Taking Levothyroxine at night

[Munting]

Hi. Just a quick question, I’m taking various supplements, including calcium, as prescribed by my Naturopath, and my GP has agreed to prescribe me Levothyroxine liquid rather than the tablets as I couldn’t tolerate them (because of the starch that’s in them). So I was just wondering if anybody takes their Levothyroxine at night as I don’t want it to interact with my supplements? Note of anxiety here too, I hope I can tolerate the liquid ….

[helvella Administrator Thyroid UK]

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...

[SlowDragon Administrator]

You can also consider splitting dose into 2 smaller doses if it’s difficult to tolerate full dose at night

Many people find taking at nighttime more convenient and possibly more effective

Liquid levothyroxine often works better than tablets

[SlowDragon Administrator]

Looking at previous posts, you were started on too small a dose of levothyroxine…plus it was Teva which upsets many, many people

Standard starter dose of levothyroxine is 50mcg

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Likely to need several further increases in levothyroxine over coming months

Essential to regularly retest vitamin D, folate, ferritin and B12.

What vitamin supplements are you currently taking

When were these vitamins last tested

Are you still on Lansoprazole. Ppi are to treat HIGH stomach acid. Most hypothyroid patients have LOW stomach acid

Lansoprazole will significantly lower vitamin levels, magnesium and B12 especially

[Munting]

Hi. Many thanks for all your support. It is much appreciated. I’m on Evening Primrose Oil, Calcium/Magnesium, Vitamin E, Paramicrocidin (which is a grapefruit seed extract to get rid of the bacterial overgrowth), Nutrigest (to help with stomach acid and is Betaine HCL, L-Glutamic Acid, Papain Protease, Bromelain Protease, Protease, Amylase, Lipase, L-Taurune, Glycine), then Promulti-Plus (which is Vit C, Pantothenic Acid, Niacin, B6, B1, B2, Vit K, Folate, B12, Biotin, Vit A, Vit D and Vit E). I know my Vit D levels are ok, but my B12 was double what it should be but it was hard to not take it as it is in the Promulti-Plus, and when I tried to lower it I had no energy at all. My mean cell volume (42A …) and my mean cell haemoglobin are slightly above range too, but not much and my naturopath said that that meant there is a need for B12 and Folate, and that it also indicates low stomach acid. I’m no longer on the Lansoprazole thank god, as I know things went downhill when I took that, not knowing my stomach acid was probably already low.

About the Levothyroxine dose, I’ve read that if you are over 50 they start you on the lower dose so I guess that’s why they said 25 mg initially. I pick up my Levothyroxine solution tomorrow so, after reading the links you sent me I think I will try just a little bit at night, just to see if I react at all. Fingers crossed and thank you to you and everybody for all your help.

[greygoose in reply to Munting]

Wow! That's some list of supplements. Sounds like a bit of over-kill, to me.

Why the calcium? That's really not a good thing to take unless you absolutely need it. It's very poorly absorbed at a cellular level and tends to build up in the soft tissues and arteries.

What was your calcium level when tested?

Promulti-Plus (which is Vit C, Pantothenic Acid, Niacin, B6, B1, B2, Vit K, Folate, B12, Biotin, Vit A, Vit D and Vit E)

You're taking vit D so that should increase your absorption of calcium from food. Do you really need that calcium supplement? And, is that vit K vit K2 or vit K1? It's the K2 that you need to get the calcium into the bones and teeth.

Plus, that's not a very good supplement, either, because it contains vit C. And vit C stops B12 working correctly in the body. They should not be taken together. Does your naturopath know, and has s/he told you, what can be taken with what? For example, zinc and magnesium should not be taken together.

And, you seem to be taking rather a lot of vit E. You can have too much because vit E is oil-soluble, so excess isn't excreeded like vits C and B12. So, I would check the amounts you're taking, if I were you.

[Munting]

Oh and I forgot, I’m also on GTA Forte which is a supplement for the thyroid which is zinc, cultured pea and lentil, porcine glandular concentrate, superoxide dismutase and catalase so I guess I should lay off that while I’m on the Levothyroxine. I’ve only just started taking it again so wasn’t on it when I tried the tablet Levothyroxine.

[greygoose in reply to Munting]

Did you get your zinc and copper tested before starting supplementing zinc? Hypos are usually high in one or the other, and they should be kept balanced.

[Munting in reply to greygoose]

Wow! I never knew all that! Thank you. For years I couldn’t tolerate dairy which I think all started when I was taking the ppi and when menopause kicked in, and I must admit I really felt like I needed it just after Christmas and introduced it slowly and separately from the magnesium (I hadn’t completely gone without Calcium and had been taking Calcium with Vit D3 from Holland and Barrett before seeing my Naturopath so had only been without for a few months). I did a DNA Health Test earlier on this year, a test to see what nutrients I was lacking and had a full blood test done which is why I’m on what I’m on. Tomorrow I’m not going to take the zinc, copper, Vit E, and have already reduced the Promulti Plus. Tomorrow night I will take some of the Levothyroxine and make a note of everything everybody has told me in readiness for my appointment with my Naturopath on Monday, who to be fair was the one who told me about the liquid and about this forum, which has been extremely helpful. Thank you.

[greygoose in reply to Munting]

I'm really not sure what needing calcium would feel like. Just because you don't eat dairy doesn't automatically mean that you are low in calcium. Lots of things contain calcium. So, you should always test before supplementing.Some things can be dangerous to over-dose on. Your naturopath may have directed you here, but he doesn't seem to be very clued up on nutriention and supplements.

Anyway, I would suggest that you post your nutrient test results on here and let people have a look.

As a general rule, Holland and Barrett is not a good place to buy supplements. They tend to use the cheapest ingredients. And, with supplements, you get what you pay for. I always go on Amazon to buy mine, because there is plenty of choice.