Is There a Best Time to Take Your Thyroid Medication?

Managing an underactive thyroid gland requires you to take a thyroid drug every single day. Consistency is key, meaning it's important to take your thyroid pill at the same time daily. Most are told to take their medication first thing in the morning, rather than before they go to sleep. But the truth is that either time of day works, although one time may better suit your lifestyle. In addition, there is some 2010 research suggesting that taking your dose at bedtime may allow for better thyroid hormone absorption.

Discuss when to take your thyroid medication with your healthcare provider. These pros and cons can help guide your conversation.

Thyroid Disease Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Morning Levothyroxine

Taking your thyroid hormone replacement medication (most commonly, levothyroxine) first thing in the morning with water and waiting at least an hour before eating breakfast or drinking coffee is what has been traditionally recommended for years by thyroid experts.

In addition to waiting an hour before eating food or drinking coffee, experts also recommend waiting at least three to four hours before taking any other medications or supplements that may interfere with levothyroxine's absorption.


For many people, taking their thyroid medication in the morning is what they have always done.

  • Given the importance of consistency, the benefit of staying with a long-standing routine cannot be overlooked.

In this instance, switching to nighttime levothyroxine does not really make sense, unless your healthcare provider is worried about medication absorption or interactions, which would be detected in your periodic thyroid-stimulating-hormone (TSH) blood test.


Some people find taking levothyroxine in the morning inconvenient and/or burdensome for the following reasons:

  • It may be difficult to wait an hour before eating or drinking coffee in the morning.
  • Other medications or supplements that can interfere with a thyroid drug's absorption, like a calcium or an iron pill, need to be taken in the morning.
when to take levothyroxine thyroid medication
​Illustration by Emily Roberts, Verywell

Nighttime Levothyroxine

Similar to the morning levothyroxine guidelines, experts recommend waiting up to four hours after your last meal or snack before taking your nighttime thyroid medication.


Here are some potential pros to taking nighttime levothyroxine:

  • You don’t have to worry about when to eat breakfast.
  • It may be easier to avoid things that can interfere with thyroid medication absorption, such as calcium, iron, and high-fiber foods.
  • Coffee drinkers don't have to wait until an hour after their medication to enjoy their first cup.
  • Research suggests that levothyroxine may be better absorbed at night.

One study, reported in the Journal of Clinical Endocrinology and Metabolism in 2009, examined the impact on thyroid hormone blood tests after changing the timing of when levothyroxine was taken from early morning to bedtime.

In all the patients, TSH decreased and free thyroxine (T4) levels rose by changing thyroxine ingestion from early morning to bedtime. Triiodothyronine (T3) levels rose in all but one subject. 

Interestingly, TSH decreased irrespective of the starting TSH levels, suggesting better absorption of the thyroid medication when taken in the evening.

The researchers of this study suggested several explanations for the results:

  • Even when waiting for at least 30 minutes to eat, breakfast may be interfering with the intestinal absorption of levothyroxine. 
  • “Bowel motility is slower at night,” which means that it takes longer for the levothyroxine tablet to transit through the intestinal system. The increased transit time results in longer tablet exposure to the intestinal wall and therefore, better absorption and uptake of the medication.
  • The conversion process of T4 to T3 may be more effective in the evening.


Taking your thyroid medication at nighttime may be challenging for the following reasons:

  • It's easy to forget to take your medication when you are tired.
  • You may have an inconsistent sleep schedule.
  • You may enjoy snacking prior to going to bed.
  • Thyroid drugs that contain T3 such as Cytomel and the natural desiccated thyroid drugs (Nature-throid and Armour Thyroid) have a slight stimulatory effect, which can make it difficult to sleep.

What Your Doctor May Recommend

If you do take a T3 drug, your healthcare provider may recommend a time-released or sustained release formulation, or splitting your dose and taking your medication several times throughout the day. These approaches may minimize any sleep interference.

A Word From Verywell

In the end, the key to optimizing your thyroid health is to maintain consistency, taking your thyroid pill around the same time and in the same way each day.

With that, if you and your healthcare provider decide to switch the timing of your thyroid medication, be sure to have your thyroid levels evaluated about six to eight weeks after you’ve made the switch.

Frequently Asked Questions

  • What can happen if I eat right after taking my thyroid medications?

    Your body won't able to absorb enough medication. Taking levothyroxine too soon before or after a meal or snack can lower absorption of the drug by about 20%, studies show.

  • How long does it take for thyroid medication to work?

    Your symptoms—fatigue, constipation, dry skin, brittle nails, and so forth—should diminish within a few days. However, it will take from four to eight weeks for your TSH blood levels to reflect the effectiveness of your medication. Your endocrinologist likely will test your blood six to eight weeks after you start treatment or begin taking a different dose.

  • What foods can interfere with thyroid medication?

    Dairy products and coffee both have been found to prevent adequate absorption of levothyroxine. Other foods that may interfere with the drug include soybeans, walnuts, and foods that are high in fiber. Grapefruit and grapefruit also may be problematic.

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Article Sources
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  1. Bolk N, Visser TJ, Nijman J, Jongste IJ, Tijssen JG, Berghout A. Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial. Arch Intern Med. 2010;170(22):1996-2003. doi:10.1001/archinternmed.2010.436

  2. Bach-huynh TG, Nayak B, Loh J, Soldin S, Jonklaas J. Timing of levothyroxine administration affects serum thyrotropin concentration. J Clin Endocrinol Metab. 2009;94(10):3905-12. doi:10.1210/jc.2009-0860

  3. Rajput R, Chatterjee S, Rajput M. Can Levothyroxine Be Taken as Evening Dose? Comparative Evaluation of Morning versus Evening Dose of Levothyroxine in Treatment of HypothyroidismJ Thyroid Res. 2011;2011:505239. doi:10.4061/2011/505239

  4. Pfizer. Cytomel (liothyronine sodium).

  5. Jonklaas J, Bianco AC, Bauer AJ, et al. Guidelines for the treatment of hypothyroidism: prepared by the american thyroid association task force on thyroid hormone replacementThyroid. 2014;24(12):1670-1751. doi:10.1089/thy.2014.0028

  6. National Institute for Diabetes and Digestive and Kidney Diseases. Hypothyroidism (underactive thyroid). Updated March 2021.

  7. Chon DA, Reisman T, Weinreb JE, et al. Concurrent milk ingestion decreases absorption of levothyroxineThyroid. 2018;28(4):454-457. doi:10.1089/thy.2017.0428

  8. Benvenga S, Bartolone L, Pappalardo MA, et al. Altered intestinal absorption of L-thyroxine caused by coffeeThyroid. 2008;18(3):293-301. doi:10.1089/thy.2007.0222

  9. MedlinePlus. Levothyroxine. Updated Feb 15, 2019.