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Is Your Breakfast Messing Up Your Medicine?

If you take medication in the morning, choose your breakfast carefully. Make sure that it is not interfering with your prescription drugs.
Is Your Breakfast Messing Up Your Medicine?
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When was the last time you read a manual? Most of us are so impatient that we skip straight to plug and play. That’s true whether it’s a computer program, a cell phone or a rental car.

Taking pills is no exception. Most people don’t take time to consult a pharmacist when they pick up a prescription. If they get printed information in the bag, chances are it gets filed or tossed but not read carefully.

How Should You Take Your Pills?

This could be disastrous because for some medicines it makes a difference how and when you take them. Most of us are busy, so it is completely understandable that we swallow our pills first thing in the morning, often with breakfast, and get on with our day. What we eat (bacon and eggs, oatmeal or a bran muffin) and what we drink (orange juice, coffee or water) can profoundly influence how our drugs work.

Synthroid and Coffee Don’t Mix:

Consider levothyroxine (Synthroid) as an example. It is one of the perennial top drugs in the pharmacy, used to treat an underperforming thyroid gland.

Patients are usually instructed to take this medication first thing in the morning, before breakfast. How long before breakfast? The prescribing information recommends 30 minutes to an hour before breakfast.

Why? Drinking coffee, as so many of us do at breakfast, reduces the rate and extent of absorption of the levothyroxine tablet (Thyroid, March, 2008).

What About Supplements?

There are other hazards lurking in breakfast as well. A survey of people taking levothyroxine found that half of them were also taking calcium or iron supplements, which can interfere with Synthroid absorption (Drugs in R&D, March, 2016). Orange juice fortified with calcium can also reduce levothyroxine absorption. One-fifth of these folks did not wait at least half an hour after taking their thyroid pill before eating breakfast.

High-Fiber Breakfast Could Be Trouble:

More than two-thirds reported eating high-fiber foods such as bran flakes or fiber bars or foods high in soy such as soy sausage or soy milk more than twice a week. These foods are also believed to interfere with levothyroxine absorption.

Other Food-Drug Interactions:

Sticking with breakfast but looking at a different medication, we find that the absorption of the beta blocker blood pressure pill atenolol can be halved if it is taken at the same time as tea (Frontiers in Pharmacology, online June 29, 2016).

New food and drug interactions are being discovered all the time. One recent research report shows that the diabetes drug repaglinide (Prandin) may be metabolized more slowly if the person has consumed the non-sugar sweetener stevia (Food and Chemical Toxicology, Aug., 2016).  Since people with diabetes often use non-sugar sweeteners, this combination could lead to unexpectedly low blood sugar.

Watching Out for Grapefruit (and Other Foods):

Other food and drug interactions are better known. Physicians and pharmacists are aware of a number of medications that can be affected by grapefruit or grapefruit juice.

Grapefruit boosts the effect of the cholesterol-lowering drugs atorvastatin, lovastatin or simvastatin. For some people that may increase their risk for side effects.

Other foods that can affect certain medicines include cranberries, mango, avocados, green leafy vegetables, apple juice and green tea. It makes sense to find out whether a medication you are taking could be affected by the foods you eat or the beverages you drink. You can learn more from our free online Guide to Drug and Food Interactions.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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