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Mary Shomon

Should You Take Your Thyroid Medicine Once a Week?

By March 26, 2009

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In some cases, doctors have recommended alternative ways of taking levothyroxine (i.e., taking all your levothyroxine once a week, rather than daily) to help ensure that patients are actually taking their medication at the prescribed dosage. But does taking all your levothyroxine for the week at one time -- versus taking it daily -- have an effect on your thyroid or your heart? Researchers studied the issue, and have some interesting findings for patients.

The researchers found that the weekly approach had no negative effect on cardiac stress in the weekly dosage group. The weekly dose was not only well tolerated but preferred by the majority of patients.

According to the researchers, “weekly levothyroxine administration was demonstrated to be well tolerated and safe; hence, it represents a valid therapeutic option for patients who find adherence to a rigorous treatment regimen difficult.”

What does this mean for you? If you have difficulty remembering to take your thyroid medication -- and remember, this applies to levothyroxine, but not to the shorter-acting medications with T3, like Thyrolar, Armour, or Cytomel -- taking it all once a week may be an option to discuss with your doctor.

Source: G.A. Carvalho et. al. “Evaluation Of An Alternative Form Of Levothyroxine Administration And Its Clinical And Laboratory Repercussions In The Treatment Of The Primary Hypothyroidism,” Abstracts of the American Thyroid Association October 2008 Meeting, Online

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Comments
March 27, 2009 at 5:17 pm
(1) jody says:

Mary, My doctor wants to switch my armour to synthroid? What do you think? Does armour thyroid work just as good? I am concerned about taking a synthetic hormone. thanks Jody

March 27, 2009 at 6:07 pm
(2) diane says:

HI I WAS TAKING THE DRUG THE DOCTOR WANTS YOU TO TAKE AND MY DOSE HAD TO ALWAYS BE CHANGED TO A HIGHER DOSE..WITH ARMOUR I LOST WEIGHT AND FEEL MUCH BETTER ,I AM ON IT FOR THREE YEARS..I HAD HYPOTHRYROID FOR 36 YEARS..I FEEL GREAT NOW WITH THE CHANGE!

March 27, 2009 at 6:23 pm
(3) ciara says:

sometimes i forget every other day…i’m thinking if it’s safe to take it all at once once a wk, then two every other day should be ok, right? and would there be any difference. i hate when i forget to take cytomel..i take 2 5mcg a day and w/o it. i’m a mess. i’ve noticed how tired i feel and no energy when i don’t take both during the day.

March 27, 2009 at 8:26 pm
(4) Rebecca says:

I just don’t get that. If taking synthetic thyroid is so sensitive one needs to take doses every other day (my dose was 1 daily and 1/2 on Sunday), how could taking 7 doses at once keep your homone level steady? I’ll stick to Armour!

March 27, 2009 at 10:48 pm
(5) Mary says:

Years ago I was on Synthroid. My TSH did not go down and my T4 never went up. With severe malabsorbtion I was obviously not absorbing it. Then I switched to Armour, can melt it in my mouth and bypass my scarred digestive system, and finally found the “magic pill”. I take 60mcg 3Xday, every 8 hours to spread out the T3 in it.

March 28, 2009 at 3:17 am
(6) Rod says:

The issue of weekly dosing is very interesting. I first noticed it on Australian sites. Then I realised that in the UK district nurses (i.e. nurses doing home visits, typically to elderly patients) often do twice-weekly dosing.

This totally conflicts with my partner’s experience where she notices (and we can see) changes from taking as little as 12 mcg of levothyroxine.

But, where a person takes a daily dose then, within 24 hours they cycle between over- and under-dosed every day. With weekly dosing they might only suffer that once a week. (I am sort of assuming that the majority of the dose, whether daily or weekly, is actually bound to carrier proteins fairly quickly.)

Makes you wonder about the ‘if you miss a dose, skip it if you are near your next dose, don’t double-up’ advice on most patient information leaflets/inserts.

My own questions lie at the very heart of the processes that bind/release thyroid hormones from carrier proteins. There seems to be little talk of what actually controls that process. In fact, I don’t think I have ever seen discussion of this. If that process were properly understood, we might be in a better position to consider whether weekly dosing made sense.

