Re: NHS guidelines on taking thyroxine

[Guest guest]

This is why most of us take our thyroxine last thing at night, so our

stomachs are empty.

Glynis

> I've just realised I usually take mine with a glass of water or a cup

> of tea/coffee and a slice of toast or cereal whilst getting ready for

> work. Perhaps THAT's why its not working?!!!

> Trouble is most of us probably (like me lately)get up at the last

> minute (a thyroid symptom - lethargy) and we're all told breakfast is

> the most important meal of the day!!!

> In future I shall take a glass of water up with me and try taking them

> when I first wake up and leave breakfast unti just before I leave for

> work. Can but try as they say......

> Regards

>

>

[Guest guest]

Hi ,

I've often wondered about this too.

I take my levothyroxine at 6am immediately on waking with a glass of

water. I then consume my breakfast half an hour after which is always

a bowl of poridge and a glass of fruit juice. (I don't take my

supplements till lunchtime.)

I was advised to try taking my levo at night to promote better sleep.

I tried this for a couple of weeks but it did not work for me so I

have reverted back to mornings on an empty stomach as my Doctor

advised me.

I don't think there is a hard and fast rule with how long you wait to

eat your breakfast. I think it is more important to take it at the

same time every day. My TSH is dropping slowly so I assume my routine

is working for me...it will be interesting to see what the others

think.

Best wishes,

Gillian

>

> I've just (by accident) come across these

> guidelines on the NHS website. Thyroxine is listed as one of the

very

> few medicines which MUST be taken before food (ideally on an empty

> stomach) and which you MUST allow at least 30 minutes (preferably an

> hour) before eating.

[Guest guest]

I must be doing something wrong here. My stomach is NEVER empty last

thing at night. It is first thing in the morning though!

Gillian

>

> This is why most of us take our thyroxine last thing at night, so our

> stomachs are empty.

> Glynis

>

[Guest guest]

Hi Gillian,

I don't think you are doing anything wrong....... my stomach is never

completely empty last thing at night either. And because of this I

always take my thyroxine in the morning wait an hour before having a

two course breakfast.

I asked my Dr about taking it at night and she said probably better

for me to keep taking it in the morning. Most likely cos I have to

eat regularly in small amounts - my last snack of the day is normally

cheese and crackers at around 9pm ........ so you see if I took my

thyroxine at night it would be fighting with the food I eat.

Each of us is different and I think we all have to find whatever

works for us.

M.

> > This is why most of us take our thyroxine last thing at night,

> > our stomachs are empty.

> > Glynis

> >

>

[Guest guest]

Hypothyroid

sufferers are treated appallingly by the NHS - doctors simply don't give you

this information because they don't even know how you should take it. The NHS

information should be updated too. A study has been done to show that those taking

their thyroxine when they go to bed have a better nights sleep, sleep longer

and awake more refreshed and feel better throughout the day. You don't take any

food for an hour before you go to bed though. Also, taking it at bed time

allows you to take other supplements that contain iron or calcium far, far away

from your thyroxine - so there is no problem with that.

If you

are not feeling any effect, can you get hold of your last thyroid function

tests and post them here together with the reference range for each of the

tests. Ask your GP also to test your Free T4, Free T3, and TSH. Also you need

to get a test to see whether any of the following are low: ferritin(stored

iron), vitamin D, vitamin B12, magnesium, copper and zinc. If any of these are

low, your thyroxine cannot get properly absorbed.

Read

our website www.tpa-uk.org.uk under

'Hypothyroidism' and click on 'Associated Conditions' that go along with being

hypothyroid and that can cause you a problem, and see if any of them might fit.

Luv -

Sheila

This has probably been raised by many others but I've

only just come

across this after taking thyroxine for more than 2 years with little

effect (doh!!). At no time have any of my so called health

practitioners mentioned HOW thyroxine should be taken or asked me WHEN

and how I take it.

[Guest guest]

***I must be doing something wrong here....

......'fraid so, Gillian Seriously, eating late in the evening is one of the worst things we can do to our health. I realize that our busy life's don't always make it possible to eat at sensible times, but it is best to have a hearty breakfast, eat something substantial at lunch time and very little in the evenings - preferably no later than 6-7 pm. Often that is not practical, I know, particularly for those who work all day.

