Når skal vi ta pillene?

[Vigdis]

Kom over en interssant diskusjon på http://www.facebook.com/pages/Save-N...0434089?ref=ts om søvnløshet og når vi egentlig bør ta Thyroid eller annen stoffskiftemedisin:

"anyone hypo and often hungry?" "Noen som er hypo og ofte sultne?" er starten på diskusjonen.

En skriver at det er gjort research (hvor?) på at thyroxin/thyorid tatt på kvelden ved sengetid, reulterer i høyere thyroid hormonkonsentrasjoner, og lavere TSH.

"Researchers reported that taking medication at bedtime, rather than the morning, results in “higher thyroid hormone concentrations and lower TSH concentrations.” TSH decreased and Free T4 levels rose in all patients by changing thyroxine ingestion from early morning to bedtime and T3 levels rose in all but one subject. And TSH decreased irrespective of the starting TSH levels, suggesting better absorption of the thyroid medication when taken in the evening. Interestingly, the researchers found that the circadian TSH rhythm -- the typical daily fluctuations of TSH that occur during a 24-hour period -- does not vary.

The researchers suggested several explanations for the results:

Even when waiting at least 30 minutes to eat, breakfast may be interfering with the intestinal absorption of levothyroxine thyroxine.

“Bowel motility is slower at night,” which means that it takes longer for the levothyroxine tablet to transit through the intestinal system, resulting in longer exposure to the intestinal wall, and therefore, better uptake of the medication.

The conversion process of T4 to T3 may be more effective in the evening.

<<Leslie>> Juan, thank you for bringing up the nighttime dose and better absorption. I've been taking meds at night for more than 5 years now after taking them in the morning, like a good patient, for decades before. I take all of my T4 and half of my TR T3 at night and the second dose of TR T3 in the morning.

The biggest surprise for me was that I sleep so well after decades of poor sleep when taking meds first thing in the morning. Two hours later I felt like I needed a nap. Now I wake up ready to get started with the day. Higher TSH signals the gland to make hormones during sleep. If your TSH is high during the day, you want to take a nap.

The hypothalamus senses low thyroid hormones, signals the pituitary to make more TSH, which signals the gland to make hormones for the next day's needs. Not just thyroid hormones either, as ACTH rises by 4 am and the adrenal glands produce cortisol. The hypothalamus also is the wake/sleep center of the brain.

In normal folks, TSH starts rising in the later evening and is a signal for sleep and by ~2 am, TSH is highest in test subjects. By morning, if the gland has been busy making hormones all night, TSH should be lower and FT4/FT3 higher than before bed. As Juan mentioned, your digestive system slows down during sleep, so meds are better absorbed.

In medicated thyroid patients, we might try to mimic this circadian rhythm by taking meds right before you go to sleep. Don't take them an hour before but just before you go to sleep. Put them out with a glass of water next to the bed, so you don't forget. By morning, the hormones will already be working. It takes an adjustment period because your body has to get used to a new timing schedule.

Here's a discussion at the About.com thyroid forum on my lengthy trials with meds at night and others' experiences. Remember that the beginning of the discussion is about 5+ years ago and I'm still taking most of my meds at night, simply because I switched from Cytomel to TR T3, compounded by my pharmacy.
http://forums.about.com/n/pfx/forum....roid&tid=61884

Remember, thyroid hormones are not 'energy pills'. They are metabolic regulators of all the body's functions. Mimicking what a normal gland would do helps all the hormone systems in the body function properly. The reason that they say to take meds in the morning is simply for patient compliance because they think we'll remember to take them in the morning. They don't have brain fog and families to get out the door in the morning!"

Tilslutt sies det: Husk at thyroidhormoner ikke er energpiller! de er metabolske regultatorer for hele kroppens funksjoner. De etterlikner det en normal kjetel skal gjøre for å hjelpe hele hormonsystemet i kroppen for å fungere godt. Grunnen til at leger sier at vi skal ta medisinene om morgene er fordi de regner med at vi husker å ta dem på morgenen. de har ikke brainfog eller famile som skal ut av døra på morgenen!

Noen som har erfaringer med å ta pillene på kvelden og tanker om dette?

[Pebles]

Jeg tar morgen,middag og kveld,
vet ikke hvorfor, har ikke fått beskjed om det men har bare fordelt det utover,
er ikke akkurat klar i hue om morgenen forde,
kansje jeg skulle tatt alle på kvelden i en periode og sett om det hjalp

[Carro]

Jeg tar alltid mine på morgenen, og helt en time før frokost.
Vet ikke om jeg tør prøve å ta på kvelden for jeg sliter med uro og hjertebank på natten...

[Vigdis]

Ja, jeg trør heller ikke teste. Jeg følger rådene til Karin Münsterhjelm og flere andre, når det gjelder folk med binyreproblemer. Så jeg deler dosen i tre utover dagen. Men det hadde vært interessant og sett om det gjorde en forskjell å ta tablettene på kvelden. jeg får en varmefølelse en liten stund etter jeg har tatt Thyroid, men varmen gir seg fort.

[Pebles]

Jeg skal prøve jeg,
kan være prøvekanin, blir det for ille kan jeg sove når det gir seg,
jeg har ingen overdoserings symptomer nå så det kan være et greit tidspunkt,
rapport følger om et par dager!!