It's official - taking levothyroxine in the eve... - Thyroid UK

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It's official - taking levothyroxine in the evening does improve matters for those with primary hypothyroidism.

nostoneunturned profile image
61 Replies

Here is a link to an interesting paper concluding that it is advantageous to take levothyroxine in the evening for those with primary hypothyroidism. Anecdotal evidence: changed over about a year ago and this winter notice I am warmer. Just as well - snow is deep and crisp and even outside.

ncbi.nlm.nih.gov/pubmed/172...

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nostoneunturned profile image
nostoneunturned
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helvella profile image
helvellaAdministrator

Just a reminder that there is a poll on this very issue.

thyroiduk.healthunlocked.co...

I think you can still "vote" and add comments. I often point people at this and your experience might be useful to anyone looking there.

Monster profile image
Monster

Thanks for the link. I have just read it and found it interesting x

helen0701 profile image
helen0701

This article was published in 2006!

helvella profile image
helvellaAdministrator in reply tohelen0701

As valid today as it was then.

It has been mentioned/linked/referred to several times but nostoneunturned simply blogged it today! Many will not have seen it so perfectly reasonable to do so. :-)

nostoneunturned profile image
nostoneunturned in reply tohelvella

That is what I thought so blogged it. Changing time of taking has changed my "perception" of the cold this winter. I used to think that apart from being hypo I, originating from West of Scotland/Ireland, might just be one of those people whose ancestors who had endured famine so descendants can have a lowered body temperature. Sorry, no links, just read it online somewhere.

Not even sure if such descendants actually feel cold, probably not.

in reply tonostoneunturned

I quizzed my doc on this, feeling cold and he felt it was psychosomatic!

ellarose1234 profile image
ellarose1234 in reply to

He's a twit!

Stourie profile image
Stourie in reply toellarose1234

hear hear!

nostoneunturned profile image
nostoneunturned in reply to

What rubbish! He should try being hypo. Also, being cold can cause fall in production of red blood cells from long bones so I guess this would probably compound the problem. I am completely sick of being regarded as a hypochondriac just for telling it like it is. GRRRRR!

in reply tonostoneunturned

He's also hypo so go figure.

nostoneunturned profile image
nostoneunturned in reply to

Probably medicating himself with the best meds at the appropriate dose available you shiver on not enough levo??

in reply tonostoneunturned

He maybe one of those people, like me, who didn't even know they were hypo. He seems to think it's no big deal. But when I went onto levo in 2008, it messed me up for the better part three years. Like my body didn't like the hormone.

nostoneunturned profile image
nostoneunturned in reply to

No big deal? He's lucky. Obviously he has not known the years of hell some people go through. Sorry that levo messed you up. I was not right in the least until T3 was added to T4.

There should be "while" between dose and available above.

in reply tonostoneunturned

Well, I'll be honest, I'm not sure myself if feeling awful for three years had more to do with my reactions to being 'ill' for the first time in my life and not being able to deal with it.

In any case, one morning I woke up and it was if I'd woken up from a bad dream. Was the the levo finally working? I have no idea.

parafluie profile image
parafluie in reply tonostoneunturned

Ditto! If you were told your hot flashes or headaches were a problem, would your OB/GYN say you are nuts because your FSH is fine?

Doctors are AHs.

Tony63 profile image
Tony63 in reply to

This seems to be the go-to answer all over the NHS! I have only recently been exposed to the shocking shortcomings of the NHS!

lesleya859 profile image
lesleya859

I've started using it at night because I can't wait an hour after taking the pill to have a up of tea with milk in it in the mornings as its not to betaken with milk I thought I read somewhere

beaton profile image
beaton

I was told to take Levo in the morning but tried taking it at night as some of you recommend it. I had awful nights, waking very alert after very little sleep.So now I'm back to mornings,wake up cold and feel drugged but get going after a while.

helvella profile image
helvellaAdministrator in reply tobeaton

It does not work for everyone.

The better absorption achieved by taking it at night could result in being effectively slightly over-dosed. For example, 125 at bed-time might work as well as 150 in the morning. However, this is rather speculative despite the possibility being raised in several papers.

beaton profile image
beaton in reply tohelvella

Thanks for the advice,I'm on 150 so might try spliting it.Just taking 50 at night and 100 in the morning.

helvella profile image
helvellaAdministrator in reply tobeaton

And don't feel that you SHOULD take it at bed-time - we are all different. But I do agree that splitting might help.

