[Idiopathic PN]

For those who are taking Synthroid in the morning, below is an article indicating that taking Synthroid at bedtime has better results.

http://thyroid.about.com/od/thyroidd.../bedtime_2.htm

I also found an article (Q&A type) that says that Nexium may also be taken at bedtime. Also, in the same Q&A, Nexium and Synthroid can be taken at the same time. Therefore, to my own interest, I made my own conclusion, Nexium and Synthroid can be taken together at bedtime. (Please refer to the 7th & 8th to the last questions.)

http://women.webmd.com/pharmacist-11...rn-indigestion

I am trying to find a way to ease my schedules. The above schedule works well with me considering that my antibiotics have to be taken on an empty stomach For the past weeks on the antibiotics, I was not compliant of the "empty stomach" regimen because of my stomach problems. However, I was advised about the relative "punch" of my presribed antibiotics (take note not all antibiotics have to be taken on an empty stomach) on an empty stomach vs. with food.

Anyway, that was a little segue from my main topic - I wonder if anybody in the forum is taking Nexium and Synthroid together at bedtime?

Thanks.

[Stacy2012]

I take NatureThroid and would not take it with any other medication. I do take it at bedtime.

Thyroid meds should not be taken with any other meds or supplements as I understand it.

[nilram]

That's interesting, it does say that levothyroxine (one of the generics for Synthroid) and Nexium can be taken at the same time. My sister (a pharmicist) prefers to take her Synthroid before bed, though her doctor would prefer (for whatever reason) that she take it in the morning. As you probably know, blood levels of your thyroid hormone matter, so take the info to your doctor to discuss, and get your TSH level checked at the recommended period of time after you make the change.

[mrsD]

There are suggestions about night time thyroid administration
coming out now. About.com was the most recent that I saw.

Probably based on this study:
http://www.ncbi.nlm.nih.gov/pubmed/17201800

Clin Endocrinol (Oxf). 2007 Jan;66(1):43-8.
Effects of evening vs morning thyroxine ingestion on serum thyroid hormone profiles in hypothyroid patients.
Bolk N, Visser TJ, Kalsbeek A, van Domburg RT, Berghout A.
Source

Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.
Abstract
OBJECTIVE:

Standard drug information resources recommend that l-thyroxine be taken half an hour before breakfast on an empty stomach, to prevent interference of its intestinal uptake by food or medication. We observed cases in which TSH levels improved markedly after changing the administration time of l-thyroxine to the late evening. We therefore conducted a pilot-study to investigate whether l-thyroxine administration at bedtime improves TSH and thyroid hormones, and whether the circadian rhythm of TSH remains intact. DESIGN Patients were studied on two occasions: on a stable regimen of morning thyroxine administration and two months after switching to night-time thyroxine using the same dose. On each occasion patients were admitted for 24 h and serial blood samples were obtained.
PATIENTS:

We investigated 12 women treated with l-thyroxine because of primary hypothyroidism, who used no medication known to interfere with l-thyroxine uptake.
MEASUREMENTS:

Patients were admitted to hospital and blood samples were obtained at hourly intervals for 24 h via an indwelling catheter. Following this first hospital admission, all women were asked to switch the administration time from morning to bedtime or vice versa. After 2 months they were readmitted for a 24-h period of hourly blood sampling. Blood samples were analysed for serum TSH (immunometric assay), FT4 and T3 (competitive immunoassay), T4 and rT3 (radioimmunoassay), serum TBG (immunometric assay) and total protein and albumin (colourimetric methods).
RESULTS:

A significant difference in TSH and thyroid hormones was found after switching to bedtime administration of l-thyroxine. Twenty-four-hour average serum values amounted to (mean +/- SD, morning vs bedtime ingestion): TSH, 5.1 +/- 0.9 vs 1.2 +/- 0.3 mU/l (P < 0.01); FT4, 16.7 +/- 1.0 vs 19.3 +/- 0.7 pmol/l (P < 0.01); T3, 1.5 +/- 0.05 vs 1.6 +/- 0.1 nmol/l (P < 0.01). There was no significant change in T4, rT3, albumin and TBG serum levels, nor in the T3/rT3 ratio. The relative amplitude and time of the nocturnal TSH surge remained intact.
CONCLUSIONS:

l-thyroxine taken at bedtime by patients with primary hypothyroidism is associated with higher thyroid hormone concentrations and lower TSH concentrations compared to the same l-thyroxine dose taken in the morning. At the same time, the circadian TSH rhythm stays intact. Our findings are best explained by a better gastrointestinal uptake of l-thyroxine during the night.

PMID:
17201800
[PubMed - indexed for MEDLINE]

Keep in mind that presence of food, is to be avoided for best results.

[Idiopathic PN]

Hi Mrs. D, Your link is very informative. It consistent to the article I read by Mary Shomon. As you know, I am taking a lot of medications/supplements. Some should be taken on empty stomach. so, I am trying to find schedules to accommodate them. I started taking the Synthroid at bedtime with at least 2 hours after my last meal. I hope that would okay.

Thank you.
Mary

[Idiopathic PN]

Originally Posted by nilram

That's interesting, it does say that levothyroxine (one of the generics for Synthroid) and Nexium can be taken at the same time. My sister (a pharmicist) prefers to take her Synthroid before bed, though her doctor would prefer (for whatever reason) that she take it in the morning. As you probably know, blood levels of your thyroid hormone matter, so take the info to your doctor to discuss, and get your TSH level checked at the recommended period of time after you make the change.

Thank you Nilram. I consulted my endocrinologist before changing my schedule. We will test the TSH 4-5 weeks after the start of hte change and see the result. I hope my TSH improves.

[mrsD]

Originally Posted by Idiopathic PN

Thank you Nilram. I consulted my endocrinologist before changing my schedule. We will test the TSH 4-5 weeks after the start of hte change and see the result. I hope my TSH improves.

Yes, Mary Shammon writes the About.com thyroid entries for the most part. That is where I first saw this topic/suggestion.

2 hrs is not enough for most people. Dinner is a big meal, and with fiber and fat (both slow digestion), there still may be food around, for the levothyroxine to get lost in.

I am taking mine now when I get up in the night to use the bathroom. There is usually a midnight or 1am visit for me.
If I don't get up, then I take it at 4am or so when I first get up.
My TSH anyway has always been good at 1.5-2 taking generic the AM empty stomach way.

[Idiopathic PN]

Originally Posted by mrsD

2 hrs is not enough for most people. Dinner is a big meal, and with fiber and fat (both slow digestion), there still may be food around, for the levothyroxin to get lost in.

I am taking mine now when I get up in the night to use the bathroom. There is usually a midnight or 1am visit for me.
If I don't get up, then I take it at 4am or so when I first get up.

I have the same bathroom schedules, I might do that as my Synthroid time. I cannot take it at 4am, as that is the antibiotic time.
Thank you Mrs. D for always advising the better way (or correct) way of taking the medications.