Is it better to take Levothyroxine in the morning than at bedtime?

[Lislaw]

Just wondering why we are told to take it in the morning...if we took it at bedtime we wouldn’t have to worry about other things we eat/supplements mixing in the morning? Is it better for you to take it in the day?

[helvella Administrator Thyroid UK]

My "standard" response!

It is often suggested that bed-time dosing results in slightly better absorption. It also seems slightly closer to the pattern healthy people have.

I have always taken my levothyroxine at bed-time.

For that reason, I cannot compare with taking in the morning.

Before diagnosis, my sleep was badly disturbed. Typically, I would fall asleep fairly easily. Then wake up after something like half an hour to two hours. Once woken I'd be unable to get back to sleep - often till dawn, or at all.

Once I started on levothyroxine, my sleep slowly improved. By the time I was taking an adequate dose, bad nights were unusual - just an occasional night where I might wake up for a while. Now, after years, I sleep very easily and deeply and rarely wake at all. If I do, I get back to sleep quickly.

We have some who prefer it; we have others who prefer other times. See our poll:

healthunlocked.com/thyroidu...

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...

[jrbarnes in reply to helvella]

Do you take it right before bed or 2-4 hours prior?

[helvella Administrator Thyroid UK in reply to jrbarnes]

Brush teeth, swallow tablets, head down. 😀

[Thenightowl in reply to helvella]

That's really useful to know, thanks for posting.

[Buddy195 Administrator]

I’ve been taking Levo at 10pm for 4 months & am finding it far more convenient, as can have breakfast & coffee as soon as I’m out of bed. I take my B and D vitamins on a morning and magnesium at teatime.

[jrbarnes in reply to Buddy195]

Do you take that a few hours before bed? Did it affect your T4 levels much?

[Buddy195 Administrator in reply to jrbarnes]

Yes I take it at least 2 hours after food. I’m still trying to get T3 and T4 higher in range & have increased my Levo dosage, but I don’t think having it later has affected this.

[shaws Administrator in reply to Buddy195]

I think we can eventually find the best way we want to take our medications, for convenience, and when we do it makes our life much easier. As long as our stomach is empty before and after taking the hormones.

[SeasideSusie Remembering]

Lislaw

If you take it at bedtime, remember that it still needs to be taken on an empty stomach so if your evening meal is your main meal then you should leave 3 hours before taking Levo, if it's a lighter meal then 2 hours will be fine. No coffee or caffeine containing drinks either as this affects absorption of Levo. Also, no other medication or supplements as Levo needs to be takien 2 hours away from them, and if you take magnesium in the evening, or Vit D or iron, then these require 4 hours.

As I regularly need the bathroom during the early hours of the morning, that's when I take mine.

[adin]

It's ok but two possible issues could be if you take levo to bed at night, 1.-some people find the levo disturbing sleep and 2. -possible that you do not have enough energy throughout the day, feel tired. You have to try.

[notdoingwell]

Hello Lislaw

I hope you have found a solution that suits you. What did you decide?

I am using this thread as I see the wise administrators are here already, to ask if anyone can recommend when I take my Cynomel (C3)? At the moment I take it much later in the morning than levo, at the same time as Betablockers, etc. I can't remember if this is best - suffering with bad brain fog at the moment.

Is it as sensitive as Levo? Does it block/change the uptake of Levo?

I am thinking of changing to evening Levo to see if that helps with brain fog, hairloss and depression, and I'm not sure whether to continue taking the Cynomel in the morning.

Any ideas?