Changing time of levothyroxine

After reading several posts I'm thinking of changing the time I take my dose from am to pm. How does this work to switch as I've found by about 10am if I haven't taken my doseage I feel really nauseous & dizzy.

Thanks

25 Replies

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  • Why are you considering taking it at night instead? Levothyroxine has a long half-life, of about a week, so the dose you take today will stay in your system for up to two weeks. Some feel better taking it at night, maybe because digestion slows down then so the pills stay longer in intestines and therefore more hormone is absorbed, but if that doesn't work for you you should just take it whenever is most convenient for you. I was on levo for ten years, always took it first thing in the morning, and never had any problems.

  • Some have found taking it at night beneficial. Try swapping over on a day that you haven't got much going on so you can deal with the dizziness a bit better. Alternatively, take your dose in the morning and another at night. Some people take their levo weekly so it shouldn't cause to much of a problem.

  • Hi

    I take mine 175mcg of levothyroxine at night.

    I feel dreadful in the morning taking it. My endo said your highest natural levels are between 6 and 8 am in the morning. So taking it at night gives my system a good boost in the morning (although still like a zombie)

    I also find that taking it at night means I have to stop snacking in the evenings! Last cup of tea at 8pm and nothing to eat til breakfast. I take the levo at 11.30pm with large glass of water.

    I take all my other vitamins and meds in the morning. So nothing clashes

    I works for me Give it a try see how you feel

  • why would you stop eating after takig it?

  • I don't eat after so no hidden calcium can stick to it (as my endo put it) also it mean I'm not stuffing my face with food I don't need. A good form of eating control for me lol

    I've put on a lot of weight after RAI treatment so any control I can have over food is good. That's sounds awful I'm not a control freak freak I promise lol

  • Thyroid replacement should be taken at least two hours after food, and at least one hour before food. Many foods interfere with it, and not much is known about the details.

  • I switched to taking mine at night a year ago and at the same time started taking several vitamins and minerals in the morning, and I've just had my second annual review where both my doctor and I agree that my thyroid levels are still good. I certainly feel much better. As I don't drink anything with milk in it after 8pm I'm fine to take my medication around 10pm whereas in the morning I'd be taking my meds and then drinking a cup of tea within 30 minutes. Personally I feel that my improvement is down to the vits and mins helping the thyroxine to absorb properly rather than the time of day I take it.

  • What vitamin and minerals do you take to help with absorption? I have been considering this for some time.

    At the moment I take iron (not at the same time as my thyroxine), a good multi vitamin for women over 50, vitamin C, vitamin D (for deficiency), calcium and magnesium. No idea if any of these support the absorption of thyroxine though!

  • Oops, think I replied in the wrong place, so here it is again: I take Zinc - 15mg daily; Vit B12 - 1000mcgs daily; Selenium -200mcg every other day; Magnesium - 375mg every other day; Co-Enzyme Q10 - 30mg daily. I get my supplements from Healthspan on Guernsey just because I like them, but am sure that once you find the doses that suit you you can get them anywhere. I picked up a copy of The Thyroid Solution by Dr Radha Arem in a charity shop and used this as a guide when trying out supplements, it's a great book if you can get hold of a copy, maybe from your local library. Think you just have to start experimenting to see what helps you. I was pushed to it when a locum doctor at my practice tried to put me on anti-depressants even though I knew it was my thyroid and not depression, enough was enough!! Good luck.

  • Thank you. That's v helpful.

  • Like you I am incredibly sensitive to changing anything on my medication. I changed to night-time dosing at suggestion of my endo, about four years ago. I find it much better.

    You could move the time you take it backwards, over 2-3 days

    Day one - normal waking time

    Day two - about 5am

    Day three - about 2am (when you get up for the loo)

    Day four - bedtime

    Bedtime - you need to have not eaten for 2 hours (longer if its large meal) only water at least an hour before.

    Occasionally if I have been out, eating/drinking late, just take Levo in middle of night

    When it's time for a new blood test, delay night before dose, until after test is done. Tests should always be as early as possible in morning and fasting.

  • I take my Levo at 5:00pm (always have) per my endo's instruction. Taking at this time allows me to take supplements in the am without worry of any interference. Many times I take Levo with a snack (typically a rice cake) and coconut water or still water.

    What dose are you on? Feeling dizzy and nauseous if you don't take your Levo seems strange to me since (a) Levo has a long half life and (b) effects are not usually immediate. I've missed doses, doubled up doses etc, without any adverse effects. I'm thinking you might be undermedicated and/or, your symptoms are due to something else. Do you also take any supplements at 10 am? Does taking your dose at whatever am time affect when you eat? Perhaps your dizziness/nausea is due to dropped/low blood sugar levels or a vitamin deficiency?

    If it were me, I simply would do a double dose the day you decide to switch - one in the early am as normal and one at the new time you want to take it.

  • I was told to take mine at 6am but that is because I have to take lots of other medication. I have adrenal, stomach, lung and bowel issues. The Endo told me I did not necessarily have to take them every day as thyroxine stays in the system for 3 days or so. As I go downhill rapidly after 2 days, I prefer to take it every day. Thyroxine, I was told, does not mix well with other medication so is best taken alone but time of day is not important. I take it at 6 am because that is when I start taking hydrocortisone which is not affected by thyroxine. I take my last tablets at 10pm with several doses in between.

