Hypothyroidism, or an under active thyroid gland, is treated by taking a daily hormone replacement tablet called levothyroxine to replace the hormone which your thyroid is not making enough of. The goal of treatment is to keep thyroid function within the same range as people without thyroid problems.

When should I take my thyroxine?

Levothyroxine works best when it is taken consistently and at the same time every day. It is important to note that there are a number of foods, medications and supplements that may interfere with its absorption. For this reason  the best time to take thyroid hormone is first thing in the morning on an empty stomach at least 30-60 minutes before food or drink. Caffeine, dairy products and fibre can all affect how much thyroxine your body absorbs.

What if I am taking other medications?

If you are taking other medications you should discuss the timing of thyroid hormone dose with your physician. Some medications and foods may interfere with the absorption of thyroxine causing people to need higher or lower doses of thyroid hormone if taken at the same time. We recommend you take your thyroxine at least 2 hours before or 4 hours after taking medications or supplements that interfere with its absorption. These include:

• Antacids
• Contraceptive pill and HRT
• Blood thinners
• Iron and calcium
• Some medications used to treat epilepsy or depression

How about taking it in the evening?

You may find taking your levothyroxine at night, ideally at least 3-4 hours after your last meal, may make it simpler to prevent your thyroid hormone interacting with food or other medication. Some people report feeling better when taking their thyroxine at bedtime, and appreciate the convenience of not having to wait for their morning coffee! This can also be a good option for those of you who have to take other medications early in the morning.

Switching between brands of thyroid hormone could affect your thyroid hormone levels – even if the dose is the same. That is why it is recommended that you stick to the same brand to keep your thyroid function stable.

Summary

Ultimately the best time to take your thyroxine is determined by many factors. The key to optimise your thyroid health is to maintain consistency, taking the thyroid pill around the same time and in the same way each day. It is best to discuss with your physician the timing of your thyroid medication that is most suitable for you and your individual circumstances.