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Why Take Thyroid Medicine In The Morning

Determine When Taking Levothyroxine Is Best For You

Thyroid Medication Tips

We have plenty of evidence that taking levothyroxine with a meal decreases its absorption and may lead to variability in TSH levels, says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, program coordinator for the Teen and Adolescent Diabetes Transition Program at the University of Chicagos Kovler Diabetes Center.

For that reason, its recommended to wait 30-60 minutes after taking the thyroid hormone before you have breakfast, particularly for those with thyroid cancer, pregnant women, and those sensitive to thyroid fluctuations.

What this study proves is that calcium does affect absorption of levothyroxine, making it inadvisable to take with cows milk at the same time, says Ms. Hess-Fischl.

For practicalitys sake, patients need to find a schedule to take their levothyroxine at a time that will not be affected by meals some examples would be right when they get up and wait at least 30-60 minute, or plan to take it four hours after they finish eating for the night, if they are having calcium-containing foods such as milk or ice cream, she tells EndocrineWeb.

Its also easier to forget to take the medication in the evening, she tells EndocrineWeb.

Dr. Cappola also points out that the research brings into question what other foods and dietary substances aside from milk, soy, and iron that have yet to be studied that may also interfere with levothyroxine.

Taking Synthroid In The Middle Of The Night:

Q. I read that you should wait at least an hour after taking Synthroid before you drink coffee or eat breakfast. To get around this restriction, I take my Synthroid when I get up in the middle of the night to go to the bathroom.

A. Your solution is sensible for those who consistently rise at that time. Some people take their levothyroxine before bed to accomplish the same goal. That way they dont have to get up in the middle of the night to take it.

Oral Vs Sublingual Delivery

With natural desiccated thyroid medications only, some people have argued that allowing the medication to dissolve under the tongue may result in faster absorption into the bloodstream. The counterargument is that these molecules are large and most will be absorbed through the intestine anyway, so taking the medication sublingually could result in irregular absorption.

The bottom line is that if you are considering taking your medication this way, talk to your doctor and make sure your thyroid levels are monitored.

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What Other Information Should I Know

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to thyroid.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking thyroid.

Thyroid tablets may have a strong odor. This does not mean that the medication is spoiled or that it cannot be used.

Learn the brand name and generic name of your medication. Check your medication each time you have your prescription refilled or receive a new prescription. Do not switch brands without talking to your doctor or pharmacist, as each brand of thyroid contains a slightly different amount of medication.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Side Effects Of Too Much Or Too Little Synthroid

Why does thyroid medication need to be taken in the ...

During Synthroid treatment, getting your thyroid hormone to the right level can sometimes be challenging. This is because even a small change in your Synthroid dose may cause your thyroid hormone level to become either too high or too low. And having either too much or too little Synthroid in your body may result in certain side effects.

For example, if you take too much Synthroid, you may have side effects of hyperthyroidism . Symptoms of hyperthyroidism may include:

  • fast heart rate
  • muscle weakness
  • hair loss

Maintaining a consistent level of Synthroid in your body can help prevent side effects of having too much or too little of the drug in your body. To do this, its very important that you take your Synthroid dose regularly, once each day. And you should try to take the drug at the same time every day.

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Plus How To Get The Absolute Most Out Of Your Thyroid Meds

The time of day you take your thyroid meds, and how you store them, can make or break your thyroid disease management.

Levothyroxine is the name of all synthetic forms of the thyroid hormone T4. This manufactured hormone mimics the natural hormone produced by your thyroid and is prescribed as the primary treatment for hypothyroidism, or an underactive thyroid.

Levothyroxine dosage is highly individualized, and your dosage may change as you and your doctor work to find what works best for you. See our levothyroxine dosage chart below to get an idea of where your treatment might begin and when to expect your doctor to check for adjustments. Starting dosages are often calculated based on your weight, but because in some cases your thyroid still makes its own T4, some doctors will start you with a lower dosage to avoid over-treatment symptoms that mimic hyperthyroidism . They also may start you on a lower dose if your body might need extra time to adjust to the effects of hormone replacement. Your doctor will then check your thyroid stimulating hormone levels over the first few months to see if your dosage needs any adjustment. Hormone replacement therapy is usually a lifelong treatment, so you should get your TSH levels checked every year to ensure youre still taking the right dose.

Infographic by Lauren Hunter

You can find more information about levothyroxine, including dosage, here.

  • Increased sweating
  • Tremors
  • Palpitations

Dosage For Tsh Suppression

The usual dose of Synthroid for thyroid stimulating hormone suppression* is 2 micrograms of drug per kilogram of body weight . This dose is taken once each day.

This means that if you weigh 75 kg , your dosage of Synthroid would be 150 mcg each day.

Your Synthroid dosage for TSH suppression will depend on the severity of your condition and other health conditions you may have. Your doctor will recommend a dose of Synthroid for TSH suppression thats best for you.

