Thyroid Disorders Community
thyroxine: Best Time of the day to take.
About This Community:

This patient support community is for discussions relating to thyroid issues, goiter, Graves disease, Hashimoto's Thyroiditis, Human Growth Hormone (HGH), hyperthyroid, hypothyroid, metabolism, parathyroid, pituitary gland, thyroiditis, and thyroid Stimulating Hormone (TSH).

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

thyroxine: Best Time of the day to take.

Hi, I
Related Discussions
181 Comments Post a Comment
Blank
Avatar_n_tn
Hello;
My Doctor has told me to take it in the morning.
I usually wake up around 5:30.
I keep a bottle of water and my Levoxyl on my nightstand.
So as soon as I wake up I take my pill and sometimes
I will fall back to sleep for an hour  or so.
When I get up I can have breakfast.
It is recommended that you take your medication one hour before eating.
Take care


Kim
Blank
Avatar_n_tn
Hello,

I was also told to take mine 1 hour before eating anything in the morning. Your body doesn't fully absorb the medication if you eat right away. I was told that I'm not getting a full dose of the medication when that happens. So I get up at 6 a.m. every morning and take my pill. I get my kids ready for school and take them, then come home and I can eat. The hour is gone before I know it. Have you had a recent blood test to make sure that your still on the correct dose of medication? Just a thought. Best wishes to you. Robyn
Blank
Avatar_f_tn
The time-of-day question has turned out to matter a lot for me, which is why I indeed have some tips as well as some information that I am certain is accurate. It really does not matter at all to your body what time of day you take your medication. The "take it in the morning" advice is based on the fact that Thyroxine makes some people wakeful at bedtime if they take the medication late in the day. My endocrinologist gave me the information that is in the last two sentences, and I have seen it from reputable sources, too.

Notice that I said Thyroxine makes "some people" wakeful. Other people (and I doubt that I am the only one), not only are NOT made wakeful by a late afternoon dose, we do better on that schedule. In addition, I have read that some people do not tolerate Thyroxine on an empty stomach. I was tolerating it beautifully, but I found that a single dose had an impact on my blood pressure that I did not like. A divided dose seems better for me. When I discovered that fact, I also discovered that it would be much easier to eat something before taking a dose than to try to take the medication on an empty stomach each time.

My endocrinologist has provided guidance and encouragement every step of the way. He said that a divided dose was perfectly all right, and he said that the timing does not matter at all. He said that if I took Thyroxine with food, it would reduce absorption by about 20%, which only meant that I would need to take a slightly higher dose of Thyroxine to compensate, and he said, "No big deal." By the way, my endo. doc is a VERY competent and also very careful physician. He would not say "no big deal" if it were not safe to say.

His primary advice has been: Whatever you do, do it consistently. His highly helpful advice has been that it is perfectly okay to experiment with my medication routine as long as I do not alter the dose without his input.

I hope that "borrowing" the guidance I have received will be helpful to you. Good luck!
Blank
Avatar_f_tn
I really AM fuzzy today. I am not having a good thyroid day, which I knew even before it took me three tries to post one coherent message. I apologize, though, for the multiple posts.

If you decide to try taking your Thyroxine with food, then of course you will need to have your dosage level reassessed--no two ways about it--and probably increased. Assuming that you have a good endocrinologist, it would be good to talk with him or her about your wish to experiment, just on general principles.

You should know, though, that taking your medication with food reduces the absorption to a degree that is predictable and not huge, so taking your medication after "padding" your stomach with food and then adjusting for the absorption reduction is not a radical approach. I want you to know this because I have seen physicians who went strictly "by the book" as they provided medical care, which was wise in some situations but which, in other situations, caused a patient to suffer needlessly.
Blank
Avatar_f_tn
P.S. Please pardon my cognitive fuzz! In the comments I posted earlier today, I failed to make something clear. I said that my endocrinologist has advised me: Whatever you do, just do it consistently. He means consistently in every way. I am accustomed to a very high-fiber diet, which he says is entirely all right as long as I keep it that way consistently. Any time of day for taking my medication is fine, but I should be consistent there, too, once I have made a decision about what sort of timing seems best. Same deal with empty stomach versus full stomach: Just do the same thing every day.

