How should thyroid medicine be taken? I helped answer that reader's question last year. Well, new research backs up my response. As someone who takes levothyroxine, I found this new research comforting. Thyroid medication can be taken in the evening instead of the morning. Most folks are taught to take their thyroid medication in the morning on an empty stomach and to wait at least one hour to eat after taking their pill. Eating breakfast can be difficult with this rigid regimen.
A new prospective randomized crossover trial in the Archives of Internal Medicine (Arch Intern Med 2010;170:1996-2003) suggests that taking levothyroxine or Synthroid on an empty stomach at night is just fine and free thyroxine levels actually increase with this practice. As an added benefit, patients don't have to wait for breakfast! While thyroid levels improved, hypothyroid symptoms didn't. Now, hypothyroid patients can enjoy an uninterpreted life at the breakfast bar once again. Between eating breakfast and not eating late at night, taking thyroid at night might be considered an effective weight loss strategy as well.
As someone who has taken levothyroxine every morning now for almost three years, I'm thinking about switching to the night time dosing, so I too can return to enjoying the free doctor's lounge granola with blueberries and milk that I used to devour every morning during my morning checkout rounds years ago. Perhaps night time levothyroxine dosing might even improve patient satisfaction surveys if I'm not stopping to have a 10:30 lunch instead of doing my discharge rounds on a full breakfast belly. On second thought, I don't think it would make any difference.