When to take levo

I am thinking of changing taking my levo at night instead of in the morning. The reason being i have been prescribed lansoprazole for Gerd, which I also take in the morning. From a post on here I gather it is not a good idea to take levo with Gerd medication. I also take blood pressure meds and water tablet in the morning..

so, my question is would it be better to take levo at night when the only other thing I take at night is a statin ?

I have always thought thyroxine needed to be taken in the morning.

30 Replies

  • Thyroxine doesn't 'need' to be taken in the morning, it can be taken when it best suits you presuming you'll continue at the chosen time. I take mine at night with no problems at all, it keeps it away from any supplements or other meds I take.

  • You sure about the statin? They are contraindicated with thyrod meds as it makes it much more likely you will get irreversible muscle pain.... Eek! ncbi.nlm.nih.gov/pmc/articl...

    Have always taken my thyroid meds last thing at night.

    G x

  • Lots of people find the benefit of taking their dose at bedtime. Remember not to have eaten anything 2 hours before taking levo as food can interfere with the uptake.

    Do you definitely have GERD? Why I ask is that hypothyroid usually causes low stomach acid which also causes symptoms which are so similar to high acid and low acid.


    Re Statins. Higher cholesterol is a clinical symptom of hypothyroidism and when on an optimum of levothyroxine or other thyroid hormones, the cholesterol reduces without the need for statins. So, personally, I would hold off statins at present and read this link. Extract

    If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.



    Many times we are given additional medications for clinical symptoms rather than a decent amount of prescribed thyroid hormones

  • Catwoman50, Take your Levothyroxine at least 2 hours away from other medication and supplements and 4 hours away from iron, calcium, vitamin D and oestrogen.

  • Thanks very much for the replies.

    My levo was reduced from 100mcg to 75 mcg a year ago as GP said tsh was high. While on 100mcg I felt well and managed to lose just over a stone over 10 months. Then gp decreased levo and all the hard work of losing weight has gone, as I have put it all back on. Another gp in practice doubled statins from 20 mg to 40mg because of high cholesterol, though I eat a low fat diet!

    Recent bloods, only tsh was tested and gp said she could not increase levo on current results. She diagnosed gerd as I was complaining of indigestion and feeling of 'choking' and dry throat. I asked her if this could be related to thyroid but she dismissed it.

    I have osteoarthritis and asthma and suffer with a lot of breathlessness on exertion. Asthma meds don't seem to really help. Gp has referred me to cardiologist but ecg at surgery was normal, so not expecting they will do much when hospital appt comes up.

    Really feel nobody listens to what your actually saying and just fob you off with 'what the book says' or more pills.

  • Do you use an inhaler?

    I have COPD and need to use an inhaler. When I was first diagnosed it took a while to find an inhaler that didn't cause me side effects - and one of the side effects was an indigestion-type pain. One of the GPs at my surgery just said "It's indigestion" rather than listen to me when I said I'd never suffered from indigestion in my life and it only started when I started the inhaler. She prescribed Omeprazole but when I read the patient information leaflet I decided not to take it because of the warnings about osteoporosis. When I next saw my own GP she said I was right not to take it.

    I'm just wondering if your inhaler might be causing side effects and whether the indigestion you're suffering is connected.

    I eventually managed to find an inhaler that didn't give me side effects but I did find that taking a pre-biotic helped. I now regularly take probiotics and a pre-biotic and it seems having better gut health has helped. It may not be what you need but I thought it worth mentioning.

    Also, your GP shouldn't have reduced your thyroxine if your TSH came back high. A higher TSH points to you being underactive, a lower or suppressed TSH is more likely to be the trigger for reducing your dose. If your FT4 came back high then that's when they're likely to reduce your dose.

    Have you got your results with ref ranges?

  • I have been diagnosed with asthma which caused terrible heart palpitations when I moved about. (Almost 3 years ago). My doc put me on a brown steroid inhaler , which helped a little but not enough. Then I asked for a blue reliever spray, which gave me cramp. Then I tried about 3 combination meds. ( they all lumped weight on me). Then a powder which absolutely wrecked my throat and voice, although I could breathe really well.

    So I went back to docs again and asked for a referral to a competent hospital. Was given a choose and book choice in dorset where I live. Had no idea which hospital to choose so I found an Nhs report about asthma care in dorset. ( it said it was variable but never said which hospitals were bad)

    But Southampton. (60 miles away). Is an internationally acclaimed centre of excellence. So I went back to the doc and told her I wanted to go there rather than do a lucky dip. the doc complained about it, but couldn't argue with my logic.