I probably do not need to say the following, but I am adding it just to be sure I do not leave any base uncovered. Once you have figured out what medication routine works the best for you, your endocrinologist should reassess your Thyroxine dose to be sure that it is still at the right level for you.
Blank
Avatar_n_tn
I thank everyone for responding to my post!
The only think I didn
Blank
Avatar_f_tn
Dear Sara,

Since your thyroid gland is not doing its job at all, I can understand your concern about taking your medication with food...as you say, if you were to lose 20% of the help the medication is providing, where would that leave you?

The answer, according to my endocrinologist, is that you would increase your dosage enough to compensate for the 20% that was not being absorbed. Unless you are taking the maximum dose of levothyroxine that a physician would be willing to give any patient for any reason--and I do not know what the maximum dose is or even if there IS an absolute maximum--then the advice given to me, who only needs to support a struggling thyroid gland with medication, is no different from the advice that would be given to someone like you, who needs to do the thyroid gland's entire job.

I was certain that my endocrinologist was being sensible when he gave me the aforementioned guidance. He seems like an excellent and prudent physician. Still, this discussion thread made me want to check my physician's advice against another source. I think that Mary Shomon can be counted on for rational guidance. When I went her website (www.thyroid.about.com), I found that her advice echoed my endocrinologist's: Taking medication with food is okay as long as a person is consistent.

The difficulty in your situation might be access to your endocrinologist. Do you see him or her once a year because you do not need your specialist's input any more frequently, or are you in some way limited to yearly access? If you are able to see your endocrinologist before your next yearly visit is due, it might be worth your while to have a discussion about changing your medication regimen. After six or eight weeks of taking your medication with food, you would need to have blood tests to see if your medication dosage needed to be increased--and I would not assume that without any doubt, it would have to be increased. There seem to be almost no absolutes about the way the body works. It seems true twice over to me where thyroid gland functioning is concerned.

I see that in my previous comments, I did not say the following. Although it may be self-evident, maybe I should say it anyway. Taking thyroid medication with food means being highly self-disciplined, in that it means eating approximately the same amount of the same kind of food just before every medication dose. I am guessing that this sort of self-discipline would seem to you like a small price to pay, considering the discomforts that you have to endure when you take medication the usual way.

I hope that you can talk about this with your endocrinologist without waiting for a long time.  I also hope that if your physician is dogmatic and says that no, you may not vary from the first-in-the-morning, empty-stomach routine, you have a way to find another endocrinologist for a second opinion.  If you go to Mary Shomon's website and put "food" into the search box, I think you will find an article that tells you: I and my endocrinologist are not just being careless kooks! Since I have had experiences that seem very similar to yours: sick, dizzy, tired, and weak...and sometimes that form of unwellness deteriorates into a migraine-like headache for me, I am sorry to think of your going through so much discomfort when it easily might be prevented.

Wishing you well,
Jenny
Blank
Avatar_n_tn
Hy i have been taking my thyroxine tablets at irregular times since 2 yrs not knowing that it should be taken at a specific time.I have been suffering from constipation,hair loss,dry skin,fatigue.My blood tests also was always high.The problem is that i work on a night basis.I dnt knw what time to take the tablet at a specific time since the next day am off.please help.any advice?
Thanks
emma
Blank
Avatar_f_tn
Take mine first thing in the morning on an empty stomach.  Have always been consistent with that for the last 14yrs.
Blank
Avatar_n_tn
I empathise with the 'cognitive fuzz' completely.  I have just been diagnosed with an underactive thyroid.  I've been taking Levothyroxine for 5 days now and I can't function.  I've had the last 3 days off of work as I can't get my head together.  I have no energy, keep dropping things and feel really low.  I went back to the doctor to see if this was normal but unfortunately, she didn't really have much to tell me other than wait another week and see how I feel.  

I just wondered if anyone else has had an experience like this? I take the tablet (25 mcg) first thing in the morning with water, at least an hour before I eat.  It's knocking me out and it's not like it's a large dose!  

