Some mornings I forget to take my thyroid meds before I eat. How must I wait before I can take it or must I wait till the next day
Synthroid - How long after I eat must I wait to take thyroid meds if I forget to take it?
Question posted by EmilyS86 on 28 July 2014
Last updated on 13 July 2021
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19 Answers Page 2
Charvi3
2 Feb 2015
I was waiting in the morning then wait 4 to 5 hours after... but, the Pharmacist
said yesterday... that when your stomach is empty... take it in the morning and wait an hour or two... on an empty stomach... it will absorb... quicker...
snoozie55
18 Feb 2015
My mother-in-law's doctor switched her thyroid med from morning to night and found it much more effective. I've read research on it to see if I could switch to night because of morning meds and vitamins that interfere with my thyroid med. I would have to wait more than four hours to take these other meds after taking my thyroid med. There are articles on the research that had been done - I've switched my med to night time. The key is to not have eaten anything for two hours or more before taking it. I actually feel better after taking it at night. Each doctor may have reasons for recommending a certain protocol. The best thing to do is to consult with your own doctor.
Kjoyner471
27 June 2015
My pharmacist just told me to take my meds in the morning before I eat.
Tlynne727
27 Sep 2015
I just had a total thyroidectomy and my doctor told me to take my Synthroid at bed time. I am extremely Hypo and certainly hope it helps soon.
LSLEDGE34
2 Feb 2015
take your dose as soon as you remember it
endlessPred
6 Sep 2014
Emily. You are not getting proper dosing by taking it later in the day. Only part metabolizes. Rather, you need a routine to help you remember. Kids can not be the excuse. Have it right next to your bedside or a safe place with a glass of water and take as soon as you wake up. Hopefully before you get out of bed. Young kids might get into it, so I hope it is kept safe from little hands. Once you develop the habit your health will be constant and you will feel better. Ok? Make a habit of it. And no coffee or other beverage, only one big glass of water when you take it and wait the half hour before eating or other liquids. All,those things affect the medication. This is life long and the habit will keep you stable. Good luck with your scheduling.
Readhead
22 Sep 2014
This is absolutely untrue, my Dr. Recommended I take it at night. in fact there is quite a bit of medical lit. out there that that says taking at night enables it to be absorbed more readily.
endlessPred
4 Oct 2014
I don't know where you got that information. I would be happy to review the medical,literature you got it in. The reason for first thing in the morning is because the stomach is totally empty and the medication can be absorbed quickly. Certain foods can prevent absorption or interact with the medication. Please don't yell at people until you can site your sources.
Readhead
4 Oct 2014
Your stomach empties approximately 2 hours after eating, so as long as you don't snack late evening it's fine. I initially got my info. On medical sites and read meant blogs where people had researched it and felt better taking it at night. I then asked my Dr. If she felt there was a problem doing so and she said it's absolutely ok to do so. It actually is absorbed better because you poop less and don't eat for many hours. It's an individual decision. I think your unrelated instructions to her about her children's safety as well as your entire tone is condescending and out of line.
endlessPred
4 Oct 2014
Dear Readhead. This is not the place to criticize. I asked for where I could read this information from you. Anyone who knows me knows I do plenty of reading. The conversation is a much longer string of information.
If you allowed private discussion on your site, we could clear this up. My doctor, chief of Endocrinology says that the morning works best for the reasons stated. Many people have night time medications to take with food, or drink something. This way there is consistent use of medication and he doesn't need to find out six months later that numbers are off because the person started new eating habits or medications and didn't have a clue of how it affected their night medication taking. This is about human behavior. Not everyone studies. That is why we have the site. Change your settings and private message me, ok?
Readhead
4 Oct 2014
This is my last entry. I have absolutely no desire to further this discussion, nor to justify my research, which says the meds can be effectively taken morning or night and many patients have have done both or either and prefer night, with approval from their physicians. I don't care when anyone takes their meds if they're satisfied and it works and don't understand why you feel such a strong need to both insist your preference is the only correct way as well as instruct a mother on keeping her children safe from ingesting her meds and self care. I believe you mean well, but she asked a simple question, not a digression on proper parenting or self care.
