I take mine as soon as I get into bed at night - as a rule I don't eat anything past two hours before bed which Endo said is fine for me. I found taking it at night helps me sleep better. I take T3 in the morning as soon as I wake up an hour before food.

My gp and chemist told me to take my levothyroxine 1 hour before eating or 3 after or 5 after a multivitamin.

I take mine in the morning, shower, get ready etc. and kill and hour for breakfast. I take my allergy pill and probiotic in the morning but the rest of my pills after dinner.

I agree that the best thing to do is to take it constantly. Although it does react with some foods, if it's consistent, than I think (note I'm not a doctor) that it would help cancel out any issue with absorption and dosage. At least that's how I've been taking it.

Side note- I'm a little horrified that there is so much inconsistency.

I started levothyroxine in January. My doctor told me to take it before bed and the pharmacist seemed surprised but just said "Oh okay, I guess that could work." I try to wait 1/2 an hour after dinner before I take it but honestly I'm not extremely consistent with how empty my stomach is- I just try not to forget about it and usually am too tired/lazy to drink a whole glass of water (since that usually makes me wake up in the middle of the night to use the restroom). My TSH level was 80.15 at the beginning, then after a month of 88mcg doses it read at 2.64 which my doctor told me is now normal. I was in the hospital for an unrelated issue in February (pulmonary embolism) and the nurses said they give their patients the same meds 1/2 an hour before/after a meal.

My mom is taking Synthroid also but her doctor told her 1/2- 1 hour before breakfast so the poor woman wakes up at 4AM(!!!), takes her meds, then goes back to bed because she's afraid of forgetting. I think it's silly, but whatever works for her I guess.

Taking birth control daily while being on thyroid treatment change the way the thyroid treatment works. Quote from Thyroid UK food and drugs leaflet.

"Oestrogen - any oestrogen raises the levels although thyroid activity is unchanged. This could make your levels look within the normal range, whereas they are really below it. Oestrogen provides more of the transport protein, making the hormone inactive. After starting on any oestrogen therapy, a woman should always have TSH tested to see if the oestrogen is having an impact on overall TSH and thyroid function and might require a dosage adjustment".

HRT is not without issue either. "Prempak C/premanin etc - made from mares urine and interferers with thyroid availability.

Add sweetcorn is now on the "list of foods which can cause problems" and as maize starch is used as filler/binders for many pills not to mention widely used by the food industry as a thickener for sauces as well as reducing the need for "fat" in low calorie foods knowing what you are eating becomes increasingly difficult.

(Sweet corn is also on foods with higher salicylate level. salicylate is a toxin produced by many plants to protect themselves from moulds and mildews which is known to medics and is why aspirin has a dose above which it becomes life threatening).

I wake at 5:30, take my L-Thyroxine and go back to sleep. Breakfast is usual around 7. Having a longer break ( I used to wait half an hour before ) made a big difference for me.

I take my Thyroxine at least 2hrs after my last meal at night, as recommended by my endo. Its all very confusing

What this seems to be saying to me, is that, the testing system shows a patient as having potentially good results but in fact they need more medication to really be where the doctor thinks they are.

As an ordinary person needing to find my own answers, I really feel for any TT patient. It seems as if no consideration is given to your, what I would consider to be your postoperative, additional needs. If you have no thyroid how do you make t4. I assume you only have those you take in the form of a pill at whatever dose you are given. (T2 is created in the ovaries, and may be the consequence of recycling or preparation for elimination, I wonder if one t2 colliding with another t2 might they create a t4 and the merry go round starts again, but I don't know.)

In the Thyroid UK leaflet talking about Hypothyroidism, on page 8, they quote the words of a Dr Anthony Toft from an article in Pulse Magazine, the magazine for doctors. He is or was a consultant endocrinologist in Edinburgh, Scotland, UK. He was at some stage a former President of the Royal College of Physicians and President of the British Thyroid Association. (I did not find his dates).....................................................................................

He says,
"the appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range -0.2 to 0.5 m U/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated - 18 - 22 p mol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum t4 will be elevated at around 24 - 28 pmol/l.

This 'exogenous sub-clinical Hyperthyroidism' is not dangerous as long as serum t3 is unequivocally normal - that is, serum total around t3 1.7nmol/l(reference range 1.0 - 2.2 nmol/l"

This in formation is probably more useful outside the UK and Europe because doctors are probably more constrained here. I am finding the booklets make interesting, thought provoking reading which others may too. (Thyroid UK is available on line. The information pack is available outside the UK though it costs more. I may have seen, if requested on line it may be provided electronically)

My endocrinologist told me to just be consistent. He can work around interferences with absorption as long as I am consistent everyday. As a rule, I take my multivitamin (with iron) in the am (on the days my throat isn't dry from snoring all night) and I take my synthroid right before I go to bed at night (since I'm more likely to remember this dose - I put my synthroid here bc it's more important than my multivitamin).

Depends greatly on what else the patient is on. I take 200/175 alt day at 0500. At about 0600 I drink 16oz water and eat breakfast around 0700-0800. This works for me, but it is the only medication I take. For most healthy people 1 hr before the first meal is fine.

If people took a multivitamin ~ 30 mins afterwards this would be fine.

Synthroid & Cytomel clear the stomach in approximately 30 minutes, after which time it's safe to eat, drink, or take supplements.