Aa
Hypothyroidism
My doctor recently told me that my thyroid was underactive and prescribed me Levothyroxine 50mg. Is there any risk that this is going to cause the thyroid to atrophy since it won't be stimulated to work anymore?
The whole thing is that T4 is absorbed better if taken on an empty stomach, such as early in the morning. T3 med is absorbed quickly, so not need to wait.
Some people have difficulty waiting to take their T4 med, so they choose to just take their T4 med with breakfast, realizing that their serum T4 will be somewhat lower, and require a higher dose to achieve equivalent serum T4 levels.
Why are you interested in taking it at bedtime?
Some people have difficulty waiting to take their T4 med, so they choose to just take their T4 med with breakfast, realizing that their serum T4 will be somewhat lower, and require a higher dose to achieve equivalent serum T4 levels.
Why are you interested in taking it at bedtime?
I tried this after reading a lot of research since it suggest that it helps to raise t3 levels since it is longer in the body without food etc. But....the big BUT is....it still must be taken on a empty stomach which is best at 5 hours or more and even then you stomach may not be empty is your system is sluggish because of your thyroid. I could tell when I tried that it was having the opposite effect because my stomach was not empty enough. to resolve this because I am hypo with a slower metabolism and slower digestion etc.....
I started taking this earlier in the morning.....some suggest a alarm for 4am may be best because you can give yourself 4 hours such as 8am to eat anything and give it longer to take effect without any interference. I hope this helps....my t3 was on the lower normal end so this is what I am trying.
I started taking this earlier in the morning.....some suggest a alarm for 4am may be best because you can give yourself 4 hours such as 8am to eat anything and give it longer to take effect without any interference. I hope this helps....my t3 was on the lower normal end so this is what I am trying.
What I dont understand is how many hours after a meal do I need to take my medication if I switched to bedtime. Anyone know this info?
COMMUNITY LEADER
I notice that you are posting this same information on many threads; are you working for Mary Shomon? Taking thyroid medication at night, does not work for everyone, nor is it an answer to every question.
Should You Take Your Thyroid Medication at Night?
By Mary Shomon, About.com
Updated: March 23, 2007
About.com Health's Disease and Condition content is reviewed by our Medical Review Board
Every thyroid patient has heard the advice that for best results, we should take our medication first thing in the morning, on an empty stomach, and wait at least 30 minutes to an hour before eating.
(And also, that we should wait at least three to four hours before taking calcium or iron, which can interfere with thyroid hormone absorption.)
But research reported in the journal Clinical Endocrinology found that taking the same dose of levothyroxine (i.e., Synthroid) at bedtime, as compared to first thing in the morning, might be better.
The small pilot study was prompted by observation that some patients had improved thyroid hormone profiles improved after they switched from taking their levothyroxine in the morning, to bedtime.
The purpose was to look at the impact on thyroid hormone profiles by changing the time levothyroxine was taken from early morning to bedtime.
They also evaluated the impact of this change on the circadian rhythm of TSH and thyroid hormones and thyroid hormone metabolism.
The study, while small (12 subjects), was fairly conclusive in its findings, which the researchers said were “striking” and which have “important consequences for the millions of patients who take l-thyroxine daily.”
Researchers reported that taking medication at bedtime, rather than the morning, results in “higher thyroid hormone concentrations and lower TSH concentrations.”
TSH decreased and Free T4 levels Rose in all patients by changing thyroxine ingestion from early morning to bedtime and T3 levels Rose in all but one subject. And TSH DECREASED irrespective of the starting TSH levels, suggesting better absorption of the thyroid medication when taken in the evening.
Interestingly, the researchers found that the circadian TSH rhythm -- the typical daily fluctuations of TSH that occur during a 24-hour period -- does not vary.
The researchers suggested several explanations for the results:
Even when waiting at least 30 minutes to eat, breakfast may be interfering with the intestinal absorption of levothyroxine thyroxine.
