# Thyroidless, i have questions



## Alya (Sep 24, 2014)

hi there, so i had my entire thyroid removed and just started with hormone replacement and i have some questions, i hope you can help me with a few

1- i take the hormone pill before i sleep on an empty stomach, i kinda don't know what's an empty stomach is exactly, for now i make sure i don't eat anything for 4 hours at least but i read somewhere that 2 hours of not eating is just as good, is that correct?

2- if i drink chamomile tea or hot chocolate 1 - 2 hours before taking the pill will this effect the absorption process?

3- will the hormone be absorbed better if there is a period of fasting *before* or *after *i take it?

4- i'm focusing on raising my metabolism for fear that the pill isn't effective enough and i may gain weight, could this make a difference if the pill did truly fail in its task or if i still need a higher dosage?

5- sadly i don't have a fixed sleeping time, if i always took the pill before i sleep but not at the same time of day, could this cause problems for me? i mean if for a week a slept at 9 pm. then the week after 12 pm then 3 pm and each day i take it before i sleep

6- i'm under the impression that the people who suffer with hypo symptoms even though they use replacement hormone still have their thyroid, thyroidless people are less likely to suffer this ups and downs, correct? or i'm just trying to convince myself that i won't suffer?

Thank you


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## Lovlkn (Dec 20, 2009)

Alya,

It's best to take 4 hours away from iron and calcium, either side of the pill as I understand.. Food is 2 hours prior to taking a pill (I believe).

If you wait until morning just be sure to take 1 hour prior to eating and still 4 hours from iron or calcium.

While Hot chocolate has some calcium - I doubt though to interfear. Tea is likely not going to bother absorbtion.

It is very important to request a Free T-4 and a Free T-3 every lab with your doctor during follow up.

You should only adjust dosing by those 2 labs.

Other tests to request - if you are female - iron - aka Ferritin, vitamin D and B-12 which are often found deficient in thyroid disease patients and happen to cause fatigue.


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## Alya (Sep 24, 2014)

Lovlkn, Thank you for your insights

can anyone else help with the questions?


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## joplin1975 (Jul 21, 2011)

1- i take the hormone pill before i sleep on an empty stomach, i kinda don't know what's an empty stomach is exactly, for now i make sure i don't eat anything for 4 hours at least but i read somewhere that 2 hours of not eating is just as good, is that correct?

I believe I've read that two hours is fine.

2- if i drink chamomile tea or hot chocolate 1 - 2 hours before taking the pill will this effect the absorption process?

Most teas won't, but some say the milk might inhibit absorption. I really doubt it. I have milk an hour and a half after I take my synthroid in the morning and have no issues. The main thing in consistency. Let's say the milk does impact absorption. As long as you consistency have your hot chocolate, your dose will be adjusted appropriately.

3- will the hormone be absorbed better if there is a period of fasting *before* or *after *i take it?

Both. You need to take it on an empty stomach and then delay eating after you've taken it for at least an hour. It's easier for me to take it in the morning (because we eat late dinners) so my stomach is empty when I take it and I wait at least an hour to eat.

4- i'm focusing on raising my metabolism for fear that the pill isn't effective enough and i may gain weight, could this make a difference if the pill did truly fail in its task or if i still need a higher dosage?

I don't understand this question. The pill won't "fail"...the bigger question is what kind of medications does your particular body need to function properly. That means testing your TSH, free t4 and free t3 until you are stable. You want your TSH around 1.00 (unless you are a thyca patient), with your free t4 and free t3 *at least* at mid-range. If your doctor won't test both, then find a new doctor. Raising your metabolism usually mean exercising. That's a good thing, but it won't drastically change weight issues if the free t4 and free t3 numbers are off.

5- sadly i don't have a fixed sleeping time, if i always took the pill before i sleep but not at the same time of day, could this cause problems for me? i mean if for a week a slept at 9 pm. then the week after 12 pm then 3 pm and each day i take it before i sleep

Consistency is the gold standard and the best thing. That said, I have heard of other people on changeable schedules and it seems with T4 meds, the bigger concern is taking it on an empty stomach with a full glass of water and waiting to eat. If you ever get on t4/t3 combo meds, then timing trumps the other issues.