* For TSH suppression, Synthroid is used to help decrease levels of TSH in your body. TSH is made when your body needs thyroid hormones. A lower TSH level means your body doesnt need thyroid hormones as much as a higher TSH level indicates.

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Synthroid For Tsh Suppression

Synthroid is approved to suppress levels of thyroid stimulating hormone . Its approved for this use in people with a form of thyroid cancer called thyrotropin-dependent well-differentiated thyroid cancer.

TSH stimulates your thyroid to make thyroid hormones. In addition, TSH is responsible for growth of cells in your thyroid gland, including growth of cancerous cells. By decreasing your TSH level, Synthroid can help decrease the growth of certain types of thyroid cancer.

Normally, when your thyroid hormone levels are low, your body makes TSH. This signals your thyroid to make more thyroid hormones. However, if youre taking Synthroid, your thyroid hormone levels wont be low. So your body wont need to make TSH, and your TSH level will be lower than usual.

With a lower TSH level, growth of cancer in your thyroid may decrease. When Synthroid is used for TSH suppression, the drug is meant to be used along with surgery and radioactive iodine treatment.

Effectiveness for TSH suppression

recommended in some people with high-risk forms of thyroid cancer. Levothyroxine is the recommended drug to use alongside surgery and radioactive iodine treatment.

There arent any clinical trials comparing TSH suppression with Synthroid to that of a placebo . However, levothyroxine is considered the recommended drug for this use.

For information on Synthroids history and the lack of clinical studies of this drug, see the History of Synthroid section just above.

Side Effects In Children

Can I take Thyroid Medicine with Coffee in the Morning? | Levothyroxine and Coffee

Children taking Synthroid may have different side effects than do adults taking the drug. For example, some children taking Synthroid have had pseudotumor cerebri . This condition may cause headaches, nausea, and vomiting.

In addition, some children taking Synthroid have had slipped capital femoral epiphysis. This disorder may cause limping or pain in the area thats affected.

This hip condition only occurs in children whose bones are still growing. However, its important to note that having decreased thyroid hormone levels, which Synthroid is used to treat, may also increase the risk of this hip disorder.

Also, certain bone growth problems may occur in infants and children who take too much Synthroid. In this case, an infants skull may become hardened too quickly, causing increased pressure on their brain. And the growth of their skull may also be affected. Other bones in children taking too much Synthroid may also be unable to grow properly. This can lead to growth problems and decreased height.

If you have questions about side effects of Synthroid in a child using the drug, talk with your childs doctor. Theyll discuss with you the risks and benefits of treatment. And they can help prepare you for what to expect from treatment with this drug.

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How To Take It

Swallow the tablets whole with a drink of water.

Levothyroxine is available as a liquid for children and people who find it difficult to swallow tablets.

If you or your child are taking levothyroxine as a liquid, it will usually be made up for you by the pharmacist. It will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have a syringe or measuring spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not give the right amount.

How It Works For Hypothyroidism

With hypothyroidism, your body doesnt make enough thyroid hormones. The main thyroid hormones in your body are T3 and T4. By taking Synthroid, youre replacing your bodys T4. And your body then uses T4 to make T3.

Synthroid helps to bring your thyroid hormone levels back to a normal range. And it also helps reduce your symptoms of hypothyroidism.

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Does Coffee Contain Mold And Toxins

There is some evidence that some brands of coffee may contain mold, which can be an issue for autoimmune and thyroid diseases, as well as those with mold sensitivities. In fact, one particular mycotoxin , ochratoxin A, is found in low levels in most coffee samples . Ochratoxin A has previously been associated with kidney disease and tumors of the urethra in humans. It has also been associated with cancer, brain damage, and hypertension, and can have immunosuppressive effects.

Coffee, especially instant varieties, can also contain toxins like acrylamide. Most people with Hashimotos have an overburdened liver and an impaired ability to eliminate toxins, which is why my healing protocol always begins with liver support and eliminating toxins. Our food, water, personal care products assault our bodies with harmful toxins on a daily basis, so adding to that burden with contaminated coffee will only exacerbate the problem.

That said, there are brands out there that claim to be free of such toxins. I personally like the Bulletproof coffee brand I mentioned above because it was developed by Dave Asprey, a Hashimotos patient who has made sure his coffee is gluten-free and free of mold. It is also tested for toxins.

Full disclosure Dave has sent me some of his coffee for Christmas in the past, and Im hoping he will send me more this year, but thats not why Im recommending his coffee. ? I also buy it myself when he forgets to send me free samples.

Best First Thing In The Morning: Thyroid Meds

1000+ images about Thyroid Info on Pinterest

To do their best work regulating your bodys hormones and metabolism, a thyroid med like levothyroxine needs to be the star of the show and make its daily debut in your stomach before you eat or drink anything else. When taken on an empty stomach, thyroid medication does not compete with anything else to be absorbed, says Eric M. Ascher, DO, a family medicine physician at Lenox Hill Hospital. He advises taking it approximately one hour prior to eatingand definitely before having any dairy. In fact, you should avoid calcium- and iron-rich roodsincluding milk, yogurt, and green, leafy vegetablesfor four hours before or after taking the medication, since they can interfere with absorption and, as a result, make your dosage less effective. Thyroid meds also happen to be one of the medications you should never stop taking abruptly.

