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Can L-thyroxine be taken before going to sleep, instead of taking it in the morning?

By October 8, 2009 - 11:42am
 
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Hi,
My daughter (17 yrs) with Down syndrome has been diagnosed with hypothyroidism. She is taking L-thyroxine (50mg) since July. She started with 25mg, after two weeks, she took 50mg, and later 75mg. After two months, another blood test was taken and the doctor saw that the dosage was too high, so she lowered it to 50mg again. While she was taking the 75mg dosage, my daughter had diarrhea every day and pain. All this time I was giving her the medication in the morning as instructed. I have to mention that my daughter visited an endocrinologist but the one following up is the family doctor.

Someone who has been taking this same medication suggested that I should try to give the L-thyroxine at bed time, to avoid the pain in the abdominal area. I asked the doctor and she immediately refused, saying that it must be taken only in the morning.
Despite the doctor's recommendation and in view that my daughter complains every day about this pain, I began to give it night, but I am not sure if the effect of the medicine will be affected.
It is worth mentioning that my daughter STILL has the pain (abdominal) in the morning, even though she is taking the pill at bed time.
On a related issue, doctor says that my daughter is overweight (76 kg) because she is eating too much, and that the diarrhea and the pain is due to this, too. She suggested that she see a nutritionist, because she believes the pain could be a psychosomatic symptom. (Not wanting to go to school because of the pain).
Seeing a nutritionist will be helpful, but it happens that my daughter is almost non-verbal and her comprenhension level is very limited.
Would appreciate your comments.
Thanks

Add a Comment12 Comments

(reply to Alison Beaver)

Hi Alison,
I am very happy to have found your site and most of all, very thankful for your kind reply!

All the answers you have given me are very helpful, which I will consider very much. I will write back, soon!

Thank you,

Ana

October 9, 2009 - 8:47am

Hi Ana,
I understand your wanting more information, and questioning some of the family doctor's recommendations. I wanted to provide you with the information about your daughter's medication, however, I assume you already know this information, as it is also printed in the patient information pamphlet that comes with her prescription.

Your daughter's diarrhea is one of the side effects of L-Thyroxine, as well as headaches, trembling and others. I am surprised that her doctor was not more sympathetic, however, to the pain she is suffering with diarrhea, even if it is one of the "known" effects of this medication. I am unsure what the remedy is, as this drug is prescribed knowing there are unpleasant side effects, but it is prescribed with the thought that the benefits of the drug outweigh the risks (side effects). If you are interested, we can also ask one of our medical experts to weigh-in on this topic.

I was surprised that the doctor said, without doubt, that your daughter's eating too much is the cause of her weight gain. This may be the case, but I am wondering if she also mentioned that having low thyroid levels is also a primary cause in weight gain? Do you know how long your daughter had hypothyroidism before seeking treatment, and if her weight gain happened during this time?

If you do not see a pattern with her weight gain (being partially caused by her thyroid condition), but do see a pattern in the amount or type of calories she consumes each day, a nutritionist would be a good idea. I assume your daughter lives with you, and if she is non-verbal with limited comprehension, I also assume that you or another family member is in charge of meal planning, shopping and preparation? If this is the case, perhaps an appointment with a Registered Dietitian would be most appropriate for all family members involved with meal planning.

Honestly, I am also surprised that the family doctor said that the pain could be psychosomatic. Do you see other symptoms of your daughter not wanting to go to school, besides the diarrhea pain? (Again, I am only questioning this, since the diarrhea is a side effect of the medication...and the family doctor, from your account, listed the pain as a "problem" for other doctors to deal with--either in her diet or it's "all in her head"). When your daughter has pain, is she allowed to skip school (or are there other inadvertent rewards she receives for the pain, such as more attention?)

Lastly, I am not sure how much you are questioning the knowledge that your daughter's family doctor has on thyroid issues, and if you are interested/able to see the endocrinologist on a more regular basis?

Would love to hear back from you soon!

October 8, 2009 - 12:46pm
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