thyroxine: Best Time of the day to take.

[mallorcasara]

Hi, Iīve been taking Thyroxine for about just over 4 years now.
I take my tablet everyday at 10 am.
I have noticed that if I eat breakfast after taking the tablet, I feel ill for the rest of the day. Also If I donīt take my tablet at the same time every day then I will feel ill.

symptoms when i feel ill...are feeling sick, dizzy, tired, very weak and sometimes leads to other problems such as migraines!


Iīve heard taking the thyroxine in the morning is the best time to take the tablet....but this means I can never have breakfast and I must take the tablet at the same time everyday...or else!

Has anyone else had the same thing? Does anyone have any tips?

Big Thanks xxxx

[kimcle]

Hello;
My Doctor has told me to take it in the morning.
I usually wake up around 5:30.
I keep a bottle of water and my Levoxyl on my nightstand.
So as soon as I wake up I take my pill and sometimes
I will fall back to sleep for an hour  or so.
When I get up I can have breakfast.
It is recommended that you take your medication one hour before eating.
Take care


Kim

[Robyn44]

Hello,

I was also told to take mine 1 hour before eating anything in the morning. Your body doesn't fully absorb the medication if you eat right away. I was told that I'm not getting a full dose of the medication when that happens. So I get up at 6 a.m. every morning and take my pill. I get my kids ready for school and take them, then come home and I can eat. The hour is gone before I know it. Have you had a recent blood test to make sure that your still on the correct dose of medication? Just a thought. Best wishes to you. Robyn

[EmpatheticJenny]

The time-of-day question has turned out to matter a lot for me, which is why I indeed have some tips as well as some information that I am certain is accurate. It really does not matter at all to your body what time of day you take your medication. The "take it in the morning" advice is based on the fact that Thyroxine makes some people wakeful at bedtime if they take the medication late in the day. My endocrinologist gave me the information that is in the last two sentences, and I have seen it from reputable sources, too.

Notice that I said Thyroxine makes "some people" wakeful. Other people (and I doubt that I am the only one), not only are NOT made wakeful by a late afternoon dose, we do better on that schedule. In addition, I have read that some people do not tolerate Thyroxine on an empty stomach. I was tolerating it beautifully, but I found that a single dose had an impact on my blood pressure that I did not like. A divided dose seems better for me. When I discovered that fact, I also discovered that it would be much easier to eat something before taking a dose than to try to take the medication on an empty stomach each time.

My endocrinologist has provided guidance and encouragement every step of the way. He said that a divided dose was perfectly all right, and he said that the timing does not matter at all. He said that if I took Thyroxine with food, it would reduce absorption by about 20%, which only meant that I would need to take a slightly higher dose of Thyroxine to compensate, and he said, "No big deal." By the way, my endo. doc is a VERY competent and also very careful physician. He would not say "no big deal" if it were not safe to say.

His primary advice has been: Whatever you do, do it consistently. His highly helpful advice has been that it is perfectly okay to experiment with my medication routine as long as I do not alter the dose without his input.

I hope that "borrowing" the guidance I have received will be helpful to you. Good luck!

[EmpatheticJenny]

P.S. Please pardon my cognitive fuzz! In the comments I posted earlier today, I failed to make something clear. I said that my endocrinologist has advised me: Whatever you do, just do it consistently. He means consistently in every way. I am accustomed to a very high-fiber diet, which he says is entirely all right as long as I keep it that way consistently. Any time of day for taking my medication is fine, but I should be consistent there, too, once I have made a decision about what sort of timing seems best. Same deal with empty stomach versus full stomach: Just do the same thing every day.

I probably do not need to say the following, but I am adding it just to be sure I do not leave any base uncovered. Once you have figured out what medication routine works the best for you, your endocrinologist should reassess your Thyroxine dose to be sure that it is still at the right level for you.

