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How to take thyroid medication properly: A comprehensive guide

January 05, 2023 8 min read

So you've just received your thyroid test results, and they aren't quite what you're looking for? Living with hypothyroidism can be a stressful and overwhelming experience. It can be even more worrying when lab tests show that your thyroid hormone levels are not in the optimal range.

This bad situation can come from forgetting to take your thyroid medication regularly. But did you know that the specific time and the way you take your pills each day also have a big impact on how well they are absorbed?

If this sounds overwhelming to you, don't worry! From the best time of day to take it to how long before eating it should be taken, we'll cover all the basics so you can start on your way to getting the most out of your thyroid hormone replacement medication.

What are the different types of thyroid medication?

Your thyroid is a butterfly-shaped gland located in the base of your neck and above the windpipe. It produces two important hormones, thyroxine (T4) and triiodothyronine (T3).

While most of the T4 hormone is inactive, the T3 hormone is active, affecting cells and metabolism. That's why your body converts the hormone T4 into T3 when the thyroid gland releases T4.

However, if you have hypothyroidism or an underactive thyroid gland, you don't have enough thyroid hormone in your blood. This is absolutely bad news, and you should get prompt treatment before the symptoms, such as slow heart rate, low blood pressure, and weight gain, become worse. There are various conditions that can lead to hypothyroidism, such as Hashimoto's thyroiditis and the removal of one's thyroid gland due to thyroid cancer.

Thyroid hormone replacement therapy is the main treatment for hypothyroidism. They work by bringing your thyroid levels back to normal, so you'll get much-needed relief from the symptoms. There are different types of thyroid drugs, but the well-known ones are synthetic thyroid drugs (Levothyroxine - T4 and Liothyronine - T3) and Natural Desiccated Thyroid (NDT), also known as Desiccated Thyroid Extract (DTE)

Levothyroxine is the most commonly used medication for hypothyroidism. However, most hypothyroid patients prefer NDT. Because NDT contains both T4 and T3 thyroid hormones, which are naturally produced by the thyroid gland, it's an excellent choice for people with hypothyroidism who don't experience any improvements with levothyroxine tablets. Plus, it has a natural origin, making it great for those looking for a more natural approach to managing their condition.

There are various brands of NDT available, such as VitaliThy, a natural desiccated thyroid you can buy online.

How should you take your thyroid medication?

Taking your thyroid hormone replacement medication properly can make a big difference in how well it works. Here are some easy-to-follow tips for getting the most out of your thyroid hormone replacement medication:

1. Take your thyroid medication on an empty stomachThyroid medications are difficult to be absorbed by your body when food is present in your stomach. Food can slow down or interfere with how much of the medication reaches your bloodstream. Therefore, as recommended by the American Thyroid Association, it's best to take your thyroid medication in the morning, as soon as you wake up, about 30 to 60 minutes before breakfast.

While you shouldn't eat anything too close to your thyroid medication, you may want to pay close attention to alcohol, grapefruit juice, walnuts, soy products, or dietary fiber.

What about coffee and tea?

Coffee and thyroid hormones don't mix well. The caffeine in coffee can cause an altered intestinal absorption of your medication. In other words, coffee can decrease the extent of absorption of your meds, making it less effective in treating hypothyroidism.

Since it's caffeine that can interfere with absorption, you might want to avoid other caffeinated beverages - like green tea. So if you can't live without caffeine, try waiting an hour after taking your medication before having a cup.

2. Avoid taking other medications and supplements at the same time

It's important to be aware of how other drugs can interact with your thyroid medication. The following are some drugs that may interact and interfere with the absorption of your thyroid replacement medications:

  • Antacids because most of them contain calcium carbonate, magnesium, or aluminum.

  • Bile acid sequestrants, such as colesevelam (Welchol), colestipol (Colestid), and cholestyramine (Prevalite).

  • Ion exchange resins, including sevelamer (Renvela) and sodium polystyrene sulfonate.

  • Proton pump inhibitors (PPIs), such as omeprazole, esomeprazole (Nexium), and pantoprazole (Protonix).

In addition to medications, some dietary supplements can also decrease the absorption of thyroid medication. These include iron, calcium, aluminum, and magnesium supplements.

In general, you need to separate your thyroid hormone replacement medication and other drugs or supplements at least four hours apart to avoid unwanted medication interactions.

What if you have other medical conditions?

You should note that the medicines, supplements, and certain foods and beverages mentioned above are for reference only. They don't constitute an exhaustive list.

If you have other medical conditions, the best thing to do is to discuss them with your doctor. Furthermore, you shouldn't arbitrarily decide to use or stop any other medication.

What if you get pregnant?

If you become pregnant while taking thyroid medication, you should talk to your doctor about it. Since thyroid hormone is important for your baby's brain development and growth, you'll likely have to keep taking the medication. In some cases, your doctor may increase your NDT or levothyroxine dosage during the first 16 weeks of pregnancy.

Don't worry. Thyroid medications are safe for pregnant women - whether you've had underactive thyroid before pregnancy or you develop it during pregnancy.

