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Thyroid UK
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Should I give up taking levothyroxine at night?

Hi,

I've been taking levothyroxine for over 10 years now and until recently have always taken it first thing in the morning. About 3 weeks ago, after following advice from others and doing some research into the benefits, I switched to taking my meds last thing at night.

I started off feeling OK and sleeping well, but then things seemed to change. I've had watery sore eyes for a couple of weeks now (something I've never had in my life) and I'm really struggling to get to sleep, plus I now wake really early (5am). Consequently I've been feeling more tired during the day than before I made the switch. I am wondering if I need to switch back. One good thing though is that I also feel calmer/happier despite being tired!

Is 3 weeks to early to decide? I'd be very interested to hear other people's experiences. I was really hoping this would make a difference for me, as I first posted on here about a month ago with concerns that though my TSH is suppressed, my T4 and T3 are still a little on the low side of normal (T4: 16.2, T3: 4.6), and I have been miscarrying constantly for the last couple of years (I'm trying for a baby). My GP wants to reduce my dose though I am ready for the battle at my next appointment to keep it at 100mcg (thanks to people on here).

I take a heap of vitamins but have bought a DIY MediCheck blood test kit to check all my vits and antibodies etc, however I am currently holding off testing till I've stabilised on my medication time of day.

Sorry for the spiel. Any advice would be great!

Emily

26 Replies
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You don't need to have an all or nothing approach to when you take thyroid meds.

Why don't you experiment with 50 T4 at bedtime and 50 12h's later. So possibly lunchtime'ish.

It is good you have experienced some positives from taking the T4 at bedtime.

Taking T4 at bedtime will alter your cortisol production as well, so this may be showing its effects with waking you up earlier. It is positive that more cortisol is being generated though, as i assume cortisol will have been lower.

Your suppressed TSH is common and i feel it is connected with a lagging cortisol production. If your thyroid and adrenal system get into a better balance the TSH will move into the 1 area. This shows your thyroid is being used up correctly and the body is naturally trying to make a bit more.

Have you had new bloods since you moved to bedtime dosing. This would be good to get as it may show some changes which can help understand a bit more what is happening behind the scenes.

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I hadn't considered splitting the dosage, I didn't realise I could/should and also it's quite difficult for me to work out my timings around all the various vitamins/minerals I take. However I think I am going to try 50 at bedtime and 50 the following morning (not quite 12 hours difference but that regime is doable).

Is it possible that taking the meds at night could make me over-medicated if it's that much more efficient? Guess I am slightly concerned the watery eyes I have might by hyperthyroid related! You are right I need a blood test doing soon to work out what's going on, but wanted to leave it at least 8 weeks to let things settle (only been 3 so far).

How are things going for you? You had a recent blood test didn't you? I know you are taking T3 as well. I still haven't managed to get any of that as there are a lot of dodgy websites to sift through out there! Should probably change one thing at a time anyway.

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Hi Emily. I’ve had the same problem about when to take Levo (levithyroxine). As I have a drink made with milk around 10pm and have milk with my breakfast cereal, both before bed and on rising have the potential for the milk to lessen the effect of the levo. Being a bloke in his late 60’s with type 2 diabetes, I’m always up in the middle of the night (loo stop!). So I now take my kevo with a glass of water in the middle of the night when I’m up anyway!

My Dr has just increased levo from 75 to 100 and asked for a retest of TSH in 8 weeks. Last time I had an increase from 50 to 75 it took up to 6 months for the increased dosage to change. I would suggest that somewhere over a month or two might be needed for the full effect to appear with you too.

Regards. Bob

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I think the middle of the night is quite a good idea, so long as you are guaranteed to wake up! I don't think that's something I can do but it definitely makes sense for you.

I agree I most likely need to wait a little longer to see the full effects. Will probably get my bloods checked at 8 weeks after making the change to night dosage.

Thank you!

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I spoke to my dr about that very subject and he said No. you have to take them first thing in the morning on an empty stomach.

Hope that helps.

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Neets52

there has been recent research showing taking it at night is more effective than in the morning so there is no simple rule that it must be taken in the morning and any other time is wrong despite your GP’s opinion on the matter.

One needs to try it to see what suits best. It varies from person to person.

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Agreed! I am curious as to whether there are many others that night time meds don't suit. Everyone I've heard from so far seems to get on with it.

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Emily78

I tried it but it didn’t suit me mainly because I fall asleep so fast - like one moment I am awake the next in deep sleep I don’t even make it to bed sometimes and wake sitting on sofa in small hours still bolt upright. (I even woke to find I was clutching my phone mid text on one occasion) so I kept missing taking it and had to revert to am. 🙄 beats hypo insomnia tho!

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Thank you for your reply. I stumbled onto this site as I have issues with the treatment. And will be sending my blood results here as I think I will get better advice than that if my dr.

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Neets52

You will get very good advice here.

A lot of GP’s know little about the condition or how to get patients on optimal treatment. They just blindly follow guidelines thinking tests “in range” are good enough, when fully optimised is what they should be aiming for with their patient free of symptoms.

Just post your problem and you will get very helpful replies!

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I will thank you

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No I tried both and preferred evening. It then on holiday I was eating later in the day so switched back. Are you leaving a gap of 2 -3 hours after food on an evening? If not that might well be why you are t doing so well.

