Make Every Thyroid Pill Count!

Make every thyroid pill count

“Take your thyroid pill every day and you will be fine.” I really wish it was that simple. Do you know there are common prescription medications, over-the-counter supplements, and even foods and drinks that can impact the absorption of your thyroid medication?

Written by Brittany Henderson, MD, ECNU

Regardless of what type of thyroid replacement you use, it’s important to get the maximum benefit from your medication. Food, prescription medications, and nutritional supplements can interact with thyroid hormone(s) and affect the way it’s absorbed. Taking your medicine too close to certain foods or prescription medications can dramatically decrease the amount of thyroid medicine absorbed into the body. Instead of absorbing 100% of your thyroid replacement medicine, which is the goal, various foods and medications can decrease absorption by 20-80%.

In order to get the maximum thyroid benefit and overall health benefit from your thyroid hormone, you should be aware of—and avoid interactions whenever possible.

Your Thyroid Pills & Food

WARNING: This may be bad news for morning coffee drinkers! Coffee (and creamer) can significantly impact the amount of thyroid medicine absorbed into the body.

Several other food groups can also impact thyroid medicine absorption. Be sure to adhere to the following guidelines:

  • Always take your thyroid medication on an empty stomach, at least two hours away from food. Even if your prescription label says 30 minutes is enough – trust me, it’s not! If you need coffee to function in the morning, consider taking your thyroid medicine in the middle of the night or at bedtime.
  • There are many types of foods/drinks that can interfere with thyroid medication absorption. It’s very important to avoid taking any of these within two hours of your medicine.
    • caffeine
    • dairy products and creamers
    • foods/drinks fortified with calcium
    • high fiber foods
    • foods rich in iron, magnesium, calcium or other minerals
    • walnuts
    • soy-based products

Your Thyroid Pills & Prescription Medications

Several types of medications can strongly interact with thyroid hormone supplementation. Some impact thyroid medicine absorption from the gut while others affect the metabolism and/or action of the medicine in the bloodstream. If you have to take any of the following prescription medicines, be sure to take them as far away as possible from your thyroid replacement as possible—at least several hours. It’s even better if you can take them at opposite ends of the day. Because so many medicines affect the absorption of thyroid medicine, a good rule of thumb is to notify your thyroid doctor when any new prescription medicines are added so that he/she can adjust your thyroid dose as needed.

Below is a list of the most common interfering prescription medicines:

  • Acid Indigestion Medicines: Cimetidine (Tagamet), Carafate, Prilosec, Protonix, Nexium, and Tums
  • ADHD Medicines: Vyvanse, Ritalin, Adderall
  • Antibiotics & Antifungals: Ciprofloxacin, Levaquin, and Avelox, Ketoconazole
  • Blood Pressure Medicines: Beta Blockers (Propranolo, Metoprolol, Atenolol), Diuretics (Acetazolamide, Lasix), Spironolactone
  • Blood Thinners: Aspirin, Heparin
  • Cancer Therapies: Ipilimumab, Nivolumab, Octreotide, Pembrolizumab, Sunitinib, Sorafenib, Lenvatinib, y-Interferon, 5-FU
  • Cholesterol lowering medications: Bile Acid Sequestrants (Colestid, Questran, Welchol) and Zetia
  • Diabetes Medicines: Metformin
  • Estrogen & Estrogen Disruptors: Birth Control Pills, Selective estrogen receptor modulators (SERMs) (Femara, Clomid, Tamoxifen, Raloxifene)
  • Kidney Medicines: Phosphorus Binders (Renagel, Renvela)
  • Heart Medicines: Amiodarone, Aspirin
  • IV Contrast: Iodinated Contrast
  • Pain Medicines: NSAIDS (Diclofenac, naproxen), Opiates (morphine and derivatives)
  • Psychiatric Medicines: Haldol, Lithium
  • Seizure Medications: Phenobarbital, carbamazepine
  • Steroids: Prednisone
  • Weight Loss Medicines: Phentermine
  • Miscellanous: Bromocriptine, Levodopa, Methimazole, PTU, Reglan

*Never stop or alter prescription medications without consent from your doctor.

Your Thyroid Pills & Supplements

A wide variety of supplements can affect thyroid health. Here are common supplements that specifically interfere with the absorption of thyroid hormone. If you take any of these, it’s best to wait at least four hours after your thyroid medicine before taking your supplement.

