I’ve just been put on a 25mcg dose of levothyroxine, and I’m discovering that it’s not nearly as simple as “take a pill a day”. With the restrictions, I feel like I need to be setting an alarm for 4am so I can meet all the requirements laid out in the instructions.
Take on an empty stomach, at least an hour before eating anything.
Don’t eat anything with calcium, iron, or fiber, for 4 hours before or after taking the pill.
So I’m never having breakfast again, I guess?
When I asked the pharmacist whether there was anything I needed to know about the medication, she said “take it first thing in the morning, before breakfast, and don’t take it with your multivitamin or any calcium supplements”. The papers that came with my pill bottle, though, are a lot more detailed and seem to place a lot more restrictions on my morning routine. I’ll be talking to my doctor about all this next week, but I’m wondering how everyone else manages to take their levothyroxine and get to work in the morning without coffee or food!
Meh - I get up and take my pill first thing. I then hop in the shower, get out, comb my hair, get my lotion on, comb my hair, etc and wander back to the kitchen about 30 minutes later and take my pill.
I’ve done it this way for a decade and I’m well controlled.
I take my vitamins with lunch.
Really, it’s easy enough if you get a bit of a routine going.
I just take it on an empty stomach and don’t eat for an hour after taking it (sometimes slightly less, mine says 30-60 minutes). Mine also says not to take it at the same time as a calcium or iron supplement, but doesn’t say not to even eat any foods with calcium or iron.
I wouldn’t worry about it that much. Maybe it will affect absorption to some tiny extent if you don’t follow the OCD instructions to the letter, and maybe it won’t even do that. They’ll be checking your thyroid levels regularly and adjusting your dosage as necessary, and if your levels are fine, then you’ll know it’s being absorbed.
Do you know what your TSH level is? 25mg is super low and they’re probably expecting to raise the dose. I’d say don’t take it all OCD now because I doubt you’ll continue to do that forever, so taking it normally will give a better idea of the true dose you need to be on. Also don’t worry if like someone surprises you with breakfast right after you take it or something. It’s a medication that builds up (and down) very slowly in your system and one day of poor absorption here and there isn’t going to matter.
I take mine upon rising and have coffee with a splash of milk usually about 30 minutes later. I don’t typically eat until at least an hour or so after that, but I was never told to avoid any specific foods for four hours. My doctor knows and my levels are fine, so this is my routine and I’m sticking with it.
My TSH was hovering around 6, so my doctor sent me for a repeat and a thyroid profile, and when the results came back, I was told it was time to start on 25mcg. I’m also currently trying to conceive, and this doctor is a reproductive endocrinologist, if that matters. I will be seeing him in a week or two to discuss it all and schedule follow-up blood work, but I plan on calling the office to speak with the nurse about it on Monday. All of this happened fairly late on Friday and I didn’t get a chance to ask my questions.
I just don’t function well without my morning coffee, and the medication insert made me a little nervous about never having breakfast again* for the rest of my life*. But tons of other people are taking this medication and are doing just fine, so it’s obviously not a big deal. Just a question of adapting.
I don’t know anything about it, but is it possible to take it at a different time of day. Could you take it when you go to bed so you don’t have to worry about anything for the next 4 hours?
If you’re trying to conceive, I’m guessing you’re already on, or will soon be on pre-natal vitamin which, IIRC have a lot of iron in them. At the very least, you’ll probably have to shift that to later in the day.
The RE didn’t tell you to delay TTC? That’s what they told my sister after she had a miscarriage and it was discovered she had hypothyroidism too (she waited a few months until her levels were good and now she just had a baby).
Did the RE say what TSH level they were shooting for? I just ask because supposedly the acceptable range is like 0.5-4.5, but a lot of people think the upper limit should be much lower. I’ve gone to two doctors who think anything under like 5 is fine even though I still didn’t feel well, so I hope yours doesn’t think that way. Usually endocrinologists know better, but one of the doctors I’m talking about was an endocrinologist. I finally went back to the clinic that originally diagnosed me and they shoot for the 1-2 range. I think my sister’s endo said around 0 is best though. There seems to be a pretty wide range of opinions on this.
Antigen, I lost my thyroid and parathyroids years ago to papillary carcinoma, and I take 125 mcg Synthroid daily, and I take a multi vitamin and calcium with the supper meal. I’m also 41, and managed to conceive a child in one try (I knew I was ovulating). The pregnancy though high risk was easy and uneventful, and I’m nursing my two month old as I write this. Anecdotal, sure, but wanted to reassure you that (barring other reproductive issues) it is possible to conceive, gestate, and nurse with no thyroid at all, and complete dependence on synthroid.
