The People's Perspective on Medicine

Drinking Coffee with Synthroid Means the Morning Dose Is No Good

Drinking coffee with Synthroid leads to lower absorption of this thyroid hormone. Fiber and cow's milk also interfere. What's for breakfast?

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. 

Update:

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.

Rate this article
star-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-emptystar-fullstar-empty
4.6- 40 ratings
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. .
Thyroid Hormones
$3.99

What symptoms signal thyroid trouble? The 25-page downloadable Guide to Thyroid Hormones has critical info on testing, treatment, and side effects. © 2015

Thyroid Hormones
Join over 150,000 Subscribers at The People's Pharmacy

We're empowering you to make wise decisions about your own health, by providing you with essential health information about both medical and alternative treatment options.

Showing 72 comments
Comments
Add your comment

I always thought black coffee was ok but that milk and creamers were the issue. This is the first time I’ve heard that coffee itself is the problem.

I have 1 question, I was reading the great comments. My question is, how about if I take a cappuccino, how long do I wait before taking my synthroid 1 hour later?

I also take Prilosec every day. I know that that must be taken at least 4 hours apart from levothyroxin. So I started taking the Prilosec at night and levothyroxin in the morning. I always have a cup of coffee first thing in the morning, but wait an hour to eat.

So, I guess I should wait and have my coffee with my meal. I’ve been on this med since 1999, when diagnosed with thyroid cancer and my thyroid was removed.

It reduces the efficiency, but that doesn’t mean it doesn’t work. Ultimately, as long as you take it the same way every time, eventually, your dose will be adjusted to match your routines. I take mine at night only because that the only way I can remember.

This article is absurd. DO NOT LISTEN TO THIS.

There are so many other possible contraindications with what you eat throughout the day (especially evening hours) that taking your levothyroxine at night is worse for absorption. In the morning on an empty stomach is the ONLY practical time you should take it. The natural fasting period that your body experiences from sleeping will clear your stomach and you will be in an optimal absorption state in the morning.

I’m sure you can find a way to avoid coffee for one hour. What’s harder, avoiding coffee for one hour after waking up or fasting for 6+ hours in the evening before bed? Because that’s how long you will need to fast before its safe to say you are avoiding contraindications with your levothyroxine.

Also, from my experience, I have always felt an energy boost from taking the medication.

Makes no sense to take at night and it’s sad that people are such slaves to caffeine that they can’t even wait an hour.

By the time I’m done getting ready in the morning and caught up on the news, it’s already been an hour. I eat breakfast and leave for work. When I get to work, I have my first cup of coffee to start the day. (I don’t need coffee to wake up, a liter of water more than does the trick).

I have been taking thyroid medicine in the morning, on empty stomach, for about 20 years. I also have my coffee short after the medicine. Last six months my TSH is below normal; a recheck two weeks ago comes out the same. The doctor keeps asking me if I take my thyroid medicine. I did every day. Now, I found out, through some readings, that my coffee might interfere with Levothyroxine. Starting today, I will wait at least one hour before having coffee or breakfast. Thanks to everyone who shares the experience.

For those who want to take synthroid at bedtime, it still needs to be on an empty stomach. Meaning no snacking between evening meal and bedtime!
And calcium needs to be taken about 6 hours after synthroid tablets.

Take your medication during the night when you go to the bathroom (I take mine around 4-4:30 a.m.). No problem drinking coffee, taking nutrients or eating what I want at breakfast. Works great!

I have found the best time to take my levothyroxine is at about 3am when I am taking my nightly stroll to the bathroom. It doesn’t conflict with any pills taken during the day or with anything I may have swallowed just before bedtime.

I take my synthroid, with decaf coffee, every morning when I wake up. I have Hashimoto, so I assume my thyroid continues to fail with time. However, I have been stable for over a year now on the same dose, so if coffee does interfere, it can’t be enough to make a difference to me! And that prompts a question: Is it the caffeine that interferes?