One of the oddities of thyroid is the time it takes to process. Takes much longer to have its full impact than we tend to think. From memory, the maximal increase in T3 from taking levothyroxine is around 48 hours later!

beaton profile image
beaton in reply tohelvella

Thanks,my GP think "Levo is a forgiving drug" like Asprin.

helvella profile image
helvellaAdministrator in reply tobeaton

Let me re-phrase that:

"My GP doesn't think, especially about unforgiving medicines like levo". :-)

beaton profile image
beaton in reply tohelvella

yes

nightingale-56 profile image
nightingale-56 in reply tobeaton

Hi Beaton, this is just how I took it in the beginning as advocated by my old GP. Took 50mcg in mornng and 25mcg in evening. Did not feel any different to how I feel now though. When I started it in 1997 no one knew about taking it at least 30 mins before food though.

beaton profile image
beaton in reply tonightingale-56

Yes it's hard to find your way through the maze,but thanks for the input of the people on this site we stand a chance.

thedoghouse profile image
thedoghouse

I would like to switch to the evening but how does it interact with a glass or two of wine?

nostoneunturned profile image
nostoneunturned in reply tothedoghouse

Sorry, really do not know.

nostoneunturned profile image
nostoneunturned in reply tonostoneunturned

But nhs.uk says "There are no known interactions of alcohol with levothyroxine".

thedoghouse profile image
thedoghouse in reply tonostoneunturned

Thank you, now I can glug away with a clear conscience.

missdove profile image
missdove in reply tothedoghouse

I like your style...:-)

Fae1960 profile image
Fae1960

Hi I am the same as you beaton I tried taking levo at night but was buzzing most of the night perhaps I have been taking it for too long in the mornings - 20years ! Lol. My daughter tho takes her levo before bed for the same reason as lesleya859 with no problems !

jaxnbreeze profile image
jaxnbreeze

When I take my levo I can feel it perking me up within a few mins. so taking the dose at night wouldn't be good for me.

in reply tojaxnbreeze

Strange to say, I don't feel any different after taking my now 125mg

b

parafluie profile image
parafluie in reply tojaxnbreeze

The only way to do it (and don't change anything if what you are doing is working!) is right before you go to sleep ore it would overstimulate you.

Again, if it ain't broke . . .

I started taking at night years ago and my doc didn't seem to care one way or the other. BTW, it works.

jaxnbreeze profile image
jaxnbreeze

Forgot to ask - what is 'primary'hypothyroidism and what over kinds are there? Thanks, Jax.

helvella profile image
helvellaAdministrator in reply tojaxnbreeze

Primary is when your thyroid does not make enough thyroid hormone for reasons to do with the thyroid itself (or lack of, after thyroidectomies). Typically Hashimoto's in the UK - but iodine deficiency could also be regarded as primary.

Secondary is when pituitary does not produce enough TSH to tell thyroid to make thyroid hormone.

Tertiary is when hypothalamus does not make enough TRH to tell pituitary to make enough TSH to tell thyroid to make thyroid hormone.

And one of the real difficulties is that with anything less than major problems of the pituitary and/or hypothalamus, they will never check and test appropriately to find that out. Hence TSH can be on floor because they are not working 100% when body does not have enough thyroid hormone.

olderlady profile image
olderlady in reply tohelvella

thank you so much; no one has ever spelled it out so clearly, especially not the GP. Very helpful---olderlady

ellarose1234 profile image
ellarose1234 in reply tohelvella

Thanks Rod nice neat explanation, is now in Thyroid file :)

Perhaps one day we the "non medics" should get together and write a book about all this and put huge profits towards thyroid research :)

Triciatextiles profile image
Triciatextiles in reply tohelvella

Rod

thanks so much for explaining this so clearly - I never knew the connection.

Tricia

nostoneunturned profile image
nostoneunturned in reply tohelvella

Thanks Rod, not even the BTA where I was digging about puts it so clearly and concisely.

I found this. Everybody can choke quietly reading it.

british-thyroid-association...

Nice to know we are really living in a medical paradise, not the hell I experienced for many years, along with many others.