    So, the message I had was that timing is not as important as spacing.

    I've been told so many things! Good luck but don't worry too much.

  • I had always taken mine in the morning but was tired of often having an upset stomach a couple of hours later.

    Changed to evening by taking it a bit later each day - feel fine & no more upset stomach for 3 months now. Don't really worry too much about eating before except not calcium foods.

  • I take mine in the morning before breakfast but told not to have any form of caffine as the body does not absorb the thyroxine very well then i have tea coffee etc about an hour after taking my thyroxine. I have also started having caffine free tea coffee etc it took some getting used too but feel so much better although I now understand these caffine free products do still very tiny amounts of caffine

  • I had trouble switching from morning to night time dosing, too. I found it works much better for me to have both doses in the day of the changeover.

  • When I changed I felt just like you - worried about how to do it. Despite what is said, I feel any slight change of dose very quickly, so the long half life doesn't help me at all!

    I split my dose to make the changeover - so I took half in the morning and the other half that night - in fact I did this for a couple of days and then took the whole dose at night (and have been ever since). I found this way my body wasn't over or under medicated to any severe extent.

    Good Luck!

  • I did not have a very good experience changing from morning to evening. After I started taking it in the evening, I would wake up in the morning absolutely starving and I would crave salty food. I would be hungry all day and was shaking. I had a blood test before switching and my TSH was 3.5, after I switched I had another blood test taken and my TSH had dropped to 1.5. I was really pleased with the result but the hunger, shakes and tummy rumbling eventually made me decide to switch back to the morning.

  • I find that fascinating! Taking meds in the morning gave a TSH of 3.5 iU/mL, but taking it in the evening reduced it to 1.5. Did you have the blood tests under identical conditions, at least 8 hours after your last meal? At what time of day and before breakfast/dinner? 3.5 is a TSH level of pretty bad hypothyroidism. I become ill and not able to walk properly at 1.0 IU/ml.

    I think I've got it. Take pill in the morning, have blood test 24 hours later TSH probably high. Take pill the night before and test the next day (only 12 hours later) TSH probably low. Interesting. Maybe that is what is going on, I am sure others will comment/correct me.

  • Hiya, I had both blood tests in the morning probably about 8.30-9am. I wouldn't have thought it mattered about when I ate my last meal etc as thyroxine is so slow acting in the body it wouldn't effect TSH that quickly? Correct me if I'm wrong though! Saying that I never eat before my blood tests anyway. Jo x

  • Well, I'm not sure but... when you take your levo in the morning and you had your last meal (dinner) 12hours prior and your meds 24 hours prior, then your test will measure a maximum of TSH. If you had your last meal at, let's say 7:00pm, then took your meds at about 10:00pm, then left 8 hours (sleeping) and had a blood test first thing next morning then you have more T4 in your system so your TSH will be minimal.

    Eating affects the absorption of the T4 meds but, like you said, you have your tests before eating, so let's forget that effect. You are right that Levo is "slow acting", has a half life of about 7 days. With our daily meds we "feed" a stable level of T4, T3 and the like but just after we take meds we will see a maximum effect and it dies off a bit during the day. While it is a stable level, it oscillates around that certain level, but that level is not a straight line. The taking of Levo lowers the TSH line and boosts the T4 line a little but then, throughout the day, TSH rises and T4 declines. I think it's that "little bit" which you are seeing in your results. And, having said all that, it's a pretty big swing, 3.5 to 1.5IU/mL.

  • Since reading comments on this website, I have started taking my thyroxin as early as possible in the morning and at least an hour before any food or drink. Since doing this for the last month, I have lost a stone In weight - still a long way to go but previously lost nothing on the same WW diet - so would recommend taking regularly which I hadn't been doing and away from food and drink

  • Nattilydressed - I take the following - Zinc - 15mg daily, VitB12 - 1000mcgs daily, Selenium - 200mcg every other day, Magnesium - 375mg every other day, Co-Enzyme Q10 - 30mg daily - I personally like the ones from Healthspan so I stick to these but guess as long as you get the dose that suits you all brands should be ok. Good luck, they've certainly helped me after 14 years of struggling on a dose of 125mcg of Thyroxine by itself.

  • The problems may be not the time, but the fact you are taking levo or synthroid. I felt sick for years til I stopped it, 2 days later I felt much better, but I still needed hormones. Then went on Armour and felt much better, but still had dizziness and brain fog. Then I found Nature-throid. Miraculous improvement in just days. Feel totally normal now. And it's much cheaper than Synthroid.

  • My prescription says take in the morning, and I have always taken it last thing at night. The main reason for this - I read somewhere that caffeine slows and disrupts the absorption rate, and for me, the first thing in the morning to wake the grey cells is an unhealthy cup of coffee.

    I think what time you take it depends on your personal lifestyle. As a few people have noted, it is more important what you take with it, and what you have eaten, or about to it.

    As a footnote - I used to have a very painful ulcer on my ankle and needed codeine for the pain. On one occasion I had mistakenly swapped the two drugs and took levo for the pain. When it was still painful a few hours later I took another dose. After another few hours I was about to take a third dose when I noticed I had swapped the foil packets. For the rest of that day I felt like a ball in a pinball machine, bouncing off everything and feeling mighty 'hyper'

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