How to Take Your Thyroid Medication Correctly (For BEST Results)

How to Take Your Thyroid Medication Correctly (For BEST Results)

Most Thyroid Patients Take Their Thyroid Medication Incorrectly

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I’ve been helping thyroid patients for years and this is an issue that is far more prevalent than it should be. 

What am I talking about?

I’m talking about how to take your thyroid medication

I do understand why many thyroid patients get it wrong, though. 

When you break down how to take your thyroid medication it can get complex rapidly. 

But it doesn’t have to be. 

Today we are going to talk about everything you need to know to ensure that you are taking your thyroid medication correctly. 

Why is this important?

Well, if you aren’t taking it correctly then you have no idea whether it is working or not. 

If you don’t take it correctly then you can’t blame your thyroid symptoms on anything else. 

And if you were to take it correctly, you might find that you see an almost immediate improvement in your thyroid symptoms. 

Taking your medication correctly ensures that the thyroid hormone that your body needs gets into your body from your gut which is no easy task as you will soon find out. 

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Follow these Steps to Ensure You are Taking Your Medication the Right Way

Before we jump in, please note that there are a couple of things you should be aware of. 

The first is that you MUST double check your medication. 

This may sound obvious but it is necessary! 

You would be surprised at the number of people who are taking a different medication from what was prescribed by their doctor because it was either changed by the pharmacist or because it wasn’t covered by insurance. 

Let me give you an example: 

Imagine that your doctor is trying to give you Synthroid so he/she writes you a prescription for Synthroid. 

You pick it up from the pharmacy and begin taking it. 

After reading this article you look at your prescription and notice that it DOESN’T say Synthroid and instead is labeled as levothyroxine

What gives?

Well, the pharmacy can change your medication without you knowing (1) if they believe that the medication is bioequivalent to another medication. 

And pharmacists believe that both levothyroxine and Synthroid are the same thing. 

Even though they contain the same active ingredient, how your body uses them can be completely different. 

So make sure that you are actually taking the medication that was prescribed to you by double checking your prescription bottle! 

The second thing I want you to know is that the information you are about to read applies to ALL thyroid medications. 

That includes medications like levothyroxine, Synthroid, formulations of NDT (natural desiccated thyroid), T3 only medications, and compounded T4/T3 medications

So regardless of the medication you are taking, you will want to follow these guidelines. 

Lastly, just do a quick double check on your prescription bottle to make sure that your medication isn’t expired and that your dose is correct. 

I’m serious. Go grab your prescription bottle and take a look at it. 

Once you’ve done that, then you can proceed!

#1. Take your medication either first thing in the morning or right before you go to bed

When it comes to WHEN you take your thyroid medication you actually have a couple of options. 

The first is either FIRST thing in the morning and the second is RIGHT before bed. 

You’ve probably been told that you need to take your thyroid medication first thing in the morning before you have breakfast, right?

This is pretty standard advice given to all thyroid patients by doctors and pharmacists and for good reason. 

The reason your doctor wants you to take your medication first thing in the morning is because by taking it then you will have a buffer between when you wake up and when you have breakfast. 

Taking your thyroid medication away from food is a good thing (which we will talk about below) but there’s nothing magical about taking your medication first thing in the morning. 

In fact, it may be the case that there is a benefit to taking it right before bed instead of first thing in the morning. 

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The reason for this isn’t exactly understood but we do know from medical studies that thyroid patients who take their thyroid medication in the evening experience better free thyroid hormone levels and TSH levels compared to those who take it in the morning. 

This is probably because of gut function and how it differs in the morning versus in the evening. 

In the morning your gut is more active which is why most people have a bowel movement when they wake up. 

If your gut is more active then your thyroid medication will spend less time in the gut which will lead to less absorption. 

If your medication is taken in the evening it will spend more time in the gut and, therefore, your body will absorb more of it as you sleep. 

You can find what works best for you but I have seen many thyroid patients see significant improvement in their symptoms simply by changing what time of day that they take their medication. 

#2. Take your medication at least 30-60 minutes AWAY from food (either before or after)

Perhaps more important than WHEN you take your thyroid medication is how you take it. 

This step is very important: 

You must take your thyroid medication on an empty stomach which means at least 30-60 minutes away from food and drink. 

You can take it before you eat or after you eat but just make sure that 30-60 minutes elapses in between these two events. 

The reason you want to do this is because foods, nutrients, and vitamins can all interfere with the absorption of your thyroid medication. 