I always followed the recommended time before eat. But after reading one of your articles, I also learned it was recommended to wait before drinking coffee I was in shock! So now, like Debbie, I take my Synthroid during the wee hours of the morning. Then I can have my morning coffee straightaway.

I have taken synthroid for 15 years in the morning and never miss my morning coffee. Given that my dose is obvious adjusted for the coffee I do not have any problems. The only things that affected my tsk numbers were a 42 pound intentional weight loss, cancer and being hit by a car. Have no thyroid so maybe it is different for those who still have some thyroid hormone.

I generally take my synthroid 1 to 1.5 hours before breakfast and have done well for years. occasionally I wait only 0.5 hours

It is very helpful to me that your articles include the medical / scientific sources of information. My doctor appreciated the information in this article about foods that interfere with the uptake or absorption of thyroid medications.

After reading about issues with coffee and it’s effectiveness, I am switching tonight to taking my levothyroxine at bed time. I was told it wasn’t a problem to have with coffee, so I set up my whole routine around that advice. I have been taking meds for about 3 months and I even though my numbers are great to the doctor, I am so out of wack: hair loss, major weight gain, foggy mind, no energy what so ever! I can not give up my coffee because that seems to be the only thing to get me moving in the morning. It will be a new routine for me, but I sure hope I see a big change, I will let you know.

I started taking Synthroid in my fifties and too busy to think about details, just took it as I headed for work. I am 85, and just learned Synthroid rules…makes me wonder what difference does it make?

Wilson’s syndrome might interest you. T4 has little activity until decarboxylated and enough made to outnumber the binding molecules. This chemical reaction occurs in the thyroid and in the body. Variations in this process have been ignored by most physicians to this date.

is the same true if one takes natural thyroid like Armour or Erfa? Thanks.

Is this drug the same as levoxyl?

I HAVE thyroid cancer that has metastizied to the lungs. I am presently taking 200 mg of thyroid to suppress the TSH. Nothing seems to work including 3 ablations. My doctor tried 225 mg of levothyroxin and that was tooooo much for me!!!! So I am back to 200 mg. But I do take the levothyroxin first thing in the morning followed by one cup of caffeine free coffee. Is this a problem? Could this be why my levothyroxin is not working?
Skip2mloo

I take multiple meds that, ideally, all have special administration rules.
Now, if I need to get up during the night to use the bathroom, I take my Levoxyl with water (which helps my dry mouth). If I don’t get up I take it on arising with black unsweetened coffee. So far my TSH levels have been relatively stable for over 25 years.

I have no problem taking my synthroid before breakfaszt. I take it as soon as I am awake. Its by my bed. By the time I am dressed and prepare my breakfast, sometimes more than an hour has passed since I’ve taken my meds.

What I’d like to know is what other meds may interfere with my synthroid as I have other a.m. meds, 2 of which are anticonvulscents, Gabapentin and Lamotrigine. I also take Famotidine (for Pepcid).

If you take Synthroid in the evening wouldn’t other meds that you take at night interfere with its absorption?

So, what is the proper/best source for information on taking Synthroid? Two people in my household are taking Synthroid for two different reasons and have different doctors and pharmacies. One was told to take it in the morning, one said it does not matter.

No mention ever made of coffee though mention has certainly been made of caffeine ingestion in the morning. What are the consequences of taking it just before bedtime? How long must one wait before coffee or breakfast (iron, calcium, and fiber included.)? Half an hour or four?

What other medications are this fussy about being taken?

I recently had two wildly different results to TSH tests. For years, I’d been taking L-thyroxin with one other prescription medication and a bunch of supplements with results always within normal range.

Then, I started taking it first thing in the morning (before coffee). Both odd test results occurred during this later time. We also changed pharmacies and I’m wondering if a different manufacturer’s formulation is causing the different results? I’m going to repeat the TSH test in two or three more weeks to see if one of the earlier results is a fluke. How does L-thyroxin react to wine (glass of wine before bed)?

