I am talking Nature throid. Polymorphisms (genetic differences) can lower the effectiveness of thyroid hormone in some people. Thyroid. No surprise. Most of the rest of the day, the T4 levels will be stable. Biotin interference with routine clinical immunoassays: understand the causes and mitigate the risks. J Thyroid Res. Hyperthyroidism is a common disease in cats, and mostly afflicts cats middle-aged and older. By then the Synthroid will be absorbed. The last time I tried to prep for the procedure, they used that diet approach for four days. It seems the best is getting your thyroid function tests done first thing in the morning, bringing your medications with you, and taking them rightafteryou have your thyroid function tests to ensure that you get accurate test results. These problems may show up in your thyroid stimulating hormone (TSH) blood test. For this reason, it may not make sense to switch to taking your medication at night. It's a good idea to carry your medication with you so you can take it on the go. You can take your MVM any time you'd like. Polyps removed during colonoscopy are sent to a laboratory for analysis to determine whether they are cancerous, precancerous or noncancerous. My first six week test results showed my TSH jumping from .861 to 3.840. AskMayoExpert. Diabetes medications: Use of these medications often needs to be changed around the time of the colonoscopy. Wear loose comfortable clothing. Furthermore, The adrenal glands need thyroid hormone to function and with low thyroid hormone as well as greater pressure due to body stress the adrenal glands cannot cope and suffer fatigue. Ferritin went up some 26.90 ng/mL. Your bowel movements are not clear after you finish your bowel prep. T4 peaks 2 hours after taking it in medication . What I understand from your article is that it shouldnt make a difference b/c it is only T4, not a combination. Mary Shomon is a writer and hormonal health and thyroid advocate. My t3 is 1.93. Question: Have you written any articles addressing the issue of natural thyroid meds and their effective suppression of TSH? I do need to be able to take the supplements as well as the thyroid and get good absorption or I will have problems with calcium deficiency etc. However, in most cases, you can take Tylenol before and after your screening unless there are unusual circumstances. Bishnoi A, Carlson HE, Gruber BL, Kaufman LD, Bock JL, Lidonnici K. Effects of commonly prescribed nonsteroidal anti-inflammatory drugs on thyroid hormone measurements. You need to take Tapazole and PTU consistently. After a bad cold I called my Doctor and she said to take the. The reason for this is that aspirin sometimes causes slight blood-thinning, which can increase the risk of bleeding if a polyp removal must be administered. You see, most of the hormones are bound by proteins to carry them around in the bloodstream, so they can be available at distant sites. Keep in mind that it takes between 4-6 weeks before thyroid replacement . Well, actually T4 does havea smallaction on the cellular level, but its biggest use is to be converted to T3 in the tissue where it will be used. And how do I know what to tell you? I'm so NOT ready to do that again. Some people think taking levothyroxine in the morning is inconvenient. The answer is yes, based on a 2007 study in Experimental and Clinical Endocrinology & Diabetes, we know what blood levels do after taking medication. https://www.drugs.com/drug-interactions/sodium-salicylate-with-synthroid-2094-0-1463-869.html. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Inform your doctor about medications you're taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners such as warfarin or heparin), clopidogrel, insulin or iron products. Great book!! Advil, Motrin), or naproxen (e.g. It would be very helpful to have some credible sources supporting the idea that it is not always dangerous to have a very low TSH. Can I take Azo Standard for one day and be okay for the test? Colonoscopy. I can take all my meds and supplements then. You'll also avoid the upset stomach that. doi:10.1007/s11695-013-1015-y. You owe it to YOURSELF AND FAMILY AND FREINDS . The choice is really just a matter of what suits your lifestyle best. Therefore patients taking aspirin should consult their doctors before stopping medication. On WP Thyroid. If the interpretation of the blood test includes T4, then the timing of the medication and blood test must be taken into account for an accurate assessment. Read our, Taking Your Medication for Hyperthyroidism. Your doctor may recommend a different bowel preparation to ensure that your bowel is completely emptied before the next colonoscopy. I recently had labs drawn and was in total shock when I saw my numbers on the report! In most cases, the sedative is combined with pain medication