# Levothyroxine



## sweetgrace (Apr 13, 2012)

Hi, I have known that I've had Hashi's for a while now but all of my other tests have come back normal. Well, I received a call from the doc today and my TSH was high and T4 was off as well. She called in a script for Levothyroxine. What is the best way to take these meds? I have read to take them in the morning an hour before food. What about coffee w/ cream? Anything else I should be aware of?


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## joplin1975 (Jul 21, 2011)

Levo does need to be taken on an empty stomach. For many, that means first thing in the morning, waiting an hour to eat. For others that means not eating two hours before bed and taking it at night...and for others, that means taking it in the middle of the night. What ever work is for you, just be consistent.

Coffee and cream could limit absorption a bit but, again, if you are consistent, your doctor will just bump up the dose until your labs and symptoms get better.

You should avoid supplements containing iron and calcium for four hours after taking the meds.


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## Italiungurl (Apr 10, 2014)

I take Unithyroid which I guess is the same? IN the afternoon.

Does it really matter?


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## joplin1975 (Jul 21, 2011)

Yes, it matters. If you take it on a full stomach, your body won't absorb the medication. And, yup, unithyroid is levo, so the same instructions apply.


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## sweetgrace (Apr 13, 2012)

Thank you! Would dairy products be considered the same as calcium? Or are they just concerned with the supplement being taken four hours from the Levo? I woke up and took it at 6 this morning so I can have my coffee and breakfast first thing.


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## joplin1975 (Jul 21, 2011)

I don't worry about things like milk and cream...the supplements are what tends to be the problem. I have cereal a lot for breakfast.


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## sweetgrace (Apr 13, 2012)

Ok great! Thank you so much


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## bigfoot (May 13, 2011)

FYI -- the reason doctors and pharmacists suggest taking thyroid meds first thing in the morning is really more for compliance than anything else. Like Joplin said, whatever you do, consistency is key.

Below is probably more than you wanted to know, but I'll throw this info out there in case you're interested... 

As far as medications go, there are quite a few. Which one works better for you in optimizing your health can depend on a number of factors. Most of us are started on T4 to begin with, which is probably just as good a place to begin as any. Do be aware that generic thyroid drugs can vary in potency / efficacy up to 10% per the FDA. For example, if you are taking 100 mcg of generic T4 from Company A, next month you might be getting 90 mcg from Company B, and the following month 110 mcg from Company C. That can potentially make things harder to stabilize. A lot of times a pharmacy will dispense generic levothyroxine because it's cheaper and the doctor didn't specify "brand name" drugs. The generic manufacturers that supply pharmacies can, and do, change often.

This is a rough list of the various types of thyroid medications floating around out there:

* Brand-name synthetic levothyroxine / aka T4 (Synthroid, Levoxyl, etc.).

* Generic synthetic levothyroxine / aka T4 (various manufacturers).

* Brand-name synthetic T3 (Cytomel).

* Generic synthetic T3 (aka "triiodothyronine").

* Desiccated products containing both T4 + T3 (Armour, Nature-Throid, West-Throid, etc.).

* Compounding pharmacy custom-made meds (could be T4, T3, or T4 + T3).


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