Hey rightray, Levothyroxine should be administered as a single daily dose, preferably one-half to one hour before breakfast. Levothyroxine should be taken at least 4 hours apart from drugs that are known to interfere with its absorption. A recent study reported in the Archives of Internal Medicine (Arch Intern Med 2010;170:1996-2003 ) suggests taking levothyroxine or Synthroid on an empty stomach at bedtime, which may be the key to lower TSH, higher T4 and T3 levels, and improved absorption of thyroid medication. These are very important findings for us. Yes, it's fine to take Synthroid at bedtime but on an empty stomach (at least 1 hour before food or 2 hours after food). and try to take it at the same time each day. In an earlier pilot study involving 11 patients with primary hypothyroidism, Dr. Bolk and colleagues found that levothyroxine taken at bedtime significantly decreased thyrotropin levels and increased free thyroxine and total triiodothyronine levels. Moreover, majority of the patients taking levothyroxine as evening/bedtime dose in the present study find it more convenient and decided to continue with evening/bedtime administration at the end of the study. Taking your Synthroid at bedtime is effective and you don’t need to worry about coffee (Archives of Internal Medicine, Dec. 13/27, 2010). Of course, you’ll want to make sure you haven’t eaten for at least an hour, or preferably longer, but that is beneficial for lowering the likelihood of nighttime reflux so you’d want to do that anyway. Should I try Levothyroxine Taken at Bedtime? I read an atcile that says it works better. Will it keep me awake? I also heard chewing it helps absorption? Bedtime levothyroxine ingestion resulted in significantly lower TSH values and higher thyroid hormone levels, indicating improved absorption of levothyroxine when taken at bedtime. There were no significant differences in cholesterol levels or quality of life measures. One study, reported in the Journal of Clinical Endocrinology and Metabolism, examined the impact on thyroid hormone blood tests after changing the timing of when levothyroxine was taken from early morning to bedtime.