[lenjan]

Synthroid, since I brought it up, seems to be pretty popular around here , so I just wanted to know if folks would share their experiences. i've been on it a week or two and it's already an enormous pain in my ***.

My sister the nurse (every single female in my immediate family is hypothyroid, BTW) told me she takes hers when she gets up in the middle of the night to pee but it's still too early to get up for work.

Well! Lately, when I'm awake, my ears are killing me, so when I get up in the middle of the night, i have some yogurt or something so I get something cold and non-chewable down. There goes that.

The pharmacist told me to take it at the same time every day, so there goes my sister's theory in the first place.

The pharmacist also told me not to take it with other meds. Friends, I am on so many other frickin meds that I would do nothing but sit here all day and take meds if I had to spread out ALL of them. Hell yeah, I'm gonna double (and triple and quadruple) them. I have "the ones i take in the morning" and "the ones I take at night" and that's as big a distinction as I'm making.

Is all this really necessary with this med? And what happens to you if your thyroid stays out of whack? Because I'm frankly ready to let it go if it's going to be this huge of a hassle.

thanks

candy

[dasiy6]

Hi Candy,
I recently had to have my thyroid removed and now take levoxyl (synthyroid) daily. My endo looked at the meds I am now taking (some need to be taken with food for comfort) and said not to worry about taking it with or without food or when I take it...........just to remember to take it .
I have been taking it in the morning with all my other meds but have recently switched to the PM (without food) to see if it helps my mood improve at all.......

Take care!

[bipolar_bear]

I have taken synthroid for a few years now. I have never been told to not take it with other meds. I have been told to take it at the same time and on an empty stomach. I will ask and see what my pharmacist and see what they say.

[jbug]

I take it and take it with all my other meds. I take it on an empty stomach but that's just because I can't eat and drink at the same time. I take it at night because I can't remember to take it in the morning.

Jbug

[pebblypoo]

The imporatant thing is that you take it the same WAY (meaning on an empty stomach or not and with other pills or not) every day and at about the same time every day.

When you initially begin thyroid hormone replacement or change your dose, it takes about 8 weeks to reach the level in your blood that it will "stay" at (I'm sure there's a term for this.) After 8 weeks get your T4, T3 and TSH checked to see if this is the optimal dose for you. It may be that if you take it with food or other meds that interfere with its absorbtion, you will need a higher dose to make up for that.

Just be aware that if you stop taking it with food, or seperate from those other meds suddenly and start feeling hyperthyroid, that may be the reason and you may need a dose decrease.

[gardenergirl]

If you take any supplements like calcium, magnesium, or iron, it's better to take those at a different time than the Synthroid, because it can affect absorption. Also, I've been told to always take my thyroid meds on an empty stomach, otherwise, you don't absorb the whole amount, and it can mess up your TSH levels.

I take mine first thing in the morning, when my alarm goes off. I keep them and some water by my bed. I also take a few other meds that can be taken on an empty stomach and don't affect the Synthroid (antidepressants and an antihystamine). I wait an hour (usually) after taking them before eating breakfast, so I usually get in the shower or sometimes go back to sleep if I can.

gg

[pebblypoo]

While it's true that you definitely shouldn't take a thyroid hormone replacement at the same time as things like a calcium supplement or down the tablet with a glass of milk, just beware of some of the "wacko" advice I've seen out there (on thyroid forums.)

Some people will tell you that you shouldn't have any calcium within 6 hours of taking a thyroid supplement! One person wrote in and asked if she shouldn't even have a little milk in her coffee and hour later and a bunch of people told her no, she couldn't! Yeah, right. They cite studies done and yes it's true that calcium is known to affect absorbtion, but another person wrote in clarifying that the studies used calcium in greatly exaggerated strengths, far greater than the average calcium supplement's strength.

I take Synthroid in the morning crushed in about 1/2 tsp applesauce , eat about 45 min later (my doctor even said 1/2 hour is fine) and take my vitamins after dinner.

[CamW]

Ideally Synthroid™ (levothyroxine) should be taken on an empty stomach in order to keep blood levels the same on a day to day basis. In the past the empty stomach rule was more or less a "suggestion" and it was just important to take it the same way (ie. with the same meds, or with a similar breakfast) every day.

I believe that the main reason that recent recommendations say to take the drug on an empty stomach is that the new pharmacy software programs (eg. Kroll Windows) print out little stickers saying to take it on an empty stomach (1 hour before or two hours after meals or other medication). To tell you the truth, I never put "empty stomach" warnings on Synthroid prescriptions until the software told me to. I always counseled just to take the medication the same way every day. There is a certain amount of leeway for blood levels of the drug, and the periodic assessment of thyroid status by blood tests give a, more or less, reasonable indication of what dose one should be taking.

That said, there are many medications and situations that will affect levels of Synthroid in the blood. The magnitude and relative clinical importance of drug interactions are likely to be patient-specific and may vary by such factors as age, gender, race, intercurrent illnesses, dosages of other drugs being taken (especially ones added or stopped), as well as timing of taking these other medications in relation to the taking of the Synthroid. Dosage adjustments may have to be made if you start or stop any of the following medications (Note: the list is long, but not all inclusive).

