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When Should You Take Thyroid Medicine

What If I Forget To Take It

When should you take your thyroid medication

If you forget to take a dose, take it as soon as you remember, unless it’s almost time for your next dose. In which case just skip the forgotten dose. Do not take 2 doses together to make up for a missed dose.

If you forget often doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

About Dr Kent Holtorf

Kent Holtorf, M.D. is the medical director of the Holtorf Medical Group with locations in Los Angeles, Foster City, Atlanta, and Philadelphia. He is also founder and director of the non-profit National Academy of Hypothyroidism , which is dedicated to dissemination of new information to doctors and patients on the diagnosis and treatment of hypothyroidism.

Dr. Holtorf has personally trained numerous physicians across the country in the use of bioidentical hormones, hypothyroidism, complex endocrine dysfunction, and innovative treatments of chronic fatigue syndrome, weight loss, fibromyalgia, and chronic infectious diseases, including Lyme disease.

He has been a featured guest on numerous TV shows including CNBC, ABC News, CNN, EXTRA TV, Discovery Health, The Learning Channel, The Today Show, The Doctors, Dr. Dean Edell, Glenn Beck, Nancy Grace, Fox Business, ESPN, Rush Limbaugh, CBS Sunday Morning, Sean Hannity, So Cal News, and quoted in numerous print media including the Wall Street Journal, Los Angeles Times, US New and World Report, San Francisco Chronicle, WebMD, Health, Elle, Better Homes and Garden, US Weekly, Forbes, Cosmopolitan, New York Daily News, Self magazine, among many others.


  • Benvenga, S., et al. Altered Intestinal Absorption of L-Thyroxine Caused by Coffee. Thyroid. 2008 18:293-301.
  • Mazzaferri, E. Thyroid Hormone Therapy. Clinical Thyroidology for Patients: Summaries for Patients from Clinical Thyroidology. 2008 Vol 1, Iss 1.
  • Not Talking To Your Doctor Before Taking Supplements

    Your healthcare provider should know about any supplements you take because they may affect your hypothyroidism treatment particularly iodine. While iodine is essential for your body to produce thyroid hormone, the vast majority of people in the United States get enough iodine from food and water alone, Dr. Adimoolam says. Because taking too much iodine can cause thyroid hormone levels to go too high or too low, its best to avoid this supplement.

    Additional reporting by Deb Shapiro.

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    Their Ingredients And Effects Are Surprisingand Sometimes Harmful

    Weight gain, fatigue, brain fog. These are all hallmark symptoms of hypothyroidism, a condition in which the thyroid, a small gland at the front of your neck, slows down or stops making the hormone thyroxine that helps keep your metabolism up to speed. If you are diagnosed with hypothyroidism , a doctor may give you a prescription for levothyroxine . This medication contains synthetic thyroid hormone that can correct the hormone deficiency and improve your symptoms.

    Unfortunately, these unwelcome symptoms are not specific for hypothyroidism, but are also part and parcel of the natural aging process, and can affect people with normally functioning thyroid glands, says endocrinologist and Consumer Reports’ chief medical adviser Marvin M. Lipman, M.D. Less than 2 percent of people have hypothyroidism, Lipman says. Nevertheless, people who are desperate to lose weight and feel more energetic turn to supplements that are marketed to boost metabolism and energy naturally. But experts warn that taking these thyroid supplements is a bad idea. Here’s why:

    When The Thyroid Gland Slows Down

    How to Properly Take Your Thyroid Medication

    When the thyroid gland can’t produce enough thyroid hormone naturally, a person might develop Hypothyroidism symptoms and generally not feel great.

    Some people have reported living for years with undiagnosed or undertreated Hypothyroidism because of inaccuracies with TSH testing. More on that later.

    Even if you don’t have a Hypothyroid diagnosis, don’t rule it out based on the TSH test. Instead, let’s look at the symptoms:

    • Low body temperature
    • and more…

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    What Is The Most Important Information I Should Know About Levothyroxine

    You may not be able to take levothyroxine if you have certain medical conditions. Tell your doctor if you have an untreated or uncontrolled adrenal gland disorder, a thyroid disorder called thyrotoxicosis, or if you have any recent or current symptoms of a heart attack.