****I take my levothyroxine at 6am immediately on waking with a glass ofwater. I then consume my breakfast half an hour after which is alwaysa bowl of poridge and a glass of fruit juice.

From what I've read, half an hour is not really enough time before eating breakfast - a minimum of 1 hour (before food) is recommended (or 3 hours after food).

You might inadvertently prevent optimal absorption of the levo by eating too soon after taking the meds. I have a feeling that porridge (oats) is high in iron, and milk, if you use that with it, is high in calcium. Orange juice (if that is what you are having) is often fortified with extra calcium too.... so all in all, not the best breakfast combination so close to your thyroxine

It could well be (in fact, I am almost certain) that taking your levo at night did not work, because you ate late, which would have the double whammy effect of disturbing your sleep as well as preventing the levo from being absorbed sufficiently

I love porridge too, and I eat it nearly on a daily basis... but I have it for lunch most of the time. - Would it be possible for you to shuffle around your meals and pill time, so that your levo gets the best chance to be absorbed 100% ?

Sorry - I hate to be the bearer of bad news, and to change long-standing habits is difficult....

Love,

PS - that reminds me.... does anyone know if armour taken sublingually has the same restrictions as when taken orally - as far as interference with iron, calcium and soya is concerned ? I would imagine that it does, but just want to make sure.....

[Guest guest]

***PS - that reminds me.... does anyone know if armour taken sublingually has the same restrictions as when taken orally - as far as interference with iron, calcium and soya is concerned ? I would imagine that it does, but just want to make sure.....

Sorry, that was a clumsily worded afterthought....

What I meant was .... Because Levothyroxine (T4) binds to iron, calcium and soya, it is advised to take it away from food. What I want to know is - since we take Armour sublingually (and it by-passes our stomachs), will it still bind to iron, calcium and soya and prevent Armour from working optimally ?

Thanks,

[Guest guest]

Doh! You must be the devil in disguise !!

Here's me thinking I am being 'super healthy' and apparently it seems

after all this time I'm not!

I'm afraid I've got to have my porridge for breakfast though as I can't

face anything else first thing...so it looks like I will have to be

patient and wait an hour instead of half an hour from now on...the

fruit juice is Tropicana Ruby Breakfast, (orange and grapefruit). There

is no calcium in it but there is 26% of RDA Folic acid so I assume that

is just as bad. Doh!

By the way, I don't eat after 8pm, and I am usually in bed by 11, so by

my calculations my stomach is only empty by three hours if I take my

levo at night...whereas in the morning it is empty by 10 hours...so I

feel the morning is still the best time for me to take my levo.

I'll see what happens to my TSH at the next blood test after I change

my timing slightly.

Thanks for the warning I appreciate all the guidance I can get.

Best wishes,

Gillian

> You might inadvertently prevent optimal absorption of the levo by

> eating too soon after taking the meds. I have a feeling that porridge

> (oats) is high in iron, and milk, if you use that with it, is high in

> calcium. Orange juice (if that is what you are having) is often

> fortified with extra calcium too.... so all in all, not the best

> breakfast combination so close to your thyroxine [:-s] > Would it

be possible for you to shuffle around your meals and pill time,

> so that your levo gets the best chance to be absorbed 100% ? Sorry - I

> hate to be the bearer of bad news, and to change long-standing habits

is

> difficult....

[Guest guest]

> ***I must be doing something wrong here....

No, not necessarily. Those of us with low thyroid may also may have

low blood sugar problems and may need to eat frequently, and may not

be able to get through the night without eating, even if we take a

snack just before going to bed. I have only recently stopped having

to eat at 10 pm and 3 am. Now it is just 10 pm!

To quote again from the excellent " Take control of your health and

escape the sickness industry " by Elaine Hollingsworth, page 25:

" Those of you with inadequate glycogen stores to provide your body

with energy throughout the night may suffer from interrupted sleep.

