Taking Levothyroxine at night: Hi I am new. Is it... - Thyroid UK

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Taking Levothyroxine at night

JSKYE profile image
39 Replies

Hi I am new. Is it ok to take Levothyroxine at night? I take 25mcg Levothyroxine and before that I was taking 150mcg but my results on this were too high. I changed brands of Levothyroxine too, I now take lactose free TEVA since my endo believed my results would improve on it and that I am lactose intolerant but my latest results seem to have looked too good for me to continue being on 150mcg. I am just being incredibly wary of going over range again and I do not want to try or take anything that will show overmedication. Diagnosed hypothyroid in 2011. Thanks

TSH 0.02 (0.2 - 4.2)

Free T4 23.1 (12 - 22)

Free T3 3.8 (3.1 - 6.8)

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JSKYE
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39 Replies
bantam12 profile image
bantam12

That's a huge reduction in dose, hopefully it wasn't done in one go ! Do you have your latest results to post on here ? and how are you feeling on such a small dose ?

JSKYE profile image
JSKYE in reply to bantam12

Hi, it was done in one go. My results were - TSH 0.02 (0.2 - 4.2) Free T4 23.1 (12 - 22) Free T3 3.8 (3.1 - 6.8)

Symptoms are tiredness, goitre, pins and needles, feeling cold, memory loss, confusion, dizziness, headaches, constipation every day, joint pain, dry skin, puffy eyes, eyelash and eyebrow loss.

bantam12 profile image
bantam12 in reply to JSKYE

Oh good grief a drop from 150 to 25 in one go is dreadful, was that an Endo or GP who did that ? they clearly have no idea ! Doses should only be reduced by 25 mcg at a time with 6 weeks in between adjustments.

Although your TSH and T4 were very slightly out your T3 was far to low so you weren't overmedicated, looks like you aren't converting very well and could do with some added T3.

JSKYE profile image
JSKYE in reply to bantam12

Hi it was a GP. Endo doesn't know about the reduction, the GP did the reduction without the endo authorising it.

bantam12 profile image
bantam12 in reply to JSKYE

You should tell your Endo what's happened and ask him/her to sort it out with the idiot GP.

You may find a slightly lower dose plus taking it at night brings your low T3 up, it worked well for me.

SeasideSusie profile image
SeasideSusieRemembering in reply to bantam12

bantam12

You are much more polite than I am feeling tonight :D

SeasideSusie profile image
SeasideSusieRemembering in reply to JSKYE

JSKYE

Endo trumps GP, endo is specialist, GP is generalist.

Refuse the reduction. Tell your GP that you will only be guided on dosing by your endo as he is the specialist.

Get a message to your endo, phone or email his secretary/himself to say what your GP has done and ask the endo to issue instructions to the GP to butt out.

Jeez, what a total d*ck your GP is!!!!!!!!!!!!!!

JSKYE profile image
JSKYE in reply to SeasideSusie

Thanks. I left a message yesterday saying my latest bloods were done too early, I did not prepare for them, I didn't know they were being done either and I don't intend to go by results done by a GP that ignores my endo recommendations.

SeasideSusie profile image
SeasideSusieRemembering in reply to JSKYE

JSKYE

For future reference, if your GP surgery springs a blood test on you like that you can refuse it. They have to have your informed consent, you can say no. If they get things ready for blood tests ask what they are testing, they must tell you, if not then they haven't got your informed consent and they are in the wrong.

When I have been seeing the nurse at my surgery for something else, a few times they've said "Whilst you're here, I'll do your thyroid function test". I just say, "No, I only have thyoid tests done very early in the morning, so I will make an appointment specifically for that". They look a bit surprised but leave it at that.

Peachykeen1 profile image
Peachykeen1 in reply to SeasideSusie

I've been discharged back to GP after my thyroidectomy, didn't even get to see endo after surgery!!! Apparently it's normal for GP to take over care now, and keep an eye on levels.????

I'm tired, I'm getting fat and puffy, nausea, regular headaches, told they don't prescribe t3 and we don't need that, and that my levels are ' brilliant' now!!

shaws profile image
shawsAdministrator in reply to JSKYE

Contact your Endo's secretary tomorrow and ask him/her to pass a message to Endo and ask her to ring you back with his decision that your GP has reduced your dose to 25mcg and you're not feeling too good.

It keeps him up to date and will also prevent your GP reducing your dose in one go.

JSKYE profile image
JSKYE in reply to shaws

Thanks. I left a message yesterday saying my latest bloods were done too early, I did not prepare for them, I didn't know they were being done either and I don't intend to go by results done by a GP that ignores my endo recommendations.

Spareribs profile image
Spareribs in reply to JSKYE

you took your dose just before the blood draw?

(they're measuring what's in the pill not what's in your system!)

JSKYE profile image
JSKYE in reply to Spareribs

No

Spareribs profile image
Spareribs in reply to JSKYE

Phew! How long after your dose ws the blood draw - should be at least 24 hours ideally - I know I've done the same but had low results too :(

JSKYE profile image
JSKYE in reply to Spareribs

Thanks I left 24 hours

Spareribs profile image
Spareribs in reply to Spareribs

PS "pins and needles, feeling cold, memory loss, confusion, dizziness, headaches, constipation every day, joint pain, dry skin, puffy eyes, eyelash and eyebrow loss".