You want to avoid any competition in absorption so that you can ensure as much hormone gets through your gut into your bloodstream. 

What about drinks?

The best way to think about it is like this:

Make sure that you take your thyroid medication away from any liquid that has calories. 

If it has calories and nutrients then these calories and nutrients may interfere with the absorption of your medication. 

Taking your thyroid meds with water is fine but try not to take it with milk or orange juice or some other liquid that has calories. 

#3. Take your medication at the same time each and every day – consistency is KEY

Another important element to getting the best results possible from your thyroid medication is consistency. 

You should plan on taking your thyroid medication at the same time of day each and every day down to the minute. 

The best way to ensure that this happens is to make it a part of your normal routine. 

If you create a habit out of taking your medication then you won’t forget it and you will ensure that you take it every single day. 

One way to do this is by linking it to something else that you are already doing every day and have been doing for years. 

Say, for example, brushing your teeth. 

You’ve probably been brushing your teeth for 20+ years each and every day. If you create a routine where you sit your thyroid medication bottle right next to your toothbrush with a glass of water then you are unlikely to miss it. 

And the chances are probably high that you are on a schedule and that you brush your teeth at pretty much the same time every single day. 

Try linking your thyroid medication to something that you are already doing such as brushing your teeth, checking your phone, going to the bathroom, reading a book, making your morning coffee, or something similar. 

Taking your thyroid medication in a consistent way will also ensure that your thyroid lab tests are accurate when they get checked which brings us to our next topic! 

#4. Do get your thyroid labs checked regularly to see if adjustments in your medication are necessary

You should be aware as a thyroid patient that your thyroid medication dose may change over the course of your life

One way to ensure that you are always taking the right dose of thyroid medication is to regularly get your thyroid labs tested

This is true even for those people who are already feeling great on whatever dose they are taking!

Don’t fall into the trap of thinking that because you are feeling great that you don’t need to get your labs tested. 

By regularly checking your thyroid labs you can be apprised of small and subtle changes in thyroid function that can be remedied before they become a big problem. 

How frequently you need to get your thyroid labs checked depends on where you are at in treatment. 

When you first get diagnosed with a thyroid problem you will want to check your thyroid tests every 6-8 weeks until you dial in your dose. 

Once your dose has been stable for a period of time and your symptoms have resolved, you can push back how frequently you get your labs tested to something like 3-6 months. 

If you’ve been stable for a long time then getting your labs checked every 6 months may be appropriate. 

If at any point you feel that your symptoms are returning don’t hesitate to pull the trigger to get your labs retested! 

Remember that things such as stress in your life, weight gain or weight loss, changes in your medical conditions, the addition or removal of prescription medications, and changes in your diet can all impact thyroid function and, therefore, your thyroid medication dose. 

#5. Do NOT take supplements at the same time as your thyroid medication, take them at least 30-60 minutes away from whenever you take your thyroid meds

If you are like many thyroid patients out there then you are probably taking something to support your thyroid. 

If you aren’t already then I would strongly recommend that you consider doing so because supplements can definitely help improve how you are feeling and how well your thyroid is functioning!

While taking thyroid supplements can be helpful for many people, they also have the potential to disrupt your thyroid medication. 

For this reason, you will want to take your thyroid medication at least 30-60 minutes away from any over the counter supplements that you are also taking. 

Do NOT take over the counter supplements at the same time as your thyroid medication. 

Your doctor and pharmacist will probably tell you that you need to wait 4 hours before you take your thyroid medication if you are also taking supplements but this is rarely necessary. 

It is necessary for two important supplements that we will talk about in just a minute but for most supplements, waiting 30-60 minutes is just fine. 

I’ve had the opportunity to test this out on more than 45,000+ thyroid patients who have used my supplements in this way and we haven’t seen any issue using this time frame. 

#6. If you are taking a dedicated calcium or iron supplement then make sure to take your thyroid medication 4 hours away from whenever you take these supplements

The 30-60 minute timeframe doesn’t apply, though, if you are taking an isolated and dedicated calcium supplement or an isolated and dedicated iron supplement. 

Both iron and calcium have been shown to bind to and inactivate thyroid hormone (2) found in thyroid medication. 

This isn’t an issue with absorption but rather an issue with binding between these two compounds. 

For this reason, you will want to wait 4 hours to ensure that your thyroid medication doesn’t run into either of these compounds in your gut. 

