a bottle of Synthroid (Levothyroxine) 50 mcg, take Synthroid, thyroid and cholesterol

Q. Can I drink coffee after taking Synthroid?

A. Synthroid (levothyroxine) is absorbed best when it is taken on an empty stomach. Patients are often advised to take it first thing in the morning, but drinking coffee or eating breakfast even 15 minutes after taking the pill can greatly reduce the amount of thyroid hormone that gets into the bloodstream (European Review for Medical and Pharmacological Sciences, 2014; vol. 18, pp. 451-456).

Absorption Problems

Synthroid and other levothyroxine tablets are not absorbed well by people taking the acid-suppressing drugs known as proton pump inhibitors (esomeprazole, lansoprazole, omeprazole, rabeprazole, etc.). It seems that gastric acid is necessary to help the pill dissolve in the stomach. A liquid formulation appears to have less disruption from these drugs (Journal of Clinical Endocrinology and Metabolism, online Sept. 26, 2014).

Grapefruit, soybeans, papaya and dietary fiber can also reduce levothyroxine absorption. The usual advice is to wait at least an hour after taking Synthroid before having your coffee or a meal.

Take at Bedtime

Some people find that taking the medicine at bedtime, at least two hours after supper, solves the problem (Archives of Internal Medicine, Dec. 13, 2010).

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  1. Nidja

    If some thyroid medicine is affected by coffee and if it is because of the caffeine why not prohibit tea, soda, chocolate and so on? Also if you have to wait approximately 4 hrs. to consume vitamins and minerals especially Calcium and Iron what is the amount of Calcium and Iron you can’t consume? Just about everything contains Calcium and Iron i.e. bread, crackers, etc. even eggs. Are you suppose to fast for that period of time?

  2. Nancyj
    Long Island , NY

    I, too take Armour Thyroid and wonder about it?

  3. jas

    I’ve read that walnuts and alcohol can prevent proper absorption of Synthroid. Although my mother’s blood tests come back within a normal level, I wonder if her walnuts & a glass of wine with her dinner can still prevent some absorption of Synthroid.

  4. Jen

    Of course not everyone needs to get up at night to use the bathroom, but…… Just in case you do, I find that is the most convenient time to take my Synthroid. Stomach empty and likely to stay that way for several more hours.

  5. Marlene

    I started taking Armour Thyroid (natural) a year or so ago, and I don’t think coffee affects the absorption. Annual blood tests show I am on the right dosage for positive results.

  6. Liz H

    Is this also true for natural thyroid products like Armour?
    I’m in the habit of taking my Armour thyroid with meals, and the doctor has set the dose to keep my blood levels where they need to be.

  7. Barbara
    Flower Mound, TX

    I started taking my thyroid medication just before bedtime about 3 months ago. It has made a difference for me. It is easier for me to wake up in the morning and I feel like I have more energy during the daytime.

  8. Tom

    I take mine around 4:00am, when I get up anyway to use the bathroom. I usually don’t get up until 8:00am or later. This works very well for me.

  9. C R Lan
    Clearwater, FL

    After reading a letter in your column recently about taking levothyroxine in the evening at bedtime being a solution to that morning sluggishness when taking before breakfast, I tried it and really love this. My doctor had always said to take it an hour before breakfast.

    When I took the clipping from the newspaper of your column, he said try it but that he recommended at least 3-4 hours after dinner of no food or beverage other than water (a little lemon in water ok). He said it takes 3 hours to digest a starchy carbohydrate and 4 hours for meat, 1 hour for bananas and 30-45 min for berries. So, he said no snacks after dinner since anything (even berries) would be sitting on top of what I had for dinner. This proved a side benefit as it took away that snacking temptation after dinner so I could take my thyroil medicine! I actually have lost a few pounds by switching to evening! Now I don’t have to wait an hour for breakfast anymore! And it encourages me to eat dinner early (which experts agree is better for weight loss) so I can get to bed on time.

  10. Deborah G.
    Rochester, NY

    Since caffeine effects synthroid, does caffeine also effect armour thyroid?

  11. Nancy

    I wonder why heart palpitations aren’t discussed when taking thyroid hormone. I wonder if anyone else has this problem. Taking atenolol helps some even though I’d rather not have to take it.

    • jafig

      I hope someone has told you that heart palpitations are a sign of maybe taking too high a dose. You might need your dose adjusted.

  12. Sally

    I would like to take my synthroid at night – How “un-full” does your stomach have to be? If I have dinner & later have some dessert (fruit), would I wait 2 hours after the last food? or 2 hours after the main meal?

  13. Patti

    Great advice. Also wait four hours before taking calcium or iron supplements. Unfortunately some of us find taking the thyroid prescription at night causes heart burn. Just a heads up…

  14. Sasha

    I wonder if that’s also true with desiccated thyroid, such as Armour. I was always told to wait to eat, but that drinking coffee after taking my pill was OK! Anyone know the answer?

    • The People's Pharmacy

      We haven’t seen any data that Armour is affected by coffee…but also no studies showing that it isn’t. Generally with thyroid hormone, taking it the same way every day is the most important factor.

  15. elizabeth

    My routine has been a 3 am awakening to use the bathroom…. so for a long time
    I take my thyroid then. This way, I am not tempted to have coffee prior to the hour
    I should wait. Hope this is ok with you. I LOVE your show and being able to read what
    others suggest regarding health issues and listing to the podcasts.

  16. Diana W.
    Boone, NC

    Do your comments above apply to all forms of thyroid supplementation? I take Armour Thyroid which is natural and not synthetic.

    • The People's Pharmacy

      We’ve not seen any research that indicates that Armour absorption is affected by coffee the same way Synthroid is.

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