Janinit profile image
Janinit in reply tonostoneunturned

They'd say anything for a laugh.....lol

Janinit profile image
Janinit in reply tohelvella

Helvella You are a star .... Thanks.

ellarose1234 profile image
ellarose1234

I started to take it at night only a few days ago and it has been wonderful. Can eat my breakfast when I want to can take my supplements when I want to and as I try to not eat anything after 7pm in the evening (diet) it means I have a nice empty tummy by about 11pm when I take my levo. Sleep like a log and feel warmer ( maybe that could be because we had the loft insulated!). have also managed to up my dose from 75/100 alternate days to 100 each night. Always seemed to make me have palpitations when I tried it during the day so with a bit of luck my TSH should come down by the next blood test. I'm just a wee bit worried it's all going too well!

nostoneunturned profile image
nostoneunturned in reply toellarose1234

I used to go to bed wrapped up like a polar bear and still had iceblocks for feet. More like a normal human being now, have proper, warm feet, plus warm hands all day. Nice feeling I had completely forgotten existed, though I still regarded myself as very well treated.

parafluie profile image
parafluie in reply toellarose1234

How do you feel? Are you feeling good? It's still important to up your dose slowly. Glad it's working for you!

Janinit profile image
Janinit

I think I might try this. I haven't been sleeping properly for a few weeks maybe this will help.

Should I start tonight or wait until tomorrow night or will that mean that I will have missed a dose... Not sure what to do ........

nostoneunturned profile image
nostoneunturned in reply toJaninit

I would say you could start tonight as levothyroxine has a long half life. I just switched same day, last morning dose levo on same day as first bedtime dose, still here. If you are really nervous still then you could gain confidence from taking just half your daily dose tonight, the other half in the morning, then a whole dose tomorrow night and so the change is achieved.

Janinit profile image
Janinit in reply tonostoneunturned

Nostoneunturned Thanks for your help. I think I might just try the whole thing with the t4 tonight and get it over and done with as I am not sleeping well anyway....

parafluie profile image
parafluie in reply toJaninit

Be sure you take it at the last minute -- "before you turn out the light" at bedtime. Evening won't work.

jaxnbreeze profile image
jaxnbreeze

Thanks for the explanation. Jax

parafluie profile image
parafluie

Please Note: this is NOT "evening", it is BEDTIME dosing. If you take it in the evening, you might well be overstimulated and not sleep well at all. You must wait until right before you turn out the light.

I've loved this report. It came out in 2007. But while it's not a new study, it's new to many and thanks for pointing it out.

I'm back on bedtime only dosage and feeling good again. I went through a period where it wasn't quite right. Now I'm taking only 85mcg at night (and increasing) and feel much bettre than when I tried divided doses and CT3M. It is important to get where you feel best, not someone else.

nostoneunturned profile image
nostoneunturned in reply toparafluie

Parafluie, that is an interesting point you make. The title use of "evening" is never used again, but "bedtime" is used 4 times; "nightime" once; "late evening" once, so the tile does not reflect what is actually meant by what text we have. It also shows that i read it incluenced by my perceptions -even "evening" was interpreted by me as "last thing at night" as that is exactly how I have taken meds for ages.

Thanks!

nostoneunturned profile image
nostoneunturned in reply tonostoneunturned

influenced!

Janinit profile image
Janinit

Thanks for all the help and advice everyone. Janinit x

parafluie profile image
parafluie

Yes, it does leave a lot to interpetation. But for me, evening is after dinner . . . 7, 8, 9 pm <g> Even night (which is later than evening in my connotation) isn't "quite right" So, if I were to take my T3 at 8pm then go to bed at 11-12, I'd be all bolloxed up and unable to sleep.

I really appreciate your reminding us of that study. It's good to read again. FWIW, many people on Mary Shomon's About site (including, I think, Leslie who posted the first link to that site that I remember) take meds at night and there's a lot written about that.

Thanks.

parafluie profile image
parafluie in reply toparafluie

Hahah. Thinking of the differences:

Good evening.

Good night!

Go to bed.

Tony63 profile image
Tony63

Would this apply to all Thyroid medication or just Levo?

PinkNinja profile image
PinkNinja in reply toTony63

It's specifically the T4 in thyroxine so it would apply, to some extent, to Armour too.

While taking a small dose of Armour once a day, it is probably more helpful to take in the morning. Joesmum's advice on your question is excellent. Once a person is taking more than one dose a day, a small dose taken at night can help some people, although a few people find it keeps them awake.

Tony63 profile image
Tony63 in reply toPinkNinja

Thanks (again!) Carolyn 8-)

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