My experience suggests that the dose of calcium and iron matters which is why I specified an isolated and dedicated version of both in my above comments. 

In other words, if you are taking an iron supplement because you are iron deficient then you will want to wait 4 hours before you take your thyroid medication. 

If, however, you are taking a small amount of iron in something like a multivitamin then the length of time that you need to wait doesn’t need to be the full 4 hours. 

Most people are fine waiting 30-60 minutes when using low doses of calcium and iron, such as those doses found in multivitamins, without any issue. 

As always, your mileage may vary, though, so don’t be afraid to wait longer if you feel that you are having issues! 

#7. Do NOT take your thyroid medication with coffee or caffeine

If you are someone who takes their thyroid medication first thing in the morning then you need to make sure you do not take it anywhere near coffee or caffeine. 

Not only does coffee have a suppressive effect on thyroid function (3), it also increases your intestinal tract which can influence thyroid medication absorption in a negative way. 

This is true of anything that contains caffeine, by the way!

Including things like caffeinated teas, decaf coffee, energy drinks, sodas, and more. 

It’s best to avoid coffee if you have a thyroid problem but there are some people who insist that they need it. 

If you are one of those people then you should try to take your thyroid medication in the evening to avoid interference with your coffee. 

If taking your thyroid medication in the evening isn’t possible then you will want to take your thyroid medication before your coffee. 

Even though this isn’t the best option it’s still better than taking it after you have your morning cup of coffee. 

#8. Remember that not all thyroid medications are created equal – switch to a thyroid medication that has fewer fillers if necessary

It’s important to remember that not all thyroid medications are created equal. 

Your doctor may try to tell you that there is no difference between Synthroid and levothyroxine and while that is true from the perspective of active ingredients, it’s not true from the perspective of how well your body may tolerate it. 

If you find that, despite your best efforts, you just aren’t feeling well on a certain type of thyroid medication then don’t be afraid to switch to a different type, even if it’s within the same family. 

Using the example above, if you are taking levothyroxine and not feeling well then give Synthroid a try. 

Even at the same dosing, you might be surprised at how different you feel just by switching your medication. 

This effect exists for all thyroid medications and has to do with the inactive ingredients found in various types of thyroid medications. 

These fillers can cause reactions themselves, interfere with absorption, and seem to cause other issues for certain thyroid patients. 

This switching doesn’t just work with Synthroid to levothyroxine, though. 

It can be used for ALL types of thyroid medications. 

I’ve included a list of the 3 main families of thyroid medications below with options that you can swap to if necessary. 

Thyroid medications found within the same family include:

You should also be aware that some thyroid medications are just naturally cleaner than other medications due to their inactive fillers. 

The cleanest thyroid medications on the market include:

  • Tirosint (3 inactive ingredients)
  • Tirosint-sol (2 inactive ingredients)
  • WP thyroid (3 inactive ingredients)

#9. Make adjustments to your thyroid medication if you become pregnant

This section is really only important if you are a female but it’s worth mentioning!

If you become pregnant then you need to immediately increase how much thyroid hormone you are taking

Here’s why:

When you take thyroid medication your own natural production of thyroid hormone is suppressed as your medication takes over for what your body should be producing. 

This works out fine if your dose stays relatively stable but becomes a problem when you have a sudden increased demand for thyroid hormone in your body because your body can’t produce more thyroid hormone to meet that demand. 

Instead of counting on your thyroid gland to produce more thyroid hormone, you must meet that demand by increasing your thyroid hormone in your thyroid medication. 

Pregnant women have a big increased demand for thyroid hormone because of their developing child. 

The developing child needs thyroid hormone for proper development, especially of the nervous system and brain. 

For this reason, you need to be prepared to increase your dose of thyroid medication the day you find out that you are pregnant. 

How much you need to increase will vary based on what type of medication you are using and how your labs look but be prepared for a 20% increase all the way up to a 100% increase in your dose. 

Optimal TSH levels for pregnant women are different from those of the general population as well so don’t be afraid of taking more thyroid hormone if you are pregnant. 

#10. Do check to make sure your other prescription medications are not interfering with your thyroid medication

Another area that may cause issues with your thyroid medication is other prescription medications that you may be taking for other issues. 

Thyroid patients tend to have other medical conditions especially things like depression, anxiety, insulin resistance, high blood pressure, and high cholesterol. 

