If you’re on the right dose there’s no need to be so regimented. It’s absorption rate is very long and waking to take it at 4am is not even remotely needed in my experience.

Sleep hygiene is 10x more important.

I take my levothyroxine in the mornings but miss at least 4 does a month and often take it with my full breakfast. Sometimes not.

Never after 3-4 pm since it can keep you up.

Hope this helps.

Michael | 53 | SCC | Right Tonsil | Dx'd: 06-10-05 | STAGE IV, T3N2bM0 | 3 Nodes R Side | MRND & Tonsillectomy 06/29/05 Dr Fee/Stanford | 8 wks Rad/Chemo startd August 15th @ MSKCC, NY | Tx Ended: 09-27-05 | Cancer free at 16+ Yrs | After-Effects of Tx: Thyroid function is 0, ok salivary function, tinnitus, some scars, neck/face asymmetry, gastric reflux. 2017 dysphagia, L Carotid stent / 2019, R Carotid occluded not eligible for stent.2022 dental issues, possible ORN, memory/recall challenges.