Is it ok if you don’t take Levothyroxine at exactly the same time every day?
What I would like to try is taking it during the night when I wake up naturally (I usually wake a couple of times or more each night for the toilet). This would mean it could be taken at 12am one night and not until 3am or so the following night etc, depending on what time I wake up. Would this affect anything if I took it this way?
I’ll explain my situation.
I have been setting an alarm and waking up at 4am every day for years to take my Levothyroxine. This is becoming a problem. For the last few years I have been having difficulty sleeping. When I set an alarm clock to wake at 4am I am finding I can’t get back to sleep, which is really affecting my sleeping and my health.
I have recently trialled taking Levothyroxine in the evening last thing at night but this means I have to stay up fairly late and if I need to go to bed to sleep early I can’t and have to force myself to stay awake. This is putting my body into a constant fight or flight mode and I then can’t sleep. (I suffer from both ME/CFS and Fibromyalgia and I find lack of sleep really affects these and makes them worse)
The first tablet I take after Levothyroxine in the morning is Lansoprazole (which to my knowledge needs a 4 hour gap between Lansoprazole and Levothyroxine) and the tablets I take in the evening include Magnesium and Tegretol Prolonged Release (which again I think need a 4 hour Gap between those and Levothyroxine).
I have several other different medications to take each day and to be able to separate them all out as I should I have to take tablets at 5 different times a day so don’t have a lot of leeway when it comes to the timing of tablets.
If I can take the Levothyroxine during the night I think that would help a lot. Is there any reason why this wouldn’t be a good idea?
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AlphaWolf5195
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Have a look at the relevant section here: thyroidpatients.ca/2020/07/...With T4 dosing, it’s almost all about maintaining a steady absorption rate from day to day...
So, to me, that means as long as you are taking it on an empty stomach, away from things that can interfere with absorption (which is what you're trying to do), and you are taking it each day, I wouldn't imagine a few hours either way would make much difference
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease and especially if on Lansoprazole or any PPI
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
As 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
Testing options and includes money off codes for private testing
I spoke to my GP on 29th February and asked if she could do FT3 and FT4 as well as TSH. She said she will try but the NHS often won’t do them. She said to have a blood test in 8 weeks from 29th as that’s when I am due to have my B12 and Iron tested again and she will do thyroid and cholesterol levels then as well.
I will arrange an appointment to speak to my GP after I have had these blood tests done. I meant to ask her last time whether I had ever had my thyroid antibodies tested but I forgot so will ask her when I speak to her next time. If I haven’t I will see whether she can get them done.
If there are any of the thyroid blood tests she can’t do I will get a private blood test done but I am trying to get everything done by the NHS if I can as my financial situation isn’t the greatest.
I’m housebound so have to have the district nurse round to do blood tests which means I have no choice when the blood test is done. They don’t let you know when they are coming and just turn up within a 2 week window. This means it’s impossible for me not to take my Levothyroxine on the day of my blood test as I don’t know when it is.
Are there any other vitamins I should have tested other than B12, Vitamin D and iron?
Are there any other vitamins I should have tested other than B12, Vitamin D and iron?
Folate and ferritin (storage form of iron)
They don’t let you know when they are coming and just turn up within a 2 week window. This means it’s impossible for me not to take my Levothyroxine on the day of my blood test as I don’t know when it is.
Ok …..not ideal….but it is what it is
Make a note after you get test done …..what time it was and how long after last dose levothyroxine
Many thanks for your help, I’ll try to get those blood tests done as well and any blood tests the GP won’t or can’t do I’ll get done privately so I can see what my actual levels are.
I want to try to see if my GP will work with me to get my thyroid to optimal level instead of just somewhere within the range as I am starting to wonder whether some of my symptoms are in fact down to my thyroid levels not being optimal and not just due to having ME/CFS and Fibromyalgia, which I have been told in the past are the reason for my symptoms.
I will try anything to not feel as consistently ill as I have been for the last decade or so. Even if it only helps a little bit.
This affects metabolism so your dose may need adjusting. I have found too many professionals lack knowledge of this or somehow forget. First step is to recheck blood levels.
As for taking it at night, it is confusing to me why you would need to stay awake longer to take it. Is it due to the magnesium in the evening? And, the other thing to be aware of changes to regime of how you take Levothyroxine may affect absorption so it’s a good idea to have your blood levels checked again anyway.
Some days I am so exhausted and need to sleep that I could do with going to at 7pm but I haven’t been able to when I have been taking Levothyroxine just before bed because I don’t take my magnesium until around 5-5.30pm and need to leave 4 hours before I could take the Levothyroxine. I have decided to try taking it in the middle of the night when I wake up (I always wake a few times every night).
I am due to have a blood test in just approximately 6 weeks time, so if it changes my levels it should show up by then hopefully.
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