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Should You Take Your Thyroid Medication at Night?

Studies Show TSH Levels Lower When Levothyroxine Taken at Bedtime


Updated June 18, 2014

Taking levothyroxine at night may improve TSH, Free T4 and T3 levels.

Taking levothyroxine at night may improve TSH, Free T4 and T3 levels.

Anecdotally, some thyroid patients have reported improvement in symptoms when taking some or all of their T3-based thyroid hormone replacement medications in the evening. But some thyroid patients also find that if they take a medication with T3 later in the day or in the evening, the slight stimulatory effect of the T3 medication can make it difficult to sleep.

So keep in mind that while it's very possible that if a similar study were conducted with T3 drugs, the results would be similar, there is some chance that it would impact sleep quality in some patients. Only make such a change after discussing it with your doctor.

Optimally, some doctors have suggested that patients who take medications use a time-released or sustained release formulation of T3, or T3 split their doses. This approach seems to minimize sleep interference.

Again, if you do make a change to how you take your T3 thyroid medication, you'll want to have a reevaluation of blood levels and symptoms after several weeks, to determine if you need to adjust the dosage or timing of your medication.


Bolk, Nienke MD; et. al. "Effects of Evening vs Morning Levothyroxine Intake: A Randomized Double-blind Crossover Trial." Archives of Internal Medicine. 2010;170(22):1996-2003, Vol. 170 No. 22, Dec 13/27, 2010, Clinical Endocrinology 66 (1), 43-48, Volume 66, Issue 1, pages 43-48, January 2007

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