given directly into your blood stream (intravenously) to lessen any discomfort. For aspirin (81 or 325 mg daily) used to prevent heart problems, this is usually safe to stop for seven (7) days prior to any procedure. You need an Endo who understands to read the other values of your lab results and respect your symptoms . You may take inhalers, eye drops You may have clear liquids up until 3 hours before your exam time. But taking iodine drops or bulking up on foods high in iodine, such as kelp, won't help. Tapazole (methimazole) and propylthiouracil (PTU) can interact with beta-blockers, digitalis, theophylline, and blood thinners like warfarin. If your doctor finds one or two polyps less than 0.4 inch (1 centimeter) in diameter, he or she may recommend a repeat colonoscopy in 7 to 10 years, depending on your other risk factors for colon cancer. Last week, they rechecked my bloodwork and my TSH is down from 16.95 to 1.xx (can't remember exact digits). The doctor will insert a colonoscope into your rectum. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. I guess every one passed the buck here. Go over your possible interactions and what to do about them with your healthcare provider and pharmacist whenever you start a new medication. During a colonoscopy, a long, flexible tube (colonoscope) is inserted into the rectum. If you're on a natural T3 medication, such as Armour or Nature Thyroid, and forget your medication, don't take your dose late or double up. 2023 Dotdash Media, Inc. All rights reserved, Mary Shomon is a writer and hormonal health and thyroid advocate. Figure out ways to remind yourself so you can be consistent. Outside of pregnancy, there's no hard and fast rule in conventional medicine that says you must take thyroid medication before the TSH exceeds 10 and you're symptomatic. National Institute for Diabetes and Digestive and Kidney Diseases. Ive researched for hours. Studies show that taking levothyroxine too soon before or after a meal or snack can lower absorption of the drug by about 20%. Hypothyroidism (low thyroid function) is treated with one or more of the following thyroid hormone replacement drugs: Hyperthyroidism (overactive thyroid) is treated with antithyroid drugs that block the production of the thyroid hormones T3 and T4, namely: Levothyroxine should be taken on an empty stomach. In your body, T4 is converted into another hormone called triiodothyronine. Mayo Clinic is a not-for-profit organization. Overview of colonoscopy in adults. Green Tea, Thyroid Disease, and Weight Loss, Keys to Taking Thyroid Medication Correctly, What Thyroid Patients Need to Know About Decongestants, Management of hypothyroidism with combination thyroxine (T4) and triiodothyronine (T3) hormone replacement in clinical practice: a review of suggested guidance, Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association, Biotin interference with routine clinical immunoassays: understand the causes and mitigate the risks, Factors affecting gastrointestinal absorption of levothyroxine: A review, Oral liquid L-thyroxine (L-t4) may be better absorbed compared to L-T4 tablets following bariatric surgery, Thyroid dysfunction and drug interactions, Selective serotonin reuptake inhibitors (SSRIs), Levothyroxine dosage may need to increase, Elavil (amitriptyline) Sinequan (doxepin) Norpramin (desipramine), Humalog (insulin lispro) Humulin N (human insulin isophane), Dosage of both drugs may need to increase, Ortho-Novum (ethinyl estradiol/norethindrone) Premarin (conjugated estrogens), Questran (cholestyramine) Colestid (colestipol), Take at least 4 hours after levothyroxine, Anticoagulant dosage may need to decrease, Tums (calcium carbonate) Mylanta (aluminum hydroxide, magnesium hydroxide), Take at least 3 hours after levothyroxine. Reasons may include: You may want to keep taking your thyroid medication in the morning because you have always done it that way. Mayo Clinic. Store thyroid drugs properly. Often the person is under conscious-sedation and thus not real. Thank you, {{form.email}}, for signing up. Food can bind with thyroid medication. Due to biopsy of abnormal cells I had a total thyroidectomy. Certain psychiatric and weight loss medicationscan cause potentially harmful interactions with anesthetic medications. They don't want to wait an hour before eating or drinking coffee. According to one study, one reason for this could be because coffee stimulates the colon, so there is less time for the medication to be absorbed. I have been on Synthroid for a year. There are a few different theories about why this might happen: Some people may find it challenging to take thyroid medication at night. You'll begin the exam lying on your side on the exam table, usually with your knees drawn toward your chest. To be consistent, try to pair taking your medication