If you are seeing a doctor regularly and getting these things checked, then chances are probably high that you are taking other prescription medications in addition to your thyroid medication. 

What you may not know, though, is that some of these medications are notorious for causing thyroid problems either because they can interfere with your thyroid medication OR because they can interfere with thyroid function. 

Imagine taking a prescription medication like an anti-depressant only to find out that your other medication is causing problems with your thyroid medication. 

The problem might not be your thyroid medication but instead, something else that you are taking! 

And don’t count on your doctor to know all of these interactions. 

I’ve spent a lot of time researching to find these interactions and many of them were a complete surprise to me. With the sheer number of prescription medications available on the market, it’s not really possible to have a complete understanding of how they all interact with one another. 

But you don’t have to worry about that because I’ve created a list of medications that can cause thyroid issues. 

Check it out below: 

  • Acid blockers – Acid blockers can interfere with thyroid medication absorption and include medications like proton pump inhibitors and H2 blockers (4). These are commonly used for acid reflux and are available over the counter. 
  • Anti-depressants – Anti-depressants, especially SSRIs (5), can interfere with your thyroid medication effectiveness. If you are on an SSRI then you may need to up your dose of thyroid medication. 
  • Birth control pills – Birth control pills impact something called SHBG (6) (sex hormone binding globulin) and can impact how available thyroid hormone is in your body by binding to it. 
  • Diabetes medications – Diabetes medications, especially metformin (7), can impact your TSH levels. If you are taking diabetic medication make sure to keep an eye on your TSH and free thyroid hormone levels. 
  • NarcoticsNarcotics (8), all types, have a tendency to suppress thyroid function from the brain. This can artificially lower your TSH and make it look like you are getting enough thyroid hormone when you really aren’t. 
  • Beta-blockers and other blood pressure medications – Blood pressure medications, especially beta-blockers, can block thyroid hormone function in your peripheral tissues. Some of these medications are used to treat hyperthyroidism (9)! 
  • Cholesterol binders – Some types of cholesterol medications work by binding cholesterol in your GI tract. These binders can also bind up thyroid hormone medication and reduce absorption. 
  • AntacidsAntacids (10) can block thyroid medication absorption much like acid blockers. 

If you are taking any of these medications then make sure to talk to your doctor about other alternatives!

Switching from a medication that negatively impacts your thyroid may improve your overall health as you improve thyroid function. 

Remember:

Your thyroid helps to control and regulate important systems like your cholesterol

As you improve thyroid hormone you might find that you really don’t need your cholesterol medication after all! 

#11. Be aware that medical conditions can also impact your thyroid medication. 

Not only can your medications impact your thyroid medication but your health problems can as well!

Certain medical conditions, especially those in the gut, create a scenario in which absorbing your thyroid medication will be very difficult. 

Some conditions which may impact your thyroid medication include:

You will notice that most of these diseases originate and cause problems in the gut but some cause problems in other organs which are important for thyroid function. 

One such organ is the liver. 

Your liver is responsible for the majority of T3 production, via thyroid conversion, floating around in your body. 

Any damage to the liver may slow down this process and, therefore, cause thyroid problems. 

Nowadays, obesity is one of the most common causes of liver dysfunction! So if you are overweight make sure you check on your liver function tests. 

Treating or managing these conditions may indirectly improve your thyroid function as well as how effective your thyroid medication can be. 

Wrapping it up

This may seem like a long and complex topic but it’s so important for thyroid patients to understand! 

There are many levels at which your thyroid medication can be negatively impacted and each of these may result in persistent hypothyroid symptoms even though you are taking your medication faithfully. 

Please spend some time on this article and figure out which areas you can improve upon. 

As you make changes to your lifestyle, when you take your thyroid medication, and other areas, you should see an improvement in how you are feeling. 

And that’s really what’s most important. How you feel. 

The whole point of doing these things is to help YOU feel better!

Now I want to hear from you:

Were you aware of these things that can impact your thyroid medication?

Did any come as a surprise to you?

Or are you a thyroid savant and nothing surprised you? 🙂

Are you planning on making any changes to help improve your thyroid medication?

Let me know in the comments below! 

