Maximizing Thyroid Hormone Replacement Therapy
Increasing the Effectiveness of Hypothyroid Treatment
Aug 17, 2009
Patients can practice methods that help their thyroid hormone dose to work at its fullest potential. While a doctor can prescribe a dose that is optimal in treating hypothyroidism, it is afterward the patient’s responsibility to take their medication on a consistent schedule and to be aware of things in their diet or supplements they may take that can hinder the effectiveness of their treatment.
Dose Scheduling
One method for making sure a dose is taken at the same time each day is to take it on an empty stomach when first rising from bed in the morning (at least a half-hour before breakfast). A consistent schedule helps to keep thyroid hormone levels more stable with any downward fluctuations in the levels occurring at about the same time each day, preferably at the end of a day’s work and activities. Most T4 brands of thyroid hormone remain stable but fluctuations in levels can occur more commonly with brands that contain T3 which has a shorter half-life (dose cycle).
If a patient has problems remembering to take her dose before heading off to work or school, placing the medication container on an alarm clock can better assure the dose will be taken. Some patients who seem to feel the effects of downward fluctuations in their thyroid hormone dose-level may prefer to take half of their dose upon waking and the other half about a half-hour, to an hour before the noon meal.
Supplements and High Fiber
Two supplements that can affect the absorption of a thyroid hormone dose are iron and calcium. These natural elements found in multivitamins, nutritional drinks and in certain foods should be avoided for at least four hours after taking the daily hormone replacement dose. If they are being taken as a daily regimen, a patient should consider taking them closer to the noon meal so that there is an approximate four-hour delay after taking her thyroid hormone dose.
With this type schedule, a patient would not be able to split the thyroid dose in halves for taking at two different times of the day, unless the second dose is taken before the final meal of the day. Some patients prefer not to do this due to the second dose being too close to bedtime and possibly giving them an energy-surge when it is time for rest and sleep. Foods high in fiber-content should also be eaten four hours apart from a thyroid hormone dose due to their ability to speed up the digestion process which can allow less time for the thyroid hormone to absorb properly in the body.
Dosing before a Blood Draw
Some doctors are of the opinion that it doesn’t matter whether a patient takes his thyroid hormone dose before a scheduled blood draw or after the blood is drawn to monitor thyroid hormone treatment levels. The manufacturer of Armour Thyroid brand however, states on its drug-information website, that a patient should have his blood drawn before taking his thyroid dose for that day. The reason for this is due to the fact that a dose can spike in the body within a few hours of taking it and if the blood draw occurs at the time of the spiked-level, this could give an incorrect impression that the dose is too high and needs decreasing.
For under-treated hypothyroid patients it could mean that their levels appear adequate when a dose increase is actually needed. This scenario may be more of an issue in patients who take thyroid doses that contain T3 hormone in them. Patients taking T4-only doses may only need to make sure that whether they take their dose before or after a blood draw, that they do the same thing consistently for each blood retest, as a precaution to assure best-possible accuracy on test results.
Additional Precautions
A patient should also be sure to take his thyroid dose each day with plenty of water because this helps the body to better absorb and metabolize the dose. This is true of most medications that are taken orally. He should also be aware of the fact that he should never make any changes in his dose-amount unless approved by his treating doctor.
It may be tempting to a patient to lower his dose if he feels he is experiencing some hyperthyroid symptoms (over-treatment) or hypothyroid symptoms (under-treatment) but an unauthorized change in dose can cause further instability. A doctor may want to first examine the patient or blood retest him before making a dose- adjustment because other problems in the body can mimic the symptoms of thyroid hormone imbalance.
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