(Thinking of a large dam on a river, what controls the water in the river downstream is the combination of rain upstream – to fill the dam – and sluice gates. Where are the sluice gates on thyroid hormone release?)

(And why does every thread seem to end up as a discussion over the relative merits of Armour?)

March 28, 2009 at 7:29 am
(7) Francesca says:

WELL NOW !!!!
One would have to wonder how you would cope taking your all of your Med’s in one whole dose !!!!
I suffer enough taking 1 tablet each day. I am currently trialling Synthroid I have been on them for almost 4 months & still feel like “S—” I hope that I am allowed to use this word as there is no other way to express how I feel.
I truly hope that 1 day someone from Glaxo or Pharmac will end up with a thyroid problem so as they will then understand just how much we are all suffering. I just hope & pray that our old medication comes back & thenn we will all start to feel healthy & well again.

March 28, 2009 at 10:59 am
(8) Cyndi says:

I think many have had the same experience I did. You have levothyroxine medication pushed on you, you tell them it does not work and you are having side effect from so much floating in your blood and not being absorbed, you finally get natural thyroid hormone and feel a million times better. Am I a little biased towards Armour and other natural thyroid hormones? Yes, I admit it, I am.

March 28, 2009 at 11:06 am
(9) Cyndi says:

I forgot to comment on the once per week discussion. I think this would be really bad for those who do not absorb levothyroxine well. Thinking back to my own experience, I remember how bad I felt taking it daily because is was not absorbing. I had side effects like bloating and aching bones, hyper symptoms like heart palpitations, etc. If you are like that and you take it all one day per week, can that be a good thing?

Would it REALLY not affect the people who don’t absorb it well? I find that very hard to believe.

I guess it would be fine for those who do well on synthetic thyroid hormone and don’t have the side effects.

March 28, 2009 at 5:56 pm
(10) Roxanne says:

Jodi,
I’ve been hypothyroid for 23 years. I have been on Synthroid, levothyroxine, and Armour. When we got a new endocrinologist at our clinic, he immediately removed me from Armour. I was against this, but did agree for one year. It was a disaster! I have found a new doctor that agrees to my being on Armour, but we still have not gotten things back to where I was 4-5 years ago when I felt my best. I have found out that you are your best advocate, so really check things out before you “just go along with your doctor”. Do what you feel is best for your body.

March 28, 2009 at 9:58 pm
(11) François says:

Rod,

I agree with what you say. The mechanism, always assumed normal, of release on demand (demand comes from where?) from proteins is somewhat unexplained. The protein level, TBG among others, must have some impact on how much can be stored.

Personally I don’t care about T4. I just hope it’s converted to T3 more than sufficiently by those 3 enzymes (D1,D2 and D3) everywhere in my body, a process again too often assumed normal.

Then what guarantees that T4 conversion is not to the inactive reverse T3. A process that happens to take place for example when we diet. It is seen as a famine by our body, so it lowers metabolism by neutralizing T4 by some other mysterious way. Our doc won’t know for sure! No wonder we accumulate so efficiently.

At least my Cytomel, for sure, gives me a supply of T3 even if everything else fails with my Synthroid…whether taken daily, nightly or weekly!

Just thinking aloud

March 29, 2009 at 4:12 am
(12) Rod says:

Cyndi,

You (and everyone else) is entirely welcome to your opinions on Armour, levothyroxine, and everything else.

But when only 2 out of the first 5 responses discuss the article at all it is a) tedious; b) off-putting; c) unlikely to be read by many.

My partner is still suffering all sorts of problems – including bloating and severe muscle pain – after several years of trying T4, Armour and T3 (in varying regimes). I am well aware that Armour can transform some people’s wellbeing.

And I do have severe doubts that weekly dosing could be anywhere near universal for many reasons – including the effects of some of the other ingredients in the levothyroxine tablets.

François,

Too many “mysterious ways” in this area of medicine. :-(

Spot on about the D1/2/3 and, by the way, how are *they* controlled? :-)

Rod

March 29, 2009 at 7:34 am
(13) David Coburn says:

I’ve just had an appointment with an eddocrinologist and he was adamant I was not taking my thyroxine regularly – I never miss. Maybe once a week would put his mind at rest!!!

