Can L-thyroxine be taken before going to sleep, instead of taking it in the morning?

Hi Ana,
I understand your wanting more information, and questioning some of the family doctor's recommendations. I wanted to provide you with the information about your daughter's medication, however, I assume you already know this information, as it is also printed in the patient information pamphlet that comes with her prescription.

Your daughter's diarrhea is one of the side effects of L-Thyroxine, as well as headaches, trembling and others. I am surprised that her doctor was not more sympathetic, however, to the pain she is suffering with diarrhea, even if it is one of the "known" effects of this medication. I am unsure what the remedy is, as this drug is prescribed knowing there are unpleasant side effects, but it is prescribed with the thought that the benefits of the drug outweigh the risks (side effects). If you are interested, we can also ask one of our medical experts to weigh-in on this topic.

I was surprised that the doctor said, without doubt, that your daughter's eating too much is the cause of her weight gain. This may be the case, but I am wondering if she also mentioned that having low thyroid levels is also a primary cause in weight gain? Do you know how long your daughter had hypothyroidism before seeking treatment, and if her weight gain happened during this time?

If you do not see a pattern with her weight gain (being partially caused by her thyroid condition), but do see a pattern in the amount or type of calories she consumes each day, a nutritionist would be a good idea. I assume your daughter lives with you, and if she is non-verbal with limited comprehension, I also assume that you or another family member is in charge of meal planning, shopping and preparation? If this is the case, perhaps an appointment with a Registered Dietitian would be most appropriate for all family members involved with meal planning.

Honestly, I am also surprised that the family doctor said that the pain could be psychosomatic. Do you see other symptoms of your daughter not wanting to go to school, besides the diarrhea pain? (Again, I am only questioning this, since the diarrhea is a side effect of the medication...and the family doctor, from your account, listed the pain as a "problem" for other doctors to deal with--either in her diet or it's "all in her head"). When your daughter has pain, is she allowed to skip school (or are there other inadvertent rewards she receives for the pain, such as more attention?)

Lastly, I am not sure how much you are questioning the knowledge that your daughter's family doctor has on thyroid issues, and if you are interested/able to see the endocrinologist on a more regular basis?

Would love to hear back from you soon!