It is often suggested that bed-time dosing results in slightly better absorption. It also seems slightly closer to the pattern healthy people have.
I have always taken my levothyroxine at bed-time.
For that reason, I cannot compare with taking in the morning.
Before diagnosis, my sleep was badly disturbed. Typically, I would fall asleep fairly easily. Then wake up after something like half an hour to two hours. Once woken I'd be unable to get back to sleep - often till dawn, or at all.
Once I started on levothyroxine, my sleep slowly improved. By the time I was taking an adequate dose, bad nights were unusual - just an occasional night where I might wake up for a while. Now, after years, I sleep very easily and deeply and rarely wake at all. If I do, I get back to sleep quickly.
We have some who prefer it; we have others who prefer other times. See our poll:
https://healthunlocked.com/thyroiduk/polls/133674000/when-do-you-take-your-thyroid-medication
Some papers which discuss taking levothyroxine at different times - such as bed-time. There are many other papers which discuss timing - this is just a sample.
Levothyroxine Replacement and Ramadan Fasting
https://pubmed.ncbi.nlm.nih.gov/23776910/
Effect of L-Thyroxine Administration Before Breakfast vs at Bedtime on Hypothyroidism: A Meta-Analysis
https://pubmed.ncbi.nlm.nih.gov/32022947/
Morning vs. Bedtime Levothyroxine Administration: What Is the Ideal Choice for Children?
https://pubmed.ncbi.nlm.nih.gov/30312169/
A Crossover Study Evaluating Effect of Timing of Levothyroxine on Thyroid Hormone Status in Patients of Hypothyroidism
https://pubmed.ncbi.nlm.nih.gov/31321928/
Effect of Timing of Levothyroxine Administration on the Treatment of Hypothyroidism: A Three-Period Crossover Randomized Study
https://pubmed.ncbi.nlm.nih.gov/30043093/
Alternative Schedules of Levothyroxine Administration
https://pubmed.ncbi.nlm.nih.gov/25694412/
Thyroid Diseases and Ramadan
https://pubmed.ncbi.nlm.nih.gov/22837909/
Pharmacotherapy: Hypothyroidism-Should Levothyroxine Be Taken at Bedtime
https://pubmed.ncbi.nlm.nih.gov/21364516/
Effects of Evening vs Morning Levothyroxine Intake: A Randomized Double-Blind Crossover Trial
https://pubmed.ncbi.nlm.nih.gov/21149757/
Timing of Levothyroxine Administration Affects Serum Thyrotropin Concentration
https://pubmed.ncbi.nlm.nih.gov/19584184/
Effects of Evening vs Morning Thyroxine Ingestion on Serum Thyroid Hormone Profiles in Hypothyroid Patients
https://pubmed.ncbi.nlm.nih.gov/17201800/
Evaluation of Bedtime vs. Morning Levothyroxine Intake to Control Hypothyroidism in Older Patients: A Pragmatic Crossover Randomized Clinical Trial
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9261378/
Previous related posts:
helvella - Levothyroxine absorption
Levothyroxine - Switching to night
https://healthunlocked.com/thyroiduk/posts/147630388/levothyroxine-switching-to-night
Levothyroxine Medication Query
Changing Dosing Time
If you wish to changeover from morning dosing to bed-time dosing, or the other way, there are many options.
|
|
|
Direct |
Split |
Split + |
Split - |
|
Day 1 - Day before |
|
|
|
|
|
|
|
Morning |
100 |
100 |
100 |
100 |
|
|
Bed-time |
0 |
0 |
0 |
0 |
|
Day 2 - Change day |
|
|
|
|
|
|
|
Morning |
0 |
50 |
50 |
50 |
|
|
Bed-time |
100 |
50 |
100 |
50 |
|
Day 3 - Day after |
|
|
|
|
|
|
|
Morning |
0 |
0 |
0 |
0 |
|
|
Bed-time |
100 |
100 |
100 |
50 |
|
Day 4 |
|
|
|
|
|
|
|
Morning |
0 |
0 |
0 |
0 |
|
|
Bed-time |
100 |
100 |
100 |
100 |
|
|
|
|
|
|
|
|
Total over 4 days |
|
400 |
400 |
450 |
350 |
Four possible ways of changing levothyroxine dose from morning to bed-time.
The simplest is simply to changeover! Completed in one day.
But if you wish to be a touch more cautious, maybe split dose on the actual change over day. Then onto the new pattern.
The Total over 4 days shows that two patterns cause a slight difference in total intake. This difference is small and should be of no significance at all within a few days. Even if you did feel slightly under- or over-dosed, it should pass quickly.
If your current dose feels only just enough, you might wish to avoid the slight gap the first two options might cause hence could use the pattern Split+ and take an extra 50.
If your current dose feels a bit high and you want to avoid any possibility of the bed-time dose making you feel as if you are taking a higher dose, you could use the pattern Split- and drop half a dose.
The numbers are percentages. You do not have to make them exact. For example, you could split 112.5 into 50 and 62.5.
The most important thing is not to be anxious. Just do it. Remembering that if it didn’t work out, you can go back to what you were doing.
If you wish to link to this page on HealthUnlocked, copy the entire dark red text below and paste into a post or reply.
[i][b]helvella - Bed-time dosing of levothyroxine [/b]
Discussion about taking levothyroxine at bed-time. Several linked references to relevant papers.
Last updated 16/09/2025[/i]
Link to blog:
https://helvella.blogspot.com/p/helevlla-bed-time-dosing-of.html
If you find anything incorrect, misleading, typos, links that don’t work, etc., please let me know. Go to my profile and use the contact details there.