with something you do every day, such as brushing your teeth. Endocr Pract. Thyroid medication, when used correctly, has a beneficial impact on quality of life. The more I try to figure out all this, with not much results, the more upset I get. Acetylsalicylic Acid. You'll start preparing for your colonoscopy a couple of days before you drink the bowel-cleansing agent. It's considered safe to take your hypothyroid treatment while breastfeeding. The authors found that patients who took their medication at bedtime had a significant increase in their levels of free T4. When the scope is moved or air is introduced, you may feel stomach cramping or the urge to have a bowel movement. If you noticed, the tests done in the study were free levels of T3 and T4. Thus, it is usually best to postpone your combination medication until after you get your lab test done. Typically, the longer you go without your medication, and the more severe your thyroid disease is, the higher your risk for severe and even life-threatening conditions. My hair is coming out, weight gain and no energy. Accessed April 1, 2022. It starts to drop immediately, and drops for 5 hours after taking the dose of medication. Before a colonoscopy, you'll need to clean out (empty) your colon. Then avoid food and drink, including coffee, for at least an hour. Tissue samples (biopsies) can be taken during a colonoscopy as well. Evaluation of how to proceed with your colonoscopy procedure should be decided on an individual basis and approved by a medical professionaland perhaps even reassured by a second opinion. How soon will depend on the amount of stool and how much of your colon was able to be seen. Adprin-B products. Start by having a 4x diurnal salivary test which tests Cortisol and DHEA. Read More Created for people with ongoing healthcare needs but benefits everyone. Ive been taking Synthroid for 23 years. Systematic Review and Meta-analysis on the Effect of Soy on Thyroid Function. I have been feeling more depressed every month and just didnt feel normal for the last few months. Apparently they were going to prescribe Magnesium Citrate and then the Miralax, but I'm already taking lots of magnesium so that one got tabled. Also, be sure to mention allergies you have to medications. Thyroid medication is usually taken first thing in the morning on an empty. Specific components of food and supplements, like calcium, can impact the total absorption of thyroid medication. Thyroid Res. So here's how it works. Reviewed 12/14/2011 by David M. Nolan, M.D.Diplomate of the American Board of Internal Medicine, 2011Currently a Fellow of Gastroenterology, at UCI 2011-2014. Thyroid function in men taking carbamazepine, oxcarbazepine, or valproate for epilepsy. Most polyps aren't cancerous, but some can be precancerous. The thyroid gland makes a little of it, but in order to distribute it widely through the body, makes more of an inactive form called T4 (thyroxine). 2014;24(12):1670-1751. doi:10.1089/thy.2014.0028. Also very swollen face. She is the author of "The Thyroid Diet Revolution. Best of luck. Terms & Conditions, My tsh is .110. I am taking T4 meds. 2017;39(2):378-403. doi:10.1016/j.clinthera.2017.01.005, Pirola I, Formenti AM, Gandossi E, et al. Aspirin (or ASA): Continue taking this as you usually do. Taking more than a single dose can cause overdose symptoms that may include: Since Tapazole (methimazole or MMI) and PTU (propylthiouracil) should be taken consistently, it's important that you find ways to remember each dosage. Taking your thyroid medication properly helps you absorb it well and limits your risk of side effects. 2018;11:1. doi:10.1186/s13044-018-0045-x. Drug interactions with levothyroxine therapy in patients with hypothyroidism: observational study in general practice. How Do Adaptogenic Herbs Benefit Hashimotos? There is hope . I don't take T4, just the natural thyroid (Thyroid NP). I just got that confirmed from the dr.s office today (the gastroenterologist). A colonoscopic examination involves gently inserting a fiber-optic colonoscope into your rectum and large intestine to view your lower gastrointestinal tract. Stop taking these one week before your procedure. 