I have seen lots of posts about people taking their Levothyroxine before they go to bed. I am really struggling in the mornings having to wait an hour before eating breakfast or drinking a cup of tea before starting work. It has meant I have been setting my alarm in the morning an hour earlier which then doesn't help with my fatigue. Can anyone advise me the pros for taking in the morning or evening and if it is ok to just swap over.
Many thanks in advance as all the support I have had so far has been so supportive and understanding.
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Crazylegs16
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No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
If you normally take magnesium at bedtime take it early evening instead
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 any 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
That’s interesting Slow Dragon - are you able to explain why we shouldn’t take Levothyroxine at the same time as other meds? I always take mine an hour before food in the morning but with my Perindropil blood pressure tablet. Statin, magnesium and omega 3 and Vit D at night and Vit B complex after lunch. Feeling loads better since I’ve been supplementing - another blood test due soon so it will be interesting to see the results now 6 months on 125 levo for 5 days and 150 levo for 2 days per week. So, back to my original question, should I not be taking levo with my blood pressure tab?
Levothyroxine reacts with so many other substances.
Sometimes (as with iron) the levothyroxine ends up bound and inaccessible to our bodies. Sometimes the other substances change our ability to absorb levothyroxine - possibly by increasing or reducing acidity, for example.
Trouble is the other substances can include both active pharmaceutical ingredients and excipients (inactive ingredients). Indeed, it is clear that some excipients that are or have been used in making levothyroxine tablets affect absorption. That is, levothyroxine absorption can be affected by the other ingredients of levothyroxine tablets. (The worst examples of this have mostly disappeared.)
While some of this is known, no-one has done the research to determine the impact of other medicines on levothyroxine. We don't have a database where we can look up the effect of any real medicine on levothyroxine. All we know is that there are very many substances that are a problem.
Thus, the only way of avoiding the possible issues is to take levothyroxine on its own.
I'll link to a paper about dosing aids (where medicines are packed onto dosettes to ease taking them for those on multiple medicines).
• Levothyroxine was on the DAA label but it was correctly not packed as the patient was taking it outside of the pack.
That is, the authors agreed that levothyroxine needs to be taken separately from what amounts to a random selection of medicines. And that is despite the patient needing a dosing aid.
That is the way manufacturers advise it to be taken for maximum benefit. It is printed on the information leaflet that comes with your levo.accord-healthcare-products....
If taken with food or other meds it may mean that you need a slightly higher dose to compensate for the inefficient absorption.
should I not be taking levo with my blood pressure tab?
Definitely not
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
No supplements or other medications within 2 hours
Vitamin D tablets should be at least 4 hours away from levothyroxine and with high fat food to aid absorption
Vitamin D mouth spray can be any time (at least an hour after Levo)
Thank you - I will re-organise my pill taking schedule.
You all do a great job with this group - I've recommended you to everyone I know who has issues with thyroid. Thanks to this group, I feel better now than I have done for years.
I take mine in a morning along with everything else I take then have my breakfast I know several say take as you get up, take after food ect but if I tried to take different one's at different times all that would happen is I would forget them most days even when I take them just after getting up whilst waiting for the kettle to boil I can forget to take them and it is only when my body tells me that I forgot to take them by making my body shake and sweat makes me think if I took them or not and its only by looking at one item that comes with with them 2 side by side where I take the one on the left in a morning and the one on the right at night but it's not untili start shaking that I think about them I now have to take 9 in a morning and 8 at night unless I am bad that I take my extra one's which add an extra 2 in a morning, 4 at lunch, 2 when i take my night ones and an extra 2 before I go to sleep most are different types of pain relief 1 for diabetes, 1 for my heart and 1 to stop me being sick when asleep, I have never liked taking tablets for all of my life but compared to when I was younger when a tiny Lomotil® I would put one at the back of my mouth then drink ½ pint of milk in one go and it would still be there, so with all of my meds if I tried to take them separately I would not have enough time in a day.
I take mine in the middle of the night, when I wake up for the loo. I put them in a little pot beside the bed at bedtime to reduce the faff and get back to sleep after I take them.
I switched to nighttime recently to see how it would go. I also felt the same as you regarding breakfast etc. I had felt tired and read that nighttime uptake of levo showed an increase in its efficacy. I do think that’s true but maybe a little too much so in my case. I can’t be sure it was that but I had a day of great energy and like an adrenaline rush. By teatime, it felt unpleasant, Perhaps what’s left of my thyroid was just confused or having a small spurt! I was due my annual Medichecks so rather than fiddle about any further, I followed Slowdragon’s advice and gradually switched back to mornings. On balance, I’m glad I did. I’m more used to that regime now - plus, I like to snack in the evening so it was a tussle between empty stomach bedtime or empty stomach morning!
I take mine in the middle of the night (between 2-3am when I need to use the loo). It means I can avoid all the food/medicine issue but still have a bedtime snack.
I used to take mine at about 4am when I woke to,use the loo.
Over the years my sleep pattern chsnged, sometimes waking twice I would panic, had I taken them? Had I taken them twice?
I tried a box with days of the week on which worked for a while, then I started sleeping through the night!
So now I take them last thing at night, about 11 pm and I avoid all food and drink (apart from water) from about 8pm. It’s not foolproof, eating out can mess it up and I wonder if part of my change in TSH is linked to the change.
Both my cousins have moved to last thing at night for similar reasons.
I take my thyroxine and liothyronine first thing when I get up, and vit pills in the evening. I don't leave an hour before breakfast, it doesn't seem to make any difference if I have it soon afterwards or not.
Thank you all for your information. It has given me some food for thought. I don't wake as much in the night so don't think that is going to be an option for me and I think I would panic if I had taken it or not. Before bed seems to be an option so while I am off work over Christmas I think I might change my routine a little.
I used to take mine early morning, but, as you say it just adds to the fatigue and worry that you may not wake up in time! For a couple of years now I have taken mine at about 10pm. We eat early, though, and have finished well before 6pm. I know that is difficult for people commuting or finishing work late, but it works for me. Another alternative might be to eat a larger meal at lunch time and a smaller meal in the evenings. I take 150mcg of Mercury Pharma Levothyroxine and I feel fitter than I have for years. I am 70 next month, so thankfully retired.
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