Certain medications will bind to Synthroid and decrease it's absorption from the intestine. Some of these are: aluminum hydroxide (in Maalox™, Diovol™, Gaviscon™, Mylanta™, etc.); cholestyramine resin (Questran™); colestipol (Colestid™); ferrous sulfate (Fer-In-Sol™); sodium polystyrene sulfonate (Kayexalate™), soybean flour (in certain infant formulas); and sucralfate (Sulcrate™).

Other medications may affect Synthroid's binding to plasma proteins or alter the concentration of plasma proteins, which may affect Synthroid's half-life (how long the drug remains active in the body). Some of these being androgens and related anabolic hormones (fluoxymesterone - Halotestin™; nandrolone - Durabolin™; and testosterones - Climacteron™, Androderm™, Androgel™, Testoderm™, Andriol™, Delatestryl™); l-asparaginase (Elspar™, Kidrolase™); clofibrate (Atromid-S™); estrogens (Premarin™, Estrace™, Estraderm™, Estrogel™, etc.); 5-fluorouracil (Adrucil™, Efudex™); furosemide (Lasix™); glucocosteroids (prednisone, cortisone, dexamethasone, etc.); meclofenamic acid (Meclomen™); mefenamic acid (Ponstan™, Ponstel™); methadone (Metadol™, Methadose™); perphenazine (Trilafon™, Etrafon™, Triavil™); phenylbutasone, phenytoin (Dilantin™); salicylates (Aspirin™, etc.); and tamoxifen (Nolvadex™, Tamofen™).

Other drugs can alter thyroid hormone or TSH levels by effects on thyroid hormone synthesis, secretion, distribution, metabolism, hormone action, or elimination, or TSH secretion: p-aminosalicylic acid (Nemasol Sodium™); amiodarone (Cordarone™); antithyroid drugs (methimazole - Tapazole™, propylthiouracil (Propyl-Thyracil™); beta-blockers (propranolol - Inderal™; atenolol - Tenormin™; bisoprolol - Monocor™, Zebeta™; metoprolol - Betaloc™, Lopressor™; etc.); carbamazepine (Tegretol™); chloral hydrate (Noctec™); dopamine (Intropin™), dopamine agonists (bromocriptine - Parlodel™; pergolide - Permax™; pramipexole - Mirapex™; ropinirol - ReQuip™); ethionamide (Trecator-SC™); heparin (Hepalean™); insulin (Humulin™, Novolin™); iodine-containing compounds, levodopa (Sinemet™, Prolopa™, Dopar™, Larodopa™); lovastatin (Mevacor™); lithium (Carbolith™, Duralith™, Lithane™); 6-mercaptopurine (Purinethol™); metoclopramide (Maxeran™, Reglan™); mitotane (Lysodren™); nitroprusside (Nitropres™); phenobarbital (Donnatal™, Phenaphen™, Bellergal Spacetabs™); rifampin (Rifadin™, Rofact™, Rifamate™, Rifater™), somatostatin (Stilamin™); sulfonamides (sulfamethoxazole - Gantanol™, Bactrim™, Septra™; sulfamethizole - Thiosulfil™; sulfanilamide - AVC™; sulfamethazine - Trisulfaminic™; sulfadiazine - Coptin™); sulfonylureas (chlorpropamide - Diabinese™; gliclazide - Diamicron™; glyburide - Diabeta™; tolbutamide); and thiazide diuretics (chlorthalidone - Tenoretic™, Regroton™; hydrochlothiazide - HydroDiuril™, Ziac™, Inhibace Plus™, Prinizide™, Zestoretic™, Hyzaar™, Uniretic™, Vaseretic™, Avalide™, Oreticyl™, Captozide™,Accuretic™, Viskazide™, Inderide™, Aldactazide™, Timolide™, etc.; indapamide - Lozide™, Lozol™; metolazone - Zaroxolyn™, Mykrox™).

Various others: interferon (Roferon™, Intron™, Rebetron™, Avonex™, Rebif™, Actimmune™, etc.); digitalis glycosides (digoxin - Lanoxin™, Lanoxicaps™); ketamine (Ketalar™); maprotiline (Ludiomil™); theophylline (Theo-Dur™, Uniphyl™, Theolair™, etc.); tricyclic antidepressants (amitriptyline - Elavil™, Endep™; nortriptyline - Aventyl™, etc.; desipramine - Nopramin™, etc.; imipramine - Tofranil, etc.; etc, etc, etc.), and many others.

Sorry, I got tired looking up the different drugs, but I think I got most of them. This list is probably why they say, "Take Synthroid On An Empty Stomach". Seriously, taking Synthroid by itself will give you better blood levels and probably you can be maintained on a lower dose than if you took it with food or other medications. Just keep in mind that any medication regimen change, or change in dosage of current medications, may necessitate a check of your thyroid levels, and perhaps even a change in Synthroid dose. Ask your doctor about this when making medication changes.

I hope that this is of some help. - Cam

[(JD)]

ff_topic: Cam!

[darkeyes]

Yay!!!!!!!!! Great to see you, Cam. I hope you'll have time to drop by more. Hope things are going okay for you, shoot a PM over, if you get a chance.

Take care now,
Roe