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* Push the syringe into the centre of the MT2 vial, there is a circle raised top of the grey cap use this as a guide for the centre (if you feel resistance you may need to place the needle slightly off centre), and push the water from the syringe into the vial (onto the side of the vial if possible) * Draw out another syringe of water and repeat as above

[2] Alternative options include taking levothyroxine at bedtime (at least 3-4 hours after the last meal) with clinician guidance

This mechanism explains in part why patients with diabetes have increased prevalence of cholesterol gallstones [27]