Levothyroxine (Synthroid) is one of the most commonly prescribed medications in the country. Approximately 20 million Americans have a thyroid condition, so perhaps we shouldn’t be surprised that synthetic thyroid hormone is so widely used. There is significant confusion about the best way to take this medicine, however. What should people on Synthroid know about their drug?
Soy Milk Could Interfere with Synthroid Absorption:
Q. I thought soy milk was supposed to be a healthy food. My doctor diagnosed me with a low thyroid condition. I had checked to make sure there weren’t any food interactions with the Synthroid I was prescribed and didn’t see anything worrisome.
Then I started drinking a cup of soy milk per day. Over just a few months, I gained 25 pounds and my TSH reading rocketed up to four times what it had been.
I’ve been unable to take that weight gain off even with increasing dosages of Synthroid. My body temperature is low and I have debilitating fatigue. Are there supplements I should avoid?
A. If you take your Synthroid at the same time as soy milk or coffee, you may not absorb the full dose (Skelin et al, Clinical Therapeutics, Feb. 2017). Digestive disorders such as celiac disease, gastritis and lactose intolerance may also interfere with absorption. Your continuing symptoms suggest that you may not have restored your thyroid hormone to an adequate level. You may need to change your schedule so that you leave at least an hour between swallowing your pill and drinking your beverage.
People on Synthroid Should Check Their Supplements:
ConsumerLab.com recently summarized some interactions between Synthroid or levothyroxine and certain supplements. In addition to soy, minerals such as iron or calcium and antacids such as aluminum hydroxide or magnesium hydroxide can interfere with levothyroxine absorption. You should leave at least four hours between swallowing any of these and taking your thyroid hormone. Walnuts and grapefruit juice may also reduce or delay levothyroxine absorption (Synthroid Prescribing Information).
You can learn more about treating your thyroid problem from our Guide to Thyroid Hormones, available at www.PeoplesPharmacy.com. It describes the symptoms of thyroid gland imbalance and how to interpret blood tests for thyroid function. In addition, people on Synthroid can read about foods and medicines that may interfere with the absorption of this important medication.
Changing the Timing:
If taking your Synthroid in the morning is too complicated, you might consider taking it at bedtime. Many people find that easier than trying to take their pill at least an hour before their morning coffee and their supplements (Bolk et al, Archives of Internal Medicine, Dec. 13, 2010).
If that is not appealing, you might ask your doctor about a liquid formulation such as Tirosint. This form of levothyroxine does not interact significantly with coffee (Vita et al, Endocrine, Feb. 2013). It also appears less likely to interact with other drugs (Guglielmi et al, Endocrine, online Sep. 14, 2017).