SPARKLER19348
15 Oct 2014
Like it or not Endless Pred your info... is not exactly correct and yes, I agree it sounds condescending... thyroid drugs do not have to be taken in the a m... you can take them when they work best for you... the whole lecture about the kids thing was totally unwarranted... you need to do some reading... some of us feel a lot better taking it before dinner...
Readhead
18 Oct 2014
Sparkler19348,
Your comments are right on. I'm sorry I allowed myself to become so annoyed at endlessPred, but getting into a dissertation, with a another patient, as if she and I are medical professionals, of studies justifying what I was told and also read on the pharmaceutical site, appeared an attempt to enlarge a simple question into a never ending discussion. As long as tests show that the medication is working, there needs to be no discussion, if it isn't, her physician will certainly have the appropriate discussion with her.
BBB1958
31 Dec 2014
My doctor told me that it may be best for me to take at bedtime too because I generally forget and drink coffee first thing in morning. I trust my doctor and will follow her advice.
Charvi3
4 Jan 2015
First of all... You need to take it on an empty stomach... so, I take mine early in the morning around 4 to 7 in the morning... and then since a lot of foods contain Calcium... which if you don't wait at least 4 to 5 hours after you take it... the Thyroid medicine will not absorb into the system right... if you take it a couple of hours after you take it... the same goes for taking Calcium and Vitamin D combination... you need to wait at least 4 to 5 hours... to make sure your body absorbs the Thyroid Pill... believe me... otherwise you will not lose weight... and you will not see a difference... also... in those Thyroid Pills is a dye that contains... Sulphur... so people that have allergies to Sulphur be careful to have your doctor to notice that factor... so, I take the 50 MCG of Synthroid that is the only amount... that does not contain Sulphur within the dye of the pill... be sure to all of you that have an allergy to, Sulphur, to say something to your doctor...
Charvi3
4 Jan 2015
Always remember... Calcium is in most foods and will prevent the absorption of Thyroid Pill because of Calcium in most foods so in order for it to get absorbed.. you need to wait for 4 to 5 hours to eat... and again... people that are allergic to Sulphur... better just to take the 50mcg of Synthroid all of the other Thyroid medicines... have Sulphur within the dye of the Thyroid Pill...
Retnemmoc
22 Jan 2015
You are completely wrong ... if you're a medical professional, they you're a dinosaur who doesn't keep up on new research studies.
1 small & 1 large follow up study have confirmed that night it better; see here:
The 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.
Retnemmoc
22 Jan 2015
Forgot to mention; my prior comment was directed toward endlessPred who incorrectly advised a commenter that taking thyroid meds in the am is better; this is completely incorrect; get your facts straight before you starting giving out medical advice:
Just to be clear; taking thyroid meds is better at bedtime!
2 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.
oldiegirl
25 Jan 2015
I don't consider endlessPred reminder of medication/kids as condescending. I took it as a reminder. Being in the medical field we get used to doing reminders. We don't mean it as condescending, we are taught to give the reminders, big or small, no matter how the advice my seam to someone else.
Anyway one should always consult their own doctor and take the recommendations after discussing their daily lifestyle. Such as: do they work days, nights, do have to have food in their stomach because of because of another medication, etc.? Some will need to take the medication at night, some in the mornings. Foods, antacids, calcium, iron supplements 'can', (not always but 'can') effect the absorption of the medication.
Manufacture recommends "Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose".
LSLEDGE34
2 Feb 2015
you can take it either morning or night as long as you take it around the same time every day
Deenasao
16 June 2015
EndlessPrep, your original post was incredibly condescending. "Kids cannot be the excuse" "I hope that it is kept safe from little hands" "... you will feel better, ok?" It rubbed me the wrong way.
Bigbear1480
9 Sep 2015
Thanks!!!
