Levothyroxine Dosing Time and TSH Levels --> RE: Levothyroxine dosing.

[Guest guest]

I'm confused on the idea of TSH's and timing of dose.

Isn't TSH sort of like HgbA1c?

At least in the sense it reflects the overall dosing/control over time and not any major day to day variance?

If it takes 6-8 weeks for TSH to stabilize at a new level based on dosing, does taking the same dose at different times during the day really matter to the TSH level in 6 weeks?

I'm not saying patients won't necessarily have different feelings on dosing during different times during the day -- but rather -- why would I expect this variation in time of day to have a major affect on TSH over time.

Just curious.

Locke, MD

From: [mailto: ] On Behalf Of Beth Sullivan, DOSent: Saturday, November 22, 2008 10:53 PMTo: Subject: Re: Levothyroxine dosing.

I have been taking mine at 2pm everyday for the last 10 years. I got in this habit while I was in residency after having my subtotal thyroidectomy. It was right at the end of lunch and before afternoon hours began. Same way the timing is done in my office. The endocrinologist I see now used to complain about my taking it this way but after 8 years of stable TSH's he has quit complaining.

Dr. Beth Sullivan, DORidgeway Family Practice, PCCommerce, GA

Levothyroxine dosing.

OK, so the patient comes in. "I can't take it first thing in the morning on an empty stomach". Doesn't matter the reason. So I say, "as long as you take it consitantly, the same way every day, that's OK". I feel it is certainly better than not taking it.

Am I wrong?

[Guest guest]

I think the original conversation started with patient having

trouble taking it on an empty stomach which is what is recommended. So

some days they would miss and some days not.

It seems, it is logical for the patient to take it the same time

every day, under the same circumstances and then dosing can be adjusted

appropriately to have that stable TSH.

Kathy Saradarian, MD

Branchville, NJ

www.qualityfamilypractice.com

Solo 4/03, Practicing since 9/90

Practice Partner 5/03

Low staffing

From:

[mailto: ] On Behalf Of Locke

Sent: Sunday, November 23, 2008 12:23 PM

To:

Subject: Levothyroxine Dosing Time and TSH Levels --> RE:

Levothyroxine dosing.

I'm confused on the idea of TSH's and timing of dose.

Isn't TSH sort of like HgbA1c?

At least in the sense it reflects the overall dosing/control over

time and not any major day to day variance?

If it takes 6-8 weeks for TSH to stabilize at a new level based on

dosing, does taking the same dose at different times during the day really

matter to the TSH level in 6 weeks?

I'm not saying patients won't necessarily have different feelings

on dosing during different times during the day -- but rather -- why would I

expect this variation in time of day to have a major affect on TSH over time.

Just curious.

Locke, MD

From:

[mailto: ] On Behalf Of Beth

Sullivan, DO

Sent: Saturday, November 22, 2008 10:53 PM

To:

Subject: Re: Levothyroxine dosing.

I

have been taking mine at 2pm everyday for the last 10 years. I got in

this habit while I was in residency after having my subtotal

thyroidectomy. It was right at the end of lunch and before afternoon

hours began. Same way the timing is done in my office. The

endocrinologist I see now used to complain about my taking it this way but

after 8 years of stable TSH's he has quit complaining.

Dr.

Beth Sullivan, DO

Ridgeway Family Practice, PC

Commerce, GA

-----

Original Message -----

From: Eads

To:

Sent: Thursday, November

20, 2008 7:53 PM

Subject: RE:

Levothyroxine dosing.

,

I

agree. I have a few pts that take their levothyroxine this way, and it

seems to work for them. They have the same thing for breakfast, with the

same pills, every morning, and their TSH stays stable. I even have one pt

who has to do it for their lunch, and they have the same PB & J, etc, and it

works. Some have been doing this for years.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O. Box 7275

Woodland Park, CO 80863

www.PinnacleFamilyMedicine.com

From:

[mailto: ] On Behalf Of nancy blake

Sent: Thursday, November 20, 2008 8:38 AM

To: IMP Group

Subject: Levothyroxine dosing.

OK,

so the patient comes in. " I can't take it first thing in the morning

on an empty stomach " . Doesn't matter the reason. So I say,

" as long as you take it consitantly, the same way every day, that's

OK " . I feel it is certainly better than not taking it.

Am

I wrong?