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2007-04-01
Published January 2007 - in a major American medicine journal - a small pilot
study surprisingly, but as well as conclusively, revealed evidence that thyroid
hormone absorption might be more effective when medication is taken at night
time.
The study outcome seriously seems challenging the ever since “Standard Procedure”
- or disobeying to one of the “Commandments” of the “Decalogue of Medicine:
Thou shalt….” take the hormone before breakfast!
Some days ago, in a German thyroid-patient internet forum - “Hashimoto Forum”
- (1) one could read a discussion upon the topic: “thyroid-hormone ingestion
at night.” (2)
The thread was built on research work (original research article) reported in
the renowned American Journal: “Clinical Endocrinology.” (3)
The research news comes from Dutch scientists of Erasmus Medical Centre &
Medical Centre Rijnmond Zuid, Rotterdam & Institute for Brain Research, Amsterdam
the Netherlands. (4)
This pilot study was prompted – according to the authors - by observation that
in some cases the TSH values distinctively improved when the tablet was administered
at night.
Usually – as everyone knows who depends on thyroid hormone – the medication
should be taken 30 minutes before breakfast on an empty stomach, with only some
water.
The patients were studied on two occasions:
12 females were studied who had no other than thyroid medication that could
have altered hormone absorption. They were hospitalized for 24 h; blood samples
were taken in hourly intervals and tested for:
TSH, FT4, T3, T4, rT3, TBG, total protein and albumin
Results
By switching medication intake from morning to bedtime:
The authors conclude that bedtime hormone administration results in higher
T4 and lower TSH concentrations, and circadian TSH profile does not vary.
The researchers discuss a more efficient gastrointestinal absorption at night
– compared to morning intake- which might be explained by:
Our practice, so far, does not posses any own experiences with hormone ingestion
at night.
Given the results proved in greater numbers we certainly would have to switch
many patients to the new drug administration time.
Hormone administration at night, however, will not work in every case:
Sure, many people would keep an empty stomach not long enough before bed time.
Some may consume alcohol until sleeping time, others may have supper at very
late night time; some may go out for late night dinner, others for parties until
late in the morning. And for shift workers the switch would not be the right
thing either.
(C) 2007 Prof. Hotze