My mom was on Synthroid from age 25 till,she died at 73. It was the first thing after waking. But even with 4 kids, that was her priority. I was diagnosed at 14 - 1964. But I had severe anxiety disorder and they wrote me off as a psych case. Now I'm 65 with a stapled stomach. Starting in 8 hours I'm back on Synthroid for good - the rest of my life. I pray I can get better. It's been horrible! I can't swallow right. I have to see my endocrinologist SOON!
Thanks for your helpful advice. I pray I get well!
eidlhuber
10 April 2016
As instructed by my doctor I take it at night. According to my doctor and the pharmacist and most information I have read recently taking this medication at night seems to work better, at least for a lot of people
Bellefonte Sean
7 Dec 2016
Not to stir a pot that appears to have settled, but...
I found the study that Retnemmoc referenced above. The conclusion is that Synthroid should be taken at bedtime:
"Compared with morning intake, direct treatment effects when levothyroxine was taken at bedtime were a decrease in thyrotropin level of 1.25 mIU/L (95% confidence interval [CI], 0.60-1.89 mIU/L; P < .001)"
Since this CI doesn't contain 0, then the mean difference in TSH is significantly less than 0.
Later in the paper, however, I read this:
"To calculate the sample size, we assumed that a difference in thyrotropin level of 1.0 mIU/L between morning and bedtime ingestion of levothyroxine would be clinically relevant."
Unfortunately, the CI from above contains 1 (which is the "clinically relevant" difference), so that CI, in actuality, *doesn't support the claim that TSH levels dropped significantly (it shows a SS difference from 0, not 1). I'm not saying there isn;t evidence; perhaps with a larger sample size (and, hence, more power) there'd be a significant drop - but, in this case, "statistical significance" doesn't equate to "practical significance".
Another question - why "1"?
UrTrashGetOut
14 Aug 2017
EndlessPred you sound like a bitch
Ledzepchick
22 Aug 2017
I've been taking meds in day, TBH it hasn't worked for me. As of last night I will take them at night, judging from the excellent day I had today. You may find it suits you best.
Deymurah
30 Dec 2017
He is correct. Nightly doses do not work. I had struggled with daily doses and started taking it at night. I had read the many online articles to support it. After gaining ten pounds and feeling more out of sorts than ever I asked my PCP. My physician said the reason it stopped working was because my body needed a 6-8 hour fast to be able to absorb the drug. I am back on track and my weight gain is slowly going down. Trust you PCP. You need a long fast with this drug. I learned the hard way!
Dink69
21 Feb 2018
My specialist & pharmacist both said it was very important to only take it in the morning, on an empty stomach. I used to take it at night and once I switched over to early mornings I saw a huge change in the way I felt. I couldn't believe the difference between taking it at night & first thing in the morning. I highly recommend taking it as soon as you wake up. I have it set up next to my bed, with a bottle of water. I put my cell phone with it so I never forget to take it.
dballard31
10 July 2018
I am on Armour and take at night. I have no problems
JUSTQUEENB62
23 July 2018
This is exactly what my doctor told me as well.
kaismama
28 July 2014
You should wait 2 hrs after you eat.
EmilyS86
28 July 2014
Thanks. I have three kids. A lot if time I forget to take it but now I know I just have to wait a few hours.
suzieq6334
8 Jan 2015
Taking at night improves absorption of levothyroxine. Read the information on the link above and also do a web search of whether taking it in the morning or at night is best. Night dosage was almost a unanimous choice by most medical sites!
dsouter
29 July 2015
I take my synthroid first thing in the morning and it is increasing my appetite. I am always hungry. I am going to try and take it at night.
annihaha
15 May 2018
Suzieq6334 Thank you so much for that link. I have absorption problems because my gall bladder was removed. My TSH is at 10 and I believe it's because I have no gall bladder. I started taking my meds at night two nights ago and am already starting to feel better.
Related topics
synthroid, underactive thyroid, thyroid disease, hashimoto's disease, thyroid
Further information
- Synthroid uses and safety info
- Synthroid prescribing info & package insert (for Health Professionals)
- Side effects of Synthroid (detailed)
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