Levothyroxine is one of the most commonly used medicines in India. It is small, cheap and powerful. But how you take it matters a lot, and many people are taking it in ways that reduce its effect.
The golden rule: empty stomach
Take it with water, first thing in the morning, at least 30 to 60 minutes before breakfast. Some people prefer bedtime, at least 3 hours after the last meal. Pick one routine and stick to it.
Things that reduce absorption
- Tea and coffee: wait at least 30 to 60 minutes.
- Calcium and iron tablets: keep a gap of 4 hours.
- Antacids and some acidity medicines: keep a gap as advised.
- High-fibre meals, soy and large amounts of walnuts too close to the tablet.
Missed a dose?
If you remember on the same day, take it. If you remember the next day, just take your usual dose. Do not double up, unless your doctor has told you. Some doctors allow a larger weekly dose in special cases, but this should be your doctor’s decision.
Do not stop when you feel better
Most people with hypothyroidism need the tablet for life. Feeling better is a sign it is working. If you stop, symptoms slowly return over weeks or months.
Brand changes
Try to stay with one brand, because small differences can shift the TSH. If you must change, recheck TSH after 6 to 8 weeks.
Follow-up
TSH is checked 6 to 8 weeks after any dose change, and then every 6 to 12 months once stable. Pregnancy, weight changes and new medicines can change your dose needs.
Signs of too high a dose
Racing heart, shaking, sweating, trouble sleeping or sudden weight loss. Tell your doctor, and do not adjust the dose on your own.
If you live in Gopanpally, Gowlidoddi, Nallagandla or Tellapur, or work in the Financial District or Nanakramguda, a simple thyroid test and follow-up are available at our clinic in Gopanpally, Gachibowli. Contact us to book a visit.
Keep reading
Your family doctor,
Akhila Reddy
MBBS, DNB (Family Medicine) | TSMC Reg. No. APMC/FMR/74261
AMC Hospital, Gopanpally, Gachibowli, Hyderabad
This article is for general health education and does not replace a check-up. Every person is different, so please speak to your doctor before changing any medicine. In an emergency, call 108 or go to the nearest hospital.
References
- Garber JR et al. Clinical practice guidelines for hypothyroidism in adults (ATA/AACE). Thyroid 2012;22(12):1200-1235.
- Bolk N et al. Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial. Arch Intern Med 2010;170(22):1996-2003.
- American Thyroid Association. Thyroid hormone treatment. https://www.thyroid.org/thyroid-hormone-treatment/