a cup of coffee, drinking coffee, chances of heart failure, decaf coffee

Many people don’t realize that coffee and several other foods may partially block absorption of the thyroid medicine Synthroid (Benvenga et al, Thyroid, March 2008). Over-the-counter medicines such as calcium carbonate (Tums, for example) can also interfere with levothyroxine absorption (Singh, Weisler & Hershman, Thyroid, Oct. 2001). This doesn’t seem to be due to reduced acid in the stomach, though: famotidine (Pepcid) and esomeprazole (Nexium) both are more powerful acid suppressors than calcium carbonate, and neither one alters levothyroxine absorption (Ananthakrishnan et al, Thyroid, May 2008).

Does All Thyroid Medicine React to Coffee?

Q. I’ve been on levothyroxine for years to treat hypothyroidism. I did not know that “take on an empty stomach” meant no coffee as well as no solid food.

When I learned that, I also read that with Tirosint you could have caffeine and even solid food. I persuaded my doctor to switch me to Tirosint. Now I don’t have to wait an hour after taking my thyroid medicine before having breakfast.

Tirosint in the Morning:

A. Tirosint capsules were developed to be better absorbed than levothyroxine tablets such as Synthroid. This medicine can be taken with breakfast and there is no effect on absorption (Cappelli et al, European Journal of Endocrinology, Jan. 2014). In general, this soft-gel form of thyroid medicine and a liquid form are better absorbed and less likely to interact with food than the usual levothyroxine pills (Fallahi et al, Expert Opinion on Drug Delivery, May 2017).

You pay for this convenience, of course: Tirosint costs more than Synthroid and about ten times as much as generic levothyroxine.

Learn More:

You will find greater detail about when and how levothyroxine tablets should be taken for greatest efficacy in our Guide to Thyroid Hormones.

You may also be interested in our recent interview with Dr. Antonio Bianco, one of the country’s leading biomedical researchers on thyroid disorders and thyroid patient advocate Mary Shomon. It is Show 1096: What You Need to Know about Treating Thyroid Disease.

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  1. Susan

    I have read that our thyroid medicine can cause insomnia- thus, I would not want to take it at night??

  2. PK

    Good info.

  3. Janet

    Easiest way to take thyroid medicine is when you wake up at 5 to urinate. Leave a pill on your nightstand and take it on your way to the bathroom.

    • Saima

      Can anyone please tell if i can take my over the counter Thyroid supplement an hour after my morning coffee with milk? i don’t eat until afternoon just coffee in the morning.

  4. Marianne

    I remember reading a segment on this site several months ago suggesting taking levothyroxine at night before bedtime. That has been my routine since and my lab work numbers have remained the same.

  5. Jan

    Here in France, the doctors won’t prescribe levothyroxine, the generic. They say it is NOT IN THE PATIENT’S BEST INTERESTS. This means, over the long term, the variations in manufacturing can create an ‘availability’ problem which is down to the pharmaceutical company strictly adhering to FDA guidelines which some ignore.

  6. Floydean

    Several years ago I read that you could take synthroid meds at bedtime. I have been doing this and my test are good

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