Thyroid Medication - Interaction

[palm91]

Hello, I take the following medicines everyday and I would like to have some guidance on how I should be taking them so they do not interact with each other. I tried different ways but it does not seem to be working well. I would really appreciate if one of the doctors could help me set a better schedule. Thank you very much!

- Nexium 40 mg (1x day)
- Synthroid 112 mcg (1x day)
- Metformin 500 mg (2x day)
- Vit D 2000 (1x day)
- Vit B12 1000 (1x day)
- Prenatal Vitamins (1x day)

[palm91]

Thank you for all the suggestions. I really appreciate them!

[Red_Star]

I missed the 2 x day for metformin. :) Metformin should be taken with meals, so the first dose would be taken with breakfast.

[Barb135]

Since you're taking the metformin 2 times/day, you should talk to your pharmacist or doctor to find out how much separation it needs from synthroid.  We've  had other members on both synthroid/levo and metformin... Seems like they only leave an hour or so, but check with your pharmacist.  Sometimes, I've had to "fudge" a bit, in order to fit everything into the day, because I take thyroid med at 3 different times.

[Red_Star]

Nexium is a short term drug only (the package insert states 4 to 8 weeks to treat GERD). There is a very good reason why acid blockers are short term drugs. Low stomach acid reduces absorption of nutrients such as iron, B12, folate, calcium and zinc; affects digestion of protein, carbohydrates and fat; and increases the risk of bacterial overgrowth and fungal infections.

I posted a lot of info on another thread about reflux and treatment options: http://www.medhelp.org/posts/GERD-Acid-Reflux/HELP-for-GERD-sufferers/show/1657073

An example of how you might want to take your supplements: take synthroid on an empty stomach, half an hour to one hour before breakfast; vitamin B12, vitamin D and prenatal vitamins for lunch (vitamin A, D, E and K are fat soluble vitamins so eat a meal containing fat for better absorption); metformin with the evening meal.

You can switch this around but avoid taking vitamins with synthroid (calcium and iron can interfer with thyroxine absorption) and metformin (can inhibit the absorption of vitamin B12).

[ahmee]

This is a great question to ask your pharmacist. Pharmacists have a lot of experience advising people which medications will interact with others. You can also call your doctor to ask. The people who post on this board, myself included, are not doctors, but other patients giving advice.

I can tell you that synthroid is best taken first thing in the morning on an empty stomach, or just before bed if you eat an early dinner (4 hours before bed or more). You will want to take vitamins at least 2 hours after your morning dose of synthroid (4 hours after if the prenatal vitamins include iron); if you are taking the synthroid at night, you can take the vitamins with dinner or earlier in the day. I don't know anything about  nexium or metformin, so again, I encourage you to speak with a pharmacist or your doctor.