# Level of Drug Compliance Required?



## WhatHappened (Nov 12, 2015)

I see and read here and there the importance of compliance with hypothyroid drugs (synthroid web site has stories of people waking up and checking email first thing in the morning before coffee and food, etc), others here and elsewhere establishing a super predictable morning routine, etc.

Just curious what level of discipline is really required? Does it really need to be exact to the hour? I get the food thing (no breakfast or coffee for 30 mins), but does it really mean getting up at 5ish on Saturday and Sundays? (I have been), and actually, perhaps eating at the 30 min mark and not much later? (I haven't been, fell back asleep this past weekend and didn't have coffee for a couple of hours). Does that screw things up immensely? So like Mon-Fri I was getting similar doses, but because of the back to bed sleep after meds, more drug? Curious to see what your experience is?

(I read the article where evening pill taking might be more efficacious, but 1) the empty stomach requirement after work and before bed is a non-starter and 2) It would at least require knowing when I was falling asleep right now :confused0024: and it frequently catches me while my back was turned.


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## joplin1975 (Jul 21, 2011)

My thoughts are that you'll feel best if you can keep your routine as consistent as possible.

That said, if I travel, I don't take me meds at the same time that I would if I were home. That is, I'm in the eastern time zone so when I travel to the west coast, I don't get up three hours earlier. I just take it when I get up.

T4 drugs have a long half life, so the exact time you take it matters less than taking it on an empty stomach, waiting an hour to eat, and avoding iron and calcium supplements for four hours.


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## Lovlkn (Dec 20, 2009)

The way I see it - get into your routine and test - You will dial in your med's to how you live your life. I never thought a splash of coffee cream would be enough to make much difference.


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## joplin1975 (Jul 21, 2011)

You need to avoid calcium supplements - calcium from dairy or other foods is fine.


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## WhatHappened (Nov 12, 2015)

@lovkln: thanks, so keeping history and patterns are important.

@joplin1975: oh! So concentrated form. In this particular case, that's easy. I don't currently own any!


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## Andros (Aug 26, 2009)

I use heavy real cream in my coffee. It is my belief that if the patient is consistent re his/her habits, the med will be titrated accordingly based on the FREE T3 findings.


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## joplin1975 (Jul 21, 2011)

Yup!

I have either cereal with milk or fruit and yogurt every morning and I'm doing fine.


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