One of the very first questions I asked when being placed on thyroid medication by my GP was “when do I take it?”

My doctor at the time told me it was to only be taken first thing in the morning – at least 1 hour before eating/drinking anything.

Now this statement looks ok in writing, but trying to physically do it is a whole other story. Am I right?

Remembering to take a blasted tablet on waking AND THEN not eating for at least an hour…..not so easy. I would find myself completely forgetting to take it some mornings, only realising I hadn’t when I was absolutely starving and sitting down to breakfast. This process caused A LOT of stress for quite a few years, as I would find myself waking earlier and earlier in an anxious state just to take the damn tablet. Talk about sleep disruption!

Something had to change.

So I began the journey of looking into the positive (and negative) aspects of taking this pesky, albeit important, little tablet at night.

You see, I personally eat dinner early and rarely eat after 8pm (at the latest), so by the time I jump into bed - about 2 hours later - I’m good to go digestion wise.

The key factor I found out was taking thyroid medication consistently. Meaning, the same time of day, each and every day away from food. What I did struggled to find were any studies showing that taking the medication in the morning was THE ONLY WAY to take it.

The Clinical Endocrinology Journal states that taking the same dose of thyroid medication at bedtime, as compared to first thing in the morning, might actually be better as it results in "higher thyroid hormone concentrations and lower TSH concentrations". Basically meaning - better absorption of the thyroid medication when taken in the evening.

The research suggested several explanations for this result, including:

That consuming breakfast, even after waiting the recommended hour, still may interfere with the absorption of thyroid medication.
Bowel elimination is slower at night, meaning it takes longer for the medication to transit through our system allowing better absorption of the medication.
The conversion process of T4 to T3 may be more effective in the evening.

So, I’ve been giving it a go, because for me personally:

It’s so much easier and way less stressful than the worry and anxiety that comes with the morning routine.
It’s much easier to avoid taking the medication when eating or taking other supplements (especially calcium, iron and high fibre foods that can interfere with thyroid medication absorption).
The possibility (no matter how slim) of my body converting more T4 to T3, is worth the try alone.

In fact, I’ve been giving it a go for over a year now with no adverse effects on any blood test results, no additional symptoms AND less stress on a morning.

Please note - this study I mention above was conducted with levothyroxine -- a synthetic form of the long-acting T4/thyroxine thyroid hormone. Always first ask your doctor or holistic specialist before changing anything.

Oroxine - when to take it?