impact of food on drugs, coffee with synthroid

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. 


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.

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  1. Tim
    Huntington Beach

    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.

  2. Michelleena

    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?

  3. Pat

    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.

  4. Mary

    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.

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