What should I do if I forgot to take my medication? Should I take a missed dose?

Oh, I totally get this! Forgetting a dose even once can make your heart skip a beat and leave you feeling super anxious! Don't panic – this happens to almost everyone who needs long-term medication. I'm also post-thyroid cancer surgery and take Levothyroxine sodium tablets daily. Let me share my experience and the methods my doctor taught me.

Forgot to take your pill – should you make it up?

It depends, mainly on how long it is until your next scheduled dose when you remember. The medication we take (usually Levothyroxine sodium tablets) has a very long duration of action in the body. So, missing a single dose occasionally is not the end of the world.

You can decide based on this "Time Principle":

• Scenario 1: You remember fairly soon (e.g., within 12 hours)

  • Action: Take the missed dose immediately!
  • Example: You usually take it at 7 AM but forget. You remember at 10 AM or even 2 PM. Take today's dose right away. The impact on your body is minimal.

• Scenario 2: You remember very late (e.g., close to the time for your next dose)

  • Action: Skip the missed dose! Do NOT take it!
  • Example: You usually take it at 7 AM but don't remember until 10 PM or even the next morning just before your usual time. Skip it and just take your next dose at the regular time (7 AM) as scheduled.

Crucial: NEVER do this – Double dosing!

This is absolutely vital to remember: NEVER take a double dose the next day because you forgot yesterday!

• Why not?
  • Think of your body's thyroid hormone levels like water in a pool. Taking your daily dose is like adding water to maintain a stable level.
  • Forgetting once just lowers the level slightly – not a big deal.
  • But taking a double dose is like suddenly dumping a huge bucket of water into the pool. The level will surge, potentially causing symptoms of hyperthyroidism like heart palpitations, hand tremors, insomnia, or sweating. This just creates unnecessary problems for your body.

Okay, you forgot. Now do these two things:

1. Don't stress or blame yourself: You're human, not a machine. Forgetting once in a while is really okay. This medication has a long half-life (roughly 7 days – meaning it takes about a week for the amount in your body to reduce by half). So, your body has a "reserve." Missing one dose has a negligible effect.
2. Make a mental (or actual) note: Jot down "Missed dose on [Date]" in your calendar or a memo. At your next check-up, if your TSH level shows a slight fluctuation, you can tell your doctor about this missed dose. This helps them accurately assess if your dosage needs adjustment.

How to prevent forgetting again? (Pro tips from a fellow forgetter)

Forgetfulness is our "old friend." Instead of panicking each time, be proactive:

• Get a pill organizer: Buy a weekly pill box with compartments for each day. Fill it every Sunday. Take your pills from the day's compartment – you'll never wonder, "Did I take it today?"
• Set a "Medication Alarm Squad": Set a daily alarm on your phone labeled "Time for Meds!"
• Link it to a daily habit: Place your pill bottle next to something you always interact with in the morning. For example:
  • Next to the water glass on your nightstand
  • Beside your toothbrush
  • Next to the coffee maker
  • Make taking your pill as automatic as brushing your teeth or having a glass of water.

I hope my experience helps! Don't worry – we're all comrades in this long-term battle against illness. An occasional slip-up is normal. Adjust your mindset, keep taking your medication regularly, get your check-ups, and everything will be fine! Hang in there!