Having said that, several factors can impact your thyroid negatively, leading to various disorders. An iodine deficiency, autoimmune diseases, inflammation caused by a virus or bacteria can all pose problems to your thyroid, in light of which doctors may prescribe oral medications with specific timings. To discuss the same, we at ETimes lifestyle, spoke with established doctors, who provide helpful insights into what thyroid disorders are, when one should resort to thyroid medications and what is the right time to take the same and why.
When should people resort to thyroid medications?
Dr. Shaival Chandalia, a consultant endocrinologist and diabetologist at Jaslok hospital, says, “People should start their thyroid medications once they are diagnosed with hyperthyroidism or hypothyroidism. It should be done in consultation with their physician.”
Hypothyroidism or underactive thyroid is a condition in which the thyroid gland fails to produce enough of certain important hormones crucial for the body. On the other hand, hyperthyroidism is a disease which occurs when the thyroid gland produces thyroid hormones in excess. Therefore, it is also known as overactive thyroid.
Hypothyroidism is one of the most common endocrine disorders, says Dr. Chandalia. According to him, the medication that is given for the condition is a thyroxine which is basically a supplementation of the thyroid hormone. “So it is not as much as allopathy as naturopathy because all I’m doing is supplementing your natural thyroid hormone by giving you thyroid hormone from outside in the form of a pill,” the doctor explains.
Is there a right time to take the medicines?
Dr. Chandalia recommends taking thyroid medicines in the morning on an empty stomach to procure maximum effectiveness. If it is taken after meals or with food, the medications won’t be absorbed properly, disallowing the thyroid levels to reach its optimum levels, he explains.
However, in the case of hypothyroidism, if a person takes a full dose of thyroxine in the morning on an empty stomach, one may get palpitations, which is when it can be split into two doses – early morning on empty stomach and before bedtime, adds the doctor.
Dr. Veenu Gupta, Consultant Internal Medicine, Manipal Hospital, Gurugram says, “Taking a thyroid medication may seem fairly simple, but one needs to know several things to make sure that the drug works as it should.” According to her, whether it is hypothyroid or hyperthyroid, taking the medication properly helps one absorb the medications well and limits one’s risk of side effects.
In case of hypothyroidism, Dr Gupta recommends the levothyroxine drug, which works best when a person takes them at the same time every day. “Missing even a day or two of your thyroid drugs can stir up symptoms. Try to pair or take your medication with something you do every day such as brushing your teeth that can help you establish the habit if you are forgetful try setting an alarm,” she says.
She further adds, “In case a person misses taking the medicine, they can take it after 2-2:30 hours of the meal. And if a person is on supplements, there should be a gap of 3 hours atleast.”
Factors that can render thyroid medications less effective
According to Dr. Gupta, certain foods, medications, supplements and medical conditions may impair how well your body absorbs the drugs. Poor absorption can make your medicines less effective.
“It is usually recommended that you take levothyroxine in the morning if you follow that advice, take it on an empty stomach, then avoid food and drink including coffee for at least an hour. Some recent research supports taking thyroid medication at bedtime to maximize absorption that is yet to be verified,” she says.
Furthermore, the doctor warns against eating high calcium foods within three hours of your thyroid drugs. She also suggests avoiding goitrogenic foods such as brussels sprouts, cabbage, cauliflower, corn, mustard greens, spinach, sweet potatoes and some of the fruits like strawberries, peaches and flax seeds and peanuts and lima beans.
Additionally, while many dietary supplements like calcium, iron, biotin, vitamin C and even iodine can interfere with absorption of the medications, a number of medical conditions like lactose intolerance, celiac disease, pancreatic and liver disease may affect the same, as per the doctor.
Common mistakes people should avoid
A hypothyroidism treatment usually aims at replacing the thyroid hormone, which the thyroid gland is unable to produce. However, there are certain important things to keep in mind so as to ensure high effectiveness.
Dr Chandalia says, while people take thyroid medications in the morning, they often take their calcium, iron and multivitamins along with it, which makes it difficult for the body to absorb the drugs. “The amount of iron in multivitamin, even though it is small, can result in the impairment of the absorption of the thyroid hormone,” he said. That said, he strongly suggests against taking iron, calcium or multivitamins along with thyroid hormone medications in the morning, because according to him, will prevent the absorption of the thyroid hormone.
Similarly, Dr Gupta suggests taking the medicine at the same time each day, while avoiding calcium consumption within three hours of taking a medicine. She recommends asking doctors about a dosage change, if the thyroid disease symptoms start to worsen.”