Levothyroxine at night?!!!

[pharmacists]

Effects of evening vs morning thyroxine ingestion ... [Clin Endocrinol (Oxf). 2007] - PubMed result

Effects of evening vs morning levothyroxine intake... [Arch Intern Med. 2010] - PubMed result

The two aforementioned articles seem to suggest taking levothyroxine at night (one published in 2007, and the other in 2010) whilst giving decent clinical data behind it. Any reason why we are still following old protocols? Not an important question I personally need answered. Just thought it was a pretty interesting proposition

[Nik]

First properly reported in the pharmacy and health media many moons ago, PJ picking it up last as usual:

Taking levothyroxine at bedtime may be more beneficial than taking it in the morning? - NeLM

From the research it is difficult to find out what dose these patients were taking - it just says 1 capsule. Could've been 25mcg or 125 mcg. Second, the no of patients enrolled in the trial was only 90. Hardly groundbreaking stuff - if it can be replicated in a larger population then it could be something for the medical profession to consider. Thirdly, no mention in the abstract of the clinical significance - all well and good saying there was an increase in x ng when taken at night but is that clinically significant ?
(If I have screwed up the interpretation then I stand to be corrected).
Certainly an interesting finding, but I have yet to see doctors rushing to switch patients to night time levo.

[STC]

If it ain't broke, don't fix it !

And as Nik says, 90 patients is not the largest sample group in the world. I could prove homeopathy works in a group that size

Stephen

[crit care]

i'd go with whatever the patient finds easier to do......its got such a long half life, so even if they miss a few doses or mix up morning and night time doses, its not the end of the world, and hardly going to send them into a thyroid storm!

[bobbin]

As far as I know, it doesn't make much difference what time of day it is taken so it makes sense to take it at a time when the stomach is empty. For me this would be the morning but not for everyone I suppose.