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Medicine timings
Hi..currently am taking thyronorm 62.5(tsh 5.7 with t3 & t4 normal) empty stomach. B12(1500 mcg) after breakfast (b12 148) and iron supplement(femzact) at night( hemoglobin 10.9). But am not getting sleep at night and whole body heats up and acidity,bloating and gas. Getting full after little bit of eating. Also weakness and body body ache. Is it due to summer or do I have to change my medicine timings.
Answers (18)
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Your symptoms are suggesting pitta imbalance and metabolic disturbances in your body. We need more details to evaluate your condition. Please consult us for further details.
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Go for a 30min walk before bed and drink plenty of water.
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Iron tablet is causing gastritis/ acidity.You can take pantoprazole 40 1 hour after taking thyroid tablet.(Before breakfast)
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Continue your medicine as prescribed,take tablet femzact after lunch and b12 (1500) during night time .
Next Steps
try to drink homemade ors alteast 2 glass to overcome heat causing dehydration.
Health Tips
eat green salads more like cucumber
coconut water
buttermilk
etc
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Your symptoms of acidity, bloating, and feeling full quickly are likely due to the iron supplement (Femzact) you are taking at night, which can cause gastric irritation. Also, your TSH is still slightly high (5.7), which can contribute to weakness and body aches. The 'body heating up' sensation can be a side effect of Iron or B12 supplements if not absorbed properly. We need to optimize your medicine timings to ensure better absorption and less acidity."
Health Tips
1. Thyronorm: Continue taking it early morning on an empty stomach with water only. Wait at least 45-60 minutes before having tea or breakfast.
2. Iron (Femzact): Try taking it 2 hours after dinner or mid-afternoon. Avoid taking it with milk, tea, or coffee as they block iron absorption. Vitamin C (like lemonade) helps in better iron absorption.
3. B12: Continue after breakfast.
4. Acidity: Since you feel full quickly, try smaller, more frequent meals instead of 3 large ones."
Do not change the dosage of Thyronorm (62.5 mcg) on your own. Since your TSH is 5.7, you need a follow-up consultation in 4 weeks with a fresh Thyroid profile. If acidity persists despite timing changes, you might need a short course of an antacid (PPI) in the morning, but only after a doctor's consultation."
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Thyroxine dosing is fine. But TSH range also needs further reduction <2.5 (if planning for pregnancy).
You have mild anemia with low hb , but have you determined the cause ? Or taking b12 and iron tablets just prophylactically. Because b12 deficiency is rare if you are taking non vegetarian food.
The symptoms you are experiencing are most likely because of gastritis. Gastritis is a multifaceted problem , one of which can be due to the iron tablets .
Other reversible causes can be emotional or physical stress,obesity, oily and spicy food, excessive tea or coffee.
Next Steps
i would suggest to do Iron profile and serum B12 to find the cause of anemia (low hb) and then proceed.
for the time being can hold the iron tablets for few days ( it's not an essential medicine for now)
take any PPI with prokinetic ( eg PAN DSR- once daily before breakfast for 10 days). and try to avoid the reversible causes.
if you are still experiencing the symptoms after 10 days, better to go for an Ultrasound of abdomen and Upper GI endoscopy to rule out any other causes that would need further medications.
Health Tips
don't lie down immediately after food, walk for 30 mins. eat 70% of full stomach.
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Continue meds as before. Avoid oily, spicy, hot, heavy meals. Take evening meal early and not just before sleeping. Take more of fresh, leafy vegetables, fruits like orange, pappaya. and drink more water.
For weakness and body ache, share results of your tests. You are already on supplements, add Tab Recolina, one every morning and evening for 4 weeks.
Tab pantaprazole 40mg one before breakfast Tab paracetamol 500mg one, if bodyache is more.
Syp maalox gel 5m.l. every 8hours for 2 weeks.
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Continue your schedule. Its appropriate and drink plenty of water to reduce heat episode.
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Hi dear,
Your medication timings are appropriate. You are suffering from gastro-intestinal side effects. These are just common side effects, usually expected with these medicines. I will suggest you a complete prescription, kindly connect with me on Practo app.
Thanks.
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Thyronorm you are taking on time.
B12 is also fine.
Try shifting the iron supplements in the day .
Next Steps
All this could be because of the heat so try to keep yourself hydrated
Health Tips
Drink plenty of water and eat more fibre alongwith your medications.
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There are a lot of things. Weather, ur thyroid , and supplements. Kindly consult with me on 94 two six eight six 78 nine six.
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Dr. Sohan Kulria
General Physician
5 yrs exp
Firozabad
If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a detailed discussion
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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Do connect and consult
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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Needs evalaution
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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