a bottle of Synthroid (Levothyroxine) 50 mcg, take Synthroid

Thyroid problems are extremely common, with about 12 percent of the American population affected by one at some point during their lives (American Thyroid Association). Since an underactive thyroid gland is by far the most prevalent of the problems that afflict the thyroid, it is little wonder that millions of people are taking levothyroxine (Levothroid, Levoxyl, Synthroid), a thyroid hormone intended to supplement or replace the inadequate production of the thyroid gland. But there is plenty of confusion about how to take this medication. It has a number of possible interactions that can make it tricky to find the best time to take Synthroid.

The Best Time to Take Synthroid:

Q. I’ve been told to take my Synthroid first thing in the morning, but I’ve read that coffee interferes with its absorption. I hate waiting an hour after I get up before I have my coffee or breakfast. Is this really necessary?

A. Levothyroxine is better absorbed when you have not eaten (Journal of Clinical Endocrinology and Metabolism, Oct., 2009). That is probably the basis for the usual admonition to take this pill first thing in the morning. But that is not always the best time to take Synthroid. Food, dietary supplements and coffee can interfere with its absorption (Thyroid, March, 2008). As a result, the most conscientious patients may end up like you, rising an hour before breakfast time and stumbling through that hour before enjoying the first sip of steaming coffee.

Try Another Time:

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.

Other readers have found it helpful to switch to taking Synthroid at bedtime.

One person wrote:

“I’ve been taking levothyroxine for years and have felt crappy the whole time. I could barely drag myself out of bed. Trying to take my thyroid medicine on an empty stomach and wait an hour before eating or drinking was really inconvenient.

“After reading on your website that thyroid could be taken at night I feel liberated. My days are normal again. Since I’m taking my vitamins, minerals and tea earlier, I’m not having trouble sleeping anymore and I don’t wake up feeling exhausted. My energy is back.”

Be Consistent:

The most important thing to remember about taking Synthroid or any other thyroid hormone is to be consistent. Even taking your pill with breakfast can work, so long as you do it every day and your breakfast time doesn’t vary too much. If you are consistent, your doctor will adjust the dose so that it is appropriate for your usual regimen.

It is better to avoid taking Synthroid at the same time as some supplements you might be swallowing with your morning juice: both iron and calcium can reduce the absorption of the hormone. It is also better not to take Synthroid or other versions of levothyroxine with a high-fiber breakfast such as bran muffins or bran flakes cereal.

Liberated from the Morning Routine:

Q. I’ve been taking levothyroxine for years and have felt crappy the whole time. I could barely drag myself out of bed. Trying to take my thyroid medicine on an empty stomach and wait an hour before eating or drinking was really inconvenient. After reading on your website that thyroid could be taken at night I feel liberated. My days are normal again. Since I’m taking my vitamins, minerals and tea earlier, I’m not having trouble sleeping anymore and I don’t wake up feeling exhausted. My energy is back.

A. Research has shown that levothyroxine to treat a sluggish thyroid works just as well if not better when taken in the evening instead of the taking thyroid medication in the morning (Journal of Thyroid Research online Jul 14, 2011; Archives of Internal Medicine, Dec. 13, 2010).

No matter when it is taken, it is important to know what foods, beverages and drugs may interact badly with levothyroxine (Synthroid). A different formulation may solve the problem as well. Italian researchers report that liquid thyroxine taken with breakfast does not appear to interact with coffee or food (Cappelli et al, Thyroid, Feb. 2016).

You’ll learn about taking your thyroid medication, along with the symptoms of thyroid disorders and innovative approaches to managing them, in our Guide to Thyroid Hormones.

Revised 12/11/17

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  1. IDA
    pembroke pines
    Reply

    Ida Pembroke PINES never stopped to take my Synthroid
    but now I take it in the middle of the night I discovered a new better life.

    I don’t take supplements. Please recommend me some important supplements? thank you

  2. taryn
    CA
    Reply

    I’m still awaiting someone to invent the levothyroxine patch. You see I can’t take this little pill at night, because my husband and I enjoy a late night snack or drink while relaxing from a long day of parenting. As I suffer ill effects of low blood sugar, going to bed hungry makes me ill.

    I can’t take this first thing in the morning because I wake before the kids for a morning jog and need food in my system (low blood sugar) before I can run. So I’m left waiting until I’m hungry near lunch time, hoping that my stomach is “empty” enough, and then being hungry for an extra hour longer (feeling ill and exhausted the whole time – once again, low blood sugar).

    This “empty stomach and wait an hour” business has been the bane of my existence for the last three years. Come on medical industry, we’re putting jellyfish DNA in mice to make them glow, let’s get this synthetic hormone in patch format so the sufferers can live their normal lives again.

  3. ida
    Pembroke PINES FL
    Reply

    I am a female, 87 years old. At 60 years old, because of a toxic thyroid gland, I got radiation and was treated with elthroxin. No problem. Because of sleeping late in the morning after taking elthroxin, I want to skip tonight’s dosage. Is this OK?

    • Terry Graedon
      Reply

      Ida, normally you are advised to take levothyroxine (Eltroxin) every day. If you skip one dose, you probably won’t notice an impact, but you don’t want to get in the habit of skipping.

  4. John
    Las Vegas
    Reply

    I take lots of supplements plus a 5 mg blood pressure med, plus my breakfast and morning coffee I’m confident the thyroid meds where blocked on the path to my thyroid.

    I will be taking the levothyroxine at bedtime, I haven’t slept in months. perhaps all this will change, I’m desperate for relief! Will advise, thanks!

  5. Jennie
    Georgia
    Reply

    I have been taking Synthroid 25 mcg for about 7 years with no problems. Recently, my osteopenia is inching toward osteoporosis, and I have begun a program of calcium, vitamins, and strontium. The timing for all these medications is getting complicated. I know I shouldn’t take Synthroid within 4 hours of the calcium supplement, but I’m wondering if there is an interaction with the strontium which I take at bedtime. I don’t eat or drink anything after dinner, except maybe a cup of non-caffeinated herbal tea. Would it be safe to switch over to bedtime for the synthroid and take it along with the strontium? Thanks!!

  6. Liz
    Ct.
    Reply

    After reading your advice about taking levothyroxine without food or liquid (coffee) in your system, I started taking it in the middle of the night when I awoke to use the john. It absolutely changed my life. I feel like myself again and have the energy back that I thought was gone forever. Many thanks.

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