Since protein replenishes glycogen, a bedtime snack of a concentrated

protein may be needed for a while, until the glycogen stores in the

liver are sufficient to sustain the brain throughout the night. "

(This is from a section about the adrenals and cortisol). " Research

has shown that the worst stress of all for the adrenals is hypoglycaemia. "

Miriam

[Guest guest]

I shall have to get this book.....this is interesting because I used

to be able to sleep for England, but since I've been hypo I have

interrupted sleep patterns, waking up two or three times a night

(every 2 or 3 hours) with fierce hot flushes and hip pain. I usually

have to go to the bathroom too at least once.

I'm thinking I shall have to get checked for hypoglycaemia to rule

this out.

Another quick question here...is there any reason why I can't take my

levothyroxine 'around 4am ish' when I wake up. (That would clear

enough time for me to have my porridge then at 6am when I get up!)

Gillian

>

> " Those of you with inadequate glycogen stores to provide your body

> with energy throughout the night may suffer from interrupted sleep.

> Since protein replenishes glycogen, a bedtime snack of a

concentrated

> protein may be needed for a while, until the glycogen stores in the

> liver are sufficient to sustain the brain throughout the night. "

[Guest guest]

Hi

No

matter how good you think you are at taking all of your Armour sublingually,

there will always be a tiny bit that escapes that you swallow which goes into

your tum - but it is absolutely minimal. Your Armour is still much more potent

taking it sublingually than taking it orally. To be safe, it is still best to

take it as far away from calcium and iron as you can. If you take your Armour

during the day - take your iron and calcium when you go to bed.

luv -

Sheila

PS - that reminds me.... does anyone know if armour taken sublingually has the same restrictions

as when taken orally - as

far as interference with iron, calcium and soya is concerned ? I

would imagine that it does, but just want to make sure.....

[Guest guest]

Oh Gillian - you are a larf! …and

then you go and spoil it all by taking your T4 at 6.00a.m with a glass of water

and consuming your breakfast half an hour afterwards with a bowl of porridge

and a glass of fruit juice. We are not saying that your stomach should be empty

if you take your T4 at night, we are saying you should not eat for an hour

before you take it. You would actually be better off taking it at night if you

don't eat anything after 8.00p.m. and you would be getting more potency from

taking it that way.

Luv - Sheila

By the way, I don't eat after 8pm, and I am usually in bed by 11, so by

my calculations my stomach is only empty by three hours if I take my

levo at night...whereas in the morning it is empty by 10 hours...so I

feel the morning is still the best time for me to take my levo.

_,_._,___

[Guest guest]

Hi Gillian,

Nothing wrong with your breakfast at all... just the timing of it <GB>. I'm sure if you allow a full hour for the levo to get into your system, then you'll be fine. You'll find that there is still calcium in orange juice though, but not very much... and the folic acid should be ok (says she, who nearly failed Chemistry )

Oh, and btw... if there were 3 hours between your evening meal and taking the meds, you should have been in the clear - just about... But night time mediation does not suit everyone - it worked very well for me though.

***Another quick question here...is there any reason why I can't take mylevothyroxine 'around 4am ish' when I wake up. (That would clearenough time for me to have my porridge then at 6am when I get up!)

Sounds like a plan to me ;o) - it might even make you sleep more soundly for what's left of the night (better set the alarm).

***but since I've been hypo I haveinterrupted sleep patterns, waking up two or three times a night(every 2 or 3 hours) with fierce hot flushes and hip pain. I usuallyhave to go to the bathroom too at least once.

It used to do exactly the same with me, Gillian, before I was on my "full" dose of thyroxine. Now that I am on Armour (and not yet the full dose) I have the same interrupted sleep pattern again as before - just like you describe. - Although, unlike before any medication at all, I don't get the hot-flush pattern any more.

Good luck !

Love,

[Guest guest]

***To be safe, it is still best to take it as far away from calcium and iron as you> can. If you take your Armour during the day - take your iron and calcium> when you go to bed.

Thanks Sheila, I am taking armour sublingually and it's no problem at all in the mornings for me, since I wake at 6 am, put it under my tongue and go back to noddy-noddy land straight away. It's the afternoon dosing that is a little tricky, as sometimes I have a late lunch, which is often said porridge.... so I want to allow at least 3 hours after lunch, but an hour before dinner (we eat around 6 pm), which means I often have to miss out on afternoon tea, which makes me grumpy <G>. But don't worry, I'll manage ...

Btw, Sheila - is there any good reason that prevents us from taking armour 3 times/day rather than twice?