I take my levothyroxine very early in the morning and wait at least an hour before eating or drinking anything. I am confused though about drinking coffee…I do usually have decaffeinated coffee with breakfast…..does drinking coffee at least an hour after taking the medication have an adverse effect on the effectiveness of the medicine? When, if ever is it o.k. to drink coffee if you are taking levothyroxine?

I have read this does not apply to Tirosint beause of the gel cap~~~

I’m usually up once a night for potty call. So what I do is place my Synthroid on the top of my pill bottle. I just take it when I get up in the middle of the night. If it’s still there in the morning, I know I must’ve slept great.

As a senior I get up at least 2-4 times a night to go to the bathroom. In the middle of these trips, I make sure to take my Levothyroxine (usually between 2-4 AM.) My Synthroid problem is solved.

Easy, leave it on your night table or on the bathroom sink. When you get up in the night to urinate take it then. Plenty of time for it to absorb. Of course those of you who are lucky enough to be able to sleep all night will just have to suffer.

I tried taking my levothyroxine at night before bed, but it did not work as well for me, so back to morning. When I was working, I’d take my pill first thing when I got up, then take my breakfast (including coffee) to work with me and eat at my desk while viewing emails. I know some people must eat as soon as they get up in the morning, but that’s never been a problem for me.

Are you just trying to confuse people to sell your health guide?

In my opinion this is important information that should come from the pharmacy that is selling the med. Many years ago I took Synthroid and as recommended I took first thing in the morning, probably with breakfast before I left for work.

How does Armour Thyroid fare regarding coffee, fiber, dairy, etc.?

I have taken Synthroid for 40+ years and even though my test results have always been “in the accepted range”, I continued to have hair loss, brittle nails, dry skin and fatigue. Two years ago a new pharmacist recommended I not take any medications within 3 to 4 hours of taking my Synthroid.

After I switched to a 10pm pill time because of meals, I no longer have any symptoms. This has been a huge relief for me. I have mentioned my success in omitting these symptoms to friends and they also have switched to a later time to take their Synthroid (Levothyoxine) and have had positive changes in their symptoms. My pharmacist had the answer to a 40 year old problem.

I’ve been taking Synthroid for at least 20+ years. Over the years I’ve had dosage changes depending what my lab tests show. While I never eat breakfast for at least 60 minutes I always have coffee (black) after taking my pill. Since my lab tests usually show within the normal limits either coffee doesn’t affect the Synthroid or my body has adjusted to it. I’ve decided not to change this routine since it works for me.

I tried taking my Levothyroxine at night and I stayed up and my heart was pounding. Then I tried 1/2 and same result. I take 0.125mcg. If it doesn’t work in AM along with coffee about 20 minutes later, then why is my blood work up to par all these years?

I am a retired nurse and for years I have tried to get physicians to understand that medications need to address real life situations. No one could ever tell me why synthroid had to be taken in the morning. Very few people waited the recommended time. My mental health clients had many different meds for both psychiatric and physical needs and were given impossible med schedules that they struggled to follow. Then they were called “non compliant” because meds were mixed up or skipped.

I take my Levothyroxine two hours after having coffee and breakfast. I don’t usually eat or take any other vitamins or supplements until lunchtime, giving the Levo about 3- 4 hours without anything to interfere with its absorption. This works well for me so maybe others could try this and keep the morning cup of joe!!

One can take Synthroid in the middle of the night–I do that when go to the bathroom in the middle of the night. I prepare for that by putting the pill in a small bowl and a glass of water next to it on my night table, and can do all that in the dark.

I do wonder why I had to learn about this interference from your site, and not from my doctor. Doctors are often remiss in giving this kind of practical, yet essential information.

Mornings and bedtime weren’t working for me, so I finish breakfast by 8:00 and take my levothyroxin at 12:00, waiting 30 minutes before I eat. I avoid caffeine at lunch. So far lab tests are fine. If I am not careful, taking this in the middle of the night sometimes makes it hard to go back to sleep. I can honestly say that I hate this med because of all the restrictions.

