Timing of taking thyroid medications

[Grits]

I am hypothyroid and have been on Lexothyroxin for almost a year. My original TSH was 6.44. After being on my medication for six months, taking it religiously in the morning an hour before breakfast, my TSH was 3.74, which my doctor was happy with. I read that patients were getting better results by taking their thyroid meds before bed, so I decided to switch to that since 3.74 was too close to the high end for my liking. I just got the TSH results back after taking my meds at night for six months, and it was 1.32! Just thought I would share that since I know there are quite a few of you who also have thyroid issues.

[indysteel]

That's interesting! I had the opposite problem in that just 25 mg taken in the middle of the night made me hyper. I have to take a hiatus and see where my TSH is in a few weeks.

How different are you feeling from when it was 3.74? It's troublesome that your doc was okay with that level of TSH.

[Grits]

The reference range the lab uses is 0.358 - 3.740, so I was literally at the very high end, and I know that the reference ranges are likely to be reduced in the future and some are already using a lower range.

I already felt so much better at 3.74 than I did when over 6. I haven't noticed much difference in how I feel with the decrease to 1.32, but the hair loss is getting better.

[Grits]

Here is a link to one of the studies I found:
http://thyroid.about.com/od/thyroiddrugstreatments/a/bedtime.htm

"The researchers found that the patients taking nighttime levothyroxine had a drop in TSH of 1.25 -- which is a significant change. The free thyroxine (Free T4) level went up by 0.07 ng/dL, and total triiodothyronine (Total T3) went up by 6.5 ng/dL. According to the researchers, there were no significant changes in the other factors.

The researchers concluded that, given the improvement in thyroid hormone levels, physicians should consider prescribing levothyroxine to be taken at bedtime."

[solobiker]

This is interesting. I have been on levothyroxine since 1989 and this is the first time I have heard about taking at night. Heck, when I first started taking it over 20 years ago it was never mentioned to take it an hour before breakfast. Thanks for the link.

[Catrin]

I try to take mine at 3:45 when I get up in the morning - I've tried to take it at night but typically forget to do so. I hear you, my thyroid was removed in 1985 and no one ever really told me about the best time to take it. I was just thankful to go from 20+ pills a day to only 1 :)

[Blueberry]

This is really interesting. How long do you have to wait after eating before taking it if you take it at night? It's not unusual for me to eat dinner within 2 hours of bedtime (bad, I know - but that's how my schedule is right now, and there's not a lot I can do about it) - wondering how long I would need to wait. Also wonder if I'd need to take my birth control at a different time, since I usually take it at bedtime. Food for thought.

[indysteel]

FWIW, I was told to split up my BCP and thyroid med, Blueberry. I assume that's because some studies show that estrogen can inhibit uptake of the Lexothyroxin. When I first started taking it, I took my BCP in the morning. I switched that to my 10 pm bedtime, and took my Synthroid in the middle of the night (usually around 3ish).

If anyone does change the timing of their dosage, make sure that you get your levels rechecked. As Grits' experience suggests, it could potentially lead to overmedication, especially for those who are already withing a normal range.

[Grits]

I keep my pill and a glass of water by the bed. You are supposed to wait two hours after eating. If that happens to be before I turn out the lights then I take it. If not, I almost always wake up during the night at some point and just take it then. Very rarely I've slept through and just take it in the morning as soon as I do wake up. I started taking BCP in the morning when I switched to taking the Lexothyroxin at night.