  • Calcium: Found in tablets, gummies, and chocolate chews
  • Iron: Over-the-counter or prescription
  • Magnesium: If you take magnesium at night, you might also get an added relaxation/sleep benefit.
  • Soy: I already mentioned that foods made from soy can affect the absorption of thyroid medication. The same is true of other soy supplements including soy-based protein powders and bars.

Final Tips for Optimizing Thyroid Levels

  • Try to take your thyroid medication the same time every day.
  • Try not to miss any days. But if you do, check with your doctor to confirm if it’s safe to double-up the following day.
  • If you take Synthroid/Levothyroxine (only), and morning dosing doesn’t work for you, try taking it at night and let your doctor know. Wait at least two hours after eating.

Don’t let poor thyroid medicine absorption hold you back. Make sure you absorb 100% of your thyroid medicine all day, every day. Make every pill count and live your best thyroid life!

About Brittany Henderson, MD, ECNU

Dr. Brittany Henderson is board-certified in internal medicine and endocrinology, with advanced training in thyroid disorders, including Hashimoto’s thyroiditis, Graves Disease, thyroid nodules, and thyroid cancer. Originally from Cleveland, Ohio, she graduated in the top 10% of at her class at Northeastern Ohio Medical University, where she received the honor of Alpha Omega Alpha (AOA). She completed her endocrinology fellowship training under a National Institutes of Health (NIH) research-training grant at Duke University Medical Center. She then served as Medical Director for the Thyroid and Endocrine Tumor Board at Duke University Medical Center and as Clinical Director for the Thyroid and Endocrine Neoplasia Clinic at Wake Forest University Baptist Medical Center.

She has received multiple prestigious grants from the American Thyroid Association (ATA) and ThyCa (Thyroid Cancer Survivors’ Association, Inc.). Her work has been featured on the cover of Thyroid and in many other scientific journals including EndocrinologyGut, and Oncotarget.

Her clinical practice is located in sunny Charleston, South Carolina and is called The Charleston Thyroid Center. Along with her co-author Allison Futterman, Dr. Henderson wrote the book What You Must Know About Hashimoto’s Disease: Restoring Thyroid Health Through Traditional and Complementary Medicine.


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About Dana Trentini

Dana Trentini founded Hypothyroid Mom October 2012 in memory of the unborn baby she lost to hypothyroidism. This is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links including the Amazon Services LLC Associates Program.


  1. Vitamin C dramatically increases absorption of thyroid meds. When my doctor refused to raise my dose of NP Thyroid, I started taking it with Vitamin C so I could get more out of the same dose. Now my Free T4 is high so I will need to cut back on my supplemental levothyroxine. The Vitamin C really works!

  2. Theresa Parnell says

    I have been taking Levothyroxcine for 6 years now and I’ve felt fine overall with routine dosage adjustments, however my hairline is receding really quickly and it’s making me panic. Does anyone have any suggestions?

    • Hello , I’ve just been diagnosed with hypothyroidism and have only been taking levothyroxine for 2months , but I’ve had the symptoms for quite a time including hair loss and my hairline has gone back quite a bit , no one at my GPS surgery picked up on the fact that I could have a thyroid problem until a new Doctor started and ordered blood tests . I have been reading quite a lot about thyroid problems and diet etc , and I’ve just found an article about “collagen “ supplements , tablets and powder , and how collagen can help with hair growth . I am in the process of finding out which is the best to take . I suggest you do some homework and find out all the information you can about the collagen supplements.

    • Michelle M Ryan says

      I take 4000 Mg of biotin per recommendation of my Rheumatologist. This is for Hair skin and nails. it seems to stop the thinning hair. when the hair loss started up again, I had my thyroid checked and sure enough my numbers changed and had to increase my Levothyroxine…Pay attention to your body, hair loss, emotions, etc.

  3. Anny Schomburg says

    Hummm, article doesn’t mention which thyroid medication is effected by these foods. I am on Armor thyroid.

  4. Thanks for sharing this blog. Thyroid disease is a medical condition that affects the function of the thyroid gland. The thyroid, certain symptoms, and physical changes can be seen. Only a small fraction of the circulating thyroid hormones are unbound or free, and, Higher than normal doses are often administered to prevent recurrence. If you want to know more about thyroid then please visit our blog-

  5. Shelby Casey says

    Diane, I have a similar issue reading as much as you can and trying new things to heal if things aren’t working. Never give up on your health

  6. Diane Tymoshuk says

    I have been taken thyroid medication for 40 years. Now i have hyperparathyroism and ostoporis. Lots of kidney stones and very depressed and tiered. What can i do.

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