5-Aminosalicylic Acid. Continue Learning about Colonoscopy Avoid ibuprofen (Advil) 7 days prior. Different effects on plasma volume, thyroid hormones and thyroid hormone-binding proteins after oral and intravenous administration. DO NOT TAKE ANY ANTACIDS OR CARAFATE BEFORE THE PROCEDURE or any of the medications mentioned. Thus, stopping medication as a precaution and risking other health issues such as heart failure may not be worth it. Walking may help relieve any discomfort. For example, the brand Synthroid contains: Always let your healthcare provider and pharmacist know about your medicine and food allergies or sensitivities. Can you take Synthroid before colonoscopy? But many people . This site complies with the HONcode standard for trustworthy health information: verify here. This is where we see the hugest difference in the timing of your tests for accurate results. There is some research, though, that suggests it may be better to take your dose at bedtime. My free t3 is 5.06. For most people, it doesn't really matter if you take your thyroid medicine in the morning or just before bed. Accessed June 10, 2021. This can take a little while to get right. Not usually..: The colon-prep is often the most difficult part for people, not the colonoscopy itself. Food and Synthroid Drug Interactions. T3, being the active form of the thyroid hormone, acts differently than T4 in that it has a relatively short half-life. In fact, the American Society for Gastrointestinal Endoscopy has deemed it unnecessary for the prevention of post-procedural bleeding after polyp removal. Beverages (not including water) can impair absorption as well. A pharmacy can make substitutions without your healthcare provider's knowledge unless they write "dispense as written/no substitutions" on your prescription. Mayo Clinic does not endorse companies or products. She would not test my rT3, so I got that ordered by my naturopath who told me not to take my meds the morning of testing. The procedure is used to look for early signs of colorectal cancer and can help doctors diagnose unexplained changes in bowel habits, abdominal pain, bleeding from the anus and weight loss. Join Dr. Dac or Ariel Bridges each week on the Colon Health Podcast to learn the latest advancements and advice on managing colon health. Coumadin), apixaban (Eliquis), dabigatran (Pradaxa), or rivaroxaban (Xarelto): Please check with your doctor about how to take them. Look up Adrenal Fatigue..a book Adrenal Fatigue A Desk Reference by Dr Salmaan Dalvi is an excellent resource providing detail about the necessary vitamins and minerals, herbs etc. She is known as the go-to person to get back your get-up-and-go when it is gone, gone, gone. What would that indicate to you? Thyroid medications. 2011;2011:505239. doi:10.4061/2011/505239, Jonklaas J, Bianco AC, Bauer AJ, et al. Your dose will likely need to be increased. https://www.uptodate.com/contents/search. It's important to be consistent with your medication. The interactions can usually be lessened by reducing the dose of the accompanying drug. Plavix), ticagrelor (Brilinta) : Usually these medications are continued. The peak is about 4 hours after taking the medication. Reasons may include: There is some evidence that taking your medication at night may help your body absorb it. Coumadin (Warfarin) How many days BEFORE your surgery to stop taking this drug. Regular medicines for sleep or for anxiety: These can be taken as usual. Examples of anticoagulation medications Six hours before your appointment: Drink the second dose of the prep. Anexsia with Codeine. Low adrenal output is common with low thyroid and visa versa. I just got that confirmed from the dr.s office today (the gastroenterologist). A reaction to the sedative used during the exam, Bleeding from the site where a tissue sample (biopsy) was taken or a polyp or other abnormal tissue was removed, A tear in the colon or rectum wall (perforation), A large polyp larger than 0.4 inch (1 centimeter), Polyps and also residual stool in the colon that prevents complete examination of the colon, Polyps with certain cell characteristics that indicate a higher risk of future cancer. Disclaimer: No Physician-Patient Relationship Otun, J., Sahebkar, A., stlundh, L. et al. A colonoscopy typically takes about 30 to 60 minutes. Experts have long recommended taking thyroid medication like levothyroxine first thing in the morning. They stay in your system for a long time because they're not quickly metabolized, so you take them just once daily. Doctors recommend patients stop taking Blood Thinners *, and Ibuprofen, including Advil, 7 days prior to your colonoscopy exam. How long does it take for thyroid medication to work? Trifiro G, Parrino F, Sultana J, et al. Comparative evaluation of morning versus evening dose of levothyroxine in treatment of hypothyroidism, Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association task force on thyroid hormone replacement, Concurrent milk ingestion decreases absorption of levothyroxine, Levothyroxine interactions with food and dietary supplementsa systematic review. Switching brands of levothyroxine or changing to a generic may affect your symptoms or side effects. Mary Shomon is a writer and hormonal health and thyroid advocate. If you take Thyroid medication, please take at least 1 hour before you begin the preparation OR wait until after you have completed the preparation 3. I need to find an endocrinologist but I have