Question: For Reference - Old Query.

Does aloe vera and amla juice taken with honey interfere with absorbtion of thyronorm tablet. I generally give a gap of 30 mins between the two. I take thyronorm 100 mg as prescribed by my Dr. at 5:30 in morning and aloevera and amla juice with honey at 6 in morning. Please advice.

Answer -

Hi,
Welcome to HCM. I have gone through the question and understand your concerns.

The recommendation is to take liquids/ medications (other than calcium) 30 minutes after thyronorm. This won't interfere with drug absorption. If your TSH is fluctuating on follow up, increase the gap to 1 hour.

So you can continue as of now.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Endocrinologist


Followup Query:
Thank you Doctor for your prompt response. The only follow up question I have is if there are any other dietry precautions required for hypothyroidism and how often should I get my TSH level checked to ascertain that my dosage is working.

Thanks and regards

Answer -

Hi,
Welcome back. The answers to your questions:

1. Diet in hypothyroidism depends on the cause. Two common causes being auto immune (Hashimoto's) and iodine deficiency.
In Hashimoto's ( more common cause) no diet modifications are needed.
In iodine deficiency hypothyroidism you can increase the consumption of iodised salt, sea foods etc and decrease the consumption of cabbage, cauliflower, millets etc
You can do a anti TPO antibody to differentiate these two

2. The testing depends on the patient features.
In children, women of reproductive age, people with fluctuations in TSH we monitor TSH every 6-12 weeks. In others every 6months or annual check up is needed.

Regards

Dr Ajish TP

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For Reference:

http://doctor.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=209888

Hello Doctor,
Hope you are doing well. I got my thyroid test done recently so thought of checking with you if my thyroid medication needs any adjustments. Currently I am taking 100 and 112.5 mcg on alternate days as suggested by you on 23rd Feb 2016. Alternatively my dietician Dr. XXXXXXX XXXXXXX XXXXXXX had also ordered some tests to check my Vitamins, Haemoglobin and Calcium levels. She observed that my TSH levels are too low and she advised me to get in touch with you to see if my dosage needs modification.I am attaching all the reports for your perusal.

Last time my thyroid test result showed TSH on slightly higher side (4.05) basis that you had modified my dose to 100 mcg and 112.5 mcg alternate days. I have continued this dose since February 2016. The recent thyroid test shows my TSH level as 0.64 mcIU/ml which according to my dietician is too low as it may start affecting my bone health. She has asked me to consult you to check if my Thyronorm dose needs to be adjusted.

Also since my Vitamin B12, Vitamin D and Hemoglobin levels are low she has prescribed me the following supplements:

1. Haem Up capsules to be taken after lunch for 6 months
2. Nervijen Plus capsules to be taken after lunch for 6 months
3. Vitamin C to be taken with Haem up at lunch.
4. Up rise D3 XXXXXXX to be taken 1 hour after dinner weekly once for first three months subsequently once every two weeks for 3 months and then once every month for life.

In addition to the above mentioned medications, I am taking my Thyronorm medication as prescribed by you empty stomach in the morning and Omega 3 plus supplements from Amway twice a day (with breakfast and dinner)

My queries are as follows:

1. Do I need a modification in my thyroid medication as indicated by my dietician?
2. Nervijen plus capsules have Alpha Lipoic Acid (100 mg). I have read that it should not be taken with patients with Thyroid disorder. If this is true then can you suggest me a suitable Vitamin B12 alternative which is safe for patients with thyroid disorder?
3. Can I continue with Omega 3 supplements or it too be counter indicative with thyroid patients.

Thank you
Warm Regards XXXXXXX