March 29, 2009 at 3:49 pm
(14) Yvonne Clark says:

Jodi,
Based on years of experience with hypothyroidism (my mother also), I know that many endocrinologists treat by the book, not by the symptoms. I was placed on Armour by one doctor who did it for the T3 activity, and kept me there because of the marked improvement in my well-being. Get yourself a better doc.

March 29, 2009 at 10:08 pm
(15) Jenna says:

Taking a 7-day dosage is a BAD idea for thyroid cancer patients. We need stable TSH levels so that there is no stimulant to grow new cancerous thyroid cells.

March 30, 2009 at 12:46 pm
(16) Cindy says:

I had trouble taking my Synthroid in the morning, upon arising, because you’re supposed to wait an hour before eating. . .which was problematic because I don’t have an hour between taking my medication and getting to work on time. Now I take it at night before bed – I can eat breakfast when I get up after exercising – and I have energy all day long!

April 1, 2009 at 11:15 pm
(17) Bre says:

Does armour work on people who’s thyroid was removed by iodine? I cant lose weight I just keep gaining and gaining.

April 3, 2009 at 11:16 am
(18) Susan says:

Does anyone know of a doctor in Ireland preferably in the Republic who will prescribe Armour.

Thank you,
Susan.

April 3, 2009 at 12:11 pm
(19) gina says:

i attempted to read the journal article at the link provided. unfortunately, it is unavailable to non-subscribers.

many of the thyroid studies i have read are poorly designed, use very small test populations, and often arrive at conclusions that seem unsupported by the evidence. is this one any different?

April 6, 2009 at 12:30 am
(20) Della Katon says:

I really believe that I would not be here had it not been for Armour. I wall falling asleep while driving and anytime I sat down. I had many arguements with PC and Endo and was told that nothing was wrong with my thyroid my test results were normal. Levoxal was horrid. After ordering Raw thyroid over the net I got much better. Finally found a Dr. that would give me armour. Now I’m told that my Vit. D level was very low. Was given 50,000 UIs a week for 8 weeks. Felt great and had energy and could stay awake all day. And now I have lost 10 lbs. no more sore muscles nor bones that hurt 24/7. Vit. D levels are now normal, hahahaha. And I’m supposed to stay on 2000 UIs per day for ever. All the symptoms are back and I feel like crud. PS. ain’t no way I will take 14mgs of Armour all at one time. Grtgranny

December 9, 2009 at 6:46 pm
(21) Rabbit says:

I had hyper thyroid palpilary cancer, and had to have my thyroid immediatley and have nothing left in my body. When I miss a dose I notice a difference in my mood and behavior. Is this normal?

October 20, 2011 at 9:24 pm
(22) starfish says:

I am very sensitive to any kind of thyroid although I need it! After terrible bouts with minimal doses of Synthroid and all the rest, my dr. is trying Armour. I took 15mg/dose for 2 days and had only a 20 minute episode of the ‘seizure’ like stuff. The tablet is small and I can’t evenly split it. My dr agreed to let me try one dose every other day. We’ll see how it goes.

May 3, 2013 at 9:33 am
(23) Kathy says:

I really like taking my levothyroxin once or twice a week. However, about the same time I started that, I began getting nerve twitches (and tiny muscle twitches) all over my body–like ants or tiny bumper cars under my skin.. Also double vision, headache and now dizziness. Has anyone else noticed similar things? I’m seeing a neuro-ophthalmologist next week.

January 13, 2014 at 6:52 am
(24) sam says:

bad idea… after reading this article, I was very excited to take my pills in one dose. Due to cancer I had my thyroid removed, and it was hard remembering to take my pills. I also shared the info with my co worker who is on synthroid for llow thyroid. we both decided to try it. by the nd of the week my co worker felt exactly how I felt. I’m the begining we felt great energy no fatigue and around the time for the next weekly dowe maybe two days before next dose. there was a crash. fatigue tired brain fog, the issue was the medicine was needed daily to keep the levels regulated. and was not lasting for the full week. the crash was worst than just missing one dose.

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