3. Take your thyroid medication at the same time every day

Taking your thyroid medication at the same time every day helps you get the most out of each dose. It allows your body to maintain a consistent level of thyroid hormones. Taking your medication in the morning one day and in the evening the next can cause fluctuating hormone levels, which can leave you feeling less than great.

Can you take your medication at night?

Experts often recommend building the habit of taking thyroid medication every morning before your first meal. However, morning or evening is not the determining factor in how well your body absorbs thyroid hormone. If you find it inconvenient to take your medication in the morning, you can always take it at night before bed, at least 3 to 4 hours after your last meal. In fact, one review found that taking thyroid medication at bedtime can significantly increase your levels of free T4 as compared to morning intake.

So whether you're an early bird or a night owl, the most important thing is to get into a habit of taking your meds at roughly the same time.

4. Take the exact same thyroid medication every time

You're probably familiar with the many popular thyroid medications available on the market. But according to the American Thyroid Association,

You are probably familiar with the popular thyroxine brands in the US market, such as Synthroid, Levothroid, Levoxyl, and Unithroid. However, according to the American Thyroid Association (ATA), there is a difference in the amount of thyroxine between these preparations, even though they have the same dosage listed on the pill.

Therefore, it's not recommended that you change the brands of your thyroid medication or switch to a generic or different product without consulting your doctor first. Otherwise, it will cause potential problems in maintaining your normal thyroid hormone levels.

5. Don't stop taking your medication abruptly

Even if you think your thyroid medication is not helping your health, don't stop taking it suddenly. You can stop taking your thyroid medication, but it must be done with your doctor's advice, supervision, and routine medical testing.

Do not speculate and act without a scientific basis. Instead, you should talk more openly with your doctor about your condition. They will help make your treatment more comfortable and effective.

6. Contact your doctor right away if you experience side effects or if your symptoms get worse

Side effects of thyroid medication often occur when you're allergic to some of the ingredients in the medicine. Therefore, don't forget to tell your doctor about your medical history, including diseases you are being treated for and surgeries you have had or are about to have.

Sometimes, the side effects occur because your dosage is not optimal. If your dose is too high, you'll experience symptoms of hyperthyroidism or overactive thyroid, such as chest pain, sweating, and nervousness. In this case, your doctor may adjust your dose.

If you experience the following serious side effects of your thyroid medication, you should immediately call your doctor or go to the nearest medical facility.

  • Shortness of breath or wheezing

  • Hives, rash

  • Swollen hands and feet

  • Stomach pain

  • Nausea.

  1. Don't expect to feel better instantly

It will take some time for your thyroid medication and for you to find your optimal dose. You should feel improvement in your hypothyroidism symptoms after about a few weeks after you take the right dose. Some people can feel better as soon as 1 to 2 weeks, while others need to wait 1 to 2 months.

What happens if you eat right after taking your medication?

Many studies have shown that absorption of thyroid medication is reduced by about 20% when the medication is taken too soon before or after a meal or snack. This essentially means that you won't experience any improvements in your symptoms. Therefore, always take your thyroid medication on an empty stomach.

What if you forget to take your thyroid medication?

If you forget to take your thyroid medication, you don't have to panic. Take it as soon as you remember. However, if it's too close to the time for your next dose, don't double up on your medication. Simply skip the missing dose and take your next dose as scheduled.

Accidentally skipping a dose or 2 of your thyroid hormone medication for hypothyroidism won't cause any harm since the medication can last in your body for several days. But after only about a week without your medication, symptoms of hypothyroidism, such as hair loss, weight gain, and fatigue, will start to appear. Over time, you will even face psychosis, myxedema coma, or possibly life-threatening conditions.

Do I need to get regular thyroid tests?

If you've been diagnosed with a thyroid disease like hypothyroidism, you might need to get regular thyroid tests, especially if it's your first time taking thyroid medication like NDT and levothyroxine therapy. These tests are done to ensure you're taking the optimal dose of your medication.

Thyroid function test results will show the levels of thyroid-stimulating hormone (TSH) and thyroxine (T4) in your blood. Based on these two numbers, your doctor will assess how well your thyroid is working. For example, a high TSH level and a low T4 level are signs of hypothyroidism.

TSH is a hormone produced and released by your pituitary gland to help your thyroid determine how much hormone it needs to make.

Conclusion: taking thyroid medication the right way is important

Understanding the medication you're taking is important to ensure that you're getting the most out of it. The simplest way to know whether you're taking your meds the right way is to pay attention to your symptoms. If you've been taking your thyroid medication for a few weeks but haven't experienced any improvements, you might be taking your medication incorrectly.

To get the full benefits of your thyroid hormone replacement medication, always make sure to take it on an empty stomach at the same time every day.

Feel like you've been taking your medication the right way and have adjusted your dose several times, yet you're still not feeling any better? It might be time to look for other options. If you've been taking levothyroxine for a while but still not feeling your best, VitaliThy, a natural desiccated thyroid you can buy online, might be the answer to your problems. This natural thyroid medication contains T4 and T3 thyroid hormones, so your body can use the medication more easily.

Wojciech Majda
Wojciech Majda

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