“Bowel motility is slower at night,” which means that it takes longer for the levothyroxine tablet to transit through the intestinal system, resulting in longer exposure to the intestinal wall, and therefore, better uptake of the medication.
The conversion process of T4 to T3 may be more effective in the evening.
From Mary Shomon: What are the Implications for Thyroid Patients?
Taking medication at bedtime instead of in the morning could have major implications for many thyroid patients.
**First, it’s easier, as you don’t have to worry about when to eat breakfast.
**Second, it’s easier to avoid medications, supplements and foods, like calcium, iron, and high-fiber foods that can interfere with thyroid medication absorption.
**Third, it might offer some improvement in symptoms to people who are just not getting optimal absorption by taking thyroid medication during the day.
While this was a small study, it confirms what many patients anecdotally have been reporting for years -- that they feel better if they take their thyroid medication in the evening, rather than the morning.
You may want to talk to your practitioner about changing the time you take your levothyroxine (i.e., Synthroid, Levoxyl, Levothroid, Unithroid, Eltroxin) to bedtime, versus morning. And if you decide to change to taking your thyroid medication in the evening, be sure to have your thyroid levels evaluated -- six to eight weeks is a reasonable timeframe -- after you’ve made the switch.
The blood test results, along with any improvements or worsening of symptoms, will help you and your doctor to determine if you need to adjust the dosage or timing of your medication.
Note, however, that this study was conducted with levothyroxine -- a synthetic form of the long acting T4/thyroxine thyroid hormone. This form of the hormone must first be converted in the body to the active form (T3) and this can take days.
T3
Thyroid drugs that contain T3 -- Cytomel, Thyrolar, and the natural desiccated thyroid drugs like Armour can by used directly by the body within hours. These drugs were not evaluated in the study.
Anecdotally, some thyroid patients have reported improvement in symptoms when taking their T3-based thyroid hormone replacement medications in the evening. But some thyroid patients also find that if they take a medication with T3 later in the day or in the evening, the slight stimulatory effect of the T3 medication can make it difficult to sleep.
So keep in mind that while it’s very possible that if a similar study were conducted with T3 drugs, the results would be similar, there is some chance that it would impact sleep quality. Only make such a change after discussing it with your doctor.
Optimally, some doctors have suggested that patients who take medications with T3 split their doses to take them throughout the day, leaving a dose for bedtime. This approach seems to minimize sleep interference.
Again, if you do make a change to how you take your T3 thyroid medication, you’ll want to have a re-evaluation of blood levels and symptoms after several weeks, to determine if you need to adjust the dosage or timing of your medication.
*************************************************
"T4 is slow acting, with a half-life of about one week — after a week, you have about half the level of the T4 still in your body, a week or so later you have half of that half remaining, and so on. Its full effects aren't reached until about six weeks after starting or changing a dose, which is why lab tests are optimally done every six weeks or so until a patient with hypothyroidism has reached satisfactory and stable thyroid hormone levels.
T3, on the other hand, has a half-life of about a day. People on T3 sometimes feel its effects within minutes after taking it."
==========================================
I started taking the Levothyroxine at bedtime and a few symptoms disappeared or improved.
By Mary Shomon, About.com
Updated: March 23, 2007
About.com Health's Disease and Condition content is reviewed by our Medical Review Board
Every thyroid patient has heard the advice that for best results, we should take our medication first thing in the morning, on an empty stomach, and wait at least 30 minutes to an hour before eating.
(And also, that we should wait at least three to four hours before taking calcium or iron, which can interfere with thyroid hormone absorption.)
But research reported in the journal Clinical Endocrinology found that taking the same dose of levothyroxine (i.e., Synthroid) at bedtime, as compared to first thing in the morning, might be better.
The small pilot study was prompted by observation that some patients had improved thyroid hormone profiles improved after they switched from taking their levothyroxine in the morning, to bedtime.
The purpose was to look at the impact on thyroid hormone profiles by changing the time levothyroxine was taken from early morning to bedtime.
