Hi-I have been on this med along with Cytomel (t-3) for about 8 years with no change in dosing. My pharmacist told me to take it on an empty stomach-30 to 60 minutes prior to eating or drinking anything other than water. I usually take it early in the morning and go back to bed for awhile. If I’m feeling ambitious I work out while I’m waiting to have my coffee. You should talk to your doctor before changing the way you take yours, though. They might want to recheck your levels after the change to make sure you are not absorbing more med than you need. I see from your other posts that you have had great success with this program-congratulations. I have tried many “diets” with no result since my thyroid problem was diagnosed. I’ve just finished my first two fast days and am hoping this program will work for me.

I was diagnosed with Graves Disease in 1992 and had a partial thyroidectomy in 1993. I now take thyroxine daily.

I also was not told to take thyroxine on an empty stomach. When conducting research about my condition, I found out. According to some material I’ve read, the absorption of thyroxine can be impaired if you take it with food. Also, taking it with supplements containing iron can also interfere with absorption unless you leave 1-2 hours between taking the thyroxine and the iron supplement (or food such as cereal that has been fortified with iron).

Please do verify this with your own research. This is what I remember from years ago!

I take thyroxine just before going to bed because evidence from clinical trials shows a better uptake of thyroxine when taken in the evening vs a morning dose.

I am not sure what clinical evidence the recommendation to take thyroxine in the morning is based on.

See;

Effects of evening vs morning thyroxine ingestion on serum thyroid hormone profiles in hypothyroid patients. Bolk N, Visser TJ, Kalsbeek A, van Domburg RT, Berghout A. Clin Endocrinol (Oxf). 2007 Jan;66(1):43-8. http://www.ncbi.nlm.nih.gov/pubmed/17201800

This concludes;

“l-thyroxine taken at bedtime by patients with primary hypothyroidism is associated with higher thyroid hormone concentrations and lower TSH concentrations compared to the same l-thyroxine dose taken in the morning. At the same time, the circadian TSH rhythm stays intact. Our findings are best explained by a better gastrointestinal uptake of l-thyroxine during the night.”

A more recent and larger study shows similar results;

Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial. Bolk N, Visser TJ, Nijman J, Jongste IJ, Tijssen JG, Berghout A. Arch Intern Med. 2010 Dec 13;170(22):1996-2003. doi: 10.1001/archinternmed.2010.436. – http://archinte.jamanetwork.com/article.aspx?articleid=776486

“Levothyroxine taken at bedtime significantly improved thyroid hormone levels. Quality-of-life variables and plasma lipid levels showed no significant changes with bedtime vs morning intake. Clinicians should consider prescribing levothyroxine intake at bedtime.”

Sarah

Wow. This is amazing information. I was told by my doctor to take my Thyroxine one hour before or after food and two hours before any other medication, even vitamin pills. He did say it didn’t matter if I took it at night or in the morning as long as I am consistent. I take it in the morning as I forget to take things at night due to tiredness. I am about to start this plan. Hope I have better luck than other diets.

I went to see an endocrinologist who specialises in thyroid problems last week, and he told me to take thyroxine at least 30 minutes before breakfast, and not to take it together with other vitamin supplements as they can have an effect on its efficacy, in particular iron and calcium. I told him i only take Vitamin D and he said to take that any other time of the day but not with my thyroxine.

good postings. Have been taking levo for 25 yrs always in the morning, but find the hour to wait a pain during the working week. Wondering how the change to night times meds has worked for you getupandgo. and heh me too getting rid of the grey fug is marvellous, had some positive energetic days and thinking wow this is how most people enjoy their days!!!!

So any advice from anyone on taking levo at night would be greatly appreciated. thanks Wendy

thanks Jane, you have found a good solution. For me I snore soundly until the alarm at 6!!!! sometimes in the early hours I vaguely feel the cat walking over me hoping for some attention–but she doesnt rouse me enough into any kind of action. The morning routine had worked for me but following a long bout of chest infections and too many antibiotics went to a herbalist who has got me on some potions that need to be taken 2 hours after my thyroxine and before food. I need to be out the door by 7:30–so I now have issues.
There seems to be a body of evidence to indicate night dose is ok–have just forked out $44 for my docs visit last week, so I’m hoping here for some cheap advice!!

