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What Is the Best Way to Take Synthroid?

To get the greatest benefit from levothyroxine for a sluggish thyroid, be consistent. Take Synthroid before bed to avoid interactions with coffee, iron or calcium pills.

An underactive thyroid is a very common cause of fatigue. Nearly 5 percent of US adolescents and adults suffer from the consequences of inadequate thyroid function. The usual treatment is a thyroid hormone, levothyroxine (Synthroid). But what is the best way to take Synthroid?

How Should You Take Synthroid?

Q. Recently I learned that I have hypothyroidism. I am looking forward to taking Synthroid, hoping it will relieve my constant fatigue, dry skin, hair loss and constipation.

The doctor is starting me on a very low dose of levothyroxine. What can you tell me about how and when to take it? The first doctor I saw said I must avoid taking anything else for at least two hours after taking it. The coordinator who instructed me about the medication this time said to take it on an empty stomach. I asked about taking it with other medications and she said that didn’t matter, just to take it on an empty stomach.

Most of the time I can take Synthroid when I first get up. But if I have morning appointments, it isn’t convenient to wait two hours. What should I do?

Does It Matter How You Take Synthroid?

A. The most important guideline for taking levothyroxine (Levothroid, Levoxyl, Synthroid) is to take it the same way every day. Some people take it before bed, having eaten supper at least three hours earlier. But even taking the pill in the morning a half-hour before breakfast can work if you do that consistently.

If you can, avoid taking Synthroid or most other levothyroxine pills at the same time as your morning coffee or mid-morning espresso. Drinking coffee or eating breakfast within 15 minutes of the time you take Synthroid can interfere with absorption, meaning you get much less of the medication in your bloodstream.

Don’t Take Synthroid with Iron:

Q. Can Synthroid and ferrous sulfate be taken at the same time of the day?

A. No. Iron supplements such as ferrous sulfate interfere with the absorption of Synthroid (levothyroxine) taken to treat thyroid problems. Wait at least two hours after Synthroid before taking iron, calcium or other minerals.

To make the scheduling of various pills less complicated, some people take Synthroid at bedtime, at least three hours after supper. Research has shown that this too works very well (Rajput et al, Journal of Thyroid Research, July 14, 2011).

Our eGuide to Thyroid Hormones tells you about timing your thyroid pills and foods and drugs that may interact with them. Your symptoms of fatigue, constipation, hair loss and dry skin are often associated with an underactive thyroid gland, so you may find that you feel much better once the dose has been adjusted properly. That sometimes takes quite a while, however.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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