How to switch from morning to night dosing? - Thyroid UK

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How to switch from morning to night dosing?

TiredMummy profile image
19 Replies

Hi everyone,

I’m taking Levothyroxine in the mornings (one hour before breakfast) and thinking about taking it at bedtime to see if that brings benefits. Does anyone know the least painful way of migrating to the regime? e.g. no Levothyroxine in the morning on day 1? I think from experience I would feel severely hypo from mid morning and would struggle to function that’s day but I can’t think of another way.

Thanks for in advance for any advice x

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TiredMummy
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19 Replies
SeasideSusie profile image
SeasideSusieRemembering

TiredMummy

The effects of taking Levothyroxine aren't instant, it takes up to 6 weeks for the full effects of today's dose, so you have a good store of Levo (T4 - the storage hormone) in your body. If you missed tomorrow morning's dose and took it tomorrow evening instead then carried taking it evenings from then on you should not notice any difference.

I think from experience I would feel severely hypo from mid morning and would struggle to function that’s day but I can’t think of another way.

I struggle to understand how anyone could feel severely hypo by delaying that day's dose. If it was T3 it might make sense, but not with Levo.

If you think it is going to make such a difference then why not stretch the time you take it by a couple of hours every day until you've made the switch from morning to evening completely.

Lalatoot profile image
Lalatoot

You could take half in the morning and half at night for a while to ease the transition.

Bingsmam profile image
Bingsmam in reply toLalatoot

That’s what I did, no problems.

jconnor123 profile image
jconnor123

t4 has a very long half life in your body. you're talking about weeks instead of hours compared to t3. you would have no probs switching overnight if you did

SlowDragon profile image
SlowDragonAdministrator

When I switched I moved time I took it backwards by 2-4 hours

So typically took it 7 am

Next day took at 5am

Next day at 2am

Next day at 11pm

TiredMummy profile image
TiredMummy

That’s really helpful, thank you everyone. I thought I would get comments on how strange it is that I feel hypo very quickly if I reduce my Levo or take it late. It’s always been like this for me but then I think to be honest I’m in a bit of a mess in that I might be over medicated and struggling with finding the right HRT regime as I’m in peri-menopause. It’s a bit of a rollercoaster to be honest!

I keep crashing at the moment, severe headaches, hot, nausea, dark circles under my eyes and I think it’s the interaction between the oestrogen patches and Levothyroxine. I was just thinking it might be better to try Levothyroxine at night to see if sleeping off the worse part of the side effects was better. I’m in bed most nights by 8:30pm as I feel so bad.

I think to be honest I will just try reducing my Levothyroxine rather than changing the timing and see if that helps. From experience though, when I try reducing from 125mcg to 100mcg the first day I feel some relief, second day starting to feel a bit hypo and third day I struggle to know what day it is. It’s like my brain shuts down! It’s pretty awful.

I will try again though, today is day one which is why I am still awake at 9pm! You never know, a miracle might happen and I won’t feel too bad tomorrow as there’s a chance my HRT might be settling down.

I will follow the ideas from your responses though if I feel I need to try night dosing so thank you everyone for your replies x

littlecandle profile image
littlecandle

I cannot sleep at night if I take my dose of levo any later than about 8 or 9 am. And even though I know it has a long half-life etc, I do notice if I miss one dose or have it much later in the day. However, a lot of people find it better to take it at night, so why not give it a try?

MonaLDN profile image
MonaLDN

I probably would do it every day an hour later. So within 2 weeks you should have changed it without having many symptoms.

SassyMH profile image
SassyMH

I just took my levo in the same morning and evening, as its a one off it wasnt a problem. I normally alternate 175/150, i took 150 4 days in a row to try any smooth the change. I felt fine. Good luck.

TiredMummy profile image
TiredMummy in reply toSassyMH

Hi SassyMH, interesting to read about your alternate dosing. I’m wondering if that’s where I might end up - alternating between 100 & 125. Can I ask how you came to be on alternate dosing?

SassyMH profile image
SassyMH in reply toTiredMummy

The Dr kept telling me i needed to reduce my dose but at 150 i felt awful, at 175 my bloods were over top of range and i still felt under medicated. It turned out i needed T3, so i take that too and alternate my dose. I feel MUCH better and my bloods are within range. X

TiredMummy profile image
TiredMummy in reply toSassyMH

I wonder if that’s where I might end up as doctors say I’m on too much Levo but feel rough when I reduce it.

jkozlow3 profile image
jkozlow3

There are some people that take their entire week’s worth of levothyroxine once a week believe it or not.

As others have stated, for most people, you could just take that day’s dosage later in the day when making the switch. You will likely need a higher dose of levothyroxine if you take it before bed however vs. in the morning. I do anyway. Doesn’t seem to get absorbed as well for me when I take it at night.

NWA6 profile image
NWA6

I just took my morning dose and then a night dose and carried on with a night dose ever since. Didn’t make a bit of difference. I only changed cause I wanted my coffee in the mornings 🤗

thyroidnodules profile image
thyroidnodules

lol same here, i take mine at night as i love my morning cup of coffee. i dont think changing over from morning to night and hence delaying it a few hours would make any difference at all. when i have been on holiday i have sometimes not taken it at night and not noticed any difference

Chriskisby profile image
Chriskisby

I take mine about 5.30am ( I always wake to use the loo then!) as when I took it last thing at night I used to have quite bad palpitations during the night. This meant I wasn’t able to sleep. I have been comparatively well since, but if I have a busy day coming up I sometimes add an extra 25mcg to my usual 125mcg. Perhaps it is psychological, but I do feel better and haven’t had palpitations for ages.

YSpencer profile image
YSpencer

Hi. I have taken mine at night for many years. I just missed the morning one and took it at night. I did it because l take Adcal and you need 4 hours between that and Levo.

TiredMummy profile image
TiredMummy

I took my Levo at 1am as woke up naturally needing the little girls room. Feeling a bit odd this morning as wasn’t able to sleep well after taking it but that could be me worrying about how bad I might feel in the morning! Tonight I could take it 9-10pm & then plan to stick to the same timing or l could just keep taking it in the middle of the night. I do feel it’s interesting there’s so much difference in reaction & opinion on this timing issue. For some it makes no difference for others, the advice out there about how important it is to take your Levo at the same time every day, is more important. It doesn’t matter a jot which theory is ‘right‘ particularly with many believing you need to wait weeks until you’ll feel a ‘difference’, what matters is what you personally experience and what works for you.

YSpencer profile image
YSpencer in reply toTiredMummy

I totally agree.

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