Hi double happy and getupandgo2 🙂
Things sound complicated DH for sorting out the pill taking! Is the 2 hours after thyroxine a really strict time? If not, I’d been inclined to take the thyroxine as I got into bed (assuming the stomach was empty) and then the other ‘potions’ as soon as I got up. I can’t see what other regime you could try without setting an alarm in the middle of the night! Let us know what you decide and how it affects you – hopefully not. Good luck!

Hi Double Happy – I’m glad your cat seems to be on your side now 🙂
This might be interesting for you as it shows positive results for pills taken at night but I expect you might have already read it:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3139142/ and this is a more general page but still interesting:

http://thyroid.about.com/od/thyroiddrugstreatments/a/bedtime.htm

5kg is brilliant and plateaux are usual, so I’m glad you have no worries about that. Take care. Jane

Hi there

I’ve only been on Thyroxine for about 4 years, but have started taking it about an hour before breakfast. I keep it by my bedside and take it when the alarm goes off about an hour before I actually get up (it takes me a long time to wake up!). Actually, I haven’t noticed much difference, but it is true that food can interfere with the effects of Thyroxine so it is recommended that it be taken well before food.

My prescription instructions say to take the thyroxine on an empty stomach, and doesn’t mention eating afterwards. Check with your doctor, but I think you take it at the same time every day — whether or not you eat right away. I do know I am to wait 1/2 hour after taking it to eat.

Good to see this topic back on the table. Had been meaning to check in re the effect of taking the tabs at night. Have trialed it for 6 weeks and feeling fine–in fact more energy. The other positive is that to have an empty tummy I usually have early dinner 6-7 and then there’s no snacking happening, even on non fast days,–so have cut out those sneaky evening nibbles.
Take my tab around 10:30–11. a few nights have had dinner later so either set the alarm or take it when I wake up in the small hours for that inevitable visit.

A real key seems to be to have an empty tummy on either side of taking it–something about the medication going straight to the duodenum and passing through the stomach as quickly and whole as possible.

i still marvel at my weight loss of 7 kg (since August) never thought it would be possible having tried so many other diets.

I usually take mine at night, around 8pm. It has helped me to have a little more energy and it helps me to remember to take it. I also read that you shouldn’t take it with coffee or have coffee in an hour either side of taking it as it stops it working. I am not sure why though or the science behind it.

I didn’t know about the coffee part. I always drink coffee very soon after taking it. Maybe I will wait until later to see if it helps.

Hello Amy – I’ve just been reading a bit about the coffee issue and I could only find the one study although lots of other pages referring to it. To be safe, it’s probably best to take the pill with water and have a coffee an hour later. This is what I do. The study didn’t test decaff or tea or other drinks.
Hi Jenny – excellent to hear you’re losing weight – be confident you’ll be shopping for those summer clothes soon!
Jane

Washington Hospital Center (USA) and Georgetown University are currently studying the effects of taking coffee with thyroxine to try to get a clearer answer. Details at http://clinicaltrials.gov/ct2/show/NCT01707056

Sarah

Really interested in the articles about taking thyroxine before bed. Have been feeling really foggy in my brain recently but have been told that I am taking the correct amount of thyroxine 50 micro grams daily. If I decide to take thyroxine before bed, surely I won’t have an empty stomach?

Lizboyd and AmyC as I said on march 8th post I have been taking it at night and have made it a manageable routine, in fact has made me regulate the after dinner nibbling that used to happen, so have dinner between 6 and 7–then only a cup of tea before bed and taking my meds at 10 or 11. Last night went out for dinner and finished eating around 8:30–but knowing that I had my meds to take I had quite a light dinner and no desert so took the tab at 11:30, and I figure the one or two off occasions are not a biggy.
what I have learnt from this WOL is that everything can be managed–surprise dinners on fast days, vacations,forgetting its a fast day and have bubbles, times of sustained feasting like Christmas and weddings–my big picture now is that all eating can be managed including timing for meds.