All indicate low vitamin levels - been tested?

especially B12 & Vit D (amongst others).

oops I forgot to say welcome to the forum - I hope you find some answers here!

J :D

JSKYE profile image
JSKYE in reply to Spareribs

Thanks. I had them checked but they were done months ago. Are they still ok to post?

shaws profile image
shawsAdministrator in reply to JSKYE

I'd put them on a new post for more responses.

SlowDragon profile image
SlowDragonAdministrator in reply to JSKYE

You really need these retested

But post your old results if that’s all you have until you get new ones

Ask a different GP to test vitamins

Has endo responded to mad GP request to drop to 25mcg

BubbleMonkey profile image
BubbleMonkey

You should be fine taking it at night as long as it's the right amount of time before and after eating still.

I agree that you should ask your endo about the dose change though so you can always ask them about that too. Your GP may be right, but I would definitely want the g ahead from endo first before a change that big.

You could also check the leaflet or call a pharmacist about the night time thing.

JSKYE profile image
JSKYE in reply to BubbleMonkey

Thanks. I left a message yesterday saying my latest bloods were done too early, I did not prepare for them, I didn't know they were being done either and I don't intend to go by results done by a GP that ignores my endo recommendations.

greygoose profile image
greygoose in reply to JSKYE

What do you mean by "bloods done too early, I did not prepare for them"? What preparation do you have to do? And do you mean too early in the day, or too soon after dose change?

JSKYE profile image
JSKYE in reply to greygoose

Too soon after dose change

jgelliss profile image
jgelliss in reply to greygoose

greygoose

Great to hear from you .

SlowDragon profile image
SlowDragonAdministrator

Your GP should NOT interfere.

The endo is specialist.

Dose should only ever be increased or decreased by 25mcg maximum

Do you have Hashimoto's - high thyroid antibodies. Also called autoimmune thyroid disease

Have you got recent tests results for vitamin D, folate, ferritin and B12

This result that GP did shows poor conversion, very common with Hashimoto's and also common if vitamins are too low

FT3 was very LOW so not over treated. Good you are refusing to follow GP's incorrect advice

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

JSKYE profile image
JSKYE in reply to SlowDragon

TPO antibody 475 (<34)

TG antibody 266.3 (<115)

041051 profile image
041051

Hi, for what it's worth, the endo suggested that I take my thyroxine at night some years ago and it works for me. Good luck.

JoyCA profile image
JoyCA in reply to 041051

Pardon my hijacking this post. What is the reason for taking thyroid meds at night? I don’t convert well and am presently only taking T3 5 mcg 1x first thing in the am.

041051 profile image
041051 in reply to JoyCA

Hi, I had been going through a stage where the amount of thyroxine I needed was going to go above 150 mcg so my G.P. referred me to the endo because he wanted me to be checked before prescribing a higher amount. The endo increased the amount of thyroxine I should take to 175 mcg and suggested I try taking it at night. I think in my case it was because of my IBS which is always bad in the morning. The theory was that my body would absorb it better at night. I've been back on 150 mcg for several years and all is well. My new G.P. was surprised when I told him I take it at night but he said he knew my endo and would ask her why in case it might help other patients. If i get to see him again I might ask him what the endo said.

Eve00675 profile image
Eve00675 in reply to JoyCA

You might find this article useful re taking it at night vs taking it first thing in morning jamanetwork.com/journals/ja...

BettyBt profile image
BettyBt

Hi, I always take Levothyroxine at night. It shouldn't be taken with calcium and I always have milk on my breakfast, so I take it last thing at night. Are you sure your doctor didn't reduce you to 125mcg? If you were taking 150mcg you were probably taking 1x 100mcg and 1x50mcg tablet. Your doctor may have given you a prescription for 25mcg thinking you still had tablets left?

I hope you get things sorted 😊

JSKYE profile image
JSKYE in reply to BettyBt

No I was asked to reduce to 25

SlowDragon profile image
SlowDragonAdministrator

Get vitamin D, folate, ferritin and B12 tested before even considering changing dose

Your FT3 is LOW showing you are not over medicated

You have poor conversion

Highly likely you have Hashimoto's and need to be strictly gluten free

Hashimoto's affects the gut and leads to low vitamin levels

Low vitamin levels stop Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

clairey73 profile image
clairey73

I take mine at 10pm every night on an empty stomach they can then get to work while I sleep i was advised to do this

Herbal24 profile image
Herbal24

I know you are to take your

Levothyroxine in an empty stomach, what did your Dr. recommend, if you take it with a full stomach it might bet the purpose, I have never tried it

Tonic143 profile image
Tonic143

i am surprised you take it at night i thought it was to give you a lift i might be wrong i have been taking in the morning since 1986

Clutter profile image
Clutter in reply to Tonic143

Tonic143,

Levothyroxine doesn't give anyone a lift. It takes 7-8 days to absorb a dose before it does anything. Nighttime dosing has been shown to be more effective than morning dosing in reducing TSH.

SlowDragon profile image
SlowDragonAdministrator in reply to Tonic143

It often improves sleep by taking at nighttime for many

verywell.com/should-i-take-...

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