#1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822816/

#2. https://pubmed.ncbi.nlm.nih.gov/28155174/

#3. https://pubmed.ncbi.nlm.nih.gov/6104718/

#4. https://pubmed.ncbi.nlm.nih.gov/25040647/

#5. https://pubmed.ncbi.nlm.nih.gov/19583486/

#6. https://pubmed.ncbi.nlm.nih.gov/32219692/

#7. https://pubmed.ncbi.nlm.nih.gov/28196954/

#8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922854/

#9. https://pubmed.ncbi.nlm.nih.gov/18193813/#:~:text=Beta%20blockers%20are%20widely%20used,resection%20of%20the%20thyroid%20gland.

#10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070767/

#11. https://pubmed.ncbi.nlm.nih.gov/22340926/

#12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4130840/

#13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4787146/

#14. https://pubmed.ncbi.nlm.nih.gov/22933169/

are you taking your thyroid medication the right way?

Dr westin childs photo

About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 70,000+ people have used them over the last 6 years. You can read more about my own personal health journey and why I am so passionate about what I do here.

P.S. Need more help? Check out my free thyroid downloads and resources.

56 thoughts on “How to Take Your Thyroid Medication Correctly (For BEST Results)”

  1. Help! I have a generic question….if someone had labs like this…
    free T4…. 1.0 out of .8-1.8
    free t3….. 2 out of 2.3-4.2
    TSH 1.53….. .40-2.91
    Reverse T3… 12 out of 8-25
    Does that warrant starting thyroid meds? Also with above range high cortisol at all four points. I’m sure it would not be advised to start thyroid meds unnecessarily. But desperate to know (before Friday!) if it would be advised. Thank you so much!

    Reply
    • I forgot to mention…no thyroid symptoms are present other than anxiety. So if the question above is too specific…. Can thyroid meds help with anxiety? Which thyroid med and what dose is best for relieving anxiety. After a lot of conflicting info, I’m a little desperate to hear from you since you’re the expert!! Crossing my fingers that you are able to respond. 🙂 Thanks!!

      Reply
      • Hi Donna,

        Thyroid medication can sometimes improve anxiety, depending on what caused the anxiety. But in the absence of other thyroid symptoms then it’s probably unrelated.

        Reply
        • Ok! So are you saying it would NOT be a good idea to start thyroid meds? Without symptoms except anxiety, Do those LABS above indicate hypothyroid and a need to start meds? Facebook groups say yes… I’d love clarification on what you think before I have to ask doctor about it this Friday (tomorrow!) Antibodies used to be 130 but now they are 0 after going gluten free. But don’t I need meds to increase that T3???

          Reply
          • Hi Donna! Is your Free T3 below range?? I’m not a doctor, but everything I’ve read says you want it to be in the upper quartile of the range. However, the symptoms are what really drive folks to take meds. Common symptoms would include fatigue, low energy, brain fog, poor concentration, forgetfulness, unexplained weight gain, miscarriages/infertility, drying crepey skin, hair loss and lower temp/feeling cold.

  2. Hi after reading your article I’m going to try and take my levothyroxine before I go to bed. It will be better as it will be easier to keep it to the same time as you recommend. However as I currently take it about 7 am should I take the next dose the same evening or the following evening. My doctor has me on alternate days of 125 mcg and 150 mcg of levothyroxine. Is this ok? I’ve been on this for about 3 years now.
    Thanks
    Carol

    Reply
    • Hi Carol,

      Many people have an alternating schedule with their medication and it can work. I don’t really love that method of dosing but it can work for some people.

      Reply
  3. I was diagnosed with a dead thyroid I take levothyroxine 50 mg.i always feel tired with no energy, and eating always makes me want to take a nap. Perhaps taking my med before bed will help

    Reply
  4. If you can stand it, does taking sublingually improve absorption? We just adjusted my medication downward and I feel great, but my cholesterol has gone up?

    Reply
  5. I’ve been taking levothyroxine for about 5 years. I was also taking liothyronine. I was losing weight, my rate of hair loss had slowed. I moved across the country and my new doctors took me off of the liothyrinine. I gained back the weight & my hair loss increased again. I have a doctor appointment later this month. I noted on my calendar to ask him about switching to Tirosint capsules after reading your article. I take atorvastatin & montelukast medications at bedtime. How long should I wait after taking these to take my thyroid medication?

    Reply
  6. Dr Westin,

    I take Levo 25mg (x6 wks) and liothryroxine 2.5. I take both in am, but af get reading this article I see I should wait a little longer before I eat. Here’s my question…. I am also on metformin 500 in am and Ozempic .5 weekly. Ozempic slows gastric emptying. How does this fit in the equation related to daily absorption of thyroid meds? My rT3 was still elevated after 3 months on t3 med and just about ready to retest after adding levothyroxine. THANKS!

