Should I take my thyroid medication on the morning of my thyroid blood work?
It depends! If you are taking a T4 only medication, you can go ahead and take your medication in the morning before the test. T4 medication has a long half-life, and your levels will be stable regardless of when you take it. If you take a T3 medication on the other hand, or a combination of T3/T4, T3 has a shorter half-life so your blood work may not be reflected accurately. It will appear that you have more thyroid hormone on board than you do. Thus it may be helpful to delay your morning dose of a T3/T4 medication until after you do the test to see (try to schedule the test in the morning).
What could cause a suppressed TSH (0.01) and low normal Free T4 (0.9) & Free T3 (2.9)? I’m feeling good and am taking Levothyroxine and Cytomel.
Sometimes this can be due to pituitary suppression. It can be due to adrenal support, steroids, or glandulars taken at bedtime. This effect may also be seen with T3 medications in some people.
Which thyroid medication is Best?
There are quite a few options for thyroid medications for hypothyroidism. Some people report feeling better on Armour Thyroid®*, while others may feel better taking Synthroid® or another version of synthetic T4 or compounded thyroid medications. Check out this article on thyroid medications for further insight.
*Note: While Armour Thyroid does not have any gluten-containing ingredients, it is not tested for gluten content, and cannot be certified as gluten-free. Armour does contain sodium starch glycolate, which can be derived from wheat or corn.
Do you recommend gluten free thyroid medications?
The benefits of following a gluten free diet with Hashimoto’s have been well described.
Many people have taken the plunge of going gluten free and are carefully checking labels to ensure that their foods do not contain any gluten ingredients, but gluten can also be found in medications and can sabotage your healing.
There are no current laws that require medication manufacturers to specify if their products contain gluten. Many progressive manufacturers have started labeling their products, but not all. I wrote this article on gluten-free thyroid medications for further insight.
What about other fillers such as dairy, soy, etc.?
Many people with Hashimoto’s are sensitive to multiple ingredients like dairy, soy, corn, eggs. Tirosint and Nature-Throid have the fewest additives as far as thyroid medications go. You can also work with a compounding pharmacist to have a special thyroid medication made for you without any ingredients that are going to sabotage your health.
Do you have any suggestions on switching thyroid medications?
Thyroid hormones are known to have a very narrow therapeutic index, they are “Goldilocks” medications, in that have to be dosed just right to ensure effectiveness and prevent adverse drug events. Thyroid hormones are dosed in micrograms; that is just 1/1000th of a milligram! When the dose is a teensy bit too high, we may have symptoms of hyperthyroidism, and when the dose is a teensy bit too low, we have symptoms of hypothyroidism!
This is why switching back and forth between different brands of thyroid medications is not recommended. Even a teensy bit difference in the formulation can make a profound impact on our well-being! Here are some helpful hints for switching thyroid medications.
Do my thyroid medications have other drug interactions?
Thyroid medications are notorious for drug interactions with other medications. This means that some medications can cause alterations in thyroid hormone levels and side effects, and in turn, thyroid medications can impact the effectiveness and toxicity profiles of other medications. Always be sure to check with your pharmacist when taking new medications or over the counter drugs. Ideally, you should fill all of your prescriptions at the same pharmacy so your pharmacist can do a check of your drug interactions every time you fill a prescription.
Are thyroid medications safe for pregnancy?
Thyroid medications are Pregnancy Category A, which means that they are considered to be safe medications for using during pregnancy. Being on a correct dose of thyroid medication can help women conceive as well as prevent miscarriage. If you get pregnant while taking thyroid hormones, be sure to see your doctor ASAP to test your levels. You will very likely need to increase your dose, as pregnancy increases the requirement of thyroid hormones. If you are thinking about pregnancy, be sure to read this guest post-Hashimoto’s and Pregnancy
When should I take my thyroid medication?
Thyroid medication absorption can be impacted by many things, including food, other medications, and supplements. Thyroid medication should be taken on an empty stomach, 30 minutes to one hour before eating, taking other medications, supplements or coffee to ensure appropriate absorption. Antacids such as Tums, iron and calcium supplements can impair the absorption of thyroid medications. Thus, you need to have at least 4 hours of time in between your thyroid medications and these agents.
Are thyroid medications lifelong?
Thyroid medications are considered lifelong for most cases of hypothyroidism, but spontaneous remission has been reported to occur in up to 20% of patients… however addressing root causes can help increase the rates of remission. If you do not address the underlying root causes of your condition, your own thyroid’s hormone production may deteriorate over time, meaning that you may require dose increases over time. Symptoms of worsening thyroid function can sometimes be subtle (such as gaining a little extra weight every year or being just a tad bit more tired), so you will need to test your thyroid function labs at least every 6-12 months to monitor your thyroid hormone levels.
For more information see the following articles: