"Thyroid disease is more common than diabetes or heart disease."

~ American College of Endocrinology

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THYROID DISEASE IS KILLING US

More than 30,000,000 people in the US and 200 million worldwide have a Thyroid Disorder Most affected are women. Some estimates are over 50 million in US and over 200 million worldwide, and growing.

Estimates vary widely as most patients are misdiagnosed or undiagnosed because doctors don't know what they are looking for.

Thyroid disease is also an autoimmune disease. This means that over 27 million people have one or more of the over 105 known autoimmune diseases.

Are you one?

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Thyroid Medication – New Study Shows to Take it at Bedtime

I take the thyroid hormone replacement medication L-thyroxine for low thyroid problems.  The medicine bottle stickers scream at me every day. There’s a very large yellow sticker, “TAKE IN THE MORNING” overlapping another big yellow sticker that reads, “TAKE ON AN EMPTY STOMACH.”  

I have to admit, I really don’t know when the dosage is too high or low or what it’s really doing for me, but I’ve been taking it for over 18 years this March since I had half of my thyroid removed. My blood tests and muscle testing advise my healthcare practitioner  how to adjust the dosage.

A recent study reported in the Archives of Internal Medicine (Arch Intern Med 2010;170:1996-2003 ) suggests taking levothyroxine or Synthroid on an empty stomach at bedtime, which  may be the key to lower TSH, higher T4 and T3 levels, and improved absorption of thyroid medication. These are very important findings for us. 

Why would taking thyroid meds at night be better than in the morning?

The researchers suggested several explanations for the results:

• The morning dose is questionable for most of us. Why? “On an empty stomach” varies for each person. So, even when waiting at least 30 minutes to eat, breakfast and vitamins and other supplements or medications may be interfering with the intestinal absorption of the medication.
• “Bowel motility is slower at night,” which means that it takes longer for the levothyroxine tablet to transit through the intestinal system, resulting in longer exposure to the intestinal wall, and therefore, better uptake of the medication.
• The conversion process of T4 to T3 may be more effective in the evening.

Taking medication at bedtime instead of in the morning is also just easier sometimes:

•  It’s easier, as you don’t have to worry about when to eat breakfast, and then waylay it or skip breakfast which is not good at all.
•  Taking the medication at night makes it easier to avoid medications, supplements and foods, like calcium, iron, and high-fiber foods that can interfere with thyroid medication absorption.
•  For coffee drinkers, they wouldn’t have to wait until an hour after their medication to enjoy their first cup! Small but important reason for a big coffee drinker!
•  Plus, taking the medication at night might offer some improvement in symptoms to people who are just not getting optimal absorption by taking thyroid medication during the day.

All pretty good reasons to try it. I’m starting tonight!  Let me know how it works for you too!

37 comments to Thyroid Medication – New Study Shows to Take it at Bedtime

  • Carol J Clever

    I have been taking levothyroxine for a number of years(8-10).I couldn’t seem to take it in the morning and have it on an empty stomach. My solution is to take the medication between 3am to 4am. I am always up at that time to the bathroom anyway, so I don’t get up just to take the med. My stomach is empty for several hours before and after taking the med. It works for me.

    • PStokes

      I, too, take during that 3-5am bathroom awakening and it’s working well for me because I also have to take calcium twice a day. Since my thyroid was removed I’ve had problems adjusting to replacement but a full glass of water just before sleep works as well as an alarm clock!

  • Nickie

    I had my thyroid removed 15 years ago and its taken several years to ‘feel’ okay on a daily morning dose of 175 micro-grams of levothyroxine. Having found and read about very good reasons for taking meds at bedtime, i’m certainly willing to give it a go (for a month or two)

  • Ericka Eubanks

    I have been on Levothyroxine 112mcg for 12 years. I have always taken this pill first thing in morning since I am not a breakfast eater, but I LOVE my coffee. I drink a cup or 2 within minutes of it. I have been “within” range of their normal .1 – 5. I can tell when it’s risen because of the way I feel(pinky and ring fingers fallin asleep at night/colder than usual/hair falling out/sluggish/& tired, but until I go beyond “their normal” my physician won’t do anything.

    So, I made the decision to switch from taking thyroid in the morning to at night before I go to bed. I also made the decision to eat healthier such as fruits and vegies all day – no junk, no red meat, no sugars, chips, etc. I have noticed that just the past 3 days that I have taken my thyroid pill at night that I don’t feel as sluggish. So, it’s working for me right now.

    • lisa

      you are probably taking too much medication and if you waited your full 30 mins before you drank your coffee you could probably reduce your dose.