    Reply
    • Hi Suzi,

      Slowing down the intestinal tract may actually help with absorption provided that the medication doesn’t impact gastric enzyme production.

      Reply
  7. I take desiccated thyroid hormone (canada) 90 mcg divided in two doses 60 in the morning and 30 in the afternoon
    It’s tricky to take away from everything
    Can i take all 90 in the morning and be done with it for the day?

    Reply
    • Hi Marie,

      Most people would have no issue with that dosing schedule. You may be someone who is sensitive to T3 but you’ll need to experiment to figure that out.

      Reply
    • I am hyperthyroidism patient. I take CARBROID TABLET, but when I take like 2months, I won’t be able to sleep in the night and I loose weight a lot. My question . What is the actual problem with my sleep and why am I losing weight?

      Reply
      • Hi Akinyemi,

        I would say most likely because your dose of anti thyroid medication is not high enough to suppress your thyroid so you are still hyperthyroid.

        Reply
  8. I just finished radiation for breast cancer. I told my oncologist that I thought my T3 was off so he did labs. My T3 RIA total was 72; T4 Free was 1.60 and mt TSH was .764. I have been on levothyroxin.100 mcp for years. He prescribed nothing for my T3 but upped my levothyroxin to .125. Everything I’ve read, it will increase my T4 and do nothing for conversion. What would you recommend.

    Reply
  9. Thanks for the info, Dr. I may try taking it at night again. I didn’t feel a difference. But is there ever a time when taking only T3 is ok? Sometimes I feel like Tyrosint makes me bloated and gives me palpitations. Taking T3 alone will always show up too high on a blood test but I just feel better without T4. Is that problematic?

    Reply
    • Hi Latonya,

      Yes, there are many people who do well on just T3 medication (without the T4). Having a high free T3 level is not necessarily problematic but it could be, depending on the situation and circumstance.

      Reply
  10. What about T3 stimulation with NP thyroid? Won’t that mess up sleep? Have you had any experience or any info on this?

    Also, how does one make the switch from taking it in the AM to taking it at night? Do you take a second dose of the day in the evening or do you skip that evening and take it the next day (>35 hr between doses)?
    Thanks!

    Reply
    • Hi Nora,

      Yep, tons! I’ve had patients take T3 medication combined with NDT or by itself at night without any issue. Rarely, some people do have issues but I would say it only happens in about 5% of people.

      Reply
  11. I was put on compounded T3/T4
    ME4M 57/13.5 MCG.
    I’ve been losing my hair consistently for 2 years. Labs are “normal”. My hair loss is not normal. Please advise.
    Thank you!

    Reply
  12. I had recently seen a video on taking your thyroid medication at night. I’m just seeing any improvement in my symptoms even though my levels are therapeutic. I work nights but have decided to try taking it at night.
    I’m also going to order the complete set of the thyroid supplements.

    Reply
  13. Hi Dr. Westin,
    Today is my first day of taking Levothyroxine 50 mcg, 6 months after my thyroid ablation. Last lab test finally showed TSH normal, T3 & T4 slightly low than normal. I don’t really feel fatigue, but I was losing hair and had problems with sleeping. I will take the levothyroxine at bedtime as you advised. My question though is I work night shift so consistency in taking the medication at bedtime will be challenge. Shall I be consistent with time of bedtime (night time) or should it be my bedtime (morning) if I come from night shift work? I want this medication to work. I’ve also been taking your supplements T3 conversion booster and the thyroid/adrenal support capsules. I usually take them before I go to work, so I should space out the levothyroxine 30-60 mins after those supplements? Appreciate your response.

    Sincerely, Lee

    Reply
    • Hi Kelly,

      I suppose you can make the argument that it could impact your medication but that’s not really how you want to think about it. Instead, you want to think about EBV impacting thyroid FUNCTION, not thyroid medication.

      Reply
  14. Dr Westin,
    Great read! I never really understood why the Armour had to be taken a certain way, this helped. I intermittent fast so I take it at 745am but don’t consume anything besides water until 10am. It’s good to know this is plenty of time to absorb. One question. I was told I could dissolve Armour under my tongue for “better absorption”, is that something you know to be accurate?

