I’ve been taking my thyroxine (100/125), with all my morning meds + tiny bit of food, followed by breakfast 60-90 minutes later for 10 years and my endo says this is fine. I can’t say I’ve ever felt the thyroxine’s made any difference, and lately other major health problems have begun to slowly resolve, leaving symptoms that seem hypothyroid related.
I take, thyroxine, Sertraline, hydrocortisone, omeprazole, Cyclizine, Vit D, high strength omega 3 fish oil. Also have B12 shot every 12 weeks and have HRT patches.
I’m thinking of trying thyroxine in the evening on its own. Mornings would be problematic as I have to take hydrocortisone as soon as I wake.
Any thoughts/advice would be very helpful, thank you 😊
Ps. My tests results last week were:
TSH 2.13 (March 2021 was 0.99)
FREE T3. 4.6
FREE T4. 17.2
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Mitsy123
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Levo should always be taken on it's own, on an empty stomach, one hour before food or two hours after, with water only and water only either side. This is to ensure that nothing affects absorption of Levo.
Any other medication or supplements should be at least 2 hours away from Levo and some need 4 hours - HRT/oestrogen (but not patches), omeprazole, anti-depressants, Vit D, calcium, magnesium, iron.
Basically doctors, including endos (who generally are diabetes specialists not thyroid specialists) know very little about treating thyroid disease, how to take thyroid meds, what may affect it, or how important optimal nutrient levels are.
They also don't know how we should do our thyroid tests, this is what we always advise:
* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH
* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.
* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
Yes, I’m beginning to see what you mean about Endos. I’ve never been told to not eat before or delay my thyroxine until after a blood test. I think I’m going to try taking thyroxine at bedtime; how long will it take to see a difference? I’m coming off Cyclizine right now, so I need to know what’s withdrawal symptoms and what’s due to new time taking thyroxine .
Thank you everyone who’s replying; it’s comforting to know you care enough to help.
I think I’m going to try taking thyroxine at bedtime; how long will it take to see a difference?
Sorry, I've no idea. I've never swapped from early morning to bedtime. I've only gone from taking it on waking to taking in a few hours earlier when I need the bathroom during the night and I found no difference. It might not make any difference at all for you, it's just a case of try it and see what happens. Everyone is different.
As Levo is a storage hormone it wont matter, you take your Levo daily dose regardless of what time. So if you want to change from morning to evening, say if you decide to change tomorrow then you could just take tomorrow morning's dose at bedtime or you could gradually move it by a few hours each day until you reach bedtime.
Hi. I started taking Levothyroxine at night approx 6 months ago after 16 years of taking first thing in morning and find it's suits much better. I wake up feeling less tired than I did and I can eat and drink on rising.. I missed the taking it in the morning but took it before bed that night with water only approx 3 hours after eating.. I know Levothyroxine is a storage hormone but it works for me..
Be aware you may need to reduce dose levothyroxine if absorption is a lot better
Or you might simply find conversion of Ft4 to Ft3 improves
Bloods should be retested 6-8 weeks after any significant changes such as this
Do you always get same brand levothyroxine at each prescription
How much levothyroxine are you currently taking
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
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
As you have B12 injections
Do you self supplement a daily vitamin B complex?
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
Recommend getting FULL thyroid and vitamin testing done 6-8 weeks after changing dose to bedtime
Looking at previous posts…can’t see any thyroid antibodies test results
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)
About 90% of primary hypothyroidism is autoimmune thyroid disease
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
In U.K. medics never call it Hashimoto’s, just autoimmune thyroid disease (and they usually ignore the autoimmune aspect)
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Hi there, thank you so much for all the info. I’m borderline vitD so just upped dose, my B12 is very good. I keep an eye on ferritin too. Once I change dose time I’ll def get a blood test. 🙂
Yep sounds a good plan. Take it before bed on an empty stomach. Your results look like you could do with an increase but see how you feel if you change your dosing to night time as it may really help absorption.
I always take mine at bedtime, usually about 10pm. That way it is 4 hours, or more since I last ate, and I take my other medication and vitamins when I get up. Works very well forme. Good luck.
Me too! the brand I take are small pills, 75mg in total, I pop them under my tongue when I wake up to go the loo and they easily dissolve. I put them in a little dish, so that I can see in the morning that I took them. Rarely ever forget but if I do then I take them as soon as I wake up, then wait for an hour or two for breakfast and don’t drink tea or coffee til mid morning, just hot water. Works well for me.
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