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Dose administration time from before breakfast to before dinner affect thyroid hormone levels?

Shahram Ala1, Ozra Akha2, Zahra Kashi2

  • 1Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran. ; Pharmaceutical Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran.

Caspian Journal of Internal Medicine
|December 9, 2015
PubMed
Summary

Changing the timing of levothyroxine (thyroid hormone replacement) from morning to evening slightly reduced its effectiveness in treating hypothyroidism. This shift may impact thyroid-stimulating hormone (TSH) and thyroxine (T4) levels.

Keywords:
AdministrationLevothyroxineT4TSH

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Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • Levothyroxine is a standard treatment for hypothyroidism.
  • Optimal absorption of levothyroxine is achieved on an empty stomach, typically in the morning.
  • Patient adherence can be challenging with morning administration.

Purpose of the Study:

  • To investigate the impact of switching levothyroxine administration from before breakfast to before dinner.
  • To assess the effect on serum thyroid-stimulating hormone (TSH) and thyroxine (T4) levels.

Main Methods:

  • A randomized study involving 50 hypothyroidism patients (aged 18-75).
  • Participants received levothyroxine and placebo tablets twice daily, switching administration times (before breakfast vs. before dinner) after two months.
  • Serum TSH and T4 levels were measured pre- and post-treatment.

Main Results:

  • A statistically significant increase in TSH levels (1.47±0.51 µIU/mL, P=0.001) was observed.
  • A non-significant decrease in T4 levels (0.35±1.05µg/dL, P=0.3) was noted.

Conclusions:

  • Shifting levothyroxine administration to before dinner minimally impacted its therapeutic efficacy.
  • The change resulted in a slight reduction in levothyroxine's effectiveness.