    Reply
    • Hello Dr Childs!
      I cannot tell you how thankful I am for your blog posts and advice. You’ve helped me so much!
      I do have a question after reading this article
      I currently take 88mg tirosint-sol and 30mcg generic liothyronine upon waking in the am. I’d like to switch to taking them at night
      I also take 4.5 mg low dose naltrexone at bedtime. .
      1) Can I take the tirosint and liothyronine at the same time as my LDN (at bedtime)?
      2) will taking the liothyronine at night keep me from falling asleep or staying asleep? Should I split the dose between waking and bedtime? Keep the whole dose in the morning?
      Thank you in advance for your help!
      Erin

      Reply
      • Hi Erin,

        Most people have no issues taking T3 at night and you never want to take any medication or supplement at the same time as your thyroid meds.

        Reply
  15. Hi , I take .75 lev one day and .88 the next for years
    I take it 1 hr before breakfast and my coffee
    Should I take my coffee longer then 1 hr longer
    Richie k
    Thank you for all the info very informative

    Reply
    • Hi Richie,

      It’s best to take your thyroid medication as far away from coffee as possible. The best case scenario is that you don’t consume coffee at all.

      Reply
  16. Dr Westin,

    Thanks for being there! I’m currently on compounded WP thyroid. Does it result in two doses on the switch day, one in the morning and the other at bed time? Would it be necessary to skip the dose on the night before lab work when taking thyroid meds at night? My doctor likes a “fasted” blood draw, especially when he orders comprehensive lab work. Also, does it really matter if one is fasting for thyroid lab work?

    Reply
  17. Dr Westin
    I take Levothyroxine Sodium 50 mcg at the same time every morning. I’d like to make a change and try taking the medication in the evening. What is the protocol for making that change please.
    I can’t remember how I discovered you online, but I’m so grateful that I did. I enjoy all your valuable information!
    Dee

    Reply
    • Hi Dee,

      There really isn’t a protocol for changing, you’d just make the switch one day and then that would be your new dosing schedule.

      Reply
  18. Hi thanks for the article can I ask I am on NDT Erfa currently take 9am and 3pm could I then take say 12 mid day and 12 midnight as that is usually when I would go to bed or is that too long between doses its 1 grain each dose or can you suggest better timings to take the doses thanks for any advice.

    Catherine

    Reply
    • Hi Catherine,

      I can’t provide medical advice but I can tell you that it would be worth playing around with your dosing to see what works best for your body 🙂

      Reply
  19. Hi Dr Westin interesting read I am going to try taking my Levo at bedtime rather than an hour after my early cup of tea in bed then wait another hour till breakfast. I have a question: I only take MarcuryPharma which is hard to come by in all dose boxes. Found a chemist that can give it but he also wants to gave me a box of Eltroxen which he says is exactly the same as MercuryPharma, same box. After your comment on Synthroid not being the same as Is thought of a similar type. Do you know if this?
    Enjoy your informative newsletters.
    Many thx
    Vanessa from UK

    Reply
  20. Dr. Westin,
    Thank you for the information about not drinking coffee with thyroid medication. You also mentioned to avoid other things like caffeinated teas, decaf coffee, energy drinks, sodas. Does this also include cacao and cocoa powder???

    Reply
    • Hi Eva,

      You really don’t want to take your thyroid medication near any type of food or drink (water is the exception).

      Reply
  21. Hi. I take NDT divided into 2 daily doses. Was recommended to try to divide to 3 daily doses. I was under the understanding that NDT should be taken 2 hours after food and one hour before (I believe that’s what it says on the Naturethroid site). This would make 3 times a day dosing tricky. Just want to clarify why you say 30-60 minutes away from food is sufficient?

    Reply
  22. This is great. Can you PLS do a video about the impact of Covid on people with hypothyroidism? My son has congenital Hypothyroidism and I need to explain to someone in the family why we need to be extra cautious as I’ve read that Covid can interact with the thyroid. Please please blog or do a video on the risk to thyroid patients because it seems like it really hasn’t been talked about much and most endocrine sites seem to minimize the risk and impact–but some studies I’ve read look concerning. Thank you!

    Reply
  23. Hi Dr. Childs, I love your articles and have learned so much! I was really excited to try Nature-Throid, had my doc look it up. It evidently has been completely pulled off the market. Hope it comes back soon.

    Thanks for all you do,
    Suzanne

    Reply
  24. Am hyperthyroidism patient. I loss weight a lot despite that I use my medication regularly.
    Pls which supplement should I use to gain my weight back.

    Reply

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