6- i'm under the impression that the people who suffer with hypo symptoms even though they use replacement hormone still have their thyroid, thyroidless people are less likely to suffer this ups and downs, correct? or i'm just trying to convince myself that i won't suffer?

As with many things, it depends. People with their thyroids often have autoimmune flare ups which makes stabilizing difficult. But, some folks who are without their thyroids have to try different meds and different routines and different doses for a long time before they stabilize. I don't like to use the word "suffer" for this process. It can be disruptive and frustrating, but I think if you go into it with a good mindset, it's not debilitating nor does it cause suffering. No doubt, it's physically taxing and not pleasant, but there's a mind over matter factor that's important.


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## Andros (Aug 26, 2009)

What thyroxine replacement are you taking and how much? And for how long?

It probably would be best to take your pill at the same time every day if that is possible. Sounds like you are working different shifts?

Welcome to the board!


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## Octavia (Aug 1, 2011)

Alya said:


> hi there, so i had my entire thyroid removed and just started with hormone replacement and i have some questions, i hope you can help me with a few
> 
> 1- i take the hormone pill before i sleep on an empty stomach, i kinda don't know what's an empty stomach is exactly, for now i make sure i don't eat anything for 4 hours at least but i read somewhere that 2 hours of not eating is just as good, is that correct?
> 
> ...


My answers to your questions are above. But really, the key word is consistency, consistency, consistency. Be as consistent as you can possibly be, and your dosage will be titrated up or down according to your needs, based on your habits. For example, if you decide you like hot chocolate an hour before going to bed each night, and you are consistent with that every single day, if it affects your absorption, that will become evident in your lab results, and your dosage will be titrated up accordingly. (Of course, the daily hot chocolate before taking your meds is not a habit I would recommend...just giving an example.)


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## Alya (Sep 24, 2014)

thank you everyone, this was truly a big help



Andros said:


> What thyroxine replacement are you taking and how much? And for how long?
> 
> It probably would be best to take your pill at the same time every day if that is possible. Sounds like you are working different shifts?
> 
> Welcome to the board!


Eltroxin 100 mcg daily, this in my 8th day on the medication

and no, i don't work, i have a personal project at home that i'm working on which means i don't have to be up and running at any fixed time

also, i just checked my weight and i've gained 1.5 kilos since i last checked 8 days ago

i'm not sure is it the effect of the few days i spent without the medication ( i removed my thyroid on 16/9 and started the medication on 26/9)

or

it is a sign that this dosage is not enough or has not became effective yet

i truly hope this will not continue much longer


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## ifthespiritmovesme (Jan 8, 2014)

It takes a few weeks for your body to level out on the medication. You should have your levels tested every 6 weeks, and medication adjusted accordingly.


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## joplin1975 (Jul 21, 2011)

Everyone is different, but you might find that, as you get used to life without a thyroid, your body will begin to "like" routine. While it's not required, I suspect you'll feel better and have more success with weight management if you stick to a schedule.


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## Alya (Sep 24, 2014)

Hello everyone and good morning,

after 1 month of using 100 mcg of Eltroxin i did a blood test and here is the results:

*TSH 10.13 Reference Range 0.35 - 4.94*

*T3 - Free T3 5.01 Reference Range 3.48 - 9.46*

*T4 - Free T4 16.17 Reference Range 9.01 - 19.05*

obviously i'm hypo, and my doctor upped my dose from 100 mcg to 150 mcg

yet i don't really feel any of the hypo symptoms, i did gain wight in the first 2 weeks of medication, but i lost them in the next 2 weeks, and i'm not doing anything over active, i have been losing weight slowly but steadily for 2 years now (before my total thyroidectomy) due to changing in my life style (no to sugar yes to honey, healthier food more walking and stuff like that)

i'm wondering if the hypo symptoms may catch up to me during these few weeks, does that happen?


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