.

T4 you definitely do not have to take at exactly the same time every day.  In fact, I read an article a while back that said that most people could probably take T4 meds once a week (at 7 times the daily dose) due to the long half-life of T4.  Not something I'd want to try, personally, but I can accept the concept in theory.

If you feel good taking it the way you're taking it, I wouldn't give it a second thought...
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thnk you for your input.
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219241 tn?1413541365
It should be within a normal range for you. For example, you normally wake at 7am to go to work and take it then, then you go on holiday and sleep in till 10am, no biggie, just take it when you wake up.
It is best to take it regularly at a set time but as long as it is not say, 7am one day then 1pm the next day then 11am the next etc. The hormone is generally best absorbed in the morning so your body can go about its business. Chopping and changing it all over the place is not ideal as we need it to be a regular dosing to try to regulate our bodies.
A few hours off here or there is no big issue though. If you are like me, and have no set regular getting up time, just as soon as you wake up is fine.
  
As goolarra says you could take it a weeks worth in one hit but not advisable. You will then get a spike and feel a bit 'funny' and if you are super sensitive like me, then it's 'funny farm feeling'!

So take it when you can but not all over the place in times.
Cheers!
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219241 tn?1413541365
Oh BTW, I meant to say, DO NOT EVER take a 7 day dose of T3 in one hit, you WILL end up in ER! Only T4 is suited to this one off dosage.
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I wasn't suggesting anyone take their T4 on a once a week basis.  I'm very sensitive, too, and it sounds like my idea of he//.  I was just using it to illustrate a point.
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I have been taking thyroid meds for several years.  When I was told to take my pill the same time every day my symptoms declined and I felt much better. It is not that difficult.  If I do not get up at the time I am suppose to take my thyroid pill my husband comes to my bed and gives me my thyroid pill and I go back to sleep. I think it would be very dangerous to take several pills in one day.
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As I said, I was quoting from an article I had read, and while I can agree with the author (a doctor, BTW) in concept, I also added "Not something I'd want to try, personally...".

I think you're making this a lot more precise than it has to be.  Would I take my meds at vastly different times of day?  No.  However, I think "first thing in the morning" can be interpreted as "when you wake up", and the exact hour, due to the long half life of T4, is relatively unimportant.  An hour or two here or there is not going to change anything.  

It's been accepted practice for years to achieve incremental increases in meds by taking an extra pill or half or quarter once a week or twice a week.  In the end, how you take your meds isn't important as long as you  feel well doing it the way you're doing it.  
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I've been on levothyroxine for a couple months now and I can relate to what you're saying, you feel energy declines frequently and it is more than likely due to an improper dose of your thyroid meds in return making you hypothyroid; or it could be that we have hyper-metabolism; meaning we metabolize the meds more quickly than others and this causes a hypothyroid reaction as well. I am going through this process myself but I've had a strange TSH reading of 0.02 for a few years now and the levothyroxine isnt helping in any way and my doctors dont seem concerned enough about it unfortunately. I also hear there is an extended release dose, does anyone know more about that? I have noticed when I dont take the meds within a 12 hour period I am lethargic, tired, and slow to think clearly. Also get sore joints swelling in my lips and tingly left cheek of my face and sometimes entire limbs of my body. It super *****!
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649848 tn?1484935765
What dosage of Levothyroxine are you taking and do you have current labs you could post for us, with reference ranges?  

Levothyroxine is a T4 medication and since it has a long half life, it builds in the system, so it doesn't wear off in 24 hours, like T3 medication that wears off in just a few hours...

You said you've been on Levothyroxine for "a couple of months"... were you just diagnosed with hypothyroidism or were you previously on a different medication?
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Do check these and make sure your levels are optimal.

* 25-hydroxy-vitamin D3 (optimal range 50 - 70)
Vitamin B12 (above 500)
Ferritin

* very important and common deficiency among hypothyroid people.

Without sufficient vitamin D levels cells can't utilize the thyroid hormones well.

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649848 tn?1484935765
"Without sufficient vitamin D levels cells can't utilize the thyroid hormones well."

