Hi all First time posting on here.
Any advice on swapping from taking levo from am to pm?. My thyroxine was increased from 75 to 100mg two days ago, but I feel that a few symptoms creep back in before the end of the night, and get muscle twitches which keep me feeling restless all night. I have taken my dose already this morning of 100mg, but is it safe to take another 100mg this evening, and then take it going forward at the night time permanently?
Appreciate any feedback thank you 😊
It can take a while to feel the benefit of an increase, could be weeks.Very unlikely to feel any difference after two days.Do you have recent thyroid results(T4,T3,TSH) and their ranges?If I read correctly on an earlier post you had been on 75mcg levo daily for 36 years?Seems a long time to be on such a low dose considering most people’s starting dose is 50mcg.The blood results would shed more light on it.
also which brand of levothyroxine was 75mcg
Is it different brand of levothyroxine for 100mcg
Can see you are on other medications for Afib
These should be taken well away from levothyroxine
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
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
markvanderpump.co.uk/blog/p...
markvanderpump.co.uk/blog/p...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
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 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
Post about Timings
healthunlocked.com/thyroidu...
Retest thyroid and vitamin levels 6-10 weeks after increase in dose levothyroxine
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)
Is your hypothyroidism autoimmune
When were vitamin D, folate, ferritin and B12 last tested
What vitamin supplements are you taking
muscle twitches often low magnesium. Are you taking magnesium at moment
Hi I had my thyroid blood test on Monday.
TSH 9.93 and T4 9.6
Rest of my full blood test was normal
switching to bedtime
you can move dose backwards over a couple of nights
Eg instead of taking waking
Next day take about 3am
Day after take at bedtime
TSH 9.93 and T4 9.6
So very hypo
How much vitamin D are you taking
Test twice year when supplementing
Suggest you test vitamin D now
NHS easy postal kit vitamin D test £31 via
Then retest FULL thyroid and vitamin levels in 2 months
Request GP test folate, B12 and ferritin as well as TSH, Ft4 and Ft3
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)
If 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
No my hypothyroidism isn't autoimmune
Have you had both TPO and TG antibodies tested
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
NHS only tests TG antibodies if TPO are high
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
Have you had ultrasound scan?
I'm taking magnesium glycinate and vit d. Not sure when my vit d, foliate, ferritin or B12 was last tested. The full blood count that I had the other day doesn't show that any of the above was tested??
No my hypothyroidism isn't autoimmune.😊
Hi…I switched taking my thyroid from 5am an hour prior to breakfast to around midnight or after like 1am.
I always get up after midnight to potty so I just take it then. It has made a huge difference in how much I absorb. I have no thyroid was removed in 2015. My labs have been all over the place so doctor suggested taking before bed or early morning hours…try it and good luck
Hi,Many thanks. I will try it this evening, hopefully it will improve. Thank you.
It's very interesting that you like to dose at night and that you had TT. I had TT too and find that night dosing before sleep works the best for me as well. My surgeon told me to dose first thing in the morning. I did not feel my best with morning dosing. Switching to bedtime dosing made a tremendous difference for me. Sleep improved too.Thank you for sharing your experiences.
I switched to a night time dose from morning. First time I missed out a morning dose and took it at night, then continued. That was without guidance from doctors but it made no impact on anything as far as I could see. I am on a very small dose, don’t know if that makes a difference
Hi Teddy999,
Welcome to the forum 😊
Do you feel particularly sensitive to Levothyroxine? Are you saying that you're currently taking it in the morning but want to change to pm as you're feeling symptomatic during the night?
Some on the forum split their dose taking it during the night (if they wake for a trip to the toilet for eg) and at another time during the day. Or you can take it all at once if that suits you avoiding other medication.
With levo being a storage hormone you could probably just do a swap from am to pm. I wouldn't take another 100mcg on the same day. I think what I'd do is take 50mcg at the usual time in the morning and the other 50mcg at night. Then the following day take all of it at pm/evening so it's a gradual change. I'll tag SlowDragon just to check.
It is a storage hormone so many don't feel particularly sensitive to changing dose timings but some do and prefer to change timings gradually.
As SlowDragon has already said in their reply, you have to avoid taking it at the same time as other medications. Also if your GP hasn't done full testing it would be an idea if you can to get your own blood tests done so you know where you're at with ferritin levels etc. Your TSH level seems quite high for someone on 100mcg?
There are many experienced forum members here who can guide you 😊
Thank you for your reply. Do you think I should be on more than 100mg thyroxine? It confuses me .. am I right in saying that they higher the TSH level, the more thyroxine you need to bring it down? I was surprised that my blood test didn't cover other things like iron, ferritin etc. I may ask the question as to why this was.😊
I changed from morning to before bed for the last 10 years and have done well on it. When I took it in the mornings I would wake up like death warmed up and it would take me at least 3 hours to feel a little bit normal. It has suited me much better.
Hi Thank you for your reply. I was thinking of around 7pm. Or would you recommend earlier than that?😊
Welcome. I would suggest running labs with vitamin D,B-12/Folate, Iron/Ferritin. In my experience I found that the Thyroid hormones work so much better when the nutrients are Optimal.
Best wishes.
My Endocrinologist suggest I take it at night a few years ago. I just swapped. I didn’t take it in the morning & took it at night on same day. I had no problems x
I’m not sure if it’s better but the Consultant said it’s better absorbed as you don’t eat after when you take it at night. I take it last thing when I go to bed. Previously I’d taken it in the morning then tried not to eat for an hour but wasn’t always possible x
Consultant said it’s better absorbed as you don’t eat after when you take it at night.
true , but just adding this to emphasise to Teddy999 the need for an empty stomach, and consistent conditions. Whether bedtime dosing works well / absorbs better will depend very much on when the last meal of evening is usually eaten , and what kind of meal it was .
ideally you want 3/4 hrs from last heavy meal , could presumably get away with a bit shorter for a light mid evening snack . bedtime dose works well if you tend to eat early and don't snack, or have milky drinks in the evening .... but for someone who regularly eats later in the evening , absorption of levo will be compromised/ inconsistent, even if they eat nothing else overnight .
Thank you. I forgot to mention that.
Liquid levothyroxin
ARISTO LEVOTHYROXIN
Herbalife with Hypothyroid medication LevoThyroxin.
TSH 23.400 after changing from Synthroid to Armour 
Have I done the right thing?
