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July 03, 2023 11 min read

Let's dive into one of the most prevalent health subjects affecting millions worldwide: hypothyroidism. Managing hypothyroidism sometimes requires a leap into the world of medications and supplements. One of the most commonly recommended treatments is Natural Desiccated Thyroid (NDT). As with all medications and supplements, timing can play a crucial role in effectiveness. So, when is the best time to take NDT? Should you split your dose into two?

The lowdown on hypothyroidism

First things first, let's dip our toes into what hypothyroidism is all about. The term 'hypothyroidism' equates to an 'underactive thyroid gland.' What this means is that your thyroid gland, neatly tucked away at the front of your neck, is not quite pulling its weight. It's not producing enough thyroid hormone, mainly thyroxine (T4) and triiodothyronine (T3) - which is critical for your body's overall health and functioning. When your thyroid hormone levels are low, you'll experience a wide range of symptoms, such as weight gain, fatigue, and more.

Hypothyroidism seems to have a pretty firm grip on the population—it's one of the major players in the realm of thyroid disorders. If we peek into some statistics from the American Thyroid Association, it paints a pretty compelling picture. Around 2% of people in America wrestle with hypothyroidism, and there are up to a whopping 10% managing mild forms of it. Here's where it becomes a bit concerning—over half of those dealing with hypothyroidism don't even realize they're on this health journey. Yes, you heard it right—more than half are walking the tightrope of hypothyroidism, often none the wiser.

Natural Desiccated Thyroid (NDT)

Natural Desiccated Thyroid (NDT), also known as desiccated thyroid extract (DTE), has quite a long and fascinating history. The trailblazer in thyroid hormone treatment, NDT, came onto the scene as the first drug therapy available for managing this condition. NDT is essentially made from the dried thyroid gland of pigs, containing both T4 and T3 hormones.

In its early reign, doctors widely used NDT, providing much-needed relief for those suffering from symptoms of hypothyroidism. It was a major breakthrough, turning the page for health providers and patients by offering control over a condition that could drastically impact the quality of life.

However, as with many innovations, a new player emerged on the scene—Levothyroxine, a synthetic form of T4. Developed with the ability to offer a more consistent dose and reduce batch variations, Levothyroxine therapy surged in popularity. It offered a promising alternative to NDT, promising precision and single-hormone simplicity.

The introduction of levothyroxine led the once go-to source for thyroid treatment, NDT, to fade into the background. For many years, NDT dwelled in the shadows of its newer, synthetic counterpart, often overlooked in favor of levothyroxine's perceived advancements.

But as is often the case in medicine, what's old becomes new again. Recently, NDT has been making a remarkable return to the forefront of hypothyroid treatment options. Healthcare professionals and patients have been reevaluating this natural treatment's potential, bringing it back into popularity.

There's been a growing recognition that NDT, despite its vintage status, might offer unique benefits. The presence of both T3 and T4 hormones in NDT provides a more comprehensive approach to hormone replacement, potentially imitating the body's natural processes more closely. For some patients, this dual hormone therapy can bring about better symptom control and an overall improved feeling of well-being.

The two most renowned brands are Armour Thyroid and Nature-Throid. US-based 'Armour Thyroid' has quite a significant history, dating back to the 19th century! It's well-regarded in the medical community and has been a trusted name for decades. On the other hand, 'Nature-Throid' is a relatively young contender, making its mark due to its allergen-free formula and consistency. However, this brand has unfortunately been unavailable since 2021.

But the good news is that the NDT world isn't restricted only to prescribed tablets; it's now part of the bustling online marketplace, too. Thanks to advancements in technology and worldwide shipping, NDT has become conveniently accessible to the global population. Today, you can now buy desiccated thyroid online in supplement form, no prescription required. One such option is VitaliThy, which is practically a powerhouse of potent ingredients proven to support thyroid function. Yes, it contains the prime components, T4 and T3 thyroid hormones, but that's not all. This NDT supplement also features spica prunellae siccus extract, ashwagandha extract, and selenium yeast. Collectively, this stellar lineup of ingredients housed within VitaliThy provides a well-rounded approach to supporting your thyroid health.

The best time to take natural desiccated thyroid (NDT)

If you've taken levothyroxine before, you're familiar with the drill - it's usually taken in the morning, an hour before eating or drinking. However, it's not set in stone. Night or day, what matters is that you're consistent in your levothyroxine administration, and you always do it on an empty stomach. This helps optimize levothyroxine absorption and allows the medication to work effectively. But if you're trying to make the switch to NDT, you might wonder: is there a different set of rules for natural desiccated thyroid (NDT)?

The importance of timing

The protocol with Natural Desiccated Thyroid (NDT) doesn't stray too far from the beaten path established by levothyroxine. The guiding words to keep in your mental notes are quite similar: Just like most people recommend morning levothyroxine intake, your NDT dose is said to be best taken in the fresh hours of the morning, a time typically quieter and less cluttered with food and drink intake.

