There are a few important rules for taking Euthyrox and L-thyroxine.

How to take it

  • Always take the medication before meals — 20–30 minutes before, ideally an hour.
  • Take it with water only: not with milk, juice, tea or coffee, sparkling water or water with lemon.
  • If you forgot to take it before a meal, you can take it 3–4 hours after eating (but only occasionally).
  • Do not change the dose on your own.
  • It is better not to split tablets but to buy the medication in the dose you need. For example, Euthyrox comes in 25, 50, 75, 100 and 125 mcg; 88, 200 and 300 mcg can also be ordered from Germany.

Combining with other medications and food

L-thyroxine (Euthyrox) should not be taken at the same time as iron, calcium or magnesium supplements or antacids (Maalox, Almagel and others). Keep a 4-hour gap between them.

In the morning after taking L-thyroxine, limit soy, cabbage and meat.

Monitoring hormones

  • If you feel unwell while taking the medication, get your TSH, free T4 and free T3 tested.
  • Once the dose is set, hormones are usually checked twice a year; while the dose is being adjusted, once every 2 months.
  • In some regimens the dose changes with the seasons: higher in autumn and winter, lower in spring and summer. Only a doctor may change the dose.

Adjusting and stopping the dose

  • During pregnancy the full dose is prescribed straight away; in other conditions it is increased gradually under hormone monitoring (dose titration).
  • When the medication is stopped, the whole dose is stopped at once, without tapering.
  • Patients who are very sensitive to the medication are prescribed low doses — 12.5, 25 or 37.5 mcg: higher doses may make them feel overdosed.

Pregnancy and side effects

Euthyrox (L-thyroxine) is officially approved for use during pregnancy and breastfeeding. During pregnancy an accurate dose is especially important, so hormone monitoring matters most.

The most common side effects are palpitations, sweating and irritability. If they do not go away within 10 days, see your doctor.

How often do you check your TSH?