[EmpatheticJenny]

I really AM fuzzy today. I am not having a good thyroid day, which I knew even before it took me three tries to post one coherent message. I apologize, though, for the multiple posts.

If you decide to try taking your Thyroxine with food, then of course you will need to have your dosage level reassessed--no two ways about it--and probably increased. Assuming that you have a good endocrinologist, it would be good to talk with him or her about your wish to experiment, just on general principles.

You should know, though, that taking your medication with food reduces the absorption to a degree that is predictable and not huge, so taking your medication after "padding" your stomach with food and then adjusting for the absorption reduction is not a radical approach. I want you to know this because I have seen physicians who went strictly "by the book" as they provided medical care, which was wise in some situations but which, in other situations, caused a patient to suffer needlessly.

[mallorcasara]

I thank everyone for responding to my post!
The only think I didnīt mention was that.  1, my first ever thyroid test showed that my levels where off the scale. when I say that I mean my thyroid is dead and doesnīt funtion at all I rely totally on the tablets. This has left me thinking that if there is a different of 20 percent if you take the tablet with food then where does that leave me.....

Also the main reason for writing on here is because I live in Mallorca. I was diagnosed here and I see my specialist here once a year. My last results were good!
Because I am English ...sometimes its hard to ask some questions ...so this is why I posted my question!

Thankyou to everyone who wrote back!!

Any other ideas please keep me posted!

[EmpatheticJenny]

Dear Sara,

Since your thyroid gland is not doing its job at all, I can understand your concern about taking your medication with food...as you say, if you were to lose 20% of the help the medication is providing, where would that leave you?

The answer, according to my endocrinologist, is that you would increase your dosage enough to compensate for the 20% that was not being absorbed. Unless you are taking the maximum dose of levothyroxine that a physician would be willing to give any patient for any reason--and I do not know what the maximum dose is or even if there IS an absolute maximum--then the advice given to me, who only needs to support a struggling thyroid gland with medication, is no different from the advice that would be given to someone like you, who needs to do the thyroid gland's entire job.

I was certain that my endocrinologist was being sensible when he gave me the aforementioned guidance. He seems like an excellent and prudent physician. Still, this discussion thread made me want to check my physician's advice against another source. I think that Mary Shomon can be counted on for rational guidance. When I went her website (www.thyroid.about.com), I found that her advice echoed my endocrinologist's: Taking medication with food is okay as long as a person is consistent.

The difficulty in your situation might be access to your endocrinologist. Do you see him or her once a year because you do not need your specialist's input any more frequently, or are you in some way limited to yearly access? If you are able to see your endocrinologist before your next yearly visit is due, it might be worth your while to have a discussion about changing your medication regimen. After six or eight weeks of taking your medication with food, you would need to have blood tests to see if your medication dosage needed to be increased--and I would not assume that without any doubt, it would have to be increased. There seem to be almost no absolutes about the way the body works. It seems true twice over to me where thyroid gland functioning is concerned.

I see that in my previous comments, I did not say the following. Although it may be self-evident, maybe I should say it anyway. Taking thyroid medication with food means being highly self-disciplined, in that it means eating approximately the same amount of the same kind of food just before every medication dose. I am guessing that this sort of self-discipline would seem to you like a small price to pay, considering the discomforts that you have to endure when you take medication the usual way.

I hope that you can talk about this with your endocrinologist without waiting for a long time.  I also hope that if your physician is dogmatic and says that no, you may not vary from the first-in-the-morning, empty-stomach routine, you have a way to find another endocrinologist for a second opinion.  If you go to Mary Shomon's website and put "food" into the search box, I think you will find an article that tells you: I and my endocrinologist are not just being careless kooks! Since I have had experiences that seem very similar to yours: sick, dizzy, tired, and weak...and sometimes that form of unwellness deteriorates into a migraine-like headache for me, I am sorry to think of your going through so much discomfort when it easily might be prevented.

