Levo "MUST" be taken in the morning!: I had a... - Thyroid UK

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Levo "MUST" be taken in the morning!

11 Replies

I had a sore throat which developed into quite a nasty cough. There's almost no sign of any lingering infection but the cough is driving me nuts and sleeping is difficult. So I went to the chemist for some cough mixture.

It seemed a good idea to check how long should be left between cough mixture nd Levo, as I take it at bed time for so I can have a cuppa in the morning with no worries.

When I told them I normally take it in the evening it was almost a Shock! Horror! reaction. Thyoxine "HAS" to be taken in the morning. I said that the experts say it's OK to take in the evening. So the pharmacist double-checked with another lady who was there and then came back to me. She said yes, in the morning [the other lady] is a doctor and she knows.

There was no point arguing so I came away. The staff at that chemist are particularly nice, and were extremely helpful advising which kind of cough mixture was best, so I don't want to antagonise them, especially knowing I can ask on here and continue to take my Levo as usual!

But what is the answer to the cough mixture question? Pholcodeine is the active ingredient but the strip on the bottle didn't peel off properly and is unreadable.

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11 Replies
humanbean profile image
humanbean

These links may help :

Summary of Product Characteristics : medicines.org.uk/emc/produc...

Patient Information Leaflet : medicines.org.uk/emc/files/...

I haven't read either of them, sorry. :)

in reply to humanbean

Thank you, that may give some idea.

humanbean profile image
humanbean

If you have gunge and phlegm in your lungs that you are struggling to cough up one possible OTC solution is to take NAC - N-AcetylCysteine. It thins mucus which makes it easier to cough up.

It is usually sold in 600mg capsules and people can take between 1 and 4 per day spread throughout the day (based on my reading about it, not what it says on the bottle). Anyone deciding to try it should decide for themselves how much they need based on their own research.

Some links on NAC :

healthline.com/nutrition/na...

livestrong.com/article/4926...

webmd.com/lung/copd/feature...

Unfortunately NAC isn't a quick treatment - it isn't like a commercial cough medicine. It could take 2 - 3 days for mucus to thin out and come up.

I've also found that taking it for too long can dry my lungs out. I am an ex-heavy smoker and I take NAC four days on, three days off because I tend to have problems with mucus and phlegm I can't shift.

in reply to humanbean

Interesting, maybe for future reference as Probably won't need it this time. My cough is mostly unproductive with just occasionally small bits of yellow. The pharmacist was concerned to make sure I was unlikely to have gunge settling on my chest for too long.

Thankfully I've never smoked, though used to have asthma as a child.

Wetsuiter profile image
Wetsuiter in reply to humanbean

Ive coughed badly my entire life, and the 'current' cough is well over a year old. I m not sure ive ever heard of NAC (off to google)

greygoose profile image
greygoose

Didn't you ask why it has to be taken in the morning? That would make interesting listening. :)

I was so surprised by their reaction that it never occurred to me. Wish it had!

Probably the reason was that's what it says on the leaflet in the box!

Rules must NOT be broken, you see! Even if they are only guidelines :-D

helvella profile image
helvellaAdministratorThyroid UK

Some papers which discuss taking levothyroxine at different times - such as bed-time.

Levothyroxine Replacement and Ramadan Fasting

pubmed.ncbi.nlm.nih.gov/237...

Effect of L-Thyroxine Administration Before Breakfast vs at Bedtime on Hypothyroidism: A Meta-Analysis

pubmed.ncbi.nlm.nih.gov/320...

Morning vs. Bedtime Levothyroxine Administration: What Is the Ideal Choice for Children?

pubmed.ncbi.nlm.nih.gov/303...

A Crossover Study Evaluating Effect of Timing of Levothyroxine on Thyroid Hormone Status in Patients of Hypothyroidism

pubmed.ncbi.nlm.nih.gov/313...

Effect of Timing of Levothyroxine Administration on the Treatment of Hypothyroidism: A Three-Period Crossover Randomized Study

pubmed.ncbi.nlm.nih.gov/300...

Alternative Schedules of Levothyroxine Administration

pubmed.ncbi.nlm.nih.gov/256...

Thyroid Diseases and Ramadan

pubmed.ncbi.nlm.nih.gov/228...

Pharmacotherapy: Hypothyroidism-Should Levothyroxine Be Taken at Bedtime?

pubmed.ncbi.nlm.nih.gov/213...

Effects of Evening vs Morning Levothyroxine Intake: A Randomized Double-Blind Crossover Trial

pubmed.ncbi.nlm.nih.gov/211...

Timing of Levothyroxine Administration Affects Serum Thyrotropin Concentration

pubmed.ncbi.nlm.nih.gov/195...

Effects of Evening vs Morning Thyroxine Ingestion on Serum Thyroid Hormone Profiles in Hypothyroid Patients

pubmed.ncbi.nlm.nih.gov/172...

SlowDragon profile image
SlowDragonAdministrator

Suggest you take these in for pharmacy....teach some old dogs new tricks

verywellhealth.com/best-tim...

gp-update.co.uk/Latest-Upda...

A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.

LAHs profile image
LAHs

Timing of Levo dose with cough medicine I can't answer but you can take Levo any time of day or night because you are only maintaining a level of T4 in your body. T4 has a half life of 7 days and just needs to be maintained at your optimal level by taking a pill each day. Now the other thing about a sore throat: Make sure you take your Levo with sufficient water so that it is flushed right into the stomach, do not let it linger stuck to your esophageal membranes because if it gets absorbed on that wall it could cause an ulcer over time, those membranes are not "built" for that type of absorption.

Thank you for the tip about the water. Last night I left an hour between the Levo and cough mixture. But not sure if the cough mixture is a good idea after all as it made my chest tight instead.

Maybe the infection isn't quite gone and I need an expectorant instead

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