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Can I Take Vitamins And Other Medications

Certain medications interact with Synthroid. Calcium, iron supplements, antacids, and other medicines may prevent your body from fully absorbing your thyroid medication, says Dr. Jayani.Plan your dosage for four hours before, or four hours after your daily thyroid medication. To avoid any interactions, its best to take Synthroid completely by itself. Consult with your healthcare provider or pharmacist about your daily schedule, and if any medications you take interact with Synthroid.

Coffee And Thyroid Hormone Absorption

Many people love coffee. But, one of the things that many people dont know is that coffee can impair the absorption of thyroid medications, and thus, it needs to be spaced out from thyroid medications.

A person with normal digestive function can take thyroid medications 15-30 minutes prior to breakfast and have the medications be well absorbed, but some people may need to postpone breakfast by a minimum of 60 minutes after taking thyroid medications, for proper absorption.

As far as coffee and thyroid meds go, Italian researchers found that their first-thing-in-the-morning-espresso-loving patients did not absorb their thyroid medications correctly. This is because coffee lowers the intestinal absorption of both inorganic and organic compounds, and seems to physically interact with thyroid medications.

In another Italian study, one person who was drinking espresso within 10 minutes of thyroid medications, had a consistently elevated TSH between 13 IU/mL and 18 IU/mL. The same person, on the same dose of medication, was later made to wait one hour to have her coffee, and took her medication with a full glass of water instead. With this new change, her TSH was now testing between to 0.03-0.1IU/mL every time she had it tested.

While most of the studies on coffee and thyroid hormone absorption have been done with levothyroxine, anecdotally, people taking T3 and natural dessicated thyroid hormones can also have a problem with absorbing them if theyre taking them with coffee.

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You Don’t Take Your Medication Correctly

Thyroid medication should generally be taken in the morning, an hour before eating any food, drinking coffee, or drinking milk, and at least three hours apart from taking any calcium or iron supplements or calcium-fortified drinks. If you take it in the evening, you should wait at least three to four hours after eating.

Some thyroid medications, however, have specialized instructions. Levoxyl brand levothyroxine, for example, needs to be taken with a full glass of water, according to prescribing instructions from the manufacturer. According to Anne: “One of my worst thyroid medication mistakes was taking Levoxyl without plenty of water. Once I started drinking a full glass of water after taking the pill, I started losing weight and my pill worked effectively.”

What Other Foods Should You Avoid When Taking Synthroid

Why You Feel Worse When You Take Thyroid Medication

Even if youre not a coffee drinker, there are certain things that can affect how well Synthroid works. According to DailyMed, the following foods can make it harder for your body to absorb Synthroid:

  • Walnuts
  • Cottonseed meal
  • Dietary fiber

Examples of foods that are high in dietary fiber include beans, broccoli, apples, berries, avocados, and quinoa.

Grapefruit juice can also inhibit the effectiveness of your medication by potentially decreasing absorption of Synthroid. If you consume these foods, ask your healthcare provider if you can safely continue to do so.

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If you have difficulty avoiding these foods throughout the day, your healthcare provider may recommend changing your medication scheduleeven though the manufacturer recommends taking it in the morning. Taking the medication at night means you can easily avoid things that interfere with your thyroid medication, says Dr. Puopolo.

There are two caveats. Its difficult to have an empty stomach for 30 to 60 minutes prior to bedtime, and many people forget to take medication before going to sleep. Thats especially true if your routine is disrupted by a late night or vacation.

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Tips To Never Missing Another Dose

Stick to a schedule that works for you

People generally take their thyroid medication first thing in the morning or right before bedtime. This approach is usually a safe bet because you typically have an empty or near-empty stomach at these times of the day. However, this schedule is not always ideal for shift workers or travelers. Whatever your lifestyle and schedule, pick a time you know will always cue you to take your medication. And, of course, follow the instruction from your thyroid doctor.

Put your medication in a prominent place

Here again, people who take their medication early in the morning or at night often put their medicines on their bedside table with a glass of water. That way, you always see it, and it becomes a habit to take the pill before turning out the light or donning your robe in the morning. In any case, find a place to keep your medication that will remind you every day, like your bedside table or by your toothbrush.

Use a pillbox

Pillboxes are helpful for everyone, even if you only have one medication. Using a pillbox keeps you from that head-scratching moment, asking yourself if you’ve already taken your pill today or not.

Set a reminder

If you are digitally inclined, you may want to set a daily reminder on your phone. The Paloma Health mobile app allows you to set automated notifications to get reminders and recommendations for how and when to take your thyroid medications.

Put your prescription on autofill


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