  • Chitapett

    I take 137MCG of Synthroid. I started taking Synthroid at night before bed after feeling desperate at the fact that my blood counts come back normal from the lab, yet, as I perceive it, my symptoms of hypothyroidism keep affecting my life.
    I believe sometimes I take my meds after a heavy meal and other times I eat too close to my bedtime. I do notice, however, that if I take my meds at night, and either after a lighter meal or after several hours of a meal, and I do so consistently for a week or more, I feel the added benefits.
    I’m considering taking apple cider vinegar after a meal or perhaps 2 hours before bed to “clean” out my stomach and intestinal track to help my body, in every way I can, to efficiently process the synthetic thyroid.
    Dawned on me though, that it’s pretty sad that hypothyroid condition has been around since the dawn of time and can literally mean the difference between happiness and an active energetic life AND depression and no energy to do anything productive, yet doctors can’t seem to find a solution to help us out.
    At the risk of adding ADHD to my long list of disorders, my neice has a disease called precocious puberty that is treated through a time release hormone implanted in her body. If ones thyroid hormone fluctuates or requires special conditions in ones body such as empty stomach or what have you, why can’t we too have an implant that auto-doses our body with the appropriate T3 and T4 we need to function?

    • kim

      Great comment, Chitapett!

      See all my posts re: thyroid medication. http://thyroidu.com/category/thyroid-medication/

      Check your medication warning label – it should say to take on an empty stomach and to not eat and hour before or after taking your thyroid med. Plus, not to have iron, calcium and a few other vitamins/minerals within “4 hours.”

      RE: night dose vs. a.m.
      I tried the night time dose, as noted in my blog post, but after a few weeks I noticed I hotflashed the next day like crazy. So I’m back to taking it in the morning.

      RE: taking apple cider vinegar after a meal or perhaps 2 hours before bed to “clean” out my stomach and intestinal track to help my body, in every way I can, to efficiently process the synthetic thyroid.

      See if it helps!

      RE: its affects on your whole life – yes, very frustrating.

      RE: an implant that auto-doses our body with the appropriate T3 and T4 we need to function?
      Hmmm, maybe someday! I’m not sure it would work though due to our hormones/ T3 and 4 being so wild.

      • Sandy Stott

        Kim, I also take Synthroid in the morning, but am considering moving it to before bed. You said taking it at night gave you bad hotflashes the next day. I was having the same problem, with or without thyroid medication. And then I read everything I could find about how hormones interact and what role menopause actually plays. Then I went back to my integrative naturopathic doctor, who actually listened and was impressed with my knowledge. She tested my estrogen, progesterone and DHEA levels. Low progesterone makes your estrogen too high in relation, which causes hot flashes. Low DHEA is indicative of adrenal exhaustion, which is a result of chronic or untreated hypothyroid. I had both hypothyroid and adrenal exhaustion. I also found out that I had chronic LYME, which I was unaware of. Untreated Lyme wipes out both thyroid and adrenals, so between chronic Lyme and the thyroid/adrenal/hormonal effects of menopause, my adrenals, thyroid and progesterone were through the floor, as they all need each other. I am now on Synthroid, DHEA cream and bioidentical Progesterone cream. My hot flashes are lessening more and more every day, after one month. I already barely notice them trying to kick in before they are gone. I hoped this might help someone who isn’t as medically educated as I have had to become.

        • kim

          Hi, Sandy,

          I’m am SO very sorry for your health issues.

          If I haven’t already shared this with you, you need to make sure you’re seeing a “thyroid specialist” who knows what to do for you.

          Try this list – http://thyroidu.com/practitioners/

          If you don’t find one on this list I highly suggest you contact my thyroid practitioner, Dr. Jared Allomong – he can work with you by phone/Skype/Email from a distance most times. Go here and call or make an appointment: http://functionalhealthcolorado.com/

          My good thoughts for your best health always, Kim

  • Nancy Seibert

    I am 65 years old and was diagnosed last year with Thyroid problems and given Levothyroxin 100MCG to take one in the morning. I lived the last few years feeling not at all myself, like someone else had taken over my life and THAT person wasn`t nice at all or patient. Talking with my wonderful sister last Tuesday we discussed my taking the thyroid med at night. The very next day I awoke feeling normal, absolutely my old self. I haven`t felt this way since before my first husband passed away in 1995. I am happier, have a feeling of well being, well adjusted, more patient, all of what I had lost back when. I am thanking God for this and am trying to help my cousin with her meds. The worst part affected my life for over 18 years and now this is my best life.
    Nancy

  • nibal

    I’m 24 years old and i have just started taking Levothyroxin 50 mcg but my doctor didn’t mention any thing about coffee .she said it’s ok to drink but not eat for an hour after i take the pill . so i was wondering is this wright and how long i should stay without eating ” empty stomach” cause i stay awake all night and i should know when to cut food .thanks ,regards

    • kim

      Hi Nibal,

      Coffee: It’s okay to drink with a thyroid condition, but if you can drink less of it or quit, that’s better. The adrenal surges associated with caffeine are not good for your thyroid condition.

      When to eat after taking medication: Check the medication information sheet that comes with your medication, it will tell you. Usually it’s one hour before or after taking med, sometimes more.

