[StaceygirlPa]

Here is the article where they are saying now we should start taking our meds at night instead of the morning.

Every thyroid patient has heard the advice that for best results, we should take our medication first thing in the morning, on an empty stomach, and wait at least 30 minutes to an hour before eating. (And also, that we should wait at least three to four hours before taking calcium or iron, which can interfere with thyroid hormone absorption.)
But two important studies -- a 2007 study published in the journal Clinical Endocrinology, and a follow-up larger randomized trial reported in the December 2010 issue of the Archives of Internal Medicine -- have found that taking the same dose of levothyroxine (i.e., Synthroid) at bedtime, as compared to first thing in the morning, may be better.

The studies were prompted by observation that some patients had improved thyroid hormone profiles improved after they switched from taking their levothyroxine in the morning, to bedtime.

In 2007, Clinical Endocrinology reported on a small pilot study, which looked at the impact on thyroid hormone profiles by changing the time levothyroxine was taken from early morning to bedtime. They also evaluated the impact of this change on the circadian rhythm of TSH and thyroid hormones and thyroid hormone metabolism. The study, while small (12 subjects), was fairly conclusive in its findings, which the researchers said were “striking” and which have “important consequences for the millions of patients who take l-thyroxine daily.”

Researchers reported that taking medication at bedtime, rather than the morning, results in “higher thyroid hormone concentrations and lower TSH concentrations.” TSH decreased and Free T4 levels rose in all patients by changing thyroxine ingestion from early morning to bedtime and T3 levels rose in all but one subject. And TSH decreased irrespective of the starting TSH levels, suggesting better absorption of the thyroid medication when taken in the evening. Interestingly, the researchers found that the circadian TSH rhythm -- the typical daily fluctuations of TSH that occur during a 24-hour period -- dids not vary.

The researchers suggested several explanations for the results:

•Even when waiting at least 30 minutes to eat, breakfast may be interfering with the intestinal absorption of levothyroxine thyroxine.
•“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.
The researchers have suggested that given the results of this pilot study, a large double-blinded randomized study was needed to confirm their results.
That study was conducted between April 2007 through November 2008m, and the results were reported on in the 2010 Archives of Internal Medicine article. The study was a randomized double-blind crossover trial. Ninety patients completed the trial, which involved a six-month period of taking 1 capsule in the morning and 1 capsule at bedtime, with one capsule active levothyroxine, the other placebo, and a switch at the three-month point. The researchers evaluated thyroid hormone levels, as well as creatinine levels, lipid levels, body mass index, heart rate, and quality of life parameters.

The researchers found that the patients taking nighttime levothyroxine had a drop in TSH of 1.25 -- which is a significant change. They 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.

[avasmom603]

I have always taken my medication at night because I take my vitamins in the morning.

[StaceygirlPa]

I just switched everything of mine around.

[MeganMomof5]

Thanks for the info! I Think i'll switch it around today

[AZsnowflake]

I always take everything at night. I can't take vitamins in the morning because they make me sick to my stomach and I've just always taken my synthroid at the same time too.

[MeganMomof5]

vitamins can actually affect your thyroid meds, you aren't supposed to take them together.

[AZsnowflake]

Yea I guess I'll start taking them in the morning! There's no way I can do vitamins in the morning, they make me nauseous!

[StaceygirlPa]

If you don't eat breakfast try eating a piece of toast or something small to help coat your stomach. You are supposed to take your thyroid meds all by themselves. Almost everything can effect your thryoid medication.

[AZsnowflake]

I do eat breakfast. I've been on these meds since I was 15 and back then I took them in the morning with other pills and breakfast as well because the other pills I had to eat with. It has never affected my thyroid levels at all, I've always been in the normal range since being on them so I don't think taking them at one time or another, with or without food, really affects me especially since my doctor knows how I was taking them and said it was fine because my levels have always been fine. But I am going to start taking them in the morning to be on the opposite of the prenatals, it can't hurt anything.

[Brittanie]

I'm kind of frustrated because only this last time my meds were refilled was I told that I shouldn't take vitamins with them. So now I have to figure out when to take my vitamins. lol

I take mine at 4:30. If I take them too soon before bed I can't sleep. No clue why, but it's true. I took them in the morning for a while but I was having a hard time waking up at I was reaching the end of the cycle...so I switched them later.

[mafiamom]

that is very interesting. i am going to talk to my ob about changing the time i take my synthroid.

[Servilia]

Definitely don't take your vitamins within 4 hours before or after your synthroid. Iron, calcium and other minerals inhibit absorption. And if you do decide to switch to nighttime I would still follow the no food for a while rule..

[StaceygirlPa]

I just switched everything around. I am now taking all of my vitamins and other meds in the morning. I am only taking my synthroid at night before I go to bed. Since my ob thinks my low thyorid levels might be a factor on the two m/c I want to do everything I can to get my numbers up.