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To be honest I struggle to leave 2-3 hours after eating, it's more like just 1 hour! I'll try as you suggest and see if it makes a difference. Thank you.

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That might well be the problem. I read two hours after food but if a protein rich meal 3 hours. Remember when we day an hour in the morning we have previous been asleep so in real terms it's often longer.

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That makes sense. I can easily leave 3-4 hours from my evening meal, it's the snacks I enjoy before bed that I am going to miss! I am a really active person with a big appetite and am pretty much hungry from the moment I get up till the moment I go to bed! But, I'll just have to adjust my eating patterns.

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Just wanted to say I left 3 hours between food and my meds last night then had a much better night's sleep and woke feeling refreshed today. I am now optimistic this might make all the difference though early days. Thank you.

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Hello, I have read your posts and replies with interest. I too have recently changed from taking my, 125 dose, in the the morning to the evening, two hours plus after supper. I have had some problems with a racing heart and some insomnia BUT as I am having difficulties in obtaining the 'original' formula for Levothyrox here in France, it may be due to the alternatives that I have been able to obtain. I was taking L-Thyroxin Henning 125 while I had these problems and I think that it may be too strong or it's the other 'packing' ingredients! I took Euthyrox 125 last night and had a good sleep and no heart problems! I shall continue with this until the box runs out but I cannot get any more in France!

Anyway, I do wish you well. I seem to be very sensitive to thyroxine so I do tend to feel better or worse almost immediately and a previous writer said each of us is different and we need to read the signs as they affect us.

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I think this is partly a judgement call. It sounds like you've had some positive benefits, and some negative effects from night time dosing.

Personally, I rate things like happiness and feeling of well being higher than getting the sleep. This is because I think the sleep issues will often sort themselves out over time. I often get a few weeks of less sleep after a dose increase, but it always settles eventually. I think it just gives the body a surprise to be getting a different dose.

The sore eyes might be a bit worse, though. That tend to be a hypothyroid symptom for me.

I think it's always best to stick with something for a big chunk of time if possible. Six weeks is the ideal as that's the rule of thumb for how long it takes a given dose to get stable. But sometimes it's not possible to bear it if unpleasant symptoms come up.

In answer to your other question, it's possible your blood numbers will change because of this change. If the hormone is absorbed better then that will show in the tests. But it may not be a big enough change to show up.

Having miscarriages is a hypothyroid symptom, so it's possible you need to change your dose to make it possible to carry a baby to term. If you start a new thread about that, put in all the blood tests you've got, and ask about miscarriages, there are very knowledgeable members who will comment.

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Thanks so much for your reply. My head's been such a jumble trying to work out what to do for the best. At 39, I don't have much time left for having a baby, so want to get my thyroid at its optimum asap. So hard when my GP is constantly harassing me about reducing my Levothyroxine dose, which is quite possibly the opposite of what I need.

You've convinced me to keep going for the time being with the night dosage. After a few more weeks I'll get a full blood workup done and post my results. I am going to try to leave a bigger gap between eating and taking my meds as someone else pointed out this might help.

I was really quite concerned about the watery eyes and convinced I'd suddenly turned hyperthyroid! But I am relieved to see this can be a hypothyroid symptom too.

Thanks again for your advice.

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Good luck! GPs can be a bit of a liability unfortunately :( You've done well to stand up for yourself and keep your dose.

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I have taken Levo first thing i.e. 6am and just before bed it made absolutely no difference to me I still felt ill on any dose for 8 /12 weeks at a time. Over a period of 8/10months

I now take NDT and T3 together and feel well again, all of the time.

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NDT and T3 sound like a good option. Do you self-medicate? Fairly confident my GP would never do me a prescription. I tried looking at buying T3 online (i.e. from abroad) but there are so many dodgy websites out there I didn't want to risk it.

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I forgot your question. Yes I do self medicate now I live in France and buy French made T3 over the counter. The NDT i buy from Thailand online and it's fine. I have been buying NDT for over two years now and the site is good and genuine.

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That's handy being able to buy T3 in France! There seems to be a lot of people posting on here who now live in France (I am envious!). I lived in Toulouse many years ago as a student, where abouts are you?

I am relieved to know there are reliable sites selling NDT out there. Hopefully I won't need it, but it's reassuring to know alternatives are available and I am happy to hear that it's working for you.

Thanks ever so much for your advice. I am probably going to continue a little longer with the night medication as I felt better today after leaving a longer gap between eating and take the meds. I'll do as you suggest though and post in January with my latest blood results.

Thanks again.

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Hi I live half way between Limoges and Poitier and buy T3 in most local pharmacies the price for two boxes is 6,96 euros.

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Well it was easier for me I didn't have my thyroid removed until 2015 I had a silent lump growing downward and it moved my trachea. Before this happened my thyroid was working fine and I was not on any medication I was 68 years old.

You are young and I think that you need to take time for yourself it took me two years to work out my correct dose.

Why not go back to the morning routine and then after Christmas take you blood test and post them on here for people to help. You will then be able to sort it and you will feel better.

I am sure that when you are properly medicated your baby will arrive safely. Take care.

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