Does coffee affect Armour Thyroid?

It is tricky to find the right time to take thyroid meds and this information is not always well known. Regular lab work can keep us on track. In fact, my labs were not exactly on target until I read about not taking thyroid meds the morning of lab work. Once I started that, my lab work has been really good. This may apply to supplements as well, like Vitamin D and I recently found out (not sure where-maybe this website) that a few days before lab work, it is best to not take Vitamin C supplements since they may influence the results. I am a big Vitamin C user so I was interested in that.

I take my meds in the middle of the night since I wake up most of the time at least once or twice. This allows me to take my supplements in the morning and not worry about problems with thyroid medication.

I take it at 2am with no interference from food or drink. I feel better and I take a lower dosage.

I take 2 antidepressants divided into two times per day, Levoxyl, Yaz, Dostinex, Copaxone injections for MS, and Clonazepam as needed for anxiety & insomnia. It’s almost impossible to keep a regular schedule with all of this much less make sure everything is taken the proper time from each other & foods I eat. My currant doctor does understand though. Life is pretty tough with illness and worse with multiple meds. Thank you.

One of my physicians said to take it when I get up to go to the bathroom at night. I take some medications before bed, so morning and bedtime are both bad for me. If/when I get up at night, I take the thyroid first, then remember I can’t have anything to eat with it. Double good!

My pharmacist told me years ago to take thyroid and blood pressure meds hours apart. I take thyroid early am, before coffee and blood pressure at night. My doctor did not know this when I told her.

Just wondering why the title of this article says, no coffee with Synthroid means morning dose is no good, doesn’t make sense, since drinking coffee with Synthroid in the morning decreases its absorption.

I am a cancer patient with a rare cancer, leiomyosarcoma. I have been taking my pain med, hydromorphone, and the synthroid pill at 5 a.m. because that is the best time for me to take these two medications. Is this a no no?

I take my thyroid med during the night after getting up to go to the bathroom usually between 2 and 3 a.m. When I get up for the day, I’m good to go and have my morning coffee and breakfast. I keep one pill at the bedside along with a glass of water. In case I have forgotten if I took the pill there is only one pill at a time to keep track of.

According to Gary E. Foresman, MD, founder and director of Middle Path Medicine, has over twenty-five years of experience in the clinical practice of Internal/Integrative Medicine. According to Dr. Foresman, Desiccated thyroid was working well for patients for more than 50 years before Synthroid, but drug companies couldn’t legally patent desiccated porcine thyroid gland ( a Tr/T3 combo) so they made synthetic T4 (which they could patent) Drug companies are quite an influence and they control the research going on at universities.

If something was being researched that threatened the pharmaceutical company’s profits, your research would get scrubbed immediately-no funding. Desiccated (NDT) is NOT unstable. It is perfectly standardized, tested, and very reliable. Doctors are just not looking into it. They have an outdated, old-school thyroid worldview.

So, since you are not supposed t eat or drink anything before taking this med how does taking it before going to bed?

We generally have dinner between 6 and 7 pm. I generally go to bed around 11 pm. Is that enough time between dinner and bed time to use the med before going to bed?

I have taken this med for 2-3 years and still have not seen any change.

I presently take thyroid in the AM and simvastatin in the evening before bedtime. Can I take both in the evening?

I take thyroid essentials put out by swanson health products also a combination of seaweeds formulated by the same company – at 88 years of age – it works for me as I have become very ‘anit’ prescription meds!
love your site

Interesting information! Does caffeine affect the absorption of Armour thyroid at all?? I’m currently taking this natural thyroid supplement and drinking coffee and eating cereal w/cow’s milk in the a.m. Should I be concerned? Thank you!

I take Nature Thyroid every morning. I wonder if this applies to this thyroid Medication.

