AM vs PM Levothyroxine

[Curious123]

Are people finding it more effective to take levothyroxine in the morning or evening? I found this study suggesting PM may be better but was wondering if there are any other studies out there and personal experiences.

jamanetwork.com/journals/ja....

[Lalatoot]

I split my dose am and pm. Splitting your dose can also improve thyroid blood levels.

[SlowDragon Administrator]

previous poll 7 years ago asking this question

healthunlocked.com/thyroidu...

I take mine at bedtime

[helvella Administrator Thyroid UK]

I have always taken my levothyroxine at bed-time.

Trouble is, I cannot compare to taking in the morning!

A tiny number of times I've inadvertently missed taking it at the right time. But I have always then found that I did not fall asleep readily - so, when I realised, have got up after a while and taken my dose. Then fallen to sleep almost immediately.

However, others have found doing so means they have sleep problems.

[Sparklingsunshine]

I've tried morning, splitting dose etc. Can't honestly say if its made a difference. I now take mine in one go in the night when I get up for the loo. But this is so it doesn't interfere with morning coffee and taking other meds rather than because I've found it better.

[Regenallotment]

I’ve gone from splitting night and morning while titrating up to just morning, I’d switched round for a blood test and just carried on. I think while adjusting to increases it helped me. On an steady dose it doesn’t matter. Similar to Sparklingsunshine what it does do is allow me to take magnesium later in the evening and I don’t mind waiting an hour for my decaf coffee in the morning. The thing to do is try one change for a number of weeks and see how you feel, rather than chopping and changing 🌱

[Buddy195 Administrator]

Think it’s very much trial and error Curious123. Did me a split dose works best (2/3 in the morning and 1/3 in the afternoon) as I was more anxious in the afternoon and my Endo suggested I try splitting.

[Curious123]

Thanks everyone. I’m trying to take some other supplements so will stick to one half of the day currently but splitting sounds like it may help also.

[shaws Administrator]

I take my one daily dose of T3 when I awake with one glass of water and wait an hour before I eat.

I am sympton-free and feel well.

I follow the advice given by Dr. John Lowe - now deceased - and I have had no problems. He was also an Adviser to Thyroiduk but due to a bad fall that caused a bleed in his brain and it caused his demise. He was also a scientist.

[Hidden in reply to shaws]

How much do you take Shaws?

[shaws Administrator in reply to Hidden]

I take 30 mcg and my helpful GP increased it as I was taking 25mcg previously.

I take it with a glass of water when I awake and wait for an hour before I eat.

[Curious123 in reply to shaws]

So you take T3 rather than T4?

[shaws Administrator in reply to Curious123]

T4 gave me awful palpitations.

[shaws Administrator]

I take 30mcg once daily and my GP has been very helpful, (not many of them around I'm sorry to say).

[overunbykids]

I take my levo in the morning along with half my daily dose of T3, and then take the other half of my T3 at night. It's just how I was told to take it.

[shaws Administrator in reply to overunbykids]

Dr John Lowe was a scientist and doctor and as a young person was researching why some people took their own lives (there were some in his family who did so).

That's when he found how important that T3 was in our bodies. He stated that one daily dose of T3 saturated all of our T3 receptor cells and they then sent out 'waves' throughout the day.

I have found that to be the case and I have no symptoms.

[McPammy]

I split my levo T4 dose am and pm. I also split my lio T3 doses am and pm. Once I tried taking half a t4 dose going to bed which increased my T4 level and even boosted my T3 level which I was surprised at.

[DaisyTed]

I take mine at bedtime, because when I took it in the morning my head felt very weird - sort of disconnected! It was a horrible feeling that stopped immediately when I took it at bedtime. I don’t really know why all GPs suggest taking it in the morning, as it’s much more difficult to avoid taking it near to dairy and caffeine etc.. at that time.

[DaisyTed in reply to DaisyTed]

Thanks for the link to the article - I must have a read!

[Tufty73]

I take my Levothyroxine in the morning, and my vitamins at night with my evening meal.