no idea who to go see either. Your doctor may recommend that you have another colonoscopy: If there was residual stool in the colon that prevented complete examination of your colon, your doctor may recommend a repeat colonoscopy. This is very interesting. information and will only use or disclose that information as set forth in our notice of Blood tests are affected in this way: TSH & free T3 are the same whether you take your T4 medication before or you have waited up to 48 hours to take the blood test. A friend just had a colonoscopy, and she was surprised at how little of the "stuff" she had to drink on the morning of the procedure. Therefore, it is important not to take the medication with meals, other medicines, or supplements. She is the author of "The Thyroid Diet Revolution. That can cause an overdose. If you're used to taking your medication in the morning, there isn't much reason to change. You should not have solids in your bowel movements. Iodine is an essential mineral for thyroid health. If your doctor is concerned about the quality of the view through the scope, he or she may recommend a repeat colonoscopy or a shorter time until your next colonoscopy. Inform your doctor about medications you're taking, particularly aspirin products, arthritis medications, anticoagulants (blood thinners such as warfarin or heparin), clopidogrel, insulin or iron products. First month 60MG and now increased to 120MG. Many different medications interact with thyroid medications. Learn more about colonoscopy at http://www.YouAndColonoscopy.com In this video, Dr. Gelrud and Dr. Echavarria explain which medications should be continued,. 2021; doi:10.1001/jama.2021.6238. The cheaper test, and more commonly done, is total T4. In many cases, blood-thinning medications have no effect on a regular colonoscopy procedure because many patients do not have large polyps that might bleed. My APRN wanted me to try switching from Synthroid 100mg to Nature-Throid. My PCP is. . My first dose of Nature-Throid was 65mg. Usually this isn't cause for alarm. Post your colon health question and get information from healthcare providers. I have been diagnosed and taking 88mcg Levothyroxine for 30 days. A single copy of these materials may be reprinted for noncommercial personal use only. If you are a Mayo Clinic patient, this could How do you give hypothyroid drugs to children? Your symptomsfatigue, constipation, dry skin, brittle nails, and so forthshould get better within a few days. You should also be able to take on your prep day. Are Your Adrenals Sabotaging Your Health? https://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-1-issue-1/vol-1-issue-1-p-21/. What they are suggesting seems reasonable considering what my body can tolerate.thank goodness! What drugs can interact with hyperthyroid drugs? The conversion process of T4 to T3 may just work better in the evening. Nothing to eat or drink at least 8 hours before the procedure. It's possible to have serious side effects from anti-thyroid drugs. I think they have something worked out that they have prescribed through a pharmacy as I got a call about picking up the prescription today. An underactive thyroid (hypothyroidism) is usually treated by taking daily hormone replacement tablets called levothyroxine. Drugs.com. I get this question from those taking thyroid medications: When I have my thyroid checked with a blood test, should I take my medication before having my blood drawn? Can You Eat Soy If You Have a Thyroid Condition? The pituitary gland responds to low levels of thyroid hormone by making more TSH and to high levels of thyroid hormone by making less TSH in most cases. This method also works for adults who have trouble swallowing pills. Still, you should keep some considerations in mind to ensure your medication is working as well as possible. That's true whether you have hypothyroidism (low thyroid activity) or hyperthyroidism (high thyroid activity). Weight gain, fatigue, brain fog. Your doctor may recommend a colonoscopy to: There is a problem with They interact with each other. of Gatorade or G2 to allow room for the Miralax. See your healthcare provider right away if you become pregnant while taking medication to treat low thyroid levels. You can take any meds expect blood thinners. If you get pregnant, you may need to increase your dosage. Advertising revenue supports our not-for-profit mission. The amount of time it takes to treat hyperthyroidism can change depending on what caused it. Recommendations for follow-up after colonoscopy and polypectomy: A consensus update by the U.S. Multi-Society Task Force on Colorectal Cancer. An exception is if your doctor is concerned about medication absorption. March 25, 2016. My GP is the only dr Ive been to so far. I am on armour thyroid but going to switch to combination