    Levothyroxine should not be used to treat obesity or weight problems.

    Can I Put Off Taking Thyroid Medication

    With patients who have lab results and symptoms that all support a diagnosis of mild Hashimotos or hypothyroidism, I often spend at least 6, and often up to 12 weeks helping them to identify Root Causes of the thyroid problem before we start thyroid hormone supplementation. Ive had patients with low iodine and non-autoimmune hypothyroidism for example, who reversed their thyroid problem with iodine supplementation, and Ive seen removal of gluten in patients with celiac disease reverse Hashimotos in a matter of months. Once we identify the Root Cause, we may then work to reverse these for several additional months, before starting thyroid hormone supplementation, and reassess regularly, usually every 6-12 weeks, based on symptoms and repeat lab results.

    However, if your lab results are far out of the normal range, if your symptoms are impacting your quality of life, or if youve been working on Root Causes for 6 weeks or more and your symptoms havent improved at all, nor have your labs , this is when I generally recommend starting thyroid hormone supplement. It can be a game changer in how you feel. As one woman shared, Getting on the right thyroid treatment at the right dose changed my life. It felt like the windshield wipers came back on in my brain and I could think clearly again for the first time in years!

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    Big Benefits Of Protein Powder & Why Thyroid Patients Should Use It

    Using the right protein powder on a daily basis can have big benefits for your weight, your thyroid, your metabolism, and more.

    Check out the potential benefits that you can expect to see if you are using protein powder correctly:

    #1. May Enhance Weight Loss & Improve Metabolism

    If you are like many thyroid patients then you are probably struggling with weight gain.

    Protein powder definitely has the potential to help with weight loss because it impacts your body and metabolism through a variety of different mechanisms.

    One of the most important factors in controlling your weight has to do with your basal metabolic rate or BMR.

    And a huge contributing factor to your BMR is your lean muscle mass.

    The more lean muscle mass that you have on your body the more calories you will burn at rest.

    Consuming a sufficient amount of protein can help support lean muscle mass which may then have an impact on muscle mass.

    The more muscle mass you have on your body the better, especially if you are struggling with weight.

    If you are trying to lose weight then you should also check out additional weight loss supplements that work through different mechanisms.

    Other supplements including berberine, fish oil, probiotics, CLA, and glucomannan all work through different mechanisms and can be safely used in conjunction with protein powder.

    You can also consider adding other prescription weight loss medications to your protein powder to enhance weight loss.

    #2. Can Help Control Appetite

    Thyroid Medication: Do You Really Need It

    Thyroid Medication Tips

    I get it. When you hear the words thyroid medication you might bristle. Who wants to take a medication they dont really need? After all, we hear about problems with medication over-prescribing and the risks of pharmaceutical side-effects all the time. It can be scary to think about starting a medication. And it also may not fit into your ideal self-concept most of us dont want to think of ourselves as needing a medication, let alone for our whole lives!

    So what do you do if youre faced with a diagnosis of Hashimotos or hypothyroidism and have been prescribed thyroid medication? Or have been so exhausted for so long now, have felt depressed, unfocused, or are still gaining weight despite your best efforts at diet and exercise and now youre ready to do just about anything to feel like yourself again.

    Youve heard thyroid medication can help with energy, weight, and mood But do you need it? is it safe? Will you become dependent on it? Is it better to wait and work on Root Causes first to try to avoid medication?

    I get questions about thyroid medication pretty much every day and its great that youre asking, too! The most common questions women ask me are:

    In this article, Im going to walk you through, step-by-step, my answers to each of these questions, which is how I help my patients with this big decision, and will hopefully help you, too.

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    How Should This Medicine Be Used

    Levothyroxine comes as a tablet and a capsule to take by mouth. It usually is taken once a day on an empty stomach, 30 minutes to 1 hour before breakfast. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take levothyroxine exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

    Swallow capsules whole do not chew or crush them. Do not remove the capsule from the package until you are ready to take it.