Nik
Blank
535581_tn?1233757224
My endo did not tell me much. But since I take Citracal (2 tab 2x day) I decided to take my thyroxine around 2-3AM and then going back to sleep.  Calcium interferes with absorption so I figured that was the best time to avoid that.  I have since switched endos b/c the first one did not even warn me about the calcium, I had to read it online.

Thank you all for the info here.
Blank
649848_tn?1357751184
I was told to take my synthroid first thing in the morning, 30 min to 1 hr before eating.  I get up about 3:30 am as I have to be at work by 6;00 am; therefore, I take my med as soon as I get up then get into the shower and start getting ready for work; by the time I'm done showering, etc at least 30 min has gone by so I usually have a cup of coffee while I finish getting ready for work.  By the time I'm dressed, hair dried and ready to go, it's been an hour or more and I can go ahead and eat before leaving the house.  

Calcium and some other supplements should seperated from thyroid med by at least 4 hrs.  I take thyroid med in am and calcium in the pm.  My doctor didn't tell me either, but it's on the sheet that comes attached to the med that instructions for taking, side effects, etc.  
Blank
535581_tn?1233757224
I see we are on the same page.  Yes, I get up to tke my synthroid so that I can take my calcium 4 hours later.I have often wondered why my first endo did not tell about not taking the calcium close to the synthroid.  That was why I switched.

Now I wonder what other supplements should not be taken with the Synthroid.  

I shall read the instructions better now.

Thanks for your advice and information.
Blank
Avatar_f_tn
I take my thyroxin at 6.30am every morning and take my multivitamins and Calcium/Vitamin D combined around dinnertime (6pm).
I never take anything with my thyroxin as I once took a Vitamin B with it and boy did I feel sick all day !
The only thing taken with my thyroxin is water then I wait an hour before I eat brekky.
Blank
Avatar_n_tn
Hi, Just found this topic.
First let me point out I am a male ! I am taking 125 mg of thyroxine, I take it every morning 1 hour before eating anything I have an underactive thyroid and since upping it from 100mg to the present 125mg I am now suffering weak and very painful muscles, ( which would suggest to much throxine ) went back to my doctor who was totally unsypathetic and told me I had tennis elbow ( which I totally disagree with ) and when I tried to get to the botton of it I was told " I can only give you another three minutes ) and when I asked to be refered to a specialist I was was told he could but wanted to know what he should put down on the referal.
I have also found out that the chemist changed my prescription for a cheaper brand and this also made me very ill, when I asked to have my original brand I was told that I had to have what the buyers got in and the only way I would get the real original thyroxine would be to ask the doctor to specifie it on the prescription. I am now having to search all the local chemists for my original thyroxine without much success. I have been informed that if your brand is changed you have to go back for another blood test.
Regards,

David.
Blank
1013194_tn?1296463081
If you have only been on meds five days its not time to notice any difference really, you need to give it at least eight weeks to get the full benefit of the meds..
Blank
Avatar_f_tn
I also felt ill after taking my thyroid medication, I was feeling rather desperate and was relieved after coming across this site. The information I got on here helped me lot.
I now take my medication when my husband gets up for work at 3am, by the time I get up at 5.30am my energy levels are much better, I no longer feel sick or have the fuzzy feeling we all seem to experiance.
At the weekends I set my alarm for 5.30AM, I take my tablets then cuddle down and go back to sleep for a bit. By doing it this way I can get up and have coffee, brekkie and take my vitamins without any problems. Thanks to all of you for the advice you have put on here I
would have been lost without it, I didn't get any of this information from my consultant.

Regards

Anna
Blank
Avatar_n_tn
so over feeling like crap sleep sleep is all i do i sleep that much that i forget to take my thyroid meds and im so over havent felt good for over 6 years and my kids are the ones that are missing out cause their mother does nothing but sleep i think ive lost my job cause ive slept the past 2 weeks and couldnt call work cause i was a sleep during working hours
Blank
Avatar_n_tn
I just started taking thyroxine about a week ago and haven't really felt any differently.  I keep hearing all of these dramatic weight loss stories, though; have any of you experienced this?  If so, how long did it take to start losing?
Blank
393685_tn?1325870933
J- Sword..

