Taking Levo at night: Hi all, Does anyone take... - Thyroid UK

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Taking Levo at night

janesp profile image
janesp

Hi all,

Does anyone take their Levo at night? Am thinking of doing this to maximise absorption and avoid the problem of having to wait to have tea/coffee/breakfast etc.

I do suffer from bouts of insomnia however so don't want to make this worse. Just wondered what people's experiences of doing this have been like.

Thanks!

15 Replies

I have always taken half my levo in the morning and half at night.

janesp profile image
janesp in reply to Lalatoot

Hi - is that to keep things even throughout the day/night?

Lalatoot profile image
Lalatoot in reply to janesp

No it is because I couldn't tolerate a full dose in one go. i also reckon if 1 dose is badly absorbed for some reason that it is only half of my daily dose that has been affected .

shaws profile image
shawsAdministrator

Yes, you can take your dose at bedtime. One of TUK's Advisers, took his in the middle of the night when he awoke to go to the bathroom.

This link may answer your query and this is an excerpt:

Results showed that the TT4 concentrations were significantly lower when levothyroxine was taken at the same time as the milk as compared to levothyroxine alone.2 Also, peak serum TT4 concentrations dropped significantly when cow’s milk was co‐administered with levothyroxine than with the levothyroxine alone.

The researchers believe that both the calcium content of the milk and the presence of protein might directly interfere with the proper and full absorption of levothyroxine, complicating the management of hypothyroid.2

“Our results show that calcium-rich foods should be consumed apart from thyroid hormone medication, as much as possible,” Dr. Leung tells EndocrineWeb. “This will help ensure that thyroid blood tests remain constant, thus decreasing the need for potentially unnecessary changes [increases] in the dose of thyroid replacement needed to manage your hypothyroidism.”

"endocrineweb.com/conditions...

janesp profile image
janesp in reply to shaws

Thank you, very useful.

SlowDragon profile image
SlowDragonAdministrator

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

REMEMBER.....very important....stop taking any supplements that contain biotin a week before ALL BLOOD TESTS as biotin can falsely affect test results - eg vitamin B complex

How much levothyroxine are you currently taking

Do you always get same brand of levothyroxine at each prescription

What vitamin supplements are you currently taking

When were vitamin levels last tested

Retest thyroid 6-8 weeks after changing to taking levothyroxine at bedtime

janesp profile image
janesp in reply to SlowDragon

Hi there,

I'm not taking any supplements at the moment, apart from probiotics. Have recently had surgery and recovery has been really rough so I don't want to take anything that might affect this.

Am on 75mcg of Levo which seems fine. Last tested in Feb 2021 and TSH was 0.69, with free T3 at 4.46. Always same brand Mercury + Accord.

My main concern with taking the Levo at night is not making insomnia worse.

No vitamin tests for a while apart from GP doing Vit D at my request which came out at 107 nmol.

SlowDragon profile image
SlowDragonAdministrator in reply to janesp

What’s range on Ft3...looks low

What was Ft4 result

Insomnia is common when under medicated/low Ft3 and or low vitamin D

janesp profile image
janesp in reply to SlowDragon

Range on Ft3 is 3.1 - 6.8.

It may well have changed and dropped since then - I think having an operation, albeit keyhole, and then having a course of antibiotics is a shock to the body.

SlowDragon profile image
SlowDragonAdministrator in reply to janesp

Ft3 was low then...only 37% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

helvella profile image
helvellaAdministrator

I keep this as a regular reply:

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...

janesp profile image
janesp in reply to helvella

Thank you for the info., that's brilliant. I have to say I am jealous of your sleep, it sounds blissful!

helvella profile image
helvellaAdministrator in reply to janesp

Usually pretty good. Confirmed by a wrist band which monitors my sleep. However, unusually, I woke up very early this morning before five o'clock - but have felt fine.

Yes - I really DO feel lucky.

Oh, will try to re-route it, not feeling too sharp this morning!

I deleted it then added as a reply to the member. It may be time for another coffee :)

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