  • Can I use raspberry ketone, I have an under active thyroid. Im on 125g of thyroid medicine a day

  • kim

    Yes, L-Thyroxine works for me, PLUS supplements and the thyroid specific diet in my manual (see bookstore). The medication alone will not work.

  • Am wondering if you have any studies regarding taking Levethyroxine (0.125 mcg) at night in relation to FM/CFS. Thank you!

  • I take Thyronorm 75mcg every morning. I want to start using Apple Cider Vinegar with Honey and warm water to assist in weight loss. I’m told just as i take my thyroid meds on empty stomach the apple cider-honey drink is also to be taken on an empty stomach. What i am confused about is, if i take my thyroid medicine first thing in the morning and then wait an hour and take the apple cider/honey drink will that be considered as empty stomach? And will the cider-honey drink help? I am already into exercising and walking but i would like to drink the cider-honey concoction to get a little extra help to loose weight.

    • kim

      Yes, take 1 hour apart.
      I cannot verify if the regimen will work for you personally. You’ll just have to do it as your practice and see if it works for you!

  • Dora love

    I drank levothyroxin for 18 years! Found out that it blocks the body from observing calcium which is why my hands and fingers and toes ached! So I demanded my doctor to prescribe to me naturethroid! I checked the CVS pharmacy first and they did carry it so I got on my doc and said switch me now I’m sick of feeling tired and heavy! They switched me! I feel like never before! Levothyroxin it any kind of synthetic thyroid works against your overall health and well being! Omg I am so mad at these uneducated doctors giving me what I don’t need! Take control of your health and tell them what to do! I found a web sight that opened my eyes called stop the thyroid madness. Look for it.

  • lisalisa

    I take mine during the early a.m. i tend to snack after dinner so my alarm is set for 1:40 a.m. take my pill right back to sleep stomach is empty, no interferance of other meds.

  • Sue

    I too Have my T3, T4, TSH in the normal ranges. T3 is on low side of normal, but “normal”. I have fought energy since before i was diagnosed with Hyper/Graves back in 09. Thyroid removal in 13, and it’s been awful, severe fatigue, aches and pains, brain fog, weight gain…I also have fibromyalgia so it’s not fun at all. I have been on 100 MCG Levothyroxin forever.I wish they would up it or lower it to give me some energy, and this weight gain is beyond depressing. I’m going to start this at night thing, but is it okay to take with other night time meds such as Ativan and muscle relaxers??

    • kim

      Hello Sue I’m so very sorry to hear of what you’re doing through.

      Please contact my thyroid practitioner, Dr. Jared Allomong – he can work with you by phone/Skype/Email from a distance most times.
      Go here and call or make an appointment: http://functionalhealthcolorado.com/

      My good thoughts for your best health always, Kim

  • Lisa

    Hello I am deaf, 52 yrs old from Alaska… I had thyroid when I was 26 yrs old. it begun. For 27 years, I still taking Levothroxine 88mg for before bed time and liothronine 10 mg every morning (no eating for 1 hr). Also I have another 2 medication for back pain and heart…. Is it safe for apple cider vinegar? I am overweight for long time and struggle with lose weight. What do you suggest me for help? What’s about exercise after drink apple cider vinegar?

    I drank coffee caffeine free. I drink lot of water 8 oz for 4 time a day.

    Thank you

    • kim

      Hello Lisa,

      Since you have a couple layers of issues going on, I highly suggest you contact my thyroid practitioner, Dr. Jared Allomong – he can work with you by phone/Skype/Email from a distance most times.
      Go here and call or make an appointment: http://functionalhealthcolorado.com/

      My good thoughts for your best health always, Kim

  • Margie Christofferson

    I take Nature-throid. I have always taken it in the morning. If I switch to taking it at night, how long after s meal would be considered an empty stomach? Thank you.

  • I like all the supporting statements but thyroid medication serves as an upper because it takes people out of their heavy sleep and brings back some much needed pep in your every step and more energy
    won’t this cause more sleeping difficulties?

    • kim

      Hi Marivel,

      Each person’s body reacts differently to medications. If it’s not a fit for you, find other times of the day. It works better for me around 1 pm. 🙂

  • kim

    I personally go with the 1 hour rule on how long to take my thyroid meds before or after food.

    You’ll need to play with a food menu for your breakfast until you fine tune it. I take my thyroid medication at 1 pm, it works best for me then.

  • Carol Gonder

    i been takeing my tyriod in the morinng cna i take it at night so it helps me seep all night because when i take it in the morining and and if i still sleepy i go bake to bed and i sleep good

  • Lois Woodward

    I need some help on why I’m gaining so much weight taking levothyroxine..what can I do

  • Gene Coyle

    I take lansoprazole so I was told not to take my levonalthyroxine at the same time as the lansoprazole puts a lining on your stomach and you do not absorb medication in the same way ,can you please tell me if this is true.

    • kim

      Hi Gene,
      I’m not finding anything about the interaction of these medications exactly.
      A good question to ask you Pharmacist or doctor who prescribed them.

      Kim

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