That is myth - do believe that taking thyroid meds will be your souce of weight loss. It rarely happens.

You need to increase your thyroid levels  to optimal preformance. You body must accept the change and heal. You must follow and eliminate many sources of processed foods and get a healthy balance of foods and life long diets to help get your thyroid meds to work to get the healing started to eventually lose some MILD weight.

See? its a whole cycle and that pill isn't the ticket to weight loss by no means.
Blank
393685_tn?1325870933
excuse me - typo correction in first sentence.

That is myth - do ( NOT )  believe that taking thyroid meds will be your souce of weight loss. It rarely happens.


Blank
1377762_tn?1278941006
Hi All
I been on on levothyroxine for 9 years now and my weight gradually went upto 300Lbs.
Then 3 years ago after another blood test and had my dosage upped once again to 200Mcg from 175Mcg.
I had alway took my meds first thing in the morning, as directed by my GP,
but nearly always felt tied by around 8pm.

Then 2 years ago out of pure curiosity and frustration over me feeling like i was never benefiting from the meds i was on.
I decided to split my tablets up throughout the day.
I now take 100Mcg at 8am i and 100Mcg at 8pm as in my own mind id be spreading the medication, as i felt the affects must of been wearing off by the late afternoon.
And i feel a million times better since switching and my weight is now down to 249Lbs which to say im happy about is an understatement.
Im still on 200Mcg which i naively thought might of been lowered due to me losing weight.

stella5349 said "the pill isnt a ticket to weight loss" which i totally agree with.
But with me personally when i was taking the meds in the morning, I always felt to tied after work to do any exercise.
But now with taking my meds in the morning and night. i now have the energy thoughout the day. I also now regularly go swimming and cycling which has been the main help to losing the weight.

Karl.
Blank
Avatar_m_tn
I would like to know about the "losing weight" part lol. I have had my whole thryoid removed and been on meds for 2 yrs now. Life has never been the same, fuzzy all day, dizzy, worn out and often feeling down at times! How nice it would be to feel normal just for a day!
Blank
Avatar_m_tn
I am taking  medicine at empty stomach and after a hour I will take coffee/Tea and there will be two hours gap and I feel gastreic. My Gas trouble increased.

Can any one tell suggesstion. My doctor says that will not happen.
Blank
Avatar_f_tn
Thyroxine does not have side affects.  If you are lactose intolerant the excipients in the tablet could have an affect but the amount is minuscle.
You should have been started on a low dose anyhow to begin and see how you fare.  However you can't live without thyroxine if you have hypothyroidism so theres no choice.

Take it 30 - 60 mins before food.  What is wrong with waking a little early to take it if you need to have breakfast at 7am.  Rather that than taking a bigger dose to compensate for the 20% loss.

The body will gradually need more and more as you get older so why use up the recommended dosage by being a little lazy and not taking it early in the morning on an empty stomach.

Also another tip if you have to take calcium don't take the calcium within 4 hrs of taking thyroxine.  

It takes a while for thyroxine to build up in the body and make you feel better.  3 months for me to enjoy the affects when I first took it.

Regards to all
Blank
Avatar_f_tn
I hope this is reassuring.  There are certainly different brands of thyroxine but thyroxine is thyroxine.  The excipients may change slightly but unless your are lactose intolerant which can be  an ingredient in the excipients the other excipients are innocuous.  All medications contain them.

The pharmaceutical companies can't mess around with a formula which is required for serious health reasons ie. hypothyroidism.  

Yes the chemists have a rota with different suppliers so every supplier gets a fair crack with sales of products but it isn't at the expense of the patient's health.

There is nothing sinister going on here.  I have been on thyroxine for 8 years and have had different brands but always with the same dose of thyroxine.  I have checked the excipients and there may have been one or two missing but replaced with another excipient but they have no adverse affect on the quantity of thyroxine and I certainly don't feel or felt any different.

