When am I supposed to take my levothyroxine?

[Taytaydarz]

I take mine every night before bed? Is this right? I’m extremly tired recently I’m only 28 and I cant cope with the tiredness I have no energy what so ever! Thanks x

[SeasideSusie Remembering]

Experiment and take it when it suits you best, as long as it's on an empty stomach, one hour before or two hours after food and away from other medication and supplements. Some people find it better to take it at night, others prefer morning, I take mine in the early hours of the morning when I need a bathroom visit, that way it's well away from my supplements.

As for your tiredness, post your latest results, with reference ranges, so that we can see if you are optimally medicated.

[SlowDragon Administrator]

You sound under medicated

Can you add latest results and ranges for TSH, FT4, FT3, antibodies and vitamin D, folate, B12 and ferritin

Yes recent research suggests taking at bedtime is best, but we are all different and it doesn't suit everyone

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

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

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased

You should have blood retest 6-8 weeks after each dose increase and dose increased in 25mcg steps until TSH is around one or less, and FT4 towards top of range and FT3 at least half way in range

If you have high thyroid antibodies this is Hashimoto's also called autoimmune thyroid disease

About 90% of all hypothyroidism in Uk is due to Hashimoto's

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

Low vitamin levels affect 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

Ask GP for coeliac blood test first

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...

thyroidpharmacist.com/artic...

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
[e-mail]

[Taytaydarz]

I’ve had a blood test Tuesday I’ve got my doctor ringing with my results on Monday so I’ll ask her to write it all down for me.. you all sound like you know what your talking about 😩 I was told I had hypothyroidism and to take levothyroxine that was pretty much it I don’t understand it really x

[Treepie in reply to Taytaydarz]

Then you need to learn .Start at Thyroid UK website.

[helvella Administrator in reply to Taytaydarz]

Taytaydarz,

None of us were born knowing these things! And few of us knew anything before hitting thyroid issues (whether our own or someone else's).

It can be tough getting going. But you will start to make more sense of things as time goes by.

You might find my Abbreviations and Acronyms document helps a little:

dropbox.com/s/og3lmxa1dqadb...

[Taytaydarz]

Thankyou very much I’ll start looking through! I’m pretty thick at understanding things.. but hopefully I’ll get there xx

[helvella Administrator in reply to Taytaydarz]

Taytaydarz,

Never blame yourself - if you don't understand it is because it has not been explained sufficiently well.

[Schristie1992]

Taytaydarz, I totally understand how your feeling. I’m only 25 and I was just recently diagnosed aswell, I have no clue either!

[Dewberry1]

Hi

I took mine at night for a few days. Even though it was 2 hours away from food and just didn’t feel right. Maybe try the morning?

And I’m only 27 so I know where you are coming from. But there is alot of good information on this site. And I feel had I not read all this I wouldn’t have pushed my drs. Or made changed to my diet etc that have helped.

It is overwhelming but having knowledge will put you in a better position.

Good luck x

[Badboomer]

I take mine in the morning. The dose is somewhat dependent upon your body weight. If you gain weight you may feel more tired if your dose is not adjusted accordingly.

[Taytaydarz in reply to Badboomer]

I haven’t gained any weight since being diagnosed my doctor said I’m one lucky girl 😳 x

[Claudia_Leonor]

I take it before going to bed. I have always done so. I go to bed late and always more than two hours after I have eaten.

Last year, after some time struggling, I took Levo in the morning for a couple of weeks (because people always say it works better in the morning) and it was a torture. Not only it was impossible for me to wait one hour to eat breakfast and then start my day, but it also messed with my vitamin D intake routine.

I tried setting an alarm clock to wake me up for Levo but it was just hell. It is just too much of a torture to wake up one hour earlier for no other reason but Levo... Impossible...

Besides, I hate taking pills and stuff. I bring them into my life the best way I can without changing my life. A headache has to last at least 24hs before I reach the paracetamol box... so I try to make the Levo taking smooth into my life routine... the night intake is the best I can do and it works...

[Taytaydarz in reply to Claudia_Leonor]

I took them this morning and I’ve felt sick all day.. I usually take mine at night but I’ve felt so tired recently thought I’d change to morning but I think I’ll go back to nights x

[Claudia_Leonor in reply to Taytaydarz]

Just make things easy for you.

Sometimes we forget that there are so many things that can come in the way of our metabolism and hurt our fragile bodies. Meaning that not all our bad moments have to do with the hours we take our pill or how much Levo we are taking.

When taking Levo, just keep in mind the two hours after eating and one hour before eating...

[Hidden]

Personally I found that the best time for me to take my medication is about supper time with some food but for years I was taking it before breakfast and didn't really seem to have any negative effects my suggestion would be that you try different times probably for 6 or 8 weeks at a time the same distance between the blood test and are between doses changes in blood tests see what works for you because for some people taking it right before bed which I did for awhile it just ended up keeping me up so I thought I'd found personally that I take it I have the best reaction when I take them at suppertime so pretty much everything is trial and error with this disease. Good luck.

One thing I will add those to definitely be sure you take it about the same time everyday that is key

[LizzieAFib]

Hello Taytaydarz.

I take my levo before I go to bed which ensures I comply with the empty stomach rules and it works best for me. Initially I took it in the morning as instructed by my GP but that didn’t work for me - need to eat when I get up! Also taking the levo when I go to bed means there’s no conflict with other meds or vitamins.

Good luck