morning or evening

[gert51]

just had a call on friday from my dr telling me he is increasing my dosage to 75 mg a day and also questioned why i took my tablet in the evening ,is there a best time of day to take it

[SeasideSusie Remembering]

is there a best time of day to take it

Yes. The best time is what suits you. There is no hard and fast rule. Some people find taking it at bedtime is better for them, some find taking it in the morning is best. Just take it on an empty stomach, one hour before or two hours after food (leave 3 hours if you take it at night and you've had a heavy meal). Also take it 2 hours away from other medication and supplements (some need 4 hours). I take mine in the early hours of the morning when I need a bathroom trip, today it was 4.15am. It suits me as it keeps it well away from my inhalers and my supplements, and I don't have breakfast until around 9-10am.

I don't discuss when I take mine with my GP.

[MaisieGray]

Researchers Bolk et al, who carried out a randomised double blind trial in 2010 found that "Levothyroxine taken at bedtime significantly improved thyroid hormone levels. Quality-of-life variables and plasma lipid levels showed no significant changes with bedtime vs morning intake. Clinicians should consider prescribing levothyroxine intake at bedtime."

If your Dr would like the numbers: "Ninety patients completed the trial and were available for analysis. Compared with morning intake, direct treatment effects when levothyroxine was taken at bedtime were a decrease in thyrotropin level of 1.25 mIU/L (95% confidence interval [CI], 0.60-1.89 mIU/L; P < .001), an increase in free thyroxine level of 0.07 ng/dL (0.02-0.13 ng/dL; P = .01), and an increase in total triiodothyronine level of 6.5 ng/dL (0.9-12.1 ng/dL; P = .02)"

But as with most things, it makes sense to do what works best for you.

[SlowDragon Administrator]

Yes, recent research suggests evening dosing is more effective

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

Also important to avoid calcium rich food within four hours of taking Levothyroxine. Most breakfasts include milk or yogurt

See point 9 - any foods to avoid

nhs.uk/medicines/levothyrox...

My own endocrinologist recommends trying evening dosing.

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 or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

Bloods should be retested 6-8 weeks after each dose increase. This continues until TSH is around one and FT4 towards top of range and FT3 at least half way in range

All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24hours prior to test, delay and take immediately after blood draw. This gives highest TSH and lowest FT4. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If normally take dose at bedtime, when going for blood test say on a Monday, delay Saturday night dose until Sunday morning. Take Sunday morning dose straight after blood draw on Monday morning. Can still take Monday evening dose that night . Levothyroxine is a storage hormone.

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

[SlowDragon Administrator]

Just read your previous post

Have you only been on 50mcg Levothyroxine for last 3 years?

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

NICE guidelines saying how to initiate and increase.

Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

cks.nice.org.uk/hypothyroid...

Very important to test vitamin D, folate, B12 and ferritin, especially if been under medicated for a long time