All the (realistic) answers involved in when to take your thyroid medication.

Here’s the thing, I have patients that come in so frazzled about taking their thyroid medication in the proper way and at the proper time. I’ve heard some insane expectations around doing this.  Surely, these imperious rules are being implemented by someone who has never actually had to take thyroid medicine. I’ve heard to take it FOUR HOURS BEFORE OR AFTER FOOD OR SUPPLEMENTS. Are we serious, people? If we are condemned for a twice daily dose of medication, what then? I guess we must resist the temptation to eat at all! Let me preface this post with, I am all about realistic expectations.  What good do dogmatic rules do us if they are so rigid it’s impossible to abide? I don’t live in a vacuum, I have children, run a business, have laundry and crazy hair. I don’t have the time or capacity for dogmatism.  I’m just assuming you don’t either. If not, check out my non-vacuum-living-advice below.

‍

1.     The food debate:

‍

NO: you do not need to wait four hours before or after eating. Who really can do this? If that’s you, I bow down to your willpower.

‍

YES: take it on an empty stomach.   Wait 30-45 minutes (ideally an hour but who’s counting the minutes) before eating and wait an hour after eating before taking it.

‍

2.     The supplement debate;

‍

NO: Again with the four hours… Really?

‍

YES: Wait a full hour after taking your medication for all supplements and wait a full hour after taking your supplements to take your medication.

‍

Disclaimer:  certain supplements must be taken hours away from your thyroid medication. This varies depending on what medication you take. I will save this for a blog in the near future.

‍

3.     What are the best times to take my thyroid medication?

‍

Levothyroxine (Synthroid, Tirosent, Unithroid, etc): This is usually taken in the morning.  It’s a long (and slow) acting medication so timing is less important here. Some people do say they feel best when they take it at night.  Perhaps they are slow metabolizers.

‍

Dessicated thyroid (Armour, Nature-throid, WP-thyroid, Westhroid, NP thyroid): These medications are short acting (think 6-8 hours) so they are best taken in the during the waking hours.  One thing that makes my thyroid approach unique is that I believe most people actually need these medications dosed twice a day: in the morning and around 2-3pm.

‍

Liothyronine (Cytomel): These medications is ultra-short acting. They are metabolized for most people in 3-5 hours meaning they too must be dosed multiple times during the day. I prefer to compound them to a sustained release form and still dose twice a day, similar to that of dessicated thyroid.

‍

4.     What happens if I miss a dose? What should I do?

‍

Levothyroxine based medications: You can take this later the same day when you realize that you have forgotten it. You can resume as normal the next day.

‍

Dessicated thyroid medications:  If it’s after 4:30pm, I would skip it altogether as if you take it too late, it will keep you awake at night. Do not double up on dosage the next day.

‍

Liothyronine: A similar concept applies to this as dessicated thyroid, skip it if it gets too late and resume as normal the following day.

I hope I’ve offered some insight into the details of taking your thyroid medication. Check out my Facebook page and post other questions about taking your thyroid medications there!

‍

‍

Be well,

‍

McCall