    Southampton have done proper testing to ascertain my triggers. (Weeds , grass and trees), have given me montelucast.. (A leuokotriene inhibitor) and a pro hormone, steroid,,, begins with c but not got it to hand,.. Which hasn't messed up my throat and hasn't added weight.

    Yep, I finally got proper treatment... But I had to be on to the doctors like a rash. You deserve to be treated properly. If they can't give you the time and correct meds, ask, in writing for a referral to somone who can.

    I now suspect I have an auto immune form of diabetes, but my doc is being a bit silly and dismissive. So have sent off for private testing. If I do have antibodies, heads will roll!

    be persistent. And read this about low acid, which can be caused by low thyroid......


    Xx. G

  • I asked my GP for a referral back to the consultant who did my original lung function tests so that I could discuss my sensitivity to inhalers and to repeat the lung function tests in case there had been deterioration of the airways since first diagnosed, as suggested by a nurse when I phoned the British Lung Foundation for advice after a recent exacerbation. I was refused the referral.

    She also asked why I wanted to try a different reliever inhaler as suggested by the pharmacist at a medicines review (I didn't have one due to the side effects of those I'd tried, I only have a once a day long acting bronchodilator), and she wanted to know why I wanted a reliever inhaler when I didn't have breathlessness!! She either didn't listen to me or doesn't know what COPD is!

    She's not so keen to discuss my thyroid either!

    I shall be asking for the new doctor when I next need to an appointment.

  • Write to the doc and copy it to the head of practise. Explain that breathlessness is causing a very real problem and that as you are disappointed with the current regime you are on, the local chemist suggested an alternative which was refused by the doc, you feel that you ought to be referred to someone who is a specialust in your condition. . Do a bit of research and see what the Nhs has to say about respiratory care in your area, work out where you want to go and say so in the letter.

    Good luck, letters seem to work best.

    Xx. G

  • Thank you clutter, that is very helpful information.

  • Thanks gala that

    I have also been told recently I am pre diabetic. Lectured about weight and diet. My diet is good I follow weight watchers don't take sugar etc. Gp completely dismissive that anything can be to do with thyroid as my 'levels' are within range. Last tsh was 1.1 (0.40-4.90) no ft or T4 tested

  • Hi Catwoman, I think much of this is related to your thyroid problem and your thyroid problem is related to something else. There is too much ignorance about treating this and people end up with so many other conditions. You need cholesterol more than you need a statin. If your reading is 250 for cholesterol do not worry. The adrenals use cholesterol for several steroids and progesterone. Watch this video for more understanding.

  • I agree. The statins, bloob pressure meds and lansoprazole are all no doubt due to titrating your dose to keep the TSH happy. Lansoprazole is a PPI class of drug and will eventually lower your B12, iron and magnesium. The doctors know they must test these levels after twelve weeks but rarely, if ever, do. Blood pressure rises in badly treated hypothyroidism, as does cholesterol. The asthma and choking feeling, if new since diagnosed hypo, are also likely to be linked.

    I was on all those meds you take when my TSH was 2.5 and on 75mcg Levo. Thanks to the wonderful people on here, I got with the programme and sorted my thyroid out. I now take nothing but Nature-Throid. Try not to go down the rabbit hole of treating every symptom on it's own, as the GPs do. As the late Dr Skinner told me, sort the thyroid and most if not all of these new horrors will abate. He was right.


  • Hi Lorraine, Dr. Skinner's story is so sad. Courageous doctors have been vilified because they go against the lying bureaucrats. Hans Sayle wrote a book called The Second Brain knowing everything that goes into your gut can change your life. This is fifty years ago! I didn't realize the extent of the deceit and ignorance that abounds. It's a good thing you found that out in time. I'm sorry because there are probably thousands of people who have no idea and are totally unaware that their lives may possibly be destroyed. I'm glad you are pointing out your story. Keep doing it.

  • Thanks Heloise. I'm only here and well thanks to the wisdom of the great people here. It terrifies me when I think back to how trusting and naive I was four years ago when I found this site. I truly couldn't believe that doctors and Endos didn't know best, despite the years of neglect I suffered at their hands. We simply HAVE to trust each other and read and research this.