Here's what a typical morning might look like: Wake up, stretch out that early morning stiffness, and reach for your NDT medication with a glass of pure, refreshing water. The aim is to have as clear a launchpad as possible for your medication—to ensure this, your stomach should ideally be empty.

Though the conventional wisdom from healthcare providers often guides you towards taking your thyroid medication in the first light of day, there's another side of the coin to consider. Opting for a nighttime regimen could indeed be a more suitable fit, particularly if your day includes juggling a roster of multiple medications. There's also some research whispering promising results favoring the body's ability to soak up the hormones more efficiently while you dream away at night.

However, other research suggests that time-of-day preferences for thyroid hormone replacement intake, be it before breakfast or before hitting the bed, do not significantly sway the levels of thyroid-stimulating hormone (TSH) levels. TSH is often used as a marker to determine if your body has an adequate supply of thyroid hormone. In short, whether you're an early bird or a night owl, it appears to have a neutral effect on this essential hormone indicator.

Why shouldn't you mix NDT with food?

After acing the first step of your morning ritual—swallowing your NDT dose, your next challenge is to exercise some self-restraint. Yes, the wafting smell of freshly brewed coffee or the visual allure of your favorite breakfast staple might be calling your name. Still, it's essential to hit the pause button on these breakfast cravings for a little while.

Should the rhythm of your life lean toward a nocturnal administration of your medication, there's also a timing component to consider. Going the night owl route requires ensuring that your last meal ended a solid 4 hours before taking your NDT. It's all about providing that clear stage for your medication to perform at its best, even if the curtain call is before bedtime.

You might wonder, why this delay? The recommended waiting period of around 30 to 60 minutes after taking your NDT dose serves a very strategic purpose. Imagine this interval as your body's exclusive VIP time, allowing the NDT to be absorbed smoothly without having to compete with food in your system. In other words, providing a solo stage for NDT absorption to perform its act ensures the medication's effectiveness isn't compromised.

However, with every rule comes an exception or at least a good old-fashioned debate. Some voices within the health and medical community argue that NDT might sidestep this classic food-drug interaction hurdle. They propose that food intake does not essentially interfere with NDT absorption, making the waiting time an optional choice rather than a mandatory obligation.

In essence, the claim here is that with NDT, you don't necessarily have to worry about playing the 'wait-for-breakfast' game in fear of altered intestinal absorption. Still, it's always a wise move to discuss such aspects with your healthcare provider for a tailored approach that best fits your health scenario.

Can you take NDT at the same time as other medications or supplements?

This is a vital query indeed. There are a few interactions that you should be aware of if you're taking NDT.

The absorption of NDT can play hide and seek with certain substances. Antacids, which include elements like calcium and aluminum hydroxide, can interfere with how your body processes NDT. Iron and calcium supplements or multivitamins containing these minerals might also gatecrash the party. Even your favorite beverages, like calcium-infused juices, can potentially alter the effectiveness of NDT in your system.

So, what's the game plan? Imagine setting up a time buffer—an absorption-friendly window—to ensure that your NDT can function without any undue interference. You're your NDT either four hours before or after consuming these specific medications, supplements, or fortified drinks to ensure optimal effectiveness. This time frame acts as a safety net, reducing the chances for NDT contentions and absorption hiccups. It's all about allowing your NDT to work its magic in an interference-free environment.

So, which one is better, morning or night?

When to take thyroid medication: The best time to take natural desiccated thyroid (NDT)

The intriguing aspect about us humans is our uniqueness. This individuality spills over into the 'perfect timing' concept when it comes to taking medication. Factors such as your eating habits, lifestyle, overall health, and personal preferences can considerably sway your choice. For some, the lure of habit may make a morning dose more appealing, while others might find the calm of the night more conducive to their medication intake. To give you a clearer perspective, let's delve into the benefits and drawbacks of scheduling your NDT dose during the morning versus nighttime:

Morning intake

The upsides

For many of us, mornings are interconnected with routines that are repeated, from putting on the kettle to tuning into the morning news. It's convenient to lace this habitual chain with your NDT intake. The reason being, a consistent routine can serve as a reminder to ensure your timely thyroid drug intake. Adhering to this can help maintain a stable level of thyroid hormones in your blood.

Given that you've fasted overnight, your stomach is primed to receive your NDT without any deterrents to absorption. Establishing a habit, such as taking NDT as part of your morning rise-and-shine ritual, can reinforce optimal drug adherence. Over time, not taking your medication could make your day feel incomplete.

The downsides

Regardless of the general accolade for morning drug administration, it's not a one-size-fits-all scenario. Not everyone is naturally tuned into being a morning person or glued to a fixed schedule, making cultivating a morning habit challenging.

If a morning NDT dose seems like a hurdle, there could be a few reasons it might not be the ideal choice for you:

  • Shift Work: To those who dance to the beat of irregular work schedules, allocating a specific time in the morning for medication may not prove to be the most pragmatic solution.

