Nighttime or morning levothyroxine

[Dawney63]

I have been taking my levothyroxine in a morning, empty stomach, nothing to eat for a hour afterwards, I avoid caffeine , use decaff coffee, tea ect.I have been reading some studies on the best time to take levothyroxine and the findings say bedtime is the best time for levothyroxine to work so thinking of changing to taking it at bedtime.

[Buddy195 Administrator]

We are all different; some members prefer morning, others evening. I’ve tried both, but personally prefer mornings (waiting an hour before my coffee!) as my bedtime routine varies a lot, yet I get up at roughly the same time.

It’s certainly worth trialling an evening dose to see if this works for you.

[RedApple Administrator]

I do both because I split dose. I take some in the morning and some in the evening. This avoids the big peak that some of us notice shortly after taking the full dose in one hit.

[helvella Administrator Thyroid UK in reply to RedApple]

The rise in FT4 after taking a dose of levothyroxine is substantial. The graph illustrates this as a percentage change. Thus, a few hours after ingestion, FT4 can be well over 10% higher in a fairly pronounced peak.

Split dosing would be expected to reduce this peak considerably - and might also reduce the depth of the trough before the next dose.

My opinion is that some form of multi-dosing (whether a simple split or a more sophisticated approach such as an implanted dosing device) should be seriously investigated. Initially, it would be great to see the effects on individuals over many months/years. I often wonder whether this peak is one of the reasons that levothyroxine is so problematical. (Not to ignore the monotherapy issues!)

Taken from europepmc.org/article/MED/3...

Screenshot of graph showing % change in FT4 after taking dose

[RedApple Administrator in reply to helvella]

It makes a lot of sense to me. But why some of us significantly notice the peak and others don't is a mystery.

[milkwoman]

I’ve always taken my Levo at 5pm and it works for me.