In the US, around 12 percent of the population is estimated to have some kind of thyroid complication, once in lifetime. This makes it a relatively prevalent condition, with impact on life in multiple ways. Various medications are part of the treatment options including Levothyroxine, synthetic T4 hormone used in treating hypothyroidism. Treatment options include medications that are prescribed alongside surgery, and in some instances – radioiodine therapy.  Patients and caregivers often have a doubt about usage of thyroid medication – should you take your thyroid medication at night? Following subsections offer in-depth details about thyroid medications and answer the above question.

Overview of thyroid medication

As outlined above, Levothyroxine is used to treat conditions wherein the thyroid gland is unable to produce the required amount of T4 hormones.  As a result of this, various symptoms manifest – for instance, overall weakness, spike in heart rate, effects on skin and hair, apart from depression. Individuals diagnosed with hypothyroidism also end up with cramps in the muscle, possible constipation, and sudden increase in weight, apart from impact on memory retention capability. Various actions in the body are linked to thyroid hormones and this makes it essential to ensure that the release of hormones is regulated to ensure the right amount.

Mechanism of action

The medication that replaces the deficiency is chemically identical to the T4 that is naturally secreted. The outcomes include increase in metabolic rate, and is also converted to T3. Upon release, it is secreted into the blood, and following a process of deiodination, it forms T3 that is known to trigger various actions.  The hormone is known to be important in infants and fetus for tissue development and growth. This includes the bones and the brain. The hormone helps regulate brain function, apart from food metabolism in adults. It is known to have an effect on the temperature of the body also. Individuals diagnosed with lower levels are known to suffer from conditions such as less energy levels, sudden increase in weight, loss of hair and abnormal sensitivity to cold climate. Individuals are also end up undesirable effects on speaking ability.

Should you take your thyroid medication at night?

With the basic information about the medication in place, it is time to answer the above question. The answer is affirmative. Thyroid medication can be taken at night, subject to an important condition. It is to be taken on an empty stomach.  The reason is pretty simple – absorption. When thyroid medication is taken on an empty stomach, it is absorbed fully, whereas food in the stomach impacts the absorption levels. The main purpose of recommending intake in the morning is to ensure that the medication is taken on an empty stomach. Typically, patients are advised to take the medication in the morning about an hour or thirty minutes before breakfast.

However, the intake can be at night; provided it meets the same criteria – empty stomach. The ideal way to achieve this at night, is to take the medication three hours after the last meal. In other words, it is to be taken three hours after dinner. It is also important to note here that thyroid medications are likely to have an impact on other drugs. The possibility of patients being on other medications is high when thyroid related issues have been diagnosed. It is therefore necessary to bear in mind that the medication is not to be taken along with other medications. The medication is also to be taken at the same time every day, for optimal efficacy.

Undesirable effects if food is consumed after intake of the thyroid medication

Individuals who consume food right after the medication are most likely to end up with poor absorption of the drug. Studies indicate that the absorption levels may be impacted by as much as 20%, when compared with empty stomach intake. Certain food products are also likely to have an impact on the medication. For instance, coffee and dairy products will negatively impact absorption levels of thyroid medication. Other products that may have undesirable effects include walnuts, and soybeans. Food products that are classified as high fiber content are also to be avoided, as this could have an impact on absorption and eventual efficacy. One variety of fruit is also known to have an adverse effect – grapefruit and grapefruit juice. It is therefore necessary to stay off these food products during intake of medication.

Comparison of thyroid medication intake in the morning and the evening


Ideally, thyroid medications are recommended to be taken an hour before the first meal in the morning. The medication is to be taken with water, and a gap of at least three to four hours are required before intake of any other medications. This includes intake of any natural health supplements. The downside of morning intake of the medication is the lengthy wait for the first beverage or breakfast. This may be challenging to a large number of individuals, who wish to down a cup of coffee or tea in the morning. Similarly, other supplements may also have been recommended to be taken in the mornings.


When taken in the nights, the medication is to be taken at least three hours after the last meal. This may be convenient for many who may not have to wait for a long time before consuming a beverage, breakfast or other supplements.  Advocates of night intake put forward theories that bowel movements are relatively sluggish in the night, and consequently, the medication may be better absorbed as it moves through the intestines. However, for many patients, night intake may be inconvenient. For instance, the long wait after the last meal may not be suitable for individuals who return from work late. Many are also known to have a late night snack, and the medication may interfere with the habit. Finally, the possibility of falling asleep, forgetting to take medications is also high because of the lengthy gap of there hours after dinner.

Thyroid medication can be taken either in the morning or in the night, subject to the empty stomach condition. For some patients, mornings may be convenient, whereas for others, night may be convenient. Medically, both are acceptable.

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