They also evaluated the impact of this change on the circadian rhythm of TSH and thyroid hormones and thyroid hormone metabolism.
The study, while small (12 subjects), was fairly conclusive in its findings, which the researchers said were “striking” and which have “important consequences for the millions of patients who take l-thyroxine daily.”
Researchers reported that taking medication at bedtime, rather than the morning, results in “higher thyroid hormone concentrations and lower TSH concentrations.”
TSH decreased and Free T4 levels Rose in all patients by changing thyroxine ingestion from early morning to bedtime and T3 levels Rose in all but one subject. And TSH DECREASED irrespective of the starting TSH levels, suggesting better absorption of the thyroid medication when taken in the evening.
Interestingly, the researchers found that the circadian TSH rhythm -- the typical daily fluctuations of TSH that occur during a 24-hour period -- does not vary.
The researchers suggested several explanations for the results:
Even when waiting at least 30 minutes to eat, breakfast may be interfering with the intestinal absorption of levothyroxine thyroxine.
“Bowel motility is slower at night,” which means that it takes longer for the levothyroxine tablet to transit through the intestinal system, resulting in longer exposure to the intestinal wall, and therefore, better uptake of the medication.
The conversion process of T4 to T3 may be more effective in the evening.
From Mary Shomon: What are the Implications for Thyroid Patients?
Taking medication at bedtime instead of in the morning could have major implications for many thyroid patients.
**First, it’s easier, as you don’t have to worry about when to eat breakfast.
**Second, it’s easier to avoid medications, supplements and foods, like calcium, iron, and high-fiber foods that can interfere with thyroid medication absorption.
**Third, it might offer some improvement in symptoms to people who are just not getting optimal absorption by taking thyroid medication during the day.
While this was a small study, it confirms what many patients anecdotally have been reporting for years -- that they feel better if they take their thyroid medication in the evening, rather than the morning.
You may want to talk to your practitioner about changing the time you take your levothyroxine (i.e., Synthroid, Levoxyl, Levothroid, Unithroid, Eltroxin) to bedtime, versus morning. And if you decide to change to taking your thyroid medication in the evening, be sure to have your thyroid levels evaluated -- six to eight weeks is a reasonable timeframe -- after you’ve made the switch.
The blood test results, along with any improvements or worsening of symptoms, will help you and your doctor to determine if you need to adjust the dosage or timing of your medication.
Note, however, that this study was conducted with levothyroxine -- a synthetic form of the long acting T4/thyroxine thyroid hormone. This form of the hormone must first be converted in the body to the active form (T3) and this can take days.
T3
Thyroid drugs that contain T3 -- Cytomel, Thyrolar, and the natural desiccated thyroid drugs like Armour can by used directly by the body within hours. These drugs were not evaluated in the study.
Anecdotally, some thyroid patients have reported improvement in symptoms when taking their T3-based thyroid hormone replacement medications in the evening. But some thyroid patients also find that if they take a medication with T3 later in the day or in the evening, the slight stimulatory effect of the T3 medication can make it difficult to sleep.
So keep in mind that while it’s very possible that if a similar study were conducted with T3 drugs, the results would be similar, there is some chance that it would impact sleep quality. Only make such a change after discussing it with your doctor.
Optimally, some doctors have suggested that patients who take medications with T3 split their doses to take them throughout the day, leaving a dose for bedtime. This approach seems to minimize sleep interference.
Again, if you do make a change to how you take your T3 thyroid medication, you’ll want to have a re-evaluation of blood levels and symptoms after several weeks, to determine if you need to adjust the dosage or timing of your medication.
*************************************************
"T4 is slow acting, with a half-life of about one week — after a week, you have about half the level of the T4 still in your body, a week or so later you have half of that half remaining, and so on. Its full effects aren't reached until about six weeks after starting or changing a dose, which is why lab tests are optimally done every six weeks or so until a patient with hypothyroidism has reached satisfactory and stable thyroid hormone levels.
T3, on the other hand, has a half-life of about a day. People on T3 sometimes feel its effects within minutes after taking it."