It is a fallacy that you need to keep on the same brand.  If you come out with an allergic rash, anapylactic shock, I'm sure it won't be the excipients of thyroxine they will be checking on anyhow.  Ok lactose intolerant people need thyroxine that doesn't contain this but that is the only exception.

Also I will say again it is not like taking a paracetomol or codeiine for a headache whee you get relief in an hour or two.  The body requires it at a consistent level over a period of time and maintained to regulate your body and for you to feel the benefits.

The www is a great source of information and I trust my dr and pharmacist with the advice they give me about this medication.

Blank
Avatar_f_tn
actually there are differences in med brands.  and some people have to switch/try out several before they find the one that is stabilizing for them.  that is from 2 endocrinologists and 1 chemist who used to work in 2 different labs....who actually stated that one of the labs was usually always inconsistent , and veered me away from that company's products...i think it was synthroid.  anyway, an up and coming branch of endocrinology is 'functional' endocrinology vs classical...worth the study....check out dr janet lang info
Blank
Avatar_n_tn
Hi there,
Was wondering if its fine to take the contraseptive pill at the same time i take my thyroxine? I have been taking Thyroxine for 14years now and although get by day to day, sometimes its hit or miss which days are good one.This probably is down to lazziness on my part and not taking pills properly.Have just come across this site and its been most helpful:)
Blank
649848_tn?1357751184
If your days are hit or miss, maybe you need adjustments in your medication.  Can you post your most current thyroid labs, along with reference ranges, for members to assess and comment on?  

Taking your contraceptive at the same time as your thyroid med, could cause your thyroid med to be absorbed improperly.  That could mean you'd need a higher dose of thyroid med.

Since this is a very old thread, why not start a new one, with your own information, so our members can try to help you out?
Blank
Avatar_m_tn
By experiencing all of these (tired, headache, fatigue, cramps,etc.) have you had any regret taking your whole thyroid out? in the case of papillary cancer, they say its a slow growing tumor and the survival rate is very high about 97% for 20 to 30 years that means, even you have the cancer tumor with you, you can still live normal and will not experience being hypo.Partial thyroidectomy which only take 1 lobe of the thyroid and let the other stay (most of the time the tumor is only on 1 side, which is the same case for me but my dr insist that the whole tyhroid should be taken out). If its is a slow growing tumor why do we not just let it be there, besides the discomfort of being hypo and other not so good feeling without thyroid gland kills us already everyday......or why not just let the other lobe be left behind.
Blank
Avatar_m_tn
All medicines carry the risk of side effects, they are nasty chemicals after all.  I have only last week experienced a very nasty reaction to levothyroxine, felt like my blood was actually boiling up, along with intense itching under the skin.  It lasted for hours and I had to sit in a cold bath to eventually gain some relief.
Blank
Avatar_m_tn
Plez help me I am pregnant and I remove right lope of thyroid gland now I take 100 thyroxcine and I suffering from anemia so I need take iron and multivitamine and calcium so when  can I take it
Blank
649848_tn?1357751184
Iron, multivitamin and calcium should not be taken within 4 hours of levothyroxine, since they can inhibit absorption of the levo.  

You will need to have your thyroid levels tested regularly (monthly) during your pregnancy and will most likely have to adjust medications, as you go in order to insure adequate hormones for your developing fetus.
Blank
Avatar_f_tn
hi i take it every day in morning before i do anything else along with 2 multiviyimans and an eving primrose tablet and ive always been fine as well wanted to no if i can also take horsetail do u no
Blank
Avatar_m_tn
Anjee,
Thanks, but it's hard to work out the meaning of your comment "that is from 2 endocrinologists and 1 chemist who used to work in 2 different labs....who actually stated that one of the labs was **usually always inconsistent** , and veered me away from that company's products."
Is it "usually" or is it "always"? - the 2 descriptions can't both apply to the same thing, you know! If something happens "usually", then by definition it DOESN'T happen "always", so what's "usually always"??
Then to make matters worse, you're talking about INconsistency - it's not possible to be "always inconsistent" since that means "consistently inconsistent" - nor is it possible to be "usually inconsistent" since that means "generally but inconsistently inconsistent".
All I wanted to know was whether a bit of a bigger dose would help with my persistent sleepiness, but now my head is spinning...
Blank
649848_tn?1357751184
Sometimes it doesn't pay to get into the grammatical aspect of things here, usually always, sometimes never - can give you a headache real quickly.......lol   That said, this is a very old thread and Anjee has not been active on the forum since that post, which was over 2 yrs ago.  

