Levothyroxine Medication Query

[Motown1977]

Hi, can I ask fellow underactive thyroid members when they take their levothyroxine medication. Have you been advised what time of day to take it? Thank you.

[Lalatoot]

I take half in the morning and half at bedtime.It is what suits you individually and suits your daily routine.

[Motown1977 in reply to Lalatoot]

Thank you Lalatoot

[SlowDragon Administrator]

Many thyroid patients take levothyroxine waking, or bedtime or middle of night if regularly get up for the loo

Most important is it’s on an empty stomach, nothing apart from water for at least an hour after

No other medications or supplements within 2 hours

Some like PPI, HRT, calcium, magnesium, vitamin D, iron at least 4 hours away from levothyroxine

[Motown1977 in reply to SlowDragon]

Thank you SlowDragon

[Sparklingsunshine in reply to Motown1977]

HiI get up each night for the loo, too much tea and ahem advancing age. Its generally around 3am. I take my Levo then. That way it doesn't interfere with a morning coffee or other meds.

[Motown1977 in reply to Sparklingsunshine]

Thank you Sparklingsunshine

[Jacks4]

I normally take them in the morning. For years with my cup of tea but only been told recently that I should have tea an hour later which have been doing some days.

[Motown1977 in reply to Jacks4]

Jacks4

[Yeswithasmile]

I take mine at 5.30am. Set my alarm, take it and then get up an hour or so later and have a cuppa.

I think it’s up to each individual to find what works for them but consistency is key. 😊

[Motown1977 in reply to Yeswithasmile]

Thank you Yeswithasmile

[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...

Previous posts:

Levothyroxine - Switching to night

healthunlocked.com/thyroidu...

[Motown1977 in reply to helvella]

Wow thank you for your detailed reply Helvella

[SEB99]

Hi, I'd been taking it in the morning for over a year. After reading some discussions here, decided to try at bedtime, what a difference! Never felt so full of energy in the morning and able to get through the day, or at least half of it. I try to take my Leo at least 3 hours after last meal, that disciplins me to avoid late dinners and a cheeky evening bisquit :). Having said that, I do support the theory that Levo absorption and action varies in individuals.

[anna-c in reply to SEB99]

Interesting, I may give this a try it will stop me snacking after dinner which I rarely do but I do drink too much coffee which I need to cut back on especially at night. Thanks for your input.

[Motown1977 in reply to SEB99]

Thank you Seb99

[buddhababa]

I take mine first thing in the morning mainly as I'll forget otherwise! 🤔💝

[Motown1977 in reply to buddhababa]

Thank you buddhababa

[Otto11]

I had a partial Thyroidectomy in 1995 & started Thyroxine a few years after. I’ve always taken it in the morning but I’ve recently seen an Endocrinologist who has recommended I take it last thing before bed. I’m only on week 6 of this. I’d never heard of taking it at night but it seems quite common.

[Motown1977 in reply to Otto11]

Thank you Otto11

[anna-c]

I take mine at 5am in the morning as it is the only regular time I can guarantee an empty stomach or not interferring with me having a coffee. It wont suit everyone. At weekends I take it a little later prob 7am as generally like a lie in

[Motown1977 in reply to anna-c]

Thank you anna-c

[Harrop]

Hi had my right lob removed 16yrs ago used to take levo in morning as regular as clock work was never told not to drink coffee after it until I was reading about it.. Now I take at night as the minute I wake I have coffee..I NO longer see my consultant just GP or nurse practioner went as was tired I had to ask her to check my t3 & t4 levels as GP practices don't do it.. When results came back I had to lower dose..

[Motown1977 in reply to Harrop]

Thank you Harrop

[Decant]

Great answers here, as ever. I used to take on waking but now take mine at bedtime. However I want to start taking magnesium at night to help sleep so I might need to revert to the morning, but then that clashes with breakfast, coffee, Vit D, etc. I don't want to be remembering some complex pill protocol!

[EebieJeebies in reply to Decant]

This is my issue too, I take ramipril, utrogestan and magnesium at night….not a morning person and need a coffee in bed to come to,,,, there never seems a good time to take Levo!

[Motown1977 in reply to EebieJeebies]

Thank you EebieJeebies

[Motown1977 in reply to Decant]

Thank you Decant

[Partner20]

I started off by taking levo in the morning, an hour before food or drink as per usual instructions. I then changed to taking it at night to fit in better with medications I needed to take in the morning, but later reverted to morning levo as a fondness for evening snacking did not allow the 4-hour window necessary! Personally, I found no difference in effect either way. I am currently taking my levo at night as I am doing intermittent fasting, so stop eating at 7.00 pm which has put an end to that tendency to snack in the evening. Long-term consistency is the best plan, with whichever timing suits you best.

[Motown1977 in reply to Partner20]

Thank you Partner20

[ThyroidalLinda]

Hi.. i take it in the morning and leave 1 to 2 hours before anything with calcium in it.. milk, yogurts, some fruits etcBest to avoid vitamin/mineral tablets too as they can hinder absorbtion.

It is better to take daily as you know where you are.. your thyroid can store 2 weeks worth .. it does take 3 months for your body to reset all the counter balances and hormones.. but if you feel tired around 1-3 pm ish you're likely to be underactive still. Tsh test is not the full testing! Free T4 is what is active and usable in your blood. Reverse T3 counters it and removes if too much in your system.

Check thyroid antibodies.. if high there is a tablet called PMG thyrotrophan.

This draws away the attacking antibodies and excretes through urine.... why is this not regularly tested or prescribed!

Also, with fatigue... check ovaries status..

If estrogen and progesterone reduce down (progesterone by approx x100 more than estrogen)

You may be entering perimenopause..

It lasts 10 years before your periods stop (menopause).

Take estradiol and the natural yam version of progesterone.. still synthesised in a lab but less side affects.

Mirena coil may be offered but it is a progesterin that can block natural progesterone... this in turn could cause thyroid to crash.

Hope this helps you. X x

[Motown1977 in reply to ThyroidalLinda]

Thank you ThyroidalLinda

[Yasrash]

Hi I’ve been to take it first thing in the morning then leave at least 1 for breakfast.

Hope this helps

Thanks

[Motown1977 in reply to Yasrash]

Thank you Yasrash

[a1glenn]

Split doses, half am/half pm. Otherwise it makes me feel really bad.

[Motown1977 in reply to a1glenn]

Thank you alglenn

[Digger0]

I take mine first thing in the morning with water. Nothing else for at least 30 minute!

[Motown1977 in reply to Digger0]

Thank you Digger0

[Russellb73]

I take mine first thing in the morning seems to work ok for me!! I’m on 100 then 75 alternate days !!