[Petalrugbaba]

I take 30mg erfa in the morning and 50mg Levo at night because I found taking it all in the morning was just too much and it made me a bit hypoglycaemic. Splitting the dose has been fine for me 😊, although I used to take magnesium at night so now have to take it at least 4 hrs earlier than the Levo dose. Also changed from magnesium Taurate to magnesium glycinate so not to become sleepy too early in the evening.

[arTistapple]

I generally take my levo in the morning. I did try taking it at night. It certainly made me much more aware of a ‘required’ routine re my meds. However my (still) lack of organisation re:food and slow digestion, made taking it at night problematical. Four hours + after food was just too difficult for me to happily settle to. Back to mornings at the moment - only one hour to worry about in morning before food. Taking it at night allowed me to more easily ‘fast’ until morning (recommended everywhere these days). Unfortunately whilst not having put weight on since starting treatment - I suddenly started putting weight on! Just can’t win. So mornings it is.

[Loafinabout]

Ive always taken levo at bedtime. However in the last year I started to have problems getting and staying asleep . After trying several remedies/routines I grasped at the straw of taking Levo on waking in morning and wait at least an hour b4 having a cuppa and breakfast. Amazingly that’s worked for me so it’s something you should consider.

[goingholiday]

I’ve tried morning and evening dosage times and also the ‘early hours getting up for a wee’ time. My preferred time is definitely before bed. I’m one of those who needs breakfast asap once I’m awake otherwise I’m extremely grumpy🤭.

I also have almond milk containing calcium for breakfast so taking levo in the evening means I don’t have to wait four hours before eating breakfast that or change my breakfast menu.

I use a magnesium spray in the evening which avoids clashing gut interactions with the levo.

We’re all different and trial and error is sometimes the best way to find the best option for yourself. Good luck finding your best dosage time 😁

[Jay_Jay]

I have taken my Thyroxine both in the mornings and at night and found that night is so much easier - as others have said, there is no having to wait an hour before breakfast. Symptom wise I noticed no change - but it didn't occur to me to link any tbf ! I did however sleep so much better not having to concern myself with making sure I took my meds at least an hour before 'waking up time' to leave the required meds to breakfast gap. I have since been told my Pharmacist and GP to resume back to mornings of which I am dutifully following 'at the moment' and am once again in the pattern of broken early morning sleep. 2 comments above mention a 4 hour 'food to meds' gap, which I am not aware of... can someone enlighten me please - am I missing something important - I tend to have a skimmed milk cereal breakfast is an hour from Thyroxine enough? Also picking up on DaisyTed's comments, does anyone else experience any weird head sensations at all - curious because I have similar and haven't attributed it to Thyroid or meds at all ?

[Batty1 in reply to Jay_Jay]

I believe one hour prior to food is enough time. Sometimes (not often) when life gets in the way of my pill taking I just take it and eat haven’t noticed issues but its not a constant … anyway different strokes for different folks.

[goingholiday in reply to Jay_Jay]

Hi Jay-Jay

The NHS website instructs to leave "at least 4 hours between taking levothyroxine and eating calcium rich foods". Hence the reason my cereal and milk breakfast didn't work when I took my levo in the morning. For some peculiar reason this information is buried right near the end of the information under 'section 8, Common questions about levothyroxine, Is there any food or drink I need to avoid?' I have added a screen shot. Goodness knows why this nugget of information isn't given a higher profile. Anyway hope this helps.

.

[Batty1]

I’ve been splitting my dose for couple of years prior I would take it all in one AM dose and by the afternoon I had zero energy…. I still have low energy but at least it’s not zero energy.

[Jay_Jay]

Thankyou

[Hashiboy]

Hi Curious_123 I’m on T3 and levo. When I was on T4 only I took it at bed time. It absorbed just the same as a morning dose. I took it a couple of hours after my last meal but I wasn’t strict about timing , iI had a fairly consistent TSH level and never noticed a difference in effect. I now take T4 with my first T3 dose for ease of remembering.