  • Morning Hypoglycemia: Waking up with low blood sugar can leave you feeling shaky and unsteady. If waiting an hour before breaking your fast feels like a ticking time bomb, a morning dose might not be ideal. Similarly, those reliant on their morning caffeine kickstart might relate to this snag.

  • Polypharmacy: If your medication roster consists of a multitude of drugs, timing can become complex. The necessity to allow a three to four-hour lag between your NDT and other medications can make the schedule inconvenient. If your NDT is at 7:00 am, ticking off your next medication box only at 11:00 am can be cumbersome.

Nighttime intake

The upsides

Getting to grips with the NDT administration at night can offer some appealing benefits. Topping the list is breaking free from the morning dose and breakfast timing conundrum. This flexibility can be a game-changer, particularly for those whose mornings are a whirlwind of getting ready for work or other commitments.

Additionally, research suggests a potential perk to the night shift for your thyroid medication—improved absorption.

Several theories propose reasons for this advantage:

  • The suggested one-hour gap before breakfast may not provide sufficient time for optimal absorption. Considering that it takes two to four hours for food to journey from your stomach to your small intestine—where levothyroxine is predominantly absorbed—a night gap could prove more beneficial.

  • The screeching halt of nighttime intestinal contractions, also known as peristalsis, may play in your favor. With these movements on the slow, your medication gets more hang time in the small intestine before moving onto the large intestine.

The downsides

While taking your NDT at night boasts of certain advantages, there are important cons to consider:

  • Stimulating drugs: NDT drugs and supplements have mild stimulating effects that may hinder a good night's sleep.

  • Irregular sleep habits: Inconsistent sleep patterns could result in missed doses, especially if you fall asleep before taking your medication. Understandably, it can be easy to forget your medication when fatigue is weighing you down.

  • Sedating drugs: Certain medications, including beta-blockers, benzodiazepines, and specific antidepressants and anticonvulsants, can cause drowsiness and are typically consumed at night. This could clutter your nighttime medication schedule.

  • Polypharmacy: Elderly patients usually prescribed ACE inhibitors for high blood pressure are often advised to take these medications at night for maximized heart attack and stroke prevention. These other drugs might end up sidelining your thyroid medications at night.

  • Snack habits: Late-night snackers or those who like to unwind with a warm cup of milk before bed may find the three to four hours post-snack wait for NDT intake inconvenient.

Can I take my NDT twice daily?

Navigating the landscape of Natural Desiccated Thyroid (NDT) usage can seem a bit challenging. An interesting aspect to note is how the T3 hormone in NDT behaves in the body. Research shows that T3 levels in the body climb swiftly, typically peaking within three to four hours post-medication intake. However, what goes up must come down, and T3 levels are no exception. They tend to plummet and normalize relatively quickly, usually within a 12-hour window. This rapid rise and fall create a wave-like pattern in T3 levels, which could potentially impact symptoms.

This is why a divided dose strategy for T3 medication might be a sound consideration for individuals with persistent symptoms. Numerous thyroid experts and NDT advocates recommend twice-a-day dosing. This approach circumvents the rapid decrease of T3 levels, providing a more stable hormonal environment in the body.

Moreover, Dr. Donna Hurlock, a health professional, recounts a recurring trend among patients: exhaustion and energy dips by mid-afternoon, often prompting such patients to reach for unhealthy, sugar-laden snacks for a quick energy fix. These potentially harmful dietary decisions are less likely to occur with a twice-a-day medication schedule.

Lastly, McCall McPherson, PA-C, who founded a clinic with a specific focus on thyroid-related issues, shared his insights on this matter. He pointed out that individuals may reap dividends from NDT treatment when they adopt a twice-daily dosing approach. In his view, splitting the dose to be administered in the morning and around the afternoon slump period of 2 to 3 pm could potentially offer better results.

Conclusion: Listen to your body

The critical part of managing hypothyroidism is to listen to your body. If you experience side effects like insomnia or vivid dreams after taking your NDT at night, then switch back to the morning or consider breaking the dose into two smaller doses at different times.

Consistency is key when it comes to taking NDT. The thyroid gland operates on a meticulous feedback loop, and the body adjusts to when it expects to receive medication. Therefore, once you've found a time that works for you, stick with it!

Moreover, it's important to regularly check your thyroid levels to ensure your NDT is working correctly. Your doctor will likely recommend blood tests every six weeks after starting a new medication or adjusting a dose until the levels stabilize.

When on the hunt for an optimal NDT supplement, VitaliThy might just be the one for you. This offering stands out given its allergen-friendly composition—it's devoid of lactose, gluten, eggs, fish, and shellfish. And that’s not all; VitaliThy, a natural desiccated thyroid you can buy online, also gives a wide berth to artificial colors and flavors, making it a health-conscious choice for your thyroid support.

Wojciech Majda
Wojciech Majda

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