Why thyroxine before food

The primary outcomes wherein the serum levels of T4 and TSH were measured at the end of the first and second course on the 60 th and th day of the study using ELISA. The serum concentration values of 0.

The paired- sample t-test was used to compare the data and the value of p-less than 0. The total number of 54 patients between 18 and 67 years were recruited in the study. Two patients one in each arm discontinued the study due to fear that changing the therapeutic regimen their disease might deteriorate and two patients one in each arm were lost to follow-up, while the 50 remaining patients were analyzed 25 patients in each group.

The full participant flow diagram is depicted in figure 1. The average administered dose of levothyroxine for the whole study population was 0. The most common symptoms among these patients were: dyspnea, excessive weight gain and hypersomnia. In both groups, within group differences in the serum TSH and T4 levels as a result of changing the administration time were similar. Since the results in both crossed over groups were the same, the two groups could be regarded as one.

To investigate the effect of age on dependent variables, the data were evaluated regarding different age groups less than 40 years and more than 40 years. The current therapeutic procedure for hypothyroidism is mainly focused on hormone replacement therapy by sodium levothyroxine. The patients are usually advised to take the medication in the morning minutes before breakfast. However, for many patients, this time schedule is not appropriate and they feel more comfortable to take the medication in the evening.

In this study, the effect of changing levothyroxine administration time from morning to evening, according to serum levels of TSH and T4 was evaluated. The effects of changing the levothyroxine administration time on serum TSH and T4 levels was previously studied 19 - But the literature data were inconsistent and contradictory.

Bartalena et al. Bolk et al. However, due to the small sample size in this study, the results were not considered to be generalizable. Thus, in a more extended study by Bolk et al. Bach-Huynh et al. Their study, in contrast, demonstrated an increase in the serum TSH levels and reduction in serum T4 levels in response to changing the levothyroxine administration time from morning to evening In a more recent study, Rajput et al.

The patients were divided into two groups receiving levothyroxine either in the morning or in the evening on an empty stomach for a period of 12 weeks. The results demonstrated considerable improvement in clinical profile for majority of patients in both groups with no significance between group differences, and the evening administration of levothyroxine was reported to be as effective as the morning administration This is in accordance with the results reported by Bach-Huynh et al.

This inconsistency might be in part due to the nutrition regimen in different patients and the effects of food intake on the absorption and oral bioavailability of levothyroxine. Data from screening large European population have revealed the influence of dietary iodine intake on the epidemiology of thyroid dysfunction 3. The comparison of the TSH and T4 levels between the age groups less than 40 years and more than 40 years did not demonstrate any significant difference either in initial or the final levels of TSH and T4.

In addition, there was no relationship between the BMI and the age group. Although the absorption, distribution, metabolism and excretion of levothyroxine, like any other drugs, depend on age and BMI of the patient, since the daily dose of levothyroxine was precisely determined for each patient by the endocrinologist physician on the basis of the preliminary conditions and the extent of hypothyroidism, these factors did not affect the study variables in different age groups.

This was also reported by Asadi et al. Their study demonstrated a higher prevalence of thyroid disorders in women compared with men Although the serum levels of T4 were not significantly changed, the changes to serum TSH levels were significant, suggesting that changing the levothyroxine administration time before breakfast to before dinner in order to enhance the patient compliance results in reduced therapeutic outcome.

Nevertheless, this administration schedule may be applicable if appropriate dose adjustment is performed in order to compensate the reduced gastrointestinal absorption of levothyroxine and provide the same bioavailability of the drug. The authors thank Dr. Adeleh Bahar for her assistance in patient selection and Dr. Roja Hadian for the literature review. D thesis of Neda Sasanpour of the Faculty of Pharmacy. Conflict of Interest: There was no conflict of interest.

Serum thyrotropin levels following levothyroxine administration at breakfast. Thyroid ; Epub June 21, For 90 days patients were assigned either to take the levothyroxine minutes be- fore a meal or during the morning meal. Then after 90 days, they switched to the other regimen. You should take the correct dose of medication at the same time, and in the same way, every day, according to the ATA.

Use a pillbox or set an alarm on your phone if you need help remembering to take your pill. If you do miss a dose, take the missed dose as soon as you remember, advises the ATA. For the most part, you shouldn't have problems with most foods if you wait at least 45 minutes after taking your thyroid medication before you eat.

That includes foods that are high in calcium, such as milk, cheese , yogurt, kale , and spinach. So just be sure to stay consistent with your soy intake. Your healthcare provider should know about any supplements you take because they may affect your hypothyroidism treatment — particularly iodine. While iodine is essential for your body to produce thyroid hormone, the vast majority of people in the United States get enough iodine from food and water alone, Dr.

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