    My personal bug bear is handing out beta blockers and PPIs to thyroid patients already undermedicated. They are only ever going to compound the problem. Magnesium deficiency is a seriously under recognised problem for us and PPIs like Lansoprazole make it ten times more serious.

  • Absolutely! That is what is so criminal. Not only refusing to recognize that people are not getting better but not recognizing that what they are doing is making them worse. It is very confounding!!!!!!!

    Not a good time to be naive.

  • I have strict instructions to take Levo in the morning with glass of water 1 hour before breakfast no coffee for 1/2 Hr. and I also take blood pressure tablets but I have learned to take them about 1 hour later as I made the mistake of taking them together and felt dizzy I find leaving that hour or more fine

  • Strict instructions from whom? And why? And do they actually know what they're talking about? Most doctors Don't, they have no idea. There is absolutely no scientific reason to take Levo in the morning. In fact, trials have shown that most people benefit from taking it at night. They just say things like that to make it look like they know what they're talking about. Ha! It's so funny!!!

  • Instructions from chemist but also my cholesterol went down from 8 to 5

  • OK. No comment.

    Of course your cholesterol went down when you went onto thyroid hormone replacement. But it had nothing to do with the time you took your Levo. :)

  • Agreed greygoose.

    Strict instructions are all very well when there is a sound basis for them.

    Other than when I delay taking my levothyroxine at blood test time, I always take mine at bed-time, and always have.

    Most pharmacists and medics who suggest taking it in the morning are simply parroting what they have heard or read.

  • Exactly. I had a terrible row with one pharmacist, making out he knew all about it, insisting I should only wait half an hour before breakfast, not an hour - what difference did it make to him?!? In the end, it just turned out he said that because that's what it said on the packet. Well, I know how to read, too! lol I Don't need a 12 year-old 'trained professional' - as he called himself - to read it for me. Oh, they do make me mad!!!

    And I said 'no comment'. Well, I've commented now. lol

  • pat, I hope you get your own blood pressure monitor and take it when you are at home. When your blood pressue goes up, it is usually for a very good reason that your body does it. Sometimes interfering with that is not a good thing.

  • Catwoman, you really, really need to find another doctor. These people aren't going to make you well, and they're probably going to make you worse. If you had a decent dose of Levo - or the type of thyroid hormone replacement that suits you - you more than likely wouldn't need to take all these other horrors that are going to damage your health. Believe me - been there, done that, ended up self-treating and feeling much, much better!

  • I take levo at 5:00pm every day, along with D3, zinc and my split dose of plaquenil (I have lupus and Sjogrens). Contrary to what most say, I eat a few water crackers along with it to make sure stomach doesn't get upset. Dinner is usually eaten around 6:30pm.

    My endo says his experience has shown that when levo is taken this way, patients do not gain weight and they do not have any sleep disturbance. This has been true for me. I've been doing this for over a year now.

  • My very eminent NHS endocrinologist recommended trying taking Levo at bedtime - I found this gave huge improvement

    There seems to be some research to support this


    Someone on this site also recommended Chris Kresser website yesterday - he gives good plain explanation of various different variations of thyroid problems and also stomach issues


    I also have found taking probiotic every morning seems to help

    Lastly never take your Levo for 24hours before a blood test or it will give false "over treated" result. If taking at bedtime - don't take it the night before a test. Get blood test as early as possible (before 9am ideally) and do not eat before hand. You can then take Levo immediately after blood test (don't eat for at least an hour after)

  • I started taking my Levo at night recently and it has made life much easier. I also take Lansoprazole and multivits. I strongly recommend it.

  • I should have made it clearer that I take the Lansoprazole and vits in the morning. Sorry....

  • Thank you all for replying, so many good links and suggestions .I will check out everything people have taken the trouble to recommend .

    I hope one day all voices will be heard to combat this horrible condition.

  • Take the levo last thing at night - at least 2 hours after food, the longer the gap the better; and stop the statins - they will do more harm than good. You don't need to do a 'low fat' diet; introduce coconut oil into your diet if you need to stir fry vegetables or spread it on toast instead of 'low fat' spreads. Avoid anything that is processed or states that it is 'low fat' Eat as much fresh produce as you can; make sure you have your 5-7 a day. Pasta no more than once a week and limit bread to 2 slices wholemeal per day. I did all of the above and my cholesterol level went down with a higher HDL which is the 'good' cholesterol. Statins damaged both my father and mother's muscles and joints to the point that they could barely walk.

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