Case Study

Joan, a 40 year old teacher is feeling tired.
She has had hashimotos thyroiditis and had become hypothyroid 3 years ago.
After some adjusting, her thyroxine dosage was found to be 150mcg mane.
At this dosage she was maintained at a TSH of 1.2 uIU/ml
Over the past 6 months she has gradually become tired again and feels she is no longer correctly dosed.

 

On closer questioning, she had started calcium tablets for prevention of osteoporosis, as a friend of hers had recommended them.

 

She had been getting to bed later and was getting up with little time to spare in the morning, so she had started taking all her medications together just before breakfast

What advice would you give her re her thyroxine?