Happened to see two papers which compare taking levothyroxine in the morning well away from breakfast against taking it with breakfast.
The difference was, in my view, very significant in terms of TSH – which was all that they seemed to care about. Going from 1.06 (away from breakfast) to 2.93 (with breakfast) in one paper and from 1.9 to 2.89 in the other.
In some countries that would take people out of their standard reference ranges. And this is the processed, averaged, figure – some individuals will have shown even larger differences. Yet both papers calmly suggest this difference only matters if a precise TSH value is the target! (What happened to the concept of the patients being well as the target?) Reckon they are more or less saying that any TSH value in range would be good enough for most people. Not that many people here would agree.
Nonetheless, they do give some sort of measure to the difference it can make.
But the other important issue is variability. Both papers say that the TSH is more variable when taking it with breakfast. Which should not be a surprise. It is actually quite hard to have a breakfast with same impact every day. Maybe you switch between cereals (even between the "big brand" and a supermarket equivalent)? Or have a croissant on Sunday? Or a full English when travelling? Or tea with a little milk one day and coffee with lots of milk another day? Or fruit and toast when on a paradise island holiday?
The mean thyrotropin concentration was 1.06 +/- 1.23 mIU/liter when levothyroxine was administered in the fasting state. When levothyroxine was taken with breakfast, the serum thyrotropin concentration was significantly higher (2.93 +/- 3.29 mIU/liter).
Thanks for that - if people aren't diagnosed - tuck in to a good breakfast.
I wonder how many of us actually have breakfast?
now I make sure I have my vit D drops in a little milk, feed animals (previously fed kids) drag myself to work, then the 11 o'clock bell triggers the Pavlov thought that I should be hungry by now, nope, force feed banana or apple/fruit. (OK weekends - bacon & eggs brunch!)
or is it just me that doesn't feel like eating first thing? I know it's wrong, but I try to do everything else right! I gag at breakfast bars too, wish they made a bacon one! J
No your not alone spareribs. I Always ate a breakfast asap until I turned 40, then could not bear to eat for several hours after rising, since. I have always taken my medication with my
first cup of tea, ie on an empty stomach. I think I was advised to do this when first diagnosed in 1966, and have continued to do so. Now aged 70.
This research is irrelevant to me as I have almost always taken my Thyroxine at night, apart from the first few months when I foolishly listened to the doctors. Since they seem to know diddly squat when it comes to the thyroid I started taking it at night after reading a Japanese paper which concluded that most medication is more effective taken at night, and found that to be so in my case.
As far as breakfast is concerned, I always eat about one or two hours after waking - whenever that happens to be, depending when I managed to get to sleep!
That is interesting but i have always taken my meds first thing with a cup of coffee for 22 yrs if ever i have taken it with breakfast this must of occured a few times over 22 yrs i havent noticed any difference.
I have always took mine in the morning around 7 o clock wait an hour drink my tea.then have breakfast only been on levo 25grms for 9 months so strtill adjusting.....
I have for some time taken mine at night, don't feel any different for it but at least I can get up and have my breakfast without waiting. I have always believed that breakfast was the most important meal of the day, but understand that some (like my hubby) can't face anything in a morning. I do exercise classes so I need some sustinance before putting myself through the mill.
crikey don,t know what happened then, anyway my free T4 is 13.6 which apparently is normal & my TSH is 0.3 which I,ve been told is low but not suppressed. I hate to admit it, but this means nothing to me, I haven,t got a clue whether its good or bad. I have an appointment with an NHS Endo in March, but if someone from Admin could tell me if the above is OK I would be obliged, as I have been feeling really awful of late. Many Thanks, Kath
Hi Kath - we need to know the range for the FT4 please, to be able to make sense of it. The range at my lab is 12-22 so your result would be low-in-range at my lab but at other labs that could be close to the top of the range. Your TSH looks OK - most people tend to feel better if is under 1. xx
When is it best time to take T3 as i always take it in the morning with my Levo and take another T3 in the afternoon an hour after food and an hour before food is this right.?
there was a poll about when folks take their meds, with comments.
I take my levo at 6.15 AM. but always have trouble sleeping as i feel more awake than in the day and also get night sweats if i try staying in bed, i was wondering if i should take my levo ay night, it may help? thanks for any advice.
Although my sister-in-law (who sees a thyroid specialist in the USA) warned me to take my thyroid meds at least an hour before breakfast I generally don't wait as I'm too hungry, and worked on the basis that if it makes a difference you will just need to take more meds to get the same result. However it has just occurred to me that when I go for a blood test I usually get my blood glucose tested as well, so apart from taking my thyroid pills with some water I fast. This means that on blood test days my TSH is likely to be lower than on my normal days, so my doc will think I'm doing better than I am. No wonder I still feel lousy! Time to start getting that hour gap in, and if you too go for fasting blood tests - beware!
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useful 'Evidence' that TSH between 0.04 - 0.4 has no increased risk to patients on Levothyroxine (UPDATED~new study does show small risk)
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