As to your question about a larger dose, we can't answer your question without further information.  You might get better attention if you start your own thread, by clicking the orange "Post a Question" button at the top of this page, type your question/comments, then click the green "Post a Comment" button.

You can also access our home page at the following link:
http://www.medhelp.org/forums/Thyroid-Disorders/show/73

Follow the above instructions for posting a new thread.  Always be sure to include current labs, with reference ranges, since ranges vary lab to lab and have to come from your own report.  

Is the sleepiness the only symptom you have?  If not, please list others, as well. Do you know if you have Hashimoto's Thyroiditis?

Deficiency in Vitamin B12 can also cause sleepiness.
Blank
Avatar_f_tn
hi 37 female I have been on thyroxin for the past 13 years. when I first started to take the medicine it took a few months to start to work before I felt better. started taking it in the morning with out food found that this did not suit my working life as I was a shift worker day night and afternoon's. so I use to take it when I got up whether it was day or night time didn't matter as long as I was consistent over the cores of my rotation, which was 3 week days three weeks nights three weeks afternoon's. Then I was felling sick when I would take it so my doctor suggested that I take it with food and he would re test my levels after 6-8 weeks then again in another 6-8 weeks as result my vary and you can get false readings just to make sure he said. If your doctor cant give you the advise you need then seek a second opinion. you should be able to get tested when ever you like and a chemist should not tell you that you can not have the original medicine that you can only have the cheaper version this is not true. Best thing to do is to find a doctor that you can trust and a thyroid specialist that is going to give you all the help you with your needs.  I found some regular exercise helped me as the thyroid sends signal to other parts of the body telling them what to do. It also regulates your metabolism go to http://en.wikipedia.org/wiki/Thyroid and see what the thyroid dose its interesting. My levels have changed through my life started on 50mg then 75mg then 100 125 150 200 now are stable and at 150 mg  still get test every 6 months and if levels change every 6-8 weeks. I have a condition called Hashimoto's thyroiditis. which means my body is attacking the thyroid it is an Autoimmune disease. Eat healthy also helps as if the thyroid is not work properly you can gain weight. If you struggle with weight like me then try to not gain more than 2kg be taking it off again as it get hard the more you put on trust me put on 40kg so hard to lose it now. If doctor say you shouldn't feel tired now that you are on thyroid meds that is not true. The medication is to regulate your thyroid but if your thyroid produced more one day than the next you may feel tired or the opposite speeding or fast. I seem to talk fast when its working better and feel very tired when its not. Exercise and eating healthy seem to help with tiredness it just some thing you need to manage and there is not one solution that fits every one. Each person may feel different to the next depending on the type of thyroid condition and treatment . my sister has the same condition as me it can be past to siblings. Her condition compared to mine has been a lot worse as she has nodule on her thyroid. My sister got to the point were she was very depressed and put on 90kg . This had to stop so she saw a endocrinologists which helped her with her situation.
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Thyroid Disorders Community Resources
RSS Expert Activity
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Emotional Eating Control: How to St...
Aug 28 by Roger Gould, M.D.Blank
233488_tn?1310696703
Blank
New Cannabis Article from NORTH Mag...
Jul 20 by John C Hagan III, MD, FACS, FAAOBlank
Top Thyroid Answerers
Avatar_m_tn
Blank
gimel
MI
649848_tn?1357751184
Blank
Barb135
FL
Avatar_f_tn
Blank
goolarra
Sisters, OR
168348_tn?1379360675
Blank
ChitChatNine
1756321_tn?1377771734
Blank
Red_Star
Queensland, Australia
657231_tn?1390151580
Blank
rumpled
Northern, NJ