levothyroxine

[ragdollcat]

Can you take levothyroxine at night instead of in the morning ? I’m getting tired of waking up and taking it . Has anyone tried taking it at night with positive results . Thank you

[Jaydee1507 Administrator]

Yes I take my Levo at night and it works well for me. It's often better absorbed taken then too.

[ragdollcat in reply to Jaydee1507]

That’s really good to hear - thank you for replying 😊

[Jazzw]

Yes, that’s absolutely fine. Lots of people find that works for them brilliantly.

[ragdollcat in reply to Jazzw]

Thank you for replying , it’s good to hear positive experiences 😊

[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...

Levothyroxine Medication Query

healthunlocked.com/thyroidu...

[Noelnoel in reply to helvella]

It is often suggested that bed-time dosing results in slightly better absorption.

Hi helvella

Are there any such suggestions for when on a combination or could T3 at bedtime, if too much, negatively impact sleep?

I realise the effects can be very individual but I wondered is there any evidence that T3 is also better absorbed at night

[helvella Administrator Thyroid UK in reply to Noelnoel]

The absorption of T3 seems much better in most of us regardless when we take it.

(Some claim almost 100% but am not wholly convinced.)

It is a question that definitely needs to be answered.

[Noelnoel in reply to helvella]

The absorption of T3 seems much better in most of us

Thank you helvella

But not necessarily better at night?

Given that hypos seem predisposed to malabsorption, what does this mean? And better than what? I’m really trying to understand this

[helvella Administrator Thyroid UK in reply to Noelnoel]

Absorption of T4 is usually said to lie in the range 60 to 80%.

Absorption of T3 is usually said to be in excess of 90%.

I meant that T3 is better absorbed than T4.

On the basis that few who are not hypothyroid will ever take T3, I think this absolutely must mean in those who are hypothyroid.

(For Levothyroxine, part of the establishment of a formulation involves giving 600 microgram doses to healthy volunteers. But I'd have to seek out something that had researched the issue for T3.)

[Noelnoel in reply to helvella]

Absorption of T4 is usually said to lie in the range 60 to 80%.Absorption of T3 is usually said to be in excess of 90%

Thank you helvella

Could this partly explain why on combination, in the form of glandulars, my FT4 is is stubbornly low at around 29% and FT3 very good at 79%? Could this be the missing link?!!

Is it a double whammy - or triple even - in that possibly I don’t convert T4 well (will never know because I take a combination), absorption of T4 is somehow low or compromised, absorption of T3 driving TSH down which then impacts the amount of T4 secreted? Hmmm. Would really like answers on why I feel so good with these numbers and yet the weight gain won’t budge

On these labs I initially lost a few ounces and the weight gain stabilised at least but I’m wondering if I take the entire dose in one go, either am or pm, might more T3 get “pushed” (as DippyDame describes it) or forced into the cells making it more efficient and effective 

Bit nervous about rocking the boat because my sleep has improved so much 

@ragdollcat, apologies for the intrusion but I thought you might not mind as your question had been answered. Should’ve asked you first though

[experimental1 in reply to helvella]

What dose do you take? I haven't been here for sometime so I apologize since you've likely shared that. I'm still trying to restore my sleep and after trying many medications prescribed by my psychiatrist, I'm returning to the use of T4. She's aware that I've been experimenting with self-purchased thyroid meds and is okay with it.

The stress level in my life has increased as my wife is gradually deteriorating from dementia. That, along with my forever struggle with bipolar, is doing a number on my sleep and overall health. That's life.

[helvella Administrator Thyroid UK in reply to experimental1]

Apologies if I have misled you - I do not take T3.

I take 112.5 T4 at bed-time.

[experimental1 in reply to helvella]

Oh, no, you didn't mislead me. No doubt it was my circuitous wording to explain, LOL.

Thank you for the information. During the spring and summer(we live in Florida) 80 mcg of T4 and .5 mg of clonazepam would give me 7 hours of sleep. The decline in my sleep length and quality could also be related to the shorter days. I'm a puzzle to myself and to my doctors.

[Lanny2010 in reply to helvella]

Hello hope you don't mind a quick question on this thread. I'm planning to start taking 25mg of levo from tonight. Bit confused about the timings, do you know if it needs to be strictly 4 hours after evening meal? Do you know if I can have drinks other than water in between? I usually drink lots of redbush tea with oatmilk in the evening and sometimes a glass of wine... ?! Thanks so much

[helvella Administrator Thyroid UK in reply to Lanny2010]

I don't believe it must be four hours. That has always seemed to me the ideal gap, if achievable. But we are all different. Some people empty their stomachs much more quickly than others.

Redbush tea is likely fine but I don't know anything specific about it. But with oatmilk, hmmm, a bit more difficult. I simply don't know.

[Lanny2010 in reply to helvella]

Thanks so much 🙏 will see how it goes

[Lulu2607 in reply to helvella]

Your sleep pattern is enviable. After years of waking up several times a night for various reasons I think my body/brain has adopted it as a habit I now can't break. I live in hope!

[helvella Administrator Thyroid UK in reply to Lulu2607]

I agree!

Before levothyroxine, I'd fall asleep OK, but then wake up and be unable to get back to sleep - sometimes not at all.

After levothyroxine, at least as the dose went up, I started to sleep through. And the odd time I do have to get up, tend to fall back to sleep easily. Just the occasional night such as most when I don't sleep quite as well.

But, in my mind, it completely links sleep to thyroid hormone levels. And in the opposite way to the imagined "hypo so falls asleep a lot".

[ragdollcat]

Thank you so much for all the information/links . Everything has being ticking over so well I’ve been scared to make a change , but I’m so sick of the alarm bell … I am ready to risk it and I can always switch back to mornings if for some reason it doesn’t suit . The not sleeping well would have been hard , no one can function without sleep . My husband snores sometimes , so I totally understand broken sleep. I’m excited about trying out my night time schedule … Yay 😁

[helvella Administrator Thyroid UK in reply to ragdollcat]

I can always switch back to mornings if for some reason it doesn’t suit

Precisely!

[Noelnoel in reply to ragdollcat]

How did the nighttime scheduling go?

[SlowDragon Administrator]

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)

Suggest you get FULL Thyroid and vitamin testing done 6-8 weeks after changing to taking levothyroxine at bedtime

Do you always get same brand levothyroxine at each prescription

How much levothyroxine are you currently taking

What vitamin supplements are you currently taking

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

[ragdollcat]

Thank you , that does make sense getting a blood test . I’m actually due one in four weeks as the doctor believes covid messed up my last blood test . I’ve been travelling well on 50 mcg for quite a while now . I am on iron supplements every second day , should be off them soon . I feel absolutely energised , it’s incredible really considering I was so sick I could barely walk last year . I was having to hold onto gates to stand up , and having to constantly lie down during the day . I’m so glad I didn’t get covid last year as I think without treatment for thyroid and iron deficiency I might not have made it through . Thanks for all the information 👍😊