T4 am/pm split dosing

[TiredMummy]

Hi all,

I’m currently taking all my thyroid medication in the morning and then having breakfast 1.5-2 hours later. I avoid taking any of the vitamins that may hamper absorption such as iron, magnesium etc until at least 4 hours later. I’m on 137.5 Levothyroxine (I take 150mcg one day and then alternate with 125mcg the next).

I’m having insomnia and wanted to try splitting my T4 dose by taking some in the morning and some at night. I’ll start with 100mcg in the mornings and either 25mcg or 50mcg at night to continue my alternate dosing. I’ve taking all my thyroid medication at night a few times in the past and this doesn’t work for me so I’d like to take the bulk of my Levo in the mornings. I’d be careful to take any vitamins that affect absorption with my lunch so they are taken at least 4 hours apart from the am and pm Levothyroxine doses.

I’ve seen on some sites (mostly American I think) that they recommend waiting at least 3 hours, preferably 4 after eating, before taking any evening Levothyroxine. I thought I’d seen advice on here before that the general recommendation was at least 2 hours? I’m an early to bed person as I have to get up 5:30am. Ive usually had dinner by say 6:30 and to get at least 8 hours sleep I’d need to take my Levothyroxine around 9pm to be able to be asleep by 9:30pm to get 8 hours of sleep before the next day. I’m worried I’d be taking my nighttime dose only 2.5 hours after eating…..is this enough to see if this split dosing idea works for me and improves my sleep?

Thank you x

[Lalatoot]

Yes that is a big enough gap. I leave 2 hours or thereabouts. I have always done this for the 8 years I have been on levo Also if one night you eat late and have a slightly shorter gap don't worry. If for that odd occasion absorption is slightly compromised, it will only affect that smaller proportion of your daily dose.

[Regenallotment Ambassador]

I do this too, I’m on 125mcg. Take the 25 mcg at bedtime (usually 10pm for me) and the 100mcg in the morning.

We eat around 6.30pm and have the occasional tv snack but I try not to eat anything after 9pm last supplement I take is magnesium and L glutamine (as a powder in water) at about 9.30pm

I have found I sleep better like this. I take the 100 mcg at 6am then have an Izabella Wentz root cause smoothie at 7.30am.

Except at weekends (like this one) when there are no commitments and I can take morning 100mcg at 6 when I wake up out of habit then go back to sleep till I wake up naturally and recharge the batteries.

let us know how it goes 🌱

[Lalatoot in reply to Regenallotment]

Regen, Magnesium affects the absorption of levo. If you want to get the max out of your second dose of levo it should be 4 hours away from magnesium. However, if you are happy with your hormone levels as they are then no need to rock the boat.

drugs.com/drug-interactions...

Studies on Magnesium and Thyroid Health - Dr. Izabella Wentzthyroidpharmacist.com › articles › new-studies-o...Note: It is important to be aware that magnesium can impair the absorption of thyroid medications, so please space out magnesium from your thyroid medications ...

[Regenallotment Ambassador in reply to Lalatoot]

that’s interesting, so many recommendations to take magnesium before bed and yet I am not feeling that different on 125mcg 4 weeks in. likely you spotted what I’m doing wrong. Thanks so much I’ll adapt and see if I get improvement.

[Lalatoot in reply to Regenallotment]

My magnesium says take with food but there are different types so who knows!

[McPammy]

I split both my levothyroxine and liothyronine doses. I take my first liothyronine dose on waking at about 7am. My first levothyroxine dose at 11.30am. My second liothyronine dose at 3pm and finally my second levothyroxine dose at 4.30pm. I don’t seem to have any issues with absorption as my test results are always good. If I ever feel like I’m going over medicated, waking too early, dizziness, over excited feelings etc what I do is drop one dose on levothyroxine. Next thing I’m fine again. I get my bloods checked by the NHS every 3 months so I know where my levels are.