    Take the tablets with a full glass of water as they may get stuck in your throat or cause choking or gagging.

    If you are giving levothyroxine to an infant, child, or adult who cannot swallow the tablet, crush and mix it in 1 to 2 teaspoons of water. Only mix the crushed tablets with water do not mix it with food or soybean infant formula. Give this mixture by spoon or dropper right away. Do not store it for later use.

    Your doctor will probably start you on a low dose of levothyroxine and gradually increase your dose.

    Levothyroxine controls hypothyroidism but does not cure it. It may take several weeks before you notice a change in your symptoms. Continue to take levothyroxine even if you feel well. Do not stop taking levothyroxine without talking to your doctor.

    Food And Levothyroxine Absorption

    In addition to minerals, certain foods may affect the way your body uses levothyroxine. Foods that are high in calcium and iron should be avoided within one hour before or after taking the medication, according to the FDA.

    • Tyrosine kinase inhibitors, such as cabozantinib
    • Tricyclic antidepressants, such as amitriptyline

    Tell your doctor if you are taking any medications, especially those on this list.

    Because some of these medications are necessary for certain conditions rather than stopping the medication, your doctor can adjust your levothyroxine dosage and monitor you for side effects.

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    Dairy Reduces Levothyroxine Concentration

    The study examined 10 healthy subjects with normal thyroid function to assess whether consuming cows milk has a direct effect on levothyroxine absorption.2

    Following an overnight fast, serum total thyroxine concentrations were measured at baseline and at 1, 2, 4, and 6 hours after the participants took 1000 g of oral levothyroxine alone or when coadministered with 12 ounces of 2% milk.

    Results showed that the TT4 concentrations were significantly lower when levothyroxine was taken at the same time as the milk as compared to levothyroxine alone.2 Also, peak serum TT4 concentrations dropped significantly when cows milk was coadministered with levothyroxine than with the levothyroxine alone.

    The researchers believe that both the calcium content of the milk and the presence of protein might directly interfere with the proper and full absorption of levothyroxine, complicating the management of hypothyroid.2

    Our results show that calcium-rich foods should be consumed apart from thyroid hormone medication, as much as possible, Dr. Leung tells EndocrineWeb. This will help ensure that thyroid blood tests remain constant, thus decreasing the need for potentially unnecessary changes in the dose of thyroid replacement needed to manage your hypothyroidism.

    Calcium-rich foods including cows milk, yogurt, cheeses and ice cream and frozen yogurt. Also, non-dairy milk like those made from almond, soy, and rice, which are fortified with calcium.4

    Can I Take Other Drugs With My Hypothyroidism Medications

    Common Thyroid Medication Mistakes That Can Affect Your ...

    There are several medications you should avoid taking with thyroid replacement medications. Most can decrease how much levothyroxine is absorbed into your body. Weve already talked about antacids, multivitamins with iron, and supplements with iron, calcium, or aluminum. Here are some other examples:

    • Proton pump inhibitors like

    To be safe, its best to separate all other medications from your hypothyroidism medications, if possible. Aim to take levothyroxine at least 2 hours before your other medications, or at least 4 hours after.

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    Taking Your Medication For Hypothyroidism

    Thyroid replacement therapylevothyroxine, T4/T3 combination therapy, or a natural desiccated thyroid drugworks best when it is taken consistently and at the same time every day. It’s also important to note that there are a number of foods, medications, supplements, and medical conditions that may decrease the chance that your body will receive the full dose.

    Processed Foods In Packages And The Frozen Aisle

    “Processed foods tend to have a lot of sodium, and people with hypothyroidism should avoid sodium,” Frechman says. Having an underactive thyroid increases a person’s risk for high blood pressure, and too much sodium further increases this risk.

    Read the “Nutrition Facts” label on the packaging of processed foods to find options lowest in sodium. People with an increased risk for high blood pressure should restrict their sodium intake to 1,500 milligrams a day, according to the American Heart Association.