I’ve solved that problem, at my age I make a trip to the bathroom between 2-4am I place my dose in an empty pill container placing it on the counter, I always take my pill during my toilet visit. Works for me.

Is it the caffeine in coffee? If so, then we should also avoid black tea–and maybe even decaffeinated beverages since I understand a little caffeine can be in them.

They still need to be taken on an empty stomach, which is 2 hours after food and allow one hour after. No dairy, iron or roughage for four hours anywhere near your dose, Cereals are fortified with iron and dairy (calcium) which totally knocks out Synthroid and other thyroid drugs.

I have not seen anything about tea. Do you know if tea interacts with Synthroid?

I have taken synthyroid for 35 years. I took it in the morning and waited 1/2 hour before having my coffee and cereal.

Now, I am learning that is possibly interfering with absorption.
In the past I have read that taking the dose in the evening and interfer with sleep.
Is that still true?

I had very low vitiman and have been taking vitamin D supplaments and getting more sun that has me back in the normal range. However, I would like to know half hour or so in the sun in shorts and no shirt how long does that vitiman stay in your body? Jerry P

Just one more question – does taking a PPI with the synthroid cause a problem? That also needs to be taken in the morning an hour before eating.

If thyroid medication is taken at night. Do I have to have not eaten for 4 hours before I take it?

your heading for this story leads one to believe that not taking coffee with the synthroid invalidates the medication

Are we talking coffee with caffeine, or decaf? Does it matter?

Honestly taking this at night, seems to act as a stimulant for me. Not in the mornings. Anyone else experience that?

I take my Synthroid around 3:00A.M. when I usually go to the bathroom during the night. My stomach is empty and I will not be eating or drinking for several hours. Have kept this practice for several years and is an easy solution. Or, keep it in your bedroom and take it as soon as you awake. It will take you an hour or more to shower and dress.

Before I go to sleep each night, I put my levothyroxin (generic Synthroid) dose in a shot glass on my night stand and take it first thing when I wake up. I usually have my first cup of coffee within 15-30 minutes of that. I’ve been doing this for years and my labs have checked out just fine. I say “if it ain’t broke, don’t fix it!”

Good Morning. Very interesting topic. Thank you. I take Armour Thyroid. ( i have none, destroyed by radiation during WWII as i was born in Spokane and leaved near Hanford N P.) Always first thing on an empty stomach wait about 15 min to drink first cup of coffee. And yes eat a bowl of doctored up oatmeal almost every morning. I take Metoprolol and Celebrex soon after both best on a full tummy. In your article you talked of the Synthetic Thyroid, only, not the Natural that has been tested numerous times is the only one I am to use.
i will take the A Thyroid in the evening now. with my low dose aspirin and evening Calcium pill.
thoughts?

Wow. What an interesting article! I was taking Synthroid but am still experiencing SEVERE hair loss. Endocrinologist thought the Synthroid might be the problem. Switched me to Naturethroid. Still experiencing hair loss to the extreme. (Not much left!) My question about all the above information is whether it is the same with Naturethroid? No coffee for at least an hour and the concerns with fiber and cows milk? I was also not given any information from doctor about the interactions with fiber, milk, etc. I take fiber supplements and have been taking my medications (for hypertension) and supplements in the evening before bedtime and taking Naturethroid first thing in the morning. I’m wondering about recommendations for when I take my medications and if I should discontinue fiber supplements? I am also on a low carb diet which has been very effective for weight loss so not eating bread, oatmeal, etc. As a result of the diet (and my predisposition anyway) I experience constipation. Frequently! Help!

I’ve been taking coffee about 20-25 minutes after my morning coffee, and my results are always good. I tried taking it at night, but unless you eat dinner at 4:00 or earlier, you still have food in your stomach, and when I tried this my blood work was really high.

Also, when you read the title to this article it really says that if you don’t drink coffee with your morning dose, then the dose is no good. You might want to drop the “No” at the beginning of the sentence :)

* Be nice, and don't over share. View comment policy^