Is There a Best Time to Take Your Thyroid Medication?

For most people, it doesn't really matter if you take your thyroid medications in the morning or at night before bedtime. It's more about what suits your lifestyle best. If you're being treated for hypothyroidism (underactive thyroid), what's important is that you take your medication at the same time every day and that you take them on an empty stomach.

Many healthcare providers will tell you to take your thyroid drugs first thing in the morning. However, taking them at night may be more convenient, especially if you take multiple medications throughout the day. There is also some evidence that your body is able to absorb the hormones better overnight.

This article discusses the pros and cons of taking thyroid medications at different times of the day so that you can make an informed choice.

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Taking Thyroid Medication in the Morning

Most healthcare providers recommend taking your thyroid medications first thing in the morning with a sip of water at least an hour before having breakfast or coffee.

You would also need to wait three to four hours before taking any other medication or supplement. This helps ensure your thyroid drugs are fully absorbed in the gut.

What Thyroid Medication to Take

The most common hypothyroid medication is levothyroxine, marketed under the brand name Synthroid and others. This drug is a synthetic version of the thyroid hormone thyroxine (T4).

In your body, T4 is converted into another thyroid hormone called triiodothyronine (T3). This hormone plays an essential role in metabolism, heart function, digestion, muscle control, brain function, and the maintenance of bones.

While most people only need levothyroxine to keep their hormone levels normal, some people may also be given a synthetic version of T3 called liothyronine (marketed under the brand name Cytomel and others).

Studies show that taking levothyroxine too soon before or after a meal or snack can lower the absorption of the drug by about 20%.


Because everyone has a morning routine they adhere to, from putting on the kettle to watching the morning news, it is easy to build medication-taking into that routine. This is important because routine ensures that you take your thyroid drugs every day as prescribed. By doing so, you maintain a consistent level of thyroid hormones in your blood.

You will also have fasted overnight and your stomach will be ready to receive your thyroid drugs without anything hindering their absorption.

Habit-building is essential to maintaining optimal drug adherence. By taking your thyroid drugs every day when first waking up, you get to a point where not taking them throws you off.


Despite the standard recommendations for thyroid drug dosing, not everyone is a morning person or lives by a set schedule. For these people, building a morning habit may not be as simple or straightforward as it seems.

There are many reasons why a morning dose may not be right for you:

  • Polypharmacy: Polypharmacy means that you take a lot of drugs. Because you need to wait three to four hours before taking other any medication, having to take levothyroxine at 7:00 a.m. and your next dose of drugs at 11:00 a.m. can become inconvenient.
  • Shift work: Many people have irregular work schedules, and, for some, the morning is the least convenient time to schedule a dose.
  • Morning hypoglycemia: Having low blood sugar (hypoglycemia) in the morning can make you feel shaky or unsteady. Waiting an hour for food may seem unbearable for some people. The same may be true for those who cannot function without their morning caffeine fix.
when to take levothyroxine thyroid medication

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Taking Thyroid Medication at Night

There is no rule saying you can't take your thyroid drugs at night. Again, the aim is to take your medications at the same time daily so that the drug remains at a consistent therapeutic level in your bloodstream.

If you decide to take your thyroid medications at night, health experts generally advise waiting until three or four hours after your last meal or snack before doing so.


Taking your thyroid medication at night has some clear benefits. Among them, you don’t have to worry about when to eat breakfast or have your morning coffee. This is especially important if you are a get-up-and-go type who needs a quick bite before rushing off to work at 7:00 a.m.

Research also suggests that levothyroxine may be better absorbed at night.

A 2020 review of studies in Clinical Endocrinology found that people who took levothyroxine before bedtime had significant increases in their free T4 level compared to those who took it in the morning. Free T4 is the active form of T4 that, unlike bound T4, is able to enter and activate body tissues.

There are a few theories about why this might occur:

  • A one-hour wait before breakfast may not be long enough. This is because it takes two to four hours for food to move from your stomach to your small intestine where the majority of levothyroxine is absorbed.
  • Intestinal contractions (called peristalsis) slow at night. As such, the drug may be able to rest in the small intestine longer before being shuttled off to the large intestine.


Despite the potential benefits of nighttime dosing, there are some significant drawbacks:

  • Irregular sleep habits: Many people don't adhere to a regular sleep routine and may fall asleep before they remember to take their nighttime dose. It is also easy to forget to take your medications when you are tired.
  • Polypharmacy: Older adults with high blood pressure are commonly advised to take ACE inhibitors at night to better reduce their risk of heart attack or stroke. These drugs may end up taking precedence over thyroid drugs at night.
  • Sedating drugs: There are chronic medications that can cause drowsiness and need to be taken at night. These include beta-blockers, benzodiazepines, and certain antidepressants and anticonvulsants.
  • Stimulating drugs: Liothyronine and Armour Thyroid (desiccated thyroid), both used to treat hypothyroidism, are mildly stimulating and may make it harder for you to sleep at night.
  • Inconvenience: Some people are late-night snackers or enjoy a warm cup of milk before bedtime. Waiting three to four hours after a snack may be inconvenient for these individuals.


It matters less if you take your thyroid medications in the morning or night as long as you take them at the same time every day. By doing so, you can keep your thyroid hormones at a consistent level in the bloodstream.

Traditionally, healthcare providers recommend that you take your thyroid drugs first thing in the morning on an empty stomach at least an hour before breakfast or coffee.

There is evidence that taking levothyroxine at night may not only be reasonable but may also help improve absorption. Even so, there are reasons why this may be impractical, including having irregular sleep habits and taking other medications that demand nighttime dosing.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Mullur R, Liu YY, Brent GA. Thyroid hormone regulation of metabolismPhysiol Rev. 2014;94(2):355-382. doi:10.1152/physrev.00030.2013

  3. 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

  4. American Thyroid Association. Thyroid Hormone Treatment.

  5. Arlinghaus KR, Johnston CA. The Importance of Creating Habits and RoutineAm J Lifestyle Med. 2018;13(2):142-144. doi:10.1177/1559827618818044

  6. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System. The Dangers of Low Blood Glucose.

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By Mary Shomon
Mary Shomon is a writer and hormonal health and thyroid advocate. She is the author of "The Thyroid Diet Revolution."