Thyroid UK
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A question of timing

Hi, I'm new to taking Levo, as I only started a few weeks ago. I just have a couple of questions re the timing of taking it. At the moment I'm taking it when I wake up needing the loo in the morning (which could be anywhere between 5am and 6:30am), then I try & go back to sleep for a bit, having breakfast at 7:15am. I know we're supposed to take it 'at the same time each day' - but how exact does this need to be? Is a flexibility of a couple of hours OK, or should I be trying to be a bit more strict with the routine? Also, I've seen some posts about people taking their Levo at night to improve sleep. I'd be interested in trying this, but I'm a bit concerned by the practicalities. I could happily not snack in the evenings, but I do enjoy a glass of wine or two at the weekend, and I think you're supposed to take Levo on and empty stomach with water only. Would I have to give up alcohol in the eves, as well as food to try this?!

9 Replies


I take levo 1st thing in morning about 2hrs before my iron tablets if I take levo on night it makes my insomnia worse ..whether that's just me I don't know ..but I find getting to sleep difficult .I wake up every few hrs

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Poor sleep can be due to low vitamin D / B

Have you had levels of vit D checked

Good website about link between low D, low B5 and autoimmune diseases

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Thankyou I will take look slowdragon


You should leave 4 hours between iron tablets and levo. The iron will affect the absorption of levo.


I think the gap between levo and iron has to be four hours. This is an extract from a previous post:-

A very important point!

It isn't only ferrous fumarate, but also sulphate, ferrous gluconate and every other iron supplement. That includes iron-fortified cereals like Special K.

The time gap is also sometimes suggested to be four hours as two hours does not guarantee a sufficient physical separation.

Levothyroxine binds strongly to iron compounds to form a complex. Once the complex has formed it simply passes through and can never be absorbed.

There are many substances which interfere with absorption which is why the only safe advice is to try to take levothyroxine away from food, drink (other than water), supplements and other medicines. For example, calcium containing medicines such as ant-acids.

Some people find taking levothyroxine at bed-time is beneficial and might help to avoid clashes. This poll has a lot of discussion - there are both positive and negative views:

This blog and the comments might well be worth reading for anyone with iron deficiency:

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It keeps me awake but I will read more about it



You can take levo in the morning and iron at lunchtime as I think you have to take it with food (I may be mistaken).


Hi Mandshef, taking your levo at night will be alright if it's 2 hour after the wine (and food). Or do you drink the wine as a nightcap?

I don't think you have to be very strict with the time you take levo, as long as it's on an empty stomach, and at least one hour before food or drink other than water. :)


I set my alarm for 6am and take my Levo then not on iron I take calcium and it was stressed to me to take this at least two hours after Levo this works fine for me as I'm on home dialysis for my kidneys and get up between 7-30 and 8am have breakfast and all my tablets after after I've done my dialysis


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