# Take T4 at night or in the morning?



## my3gr8girls (Mar 18, 2016)

Okay, I'm going to attempt to distract myself from the frustration with this dosing process by starting a new subject (other than complaining about fatigue). I have read studies that say it's helpful to take levothyroxine at night instead of in the morning. Does anyone here do that? It sounds like it can help with the brain fog. I am currently taking mine around 5ish am, whenever I first wake up. Then I go back to sleep (or doze) until time to get up an hour later. I feel like some days I start feeling more lively in the afternoon/evening so I wonder if my body would do better taking it at night so I could be sleepy/foggy/tired when I'm actually in bed instead of when I'm trying to work. Anyone have experience with this or know of anyone who took the levo at night?


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## Lovlkn (Dec 20, 2009)

Can you please edit your signature with a short history so it follows any topic post you make - which makes it easier for people to understand your situation.

Include diagnosis, last lab's with ranges and current medication and dosage.

Click on your log in name, Profile, edit profile and on the left is signature.

I take my Levo ( Unithroid) at 2:00 am as I seem to wake every night at that time and felt if would be a good idea as I take Calcium supplements at Breakfast lunch and dinner and Levo should be taken 4 hours either side of Levo.

I noticed NO effect on sleep by taking it in the middle of the night. It's a long 1/2 life medication so I feel the immediate punch from the dose. Cytomel tends to kick in about 2 hours after taking it, although I notice no difference when I take it at 5 a.m. for some reason.


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## my3gr8girls (Mar 18, 2016)

Okay, signature is done.

Here is a link to one of the studies talking about taking levo at bedtime: http://www.ncbi.nlm.nih.gov/pubmed/17201800

I have also read about a lot of people on different websites who seem to feel better immediately after switching to taking the levo at night. I am just wondering if because I seem to feel badly for 6-8 hours after taking the levo, if I take it at night I might sleep through that part. Maybe it's just an adjustment thing, but if I could sleep through the adjustment period, that would be just great.

I might skip the morning dose tomorrow and then take it at bedtime to see what happens.

After work today, my husband wanted to go for a walk and I went but I hated every minute of it because all I could think about was how it was going to take every last ounce of my energy and I was going to be totally zonked for 24 hours afterward. I'm literally terrified to expend any extra energy.

Let's see if this signature works...


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## Lovlkn (Dec 20, 2009)

my3gr8girls said:


> Okay, signature is done.
> 
> Here is a link to one of the studies talking about taking levo at bedtime: http://www.ncbi.nlm.nih.gov/pubmed/17201800
> 
> ...


Per your Pubmed link



> CONCLUSIONS:
> 
> l-thyroxine taken at bedtime by patients with primary hypothyroidism is associated with higher thyroid hormone concentrations and lower TSH concentrations compared to the same l-thyroxine dose taken in the morning. At the same time, the circadian TSH rhythm stays intact. Our findings are best explained by a better gastrointestinal uptake of l-thyroxine during the night.
> 
> ...


Free T-4 and Free T-3 show unbound thyroid hormone at time of draw. TSH is a pituitary hormone and can can be impacted by antibodies.

If you are a regular awaker at night - the advantage to taking thyroxine at night is you avoid all interactions with it's absorption.

.


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## my3gr8girls (Mar 18, 2016)

It may be too early to really tell, but I think taking levothyroxine at night is going to be my saving grace. I skipped yesterday morning's dose and made sure to be done by dinner at 7 pm. Then I took my levo at 10 pm just before going to bed. I awoke this morning feeling normal. At least I think so. I'm not sure I know what normal is anymore. I don't have brain fog, and I'm not physically and mentally exhausted. Even yesterday, after skipping the morning dose, I felt more normal yesterday than I do on the days when I take the levo in the morning.

I don't know if the response I have to levo (fatigue, spaciness, exhaustion) is an adjustment thing or just how my body responds after the first several hours to the introduction of T4 into it, but I am glad I figured this out because I kept thinking the levo wasn't working and I needed more because I was desperate to feel normal. I don't know how anyone can go for months or years feeling that way and be a functional human.

I will let you know if this continues to be a successful routine for me. It might help some other people who have difficulty when starting levothyroxine.


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## Octavia (Aug 1, 2011)

Cool! I hope it's a good solution for you! Nothing to lose by trying.


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## my3gr8girls (Mar 18, 2016)

It appears that the nighttime regimen is working! Taking my levothyroxine at 10 pm is allowing me to sleep through the fatigue and fog and awake refreshed and able to deal with my responsibilities at work and at home. We'll see if it continues...


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