How do you take your Synthroid, the levothyroxine medication used to treat an underactive thyroid gland? Usually, people are urged to take it first thing in the morning. Ideally, it is taken at least half an hour to an hour before eating or drinking anything else. That’s because quite a few things interfere with Synthroid absorption. But not everyone is willing to give up morning coffee with Synthroid. What else can you do?
Is It Essential to Take Synthroid in the Morning?
Q. I was told to take my Synthroid before breakfast. Some of my favorite healthy breakfast choices have a lot of fiber, like oatmeal and granola and walnuts. I read that fiber can interfere with Synthroid absorption.
When I discovered coffee also was prohibited for at least an hour after taking the pill, that did it! No more morning Synthroid for me. Why don’t doctors know these things?
Alternate Dosing Avoids Coffee with Synthroid:
A. That is a good question. The FDA includes a warning about fiber reducing levothyroxine (Synthroid) absorption in its prescribing information available to every doctor.
Quite a few foods can affect Synthroid absorption. Coffee and soybeans can significantly reduce the amount of levothyroxine that is absorbed, while vitamin C increases absorption (Skelin et al, Clinical Therapeutics, Feb. 2017). If you like a latte, or put milk on your bran flakes, the plot thickens. Cow’s milk also interferes with optimal levothyroxine absorption (Chon, Endocrine Society, April 1, 2017).
Taking Synthroid at Bedtime:
Many people have concluded, just as you did, that no coffee in the morning is a non-starter. Instead, they take their Synthroid in the evening. That eliminates the problem of coffee with Synthroid and works just as well, if not better (Bolk et al, Archives of Internal Medicine, Dec. 13, 2010).
You can learn more about the pros and cons of levothyroxine and the best ways to take it from our Guide to Thyroid Hormones.
A previous version of this article was entitled “No Coffee with Synthroid Means the Morning Dose Is No Good.” We have changed the title to “Drinking Coffee with Synthroid Means the Morning Dose Is No Good,” because the previous title was confusing.