At 08:42 7/02/97 -0800, Graciela Spivak wrote:
>A question for Francisco Lopez Rueda,
>my bottle of Synthroid says to take it 0ne hour before or two hours after
>meals.  This is difficult enough for me to do (I eat all day long, small
>meals) for one dose each day, so it'd be even harder if the dose is split
>into several pills a day.
>How important is it to take Synthroid in an empty stomach?
>And is it true that T4 (thyroid) and estrogen have opposite effects and
>should not be taken together?
>Thank you
>Graciela Spivak
 
        Our patients take synthroid with the meals, the absorption is more
slow, but similar, 50%. You can take it inmediately before your small meals
(have you reactive hypoglucemic?).
 
        T4 and estrogen have not opposite effects, they have different
effects. The real question is that estrogen increase the protein binding
T4..., and if you testing your total T4 serum level taking estrogen will
appear wrongly increased. The solution is easy, you must always testing free
T4 (FT4) when you are taking estrogen.
 
        And the main question that we have in mind is why thyroid illnesses
are so much frequent in women than in men, why the relationship is 10/1
women/men and why this quotient tends to equal in menopause...?. Which the
culprit is?. Our hypothesis is that estrogens sensitize thyroid gland,
making it more vulnerable to different aggressions.
 
 
 Francisco L. Rueda, MD