Hypothyroid medication (daily) dose timing - Thyroid UK

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Hypothyroid medication (daily) dose timing

Clarrisa
Clarrisa

Question: Is taking a portion of your daily hypothyroid medication (Tirosint in my case) in the morning & a portion in the evenings done in practice? Or is hypothyroid medication taken all in the morning, or all in the evening as the general rule? I tried to search it on here, but did succeed in locating this topic.

Please note I currently must infrequently check this site due to a eye problem (I am under eye doctor care). I increased my B12 & it really seems to help eye symptoms, so I am hopeful this problem will be short lived. Thank you in advance for any information.

10 Replies
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SeasideSusie
SeasideSusieAdministrator

Clarrisa

Tirosint is levothyroxine so just T4, it is not a fast acting hormone and the dose you take today will take 7-10 days to enter the body's cells properly. There is no benefit in splitting dose of T4 (although there can be for splitting dose of T3 as that is a faster acting hormone).

Whether you take it all in the morning or all in the evening, or even in the early hours of the morning when needing a bathroom trip, is down to the individual, trial and error will tell you which suits you best. Just ensure that you take your Levo on an empty stomach, one hour before or two hours after food, with a glass of water only, no tea, coffee, milk, etc, for an hour either side as absorption will be affected. Take any other medication and supplements 2 hours away from Levo, some need 4 hours.

I had gotten the impression from speaking to the drug manufacture (phone line earlier re: shadows around my eyes) that Tirosint peaks a couple of hours after you take it. Thank you SeasideSusie for pointing out it takes 7 to 10 days to work, not hours.

SeasideSusie
SeasideSusieAdministrator
in reply to Clarrisa

Peaking in the blood and reaching the cells aren't the same. I can't remember exactly how long after ingestion that Levo takes to peak in the blood.

I do know that T3 peaks in the blood 2-4 hours after ingestion and is no longer detectable in the blood after 12 hours. It has a half life of about 24 hours according to what I've read on here.

I have tried various different timings of my doses. I have found best taking one during the night after 1pm(I go to bed at 9pm) which means I have an empty stomach and get up at 6am which m,eans I dont have to worry about having a cup of tea and going back to bed before i get up properly. additionaly whenever ive tried taking thyroid in the morning it didnt seem as effective as taking it during the night. i suspect everybody is different.

re your eye issue. I have foundthat some days i could see without my glasses other days my glasses were fine and other day i couldnt see even with my glasses. i went to a new opticion and asked if it was worth being tested for new glasses. He immediately said I bet you have a thyroid issue!! It was the first time the two things were connected for me. I have also found that when my water retention problem worsens so does my sight. Hope this helps and doresnt muddle ypou further.

Clarrisa
Clarrisa
in reply to Geetal

I wish my health care providers were as smart as yours. Thank you for sharing your experience.

Hi, there have been studies done to show that you have a higher bioavailability of T4 when you take it at bedtime - but as others have pointed out, T4 is a storage hormone, so it should really make no difference when you take it.

The only thing is NOT to take it before a blood test. When you take T4, peak plasma concentrations are reached 4h after ingestion - although it will be a small increase, it will still skew your test results and indicate a higher fT4 than it actually is, hence the advice to not take it before a blood draw.

Hope this will help!

Clarrisa
Clarrisa
in reply to Tina_Maria

Thank you Tina for sharing your knowledge. My face appears puffy after getting out of bed in the a.m. The Tirosint seems to pull this fluid off me to the point my face appears dehydrated at peaking time (Gravity may play into this as well). That is why I was inquiring about taking half my daily dose in the morning, & the remainder in the evening. The two overall peak levels might reduce overall(?).

Perhaps because my face puffs overnight when reclined it would make more sense to take all the Tirosint in the evening. I do think I am sensitive to something in these hypothyroid medications. I saw a allergist but they just seemed to weigh if the benefits of taking the medication outweigh the disadvantages of not taking it. The Allergist seemed to only want to deal with a full scale allergy, not a sensitivity. Any lay person can diagnosis a full blown allergy, one wonders if this has dawned on them ...

Tina_Maria
Tina_Maria
in reply to Clarrisa

Hi Clarissa,

Is there perhaps something in your sleeping environment that you react to and when you get up you may get better? It could perhaps be fluid retention or like you have mentioned allergy? Have you changed your pillow / bedcover recently or not? Feathers can elicit a reaction in sensitive people, maybe try some hypo-allergenic pillows etc?

Also, are you getting enough fluids throughout the day? Could also be a sign of not drinking enough.....

If the above things are not the trigger, the only other thing I could think of is that you may not get enough thyroid hormones? Are your levels optimal? An underactive thyroid is connected with fluid retention..... and it would make sense that when you have the medicine, this puffiness will disappear.....

Just some thoughts..... :-)

Clarrisa
Clarrisa
in reply to Tina_Maria

Thank you very much for your thoughts. I think it is all of the above: I may have developed sensitivity to the cat that sleeps on my bed. My fluid intake drops off over the course of the day. My last thyroid labs were not ideal.

I self paid for a vitamin B panel & my B-2 level was low. Also my B-12 level was half what it was over the summer. I was hoping improving these two levels with supplements would also help with fluid third spacing, or whatever you call it.

I have also been working towards preparing my own foods to avoid salt, additives & increase healthy proteins. I think you are right, I need to tweak those things. Thank you again for your valuable input & time.

Tina_Maria
Tina_Maria
in reply to Clarrisa

No worries, hope you will feel better soon!

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