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Patient's name Date Your dose (micrograms)

Take it

Morning, empty stomachBedtime

Next TSH test on

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How to take it

Take it on an empty stomach, with plain water.
Then wait at least 30 minutes, ideally 60, before tea, coffee, milk or breakfast.
Take it at the same time and in the same way every day. First thing in the morning suits most people.
If mornings are difficult, bedtime is an alternative: at least 3 hours after your last meal. Choose one and keep to it.

Keep a gap from these

What	Gap from the thyroid tablet
Calcium and iron tablets	4 hours
Antacids, and vitamins that contain calcium or iron	4 hours
Tea, coffee, milk, soya, high-fibre food	30 to 60 minutes

Important

Do not stop the tablet when you feel well. For most people it is lifelong.
Missed a tablet? Take it when you remember that day. If you remember only the next day, take your usual dose. Do not take two together. One missed tablet is not harmful.
Do not change the brand without telling your doctor. Different brands can act differently.
The dose is in micrograms and small changes matter. Check the strength each time you buy.
Store it in its original bottle with the lid tightly closed, in a cool, dry place, away from sunlight, the kitchen and the bathroom.

Blood tests

TSH is checked 6 to 8 weeks after starting or after any change of dose, then as your doctor advises.
On the day of the test, give the sample before you take the tablet.
Stop biotin (found in hair and nail vitamins) for 2 days before the test. It gives false results.

Planning a pregnancy, or pregnant?

Tell your doctor at once. The dose usually needs to be raised early in pregnancy, and the test is repeated about every 4 weeks. Ask your doctor now what to do on the day your pregnancy test is positive. Many advise this until you are seen: take your usual tablet every day, and one extra tablet on 2 days of the week (9 tablets a week instead of 7).

Signs the dose may be wrong

Too much

Fast heartbeat or palpitations
Feeling hot, sweating
Nervousness, shaking hands
Poor sleep
Loss of weight, loose motions

Too little

Tiredness
Feeling cold
Weight gain
Constipation
Dry skin, puffy face

Do not change the dose yourself. Get a TSH test and see the doctor. Chest pain, or a very fast or irregular heartbeat: go to a hospital.

Questions about this sheet? Call Caspian Healthcare reception on +91 89193 41154. A doctor is on duty at all hours for problems that are not critical. Caspian has no emergency department: in an emergency call 108.

Where this comes from

Prepared by Caspian Healthcare from the sources above. Last reviewed October 2026. General information: your own doctor's written instructions come first.