Wishing you well,
Jenny

[emma0212]

Hy i have been taking my thyroxine tablets at irregular times since 2 yrs not knowing that it should be taken at a specific time.I have been suffering from constipation,hair loss,dry skin,fatigue.My blood tests also was always high.The problem is that i work on a night basis.I dnt knw what time to take the tablet at a specific time since the next day am off.please help.any advice?
Thanks
emma

[Totie]

Take mine first thing in the morning on an empty stomach.  Have always been consistent with that for the last 14yrs.

[Niksi]

I empathise with the 'cognitive fuzz' completely.  I have just been diagnosed with an underactive thyroid.  I've been taking Levothyroxine for 5 days now and I can't function.  I've had the last 3 days off of work as I can't get my head together.  I have no energy, keep dropping things and feel really low.  I went back to the doctor to see if this was normal but unfortunately, she didn't really have much to tell me other than wait another week and see how I feel.  

I just wondered if anyone else has had an experience like this? I take the tablet (25 mcg) first thing in the morning with water, at least an hour before I eat.  It's knocking me out and it's not like it's a large dose!  

Nik

[Janie416]

My endo did not tell me much. But since I take Citracal (2 tab 2x day) I decided to take my thyroxine around 2-3AM and then going back to sleep.  Calcium interferes with absorption so I figured that was the best time to avoid that.  I have since switched endos b/c the first one did not even warn me about the calcium, I had to read it online.

Thank you all for the info here.

[Barb135]

I was told to take my synthroid first thing in the morning, 30 min to 1 hr before eating.  I get up about 3:30 am as I have to be at work by 6;00 am; therefore, I take my med as soon as I get up then get into the shower and start getting ready for work; by the time I'm done showering, etc at least 30 min has gone by so I usually have a cup of coffee while I finish getting ready for work.  By the time I'm dressed, hair dried and ready to go, it's been an hour or more and I can go ahead and eat before leaving the house.  

Calcium and some other supplements should seperated from thyroid med by at least 4 hrs.  I take thyroid med in am and calcium in the pm.  My doctor didn't tell me either, but it's on the sheet that comes attached to the med that instructions for taking, side effects, etc.  

[Janie416]

I see we are on the same page.  Yes, I get up to tke my synthroid so that I can take my calcium 4 hours later.I have often wondered why my first endo did not tell about not taking the calcium close to the synthroid.  That was why I switched.

Now I wonder what other supplements should not be taken with the Synthroid.  

I shall read the instructions better now.

Thanks for your advice and information.

[Smilerdeb]

I take my thyroxin at 6.30am every morning and take my multivitamins and Calcium/Vitamin D combined around dinnertime (6pm).
I never take anything with my thyroxin as I once took a Vitamin B with it and boy did I feel sick all day !
The only thing taken with my thyroxin is water then I wait an hour before I eat brekky.

[David51]

Hi, Just found this topic.
First let me point out I am a male ! I am taking 125 mg of thyroxine, I take it every morning 1 hour before eating anything I have an underactive thyroid and since upping it from 100mg to the present 125mg I am now suffering weak and very painful muscles, ( which would suggest to much throxine ) went back to my doctor who was totally unsypathetic and told me I had tennis elbow ( which I totally disagree with ) and when I tried to get to the botton of it I was told " I can only give you another three minutes ) and when I asked to be refered to a specialist I was was told he could but wanted to know what he should put down on the referal.
I have also found out that the chemist changed my prescription for a cheaper brand and this also made me very ill, when I asked to have my original brand I was told that I had to have what the buyers got in and the only way I would get the real original thyroxine would be to ask the doctor to specifie it on the prescription. I am now having to search all the local chemists for my original thyroxine without much success. I have been informed that if your brand is changed you have to go back for another blood test.
Regards,

David.

[dawnangela]

If you have only been on meds five days its not time to notice any difference really, you need to give it at least eight weeks to get the full benefit of the meds..