I was perscribed it in May. My body is producing more than enough, but somehow the end level was just very slightly low. Of course my drug happy doctor added it to the list. I was told “don’t eat or drink anything but water for 30 minutes after taking it”, nothing more than that.
My morning routine is to stumble straight into the shower, so I put my pill bottle on the sink and try to remember to take it before I step into the shower. That way by the time I’ve showered, shaved, dressed and so forth, I can probably eat breakfast.
The problem I run into is that the pill pretty much sticks in my throat until it dissolves. This week I’ve had a raw throat and cold, and I’m hacking up a lot of phlem in the shower. So I haven’t been taking it because I know I’ll just be coughing it out.
But like I said, I was only marginally low while producing more than enough, and that test was taken before I got some other issues under control. So when I switch doctors here this fall, I’m going to ask the new one to run the tests again and see if we can take this off my list.
I’m with you. Half the time I forget to take it and the other half it’s pretty much about 10 minutes before breakfast. I don’t get up an hour before breakfast and I’m certainly not going to start so that I can take one silly little pill.
That being said, I’m actually only taking 12.5 mcg so I think I’m probably going to be ok. I think mine will get checked again in the next three months or so and I’ll know for sure if this is working or if I need to adjust something.
When we had our initial consultation with the RE a month or so ago, I brought in all my recent labs to show him: my TSH has been hovering around the 4.5 “normal” for years, but while I’ve suffered the symptoms (sluggish, depressed, hair loss, 40-day cycles, always cold, etc), I’ve never been treated, since I’m “normal”. My T3 and T4 have also been normal, but at the low end of the range (not sure what the numbers were this time, though, the nurse didn’t have it all handy when she called me). Previous doctors have not wanted to start me on medication based on my numbers (symptoms apparently unimportant and all in my head, I guess), but the RE said that in his practice, they like to have TSH under 4, and preferably closer to 2. I wasn’t told to delay TTC, but I will ask them about it when I call on Monday, thanks. The nurse we’ve been assigned at this RE clinic is less than stellar, and I’m not sure she’s giving me all the important information.
A little label on my pill bottle says to take it with a full glass of water. I guess it’s in part to help prevent the sticking?
What’s important is that you take it the same way every day, so it is absorbed the same way every day and your dose can be regulated. If you want to take it with your morning coffee, then do it. I did for years and years. Turns out that the dose I needed was 25mcg higher than the one I need now that I’m taking it at my regular early-morning wake-up. Big whoop.
Just don’t take it in the PM. It will interfere with your sleep.
Hey–I am TTC too. I conceived my daughter on the second try while on levothyroxine (because of Hashimoto’s disease).
I have been taking it for 45 years and it does seem like a pain sometimes. For example, if I sleep lae on weekends and my husband wants to go out to breakfast I remind him I can’t eat for an hour (small town, I shower at night, and McDonald’s is 4 minutes away). Sort of puts a damper on things because once the after-church crowd gets there, there is a long line and no seats!
I know not to eat for an hour, but I’ve never been told to avoid any foods for 4 - 6 hours.
I take 100 Mcg daily. I take it in the evening (somewhere between 7:00 PM and whenever I happen to go to bed), with or without food. I don’t have any problems. One of my sisters who takes it has to be very careful about the timing and food or she will feel sick and the other is less sensitive than that, but still way more than I am. It seems to vary with individuals.
I find it gives the most spectacular dreams - really vivid and usually unpleasant subject matter.
Pai325 - I usually get up and take my pill and then go back to bed if I want to have a bit of a sleep in - you could try that on the weekend and enjoy some of the aforementioned spectacular dreams.
Is your sister seeing an endo for thyroid cancer? If someone is being treated for thyroid cancer then it’s not unusual to try to suppress TSH production as low as possible to reduce the risk of cancer recurrence despite the known risks of putting someone in hyperthyroid state. However, for people being treated for hypothyroidism I think most doctors would not recommend treating it so aggressively due to the risks of inducing hyperthyroidism. Hyperthyroidism increases someone’s risk of having heart problems among other issues.
No, she’s not. They figure she (and I) have Hashimoto’s. I’m pretty sure she said her endocrinologist aims for 0, but I’ll have to ask her if I’m remembering that wrong. You’re a doctor, right? What do you consider the ideal range?