different. The problem is she is ignoring symptoms in pursuit of this number. Stick with your doctor's prescription to keep your condition under control. These questions must be answered by the doctor that will be doing your colonoscopy. i was diagnosed with pvc premature ventricular contraction ,i been on 112 mg of levothyroxine for years never had this but i feel as if i get upset or nervious or eat something i get these so called palpitations any recommendations ? What drugs are used to treat hypothyroidism? Khanna S (expert opinion). Yes, depressed too. The influence of carbamazepine on thyroid hormones and thyroxine binding globulin in hypothyroid patients substituted with thyroxine. Thanks for replying though and good to know that others have survived this ordeal. GREAT TOPIC . Then, it begins to rise, and reaches a stable point about 13 hours after taking the medication. On the other hand, it may not be a good strategy if you don't always go to bed at the same time or if your medication interferes with your sleep. And before starting on Armour my antibodies 276 IU/mL. Studies show minimal amounts get into the milk. Related Articles. Downside to all this is that my endo only manages my care by TSH. by Cheryl Kasdorf | Alternative Medicine, Dr. Cheryl Kasdorf ND, Hormonal Imbalances, Thyroid | 17 comments. Consult your doctor if you continue to pass blood or blood clots or if you have persistent abdominal pain or a fever. Don't drive or make important decisions or go back to work for the rest of the day. Have your thyroid levels checked about six to eight weeks after you make the switch. Step 1: Plan Your Prep. However, studies have found that taking your thyroid drugs with coffee could reduce absorption of the medication by up to 36%. This problem happens to many of us with low thyroid hormone physical, emotional and psychological stress including illness will impact the Adrenal glands. Medications Used to Treat Thyroid Disease, Why Your Thyroid Hormone Levels May Be Fluctuating. If you experience nausea or vomiting rinse your . My doctor feels that Im not absorbing my Synthroid now. TSH is the hormone that tells your body to make thyroid hormones. Medication can be taken 4 hours before examination with little sips of water. So now Im on Armour Thyroid. When I got to taking the "stuff", I had an allergic reaction and ended up in an ambulance. So I'm set up with the Go-Litely stuff in a huge jug. Im wondering if its too much medicine but now Im down to cutting 50 mgs into four pieces and taking it 4x a day but still having heart palpitations and anxiety! Ive been on Levothyroxine 112 MCG for about 5 years. As many things in life, the answer is: it depends. For example, a 100 mcg tablet may contain between 95 mcg and 105 mcg of hormone. Taking your medication at night may have some benefits, including: A 2020 review looked at a number of studies that compared morning doses of thyroid medication to nighttime doses. I don't understand why you can't take magnesium citrate for the prep. sooziechen I would very strongly suggest you to read and do your own research and never give up . Has anyone been through this? Thyroid dysfunction and drug interactions. If you are taking thyroid medication, talk to your healthcare provider before taking supplements. Aanderud S, Myking OL, Strandjord RE. I would like to know your opinion, as well. Take your thyroid medication around the same time and in the same way every day. It may be easier to avoid things that can interfere with thyroid medication absorption. Step 2: Tweak Your Diet. Sodium salicylate and synthroid interactions. Bipolar Disorder: Understanding Your Treatment Options, How to Care for Your Skin When You Have Acute GVHD. Watch for negative side effects and drug interactions. Diarrhea. Green Tea, Thyroid Disease, and Weight Loss, How Coffee Interferes With Synthroid (Levothyroxine), Guide to Dietary Supplements and Thyroid Disease, Effect of lthyroxine administration before breakfast vs at bedtime on hypothyroidism: A metaanalysis, Levothyroxine absorption in health and disease, and new therapeutic perspectives, Can levothyroxine be taken as evening dose? Please see the instructions for patients with diabetes preparing for a colonoscopy. Dr Barry Durrant-Peatfields book will describe detail of adrenal support using physiological Cortisol. Im so confused. 18 December, 2018 Many people take prescribed or over-the-counter medications they must stop using before a colonoscopy. Drugs that interact with levothyroxine: an observational study from the Thyroid Epidemiology, Audit and Research Study (TEARS). Controversy: Is Coffee Bad For Your Thyroid? 2014;18(4):451-6. doi:10.1016/j.clinthera.2017.01.005, Rajput R, Chatterjee S, Rajput M. Can levothyroxine be taken as evening dose?
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