I am planning to introduce my next half grain (in due course !!) at night, so I'd initially take 1/2 grain at ~11 pm, 6 am and ~4 pm .... later I would combine it into 2 doses, either at night and late morning or morning and afternoon dosing as right now - whichever feels best. - Are there any good reasons not to do that? - Oh, and I don't take any calcium or iron supplements - if anything I am too high on ferritin (last count 1 year ago was 248 !) and calcium was fine at last count.

love,

[Guest guest]

Oh dear....Now I can see why its so funny! I've been doing it all wrong

haven't I. I have to say it is very confusing reading all these tippets

of information about the best timing....my problem is I do take things

too literally!

Looks like I'll have to give the night time another trial, so bedtime

it is then!

Gillian

>

> Oh Gillian - you are a larf! .and then you go and spoil it all by

taking

> your T4 at 6.00a.m with a glass of water and consuming your breakfast

half

> an hour afterwards with a bowl of porridge and a glass of fruit

juice.

[Guest guest]

I'd like to scotch this rumour about eating at night, it is a complete

fallacy that if you eat in the evenings you don't digest your food and

you put on weight. What matters is the amount of CALORIES per DAY, not

when you eat. You could have one huge meal per day, in theory, as long

as you did not exceed your calorie intake.

I say in theory 'cos I'd be as sick as a lighthouse cat if I ate that

much food in one go!!lol!!

I certainly wouldn't want to be eating before I went to be though.

[Guest guest]

''hose of us with low thyroid may also may have

low blood sugar problems and may need to eat frequently, and may not

be able to get through the night without eating, even if we take a

snack just before going to bed.''

I am glad I don't take levo any more because this applies to me..

luv Dawnx

[Guest guest]

,

My package labels and inserts also caution against taking T4 within four

hours of calcium and iron supplements.

Chuck

You wrote:

>

> ... There is nothing about this on the label on the boxes - it simply says

> take 1 tablet each morning. The patient information leaflet is

> similarly unhelpful and makes no mention of not eating for an hour

> after taking....

[Guest guest]

There is no reason why you shouldn't take your

Armour chopped up into little pieces and taken several times a day- but again,

if you have three regular meals a day, that could be a problem. Taking it at

6.00a.m - 4.00p.m. and 11.00p.m. sounds to be an excellent regime for your

particular circumstances .

Btw, Sheila - is there any good reason that prevents us from taking

armour 3 times/day rather than twice?

I am planning to introduce my next half grain (in due course !!) at

night, so I'd initially take 1/2 grain at ~11 pm, 6 am and ~4 pm

..... later I would combine it into 2 doses, either at night and late

morning or morning and afternoon dosing as right

[Guest guest]

I do not think it possible that none of it at all goes down the throat. It is best to also wait an hour before food/drinks.

Val

What I want to know is - since we take Armoursublingually (and it by-passes our stomachs),

[Guest guest]

*** Taking it at 6.00a.m - 4.00p.m. and 11.00p.m. sounds to be an excellent regime for your particular circumstances .

Many thanks, Sheila. I'll do that then, at least to begin with, and if it causes me no problems, I'll try to combine it into 2 doses later. It would be awfully convenient for me if my system will get used to 11 pm and 11 am eventually.....

Love,

[Guest guest]

Thanks Chuck - this is useful to know. I do not take any supplements

at all but note this for future reference as there is no such warning

on my patient information leaflet. Perhaps as usual the NHS/UK is

behind the times........?

Cheers

>

> ,

>

> My package labels and inserts also caution against taking T4 within

four

> hours of calcium and iron supplements.

>

> Chuck

>

[Guest guest]

Hi Gillian,

Sounds like a good idea to me- I've always jokingly said

that I'd prefer to take my meds an hour before I wake up!

Subject: Re: NHS guidelines on taking thyroxine

I shall have to get this book.....this is interesting because I used

to be able to sleep for England, but since I've been hypo I have

interrupted sleep patterns, waking up two or three times a night

Another quick question here...is there any reason why I can't take my

levothyroxine 'around 4am ish' when I wake up.

Gillian

------------------------------------

TPA is not medically qualified. Consult with a qualified medical

practitioner before changing medication.