==========================================
I started taking the Levothyroxine at bedtime and a few symptoms disappeared or improved.
Be sure to get those tests done, as I suggested above. Also, be aware that many of our members, myself included, report that symptom relief required that Free T3 was adjusted into the upper third of the range and Free T4 adjusted to around the middle of its range. The other thing that is most important is to find out if your doctor is willing to treat you clinically, and also prescribe T3 meds if needed to raise your Free T3 level.
Here I the symptoms that I exhibited (out of those on the list you referred me to):
•Decreased ability to exercise.
•Swollen ankles
•Depression
•Joint and muscle pain, aches, and stiffness
•Feeling tired (fatigue) and sluggishness
•Decreased ability to exercise.
•Swollen ankles
•Depression
•Joint and muscle pain, aches, and stiffness
•Feeling tired (fatigue) and sluggishness
It depends on the a cause of your hypothyroidism. If it is due to Hashimoto's Thyroiditis, then the associated thyroid antibodies are gradually destroying your thyroid glands anyway, so you will need gradually increasing amounts of thyroid meds to offset the loss of natural thyroid hormone production.
If your hypothyroidism is is due to a weak TSH signal from the pituitary, then yes, as your meds are increased, the TSH will go down and your glands will eventually not be producing thyroid hormone. But so what? I am not aware of any other alternative that will get your Free T3 and Free T4 levels high enough to relieve your hypo symptoms. I have been in that state for over 30 years (thyroid suppressed), without any related problems.
Please post your thyroid test results and reference ranges shown on the lab report. Also, have you ever been tested for the thyroid antibodies TPO ab and TG ab, to see if Hashi's is the cause? If you look at the list of 26 typical hypo symptoms in this link, which ones do you have?
http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
If your doctor is a good thyroid doctor he will treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms without being constrained by resultant TSH levels. Symptom relief should be all important. You can get some good insight from this letter written by a good thyroid doctor for patients that he consults with from a distance. The letter is sent to the PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
If you haven't been tested for Free T3 and Free T4, you should make sure that is done each time you go for tests. Other testrs that would be advisable are Vitamin A, D, B12, zinc, selenium, and RBC magnesium. You noted that you were male. If that is wrong, as sometimes happens when logging in, then you should also get a full test panel for iron anemia.
Also it would be a good idea to find out if your doctor is going to be willing to treat you clinically as described in the letter. If not, then in the near future you are going to need a doctor that will do so.
If your hypothyroidism is is due to a weak TSH signal from the pituitary, then yes, as your meds are increased, the TSH will go down and your glands will eventually not be producing thyroid hormone. But so what? I am not aware of any other alternative that will get your Free T3 and Free T4 levels high enough to relieve your hypo symptoms. I have been in that state for over 30 years (thyroid suppressed), without any related problems.
Please post your thyroid test results and reference ranges shown on the lab report. Also, have you ever been tested for the thyroid antibodies TPO ab and TG ab, to see if Hashi's is the cause? If you look at the list of 26 typical hypo symptoms in this link, which ones do you have?
http://endocrine-system.emedtv.com/hypothyroidism/hypothyroidism-symptoms-and-signs.html
If your doctor is a good thyroid doctor he will treat you clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms without being constrained by resultant TSH levels. Symptom relief should be all important. You can get some good insight from this letter written by a good thyroid doctor for patients that he consults with from a distance. The letter is sent to the PCP of the patient to help guide treatment.
http://hormonerestoration.com/files/ThyroidPMD.pdf
If you haven't been tested for Free T3 and Free T4, you should make sure that is done each time you go for tests. Other testrs that would be advisable are Vitamin A, D, B12, zinc, selenium, and RBC magnesium. You noted that you were male. If that is wrong, as sometimes happens when logging in, then you should also get a full test panel for iron anemia.
Also it would be a good idea to find out if your doctor is going to be willing to treat you clinically as described in the letter. If not, then in the near future you are going to need a doctor that will do so.
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