Dr. Keith Roach
Dear Dr. Roach: I had a thyroidectomy and am on levothyroxine. The drug leaflet states that it should not be taken within 4 hours of taking calcium. The discussion on this drug does not clearly state whether this refers only to calcium supplements or also includes high-calcium foods.
I usually try to avoid dairy products for breakfast (yogurt, cheese, soy milk, etc.) and foods for dinner (broccoli, leafy greens, dairy products, soybeans). take levothyroxine. I go to bed pretty early. I eat mostly plant-based and dairy.
I also asked several doctors and pharmacists to simply answer, “Isn’t that just about supplements?” don’t know! That’s why I’m listening. I hope the thyroid formula works as expected. Can you shed some light on this issue?
—E.G.
Dear EG: High doses of elemental calcium reduce the absorption of the thyroid hormone thyroxine (such as synthroid). Taking thyroxine at the same time as a large calcium tablet would be expected to reduce the absorption of thyroid drugs by about 7-8%. (Iron and caffeine also reduce thyroid hormone absorption.) Consuming a glass of milk at the same time reduces thyroid hormone absorption. Although soymilk has not been studied, calcium-fortified soymilk is expected to be similar to milk, yogurt, and possibly high-calcium cheese in its ability to reduce thyroxine absorption.
But I suspect you are taking things too far. One hour would probably be enough for him to separate the calcium from the thyroxine. Additionally, if taken consistently, the dosage will be adjusted to the correct level. I doubt that vegetables affect absorption.
Finally, in a study of people who took thyroxine with occasional or no calcium intake, levels were clearly affected, but the changes were not sufficient to move them out of the desired range. . Thyroid hormone dosages are somewhat lenient for most people, but some people, such as those with a history of thyroid cancer who are currently undergoing replacement therapy after surgery, require very precise dosages. will be needed. Therefore, in such cases, it is important to be careful to avoid calcium, iron and caffeine.
Dear Dr. Roach: I am a 72 year old female. She developed an allergy to Tylenol and all her NSAIDs as an adult. Just this week she developed a rash after taking aspirin, her last resort for pain. She got tramadol prescribed but doesn’t want to take narcotics because of the pain that only occurs on a regular basis. I do ice, heat, stretching, and exercise, so most of the time there is no pain.
— TW
Dear TW: I have rarely seen people allergic to so many types of medications, but it can happen on rare occasions. Unfortunately, I do agree that opioids (the term narcotic is no longer used) are too strong drugs to be taken lightly. Like other opioids, tramadol can have serious side effects, and even proper use of opioids can lead to opioid use disorder. Prescription drug misuse is a major problem in North America, and not prescribing prescription drugs in the first place is a good way to prevent problems. (People who misuse opioids usually get them from friends or relatives.)
A non-prescription method of treating pain seems like a very good way to treat the pain we all experience from time to time. Topical treatments such as menthol, camphor-based creams, and even topical NSAIDs such as diclofenac may not cause allergic reactions, so trying these may be successful.
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