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    Supporting The Thyroid Naturally

    Here is where the story gets interesting. For the thyroid gland to make thyroid hormones, it needs two essential minerals: Iodine and Selenium.

    The thyroid gland uses Iodine to help make mostly T4 thyroid hormone and a little T3. The body then needs adequate levels of Selenium to help convert that T4 into T3 for energy, metabolic function, and immune health.

    Iodine is essential for all human life and well-being. The body can’t make a single hormone without it. Unfortunately, contrary to widespread assumption, many people may not get enough Iodine or Selenium through our diets and, as a result, may not have the essential nutrients to make enough thyroid hormones.

    Assuming A Change In Medication Brand Isnt A Big Deal

    (TBS #17) Whats the Best Way to Take your Thyroid Medication? AM vs PM? Split Dosing?

    Per the ATA, every brand and generic thyroid medication contains the same amount of thyroid replacement hormone. However, many endocrinologists believe that there is a variation in hormone content among the various brands, and that there are additional factors that can interfere with how the hormone is absorbed with each one, notes the ADA. Therefore, when getting a prescription filled at the pharmacy, you should not change from one brand to another, from a brand name to a generic, or from one generic to another without first checking with your doctor.

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    The Relationship Between The Thyroid Gland And Collagen

    The Thyroid gland is located within the neck the gland secretes two very important hormones that do not only act on metabolism in the body but many other factors as well. The two hormones include Triiodothyronine, also called T3, as well as Thyroxin, or T4 for short.

    There are various conditions that may affect the Thyroid gland and this can lead to two diseases. The two diseases that are relatively common in the general population include Hyperthyroidism and Hypothyroidism.

    When a patient has hypothyroidism, the Thyroids ability to function normally is usually suppressed. The result is a decline in the number of Thyroid hormones that are secreted into the blood circulatory system.

    A patient with hyperthyroidism, on the other hand, will usually have an excess number of these hormones being secreted into their bloodstream.

    With hypothyroidism, metabolism becomes slower, but with hyperthyroidism, metabolism is increased. In addition to these potential complications, it is important to consider the fact that both of these conditions may lead to additional complications in a patients body. Some of these effects may impact collagen in the body leading to excessive production or a decline in the production of collagen.

    Medical Conditions That Affect Absorption

    There are a number of medical conditions that may affect the absorption of thyroid medications, and, hence, the effectiveness of a particular dose. Some of these include:

    • Lactose intolerance
    • Pancreatic diseases
    • Liver disease

    Gene differences may also result in decreased effectiveness in some people, such as those who have polymorphisms in iodothyronine deiodinase 2.

    For people with health conditions that affect digestion such as inflammatory bowel disease , or celiac disease, the Tirosint brand of levothyroxine with fewer ingredients that may be better tolerated. In addition, the liquid or gel cap form of levothyroxine may be better absorbed than levothyroxine pills.

    If you have any of these conditions, it will be important to have your thyroid tested regularly.

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    Why Is This Medication Prescribed

    Levothyroxine is used to treat hypothyroidism . It is also used with surgery and radioactive iodine therapy to treat thyroid cancer. Levothyroxine is in a class of medications called hormones. It works by replacing thyroid hormone that is normally produced by the body.

    Without thyroid hormone, your body cannot function properly, which may result in poor growth, slow speech, lack of energy, excessive tiredness, constipation, weight gain, hair loss, dry, thick skin, increased sensitivity to cold, joint and muscle pain, heavy or irregular menstrual periods, and depression. When taken correctly, levothyroxine reverses these symptoms.

    What Happens If I Eat Or Take Medication Too Soon

    Pin on Thyroid Medication (NDT + T4 + T3 + T4/T3 Combos)

    If you occasionally do not wait the full recommended time before eating or drinking, do not worry. This is not dangerous. Just do your best the next day.

    The recommendations provided here help your doctors to dose your thyroid medication more accurately and decrease the need for frequent blood tests. If you are having trouble taking your thyroid hormone consistently, please speak with your doctor.

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