That isn't a correct statement...
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Consider a person having severe vitamin deficiency like 25 ohd less than 5 ng/ml then how much he take thyroid hormone pill he not feel good though his tsh get stabilized. This is what I am trying to convey. Many times its not thyroid issue alone though doctors and everyone put blame on thyroid but fail to address basics like vitamin D, b12, ferritin etc.
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649848 tn?1484935765
Yes, you're right that someone with low vitamin D won't feel good even with adequate thyroid hormones, but the low vitamin D is not preventing the cells from utilizing the thyroid hormones.  

The low vitamin D is causing symptoms separately from thyroid symptoms, even they may mimic symptoms of low thyroid hormones.

You're also correct that many times thyroid gets blamed when one has a deficiency of vitamin D, B-12 or iron, but that doesn't mean they're directly related to the thyroid issue... it simply means symptoms of deficiency can be similar to those of hypothyroidism. Not everyone with a thyroid condition is deficient in one or more of those vitamins/minerals.

You also have to keep in mind that we aren't worried about "stabilizing TSH"... we're concerned with making sure people have adequate Free T3 and Free T4 - that's what determines optimal thyroid function, not TSH...
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But TSH is also important marker for hypothyroidism along with Free T3 and Free T4. For example this is my result when I am on various levothyroxine dose.

When I am on no medication my TSH value is above 14.5

when on 12.5 mcg levo

TSH = 9.46

Free T4 = 17.96 pmol/uL (9 - 20)

when on 25 mcg levo

TSH = 5.55

Free T4 = 18.3 pmol/uL (9 - 20)

Free T3 = 5.6 pmol/uL (4 - 8.33)

In both these Free T4 and Free T3 almost same even if I increase dose or reduce it and only thing which is changing is TSH value and yes i do have hypothyroid symptoms and it seem to get lower somewhat when dose is increased even if its small one. Recently I checked vitamin D and its in 19.2 ng/ml value though i took vitamin D supplements for some some months so during when these thyroid tests are made mine level was possibly less than 10 ng/ml.
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this is why i keep repeating about checking vitamin d levels every time i see  posts about hypothyroid problems as i don't want anyone to go through mine like long standing vitamin d deficiency.

also doctors prefer to give iron tablets and syrups without checking actual ferritin levels me too gone like that and as a result my ferritin went very high like 330 and luckily done ferritin test me itself and stopped taking iron supplements. same with b12, mine when tested 861 (200 - 900) and as a result stopped b12 supplements. checking vitamin d, b12 and ferritin is so important in any health condition and supplements should be taken only after knowing the actual levels as iron is hard to expel from body if taken, same with vitamin d and b12 though its not so harmful like excess iron.
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649848 tn?1484935765
You need T3 medication and I understand you might not be able to get it in your country... while taking vitamin D will resolve the symptoms that deficiency causes, it will not resolve the hypo symptoms that low Free T3 causes... Simply decreasing your TSH is not helping your hypo symptoms, because TSH doesn't cause or alleviate symptoms...

Vitamin B-12 is not toxic, so your level of 861 is just fine... my level is often well over the range my lab uses, which is 200-1100...

If you have high ferritin, you need to have an iron panel... high ferritin doesn't always mean iron is too high!!  My own ferritin was close to 300, but a full iron panel showed that my iron was just where it should be... high ferritin can be an indication of inflammation in the body and my CRP, which is another inflammation marker is also high.  If you have high ferritin, you should have a complete iron panel done to make sure high iron is really the problem... Also get CRP tested to see if you have inflammation... don't just "assume" that you have high iron; that may not be the case.
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I'm a little late, but I think it's important to remember that we are all on different doses and this can effect if the fluctuations bother you. I had a TT and take a really large dose, so for me I definitely feel more side effects if I take my pill later than usual. Keeping a routine was a breakthrough for me because I used to experience a lot of side effects. Some days I mess up, but generally I feel better getting up (or just keeping it by my bedside and waking up for a minute to take it).
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