The People's Perspective on Medicine

What Is the Best Way to Take Synthroid?

To get the greatest benefit from levothyroxine for a sluggish thyroid, be consistent. Take Synthroid before bed to avoid interactions with coffee, iron or calcium pills.
Synthroid 50 mcg

An underactive thyroid is a very common cause of fatigue. Nearly 5 percent of US adolescents and adults suffer from the consequences of inadequate thyroid function. The usual treatment is a thyroid hormone, levothyroxine (Synthroid). But what is the best way to take Synthroid?

How Should You Take Synthroid?

Q. Recently I learned that I have hypothyroidism. I am looking forward to taking Synthroid, hoping it will relieve my constant fatigue, dry skin, hair loss and constipation.

The doctor is starting me on a very low dose of levothyroxine. What can you tell me about how and when to take it? The first doctor I saw said I must avoid taking anything else for at least two hours after taking it. The coordinator who instructed me about the medication this time said to take it on an empty stomach. I asked about taking it with other medications and she said that didn’t matter, just to take it on an empty stomach.

Most of the time I can take Synthroid when I first get up. But if I have morning appointments, it isn’t convenient to wait two hours. What should I do?

Does It Matter How You Take Synthroid?

A. The most important guideline for taking levothyroxine (Levothroid, Levoxyl, Synthroid) is to take it the same way every day. Some people take it before bed, having eaten supper at least three hours earlier. But even taking the pill in the morning a half-hour before breakfast can work if you do that consistently.

If you can, avoid taking Synthroid or most other levothyroxine pills at the same time as your morning coffee or mid-morning espresso. Drinking coffee or eating breakfast within 15 minutes of the time you take Synthroid can interfere with absorption, meaning you get much less of the medication in your bloodstream.

Don’t Take Synthroid with Iron:

Q. Can Synthroid and ferrous sulfate be taken at the same time of the day?

A. No. Iron supplements such as ferrous sulfate interfere with the absorption of Synthroid (levothyroxine) taken to treat thyroid problems. Wait at least two hours after Synthroid before taking iron, calcium or other minerals.

To make the scheduling of various pills less complicated, some people take Synthroid at bedtime, at least three hours after supper. Research has shown that this too works very well (Rajput et al, Journal of Thyroid Research, July 14, 2011).

Our eGuide to Thyroid Hormones tells you about timing your thyroid pills and foods and drugs that may interact with them. Your symptoms of fatigue, constipation, hair loss and dry skin are often associated with an underactive thyroid gland, so you may find that you feel much better once the dose has been adjusted properly. That sometimes takes quite a while, however.

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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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    A Naturo[athic physician recommended I take Berberine for diabetes instead of Metformin because it does not affect absorption of Levothyroxine and does not lower TSH scores. Although my Free T3 and Free T4 scores have been within normal range, my TSH score has consistently been too low. Dr. Jonathan Wright has written about several other advantages of Berberine over Metformin for those of us who take thyroid medications..

    I have not increased my thyroid dosages or changed my diet. I have had more energy since I started taking Berberine instead of Metformin

    I actually take it in the middle of the night when I get up to potty. It’s way after and way before eating anything.

    I was taking Amour for my hypothyroid until a few years ago when the pharmacuticals said they were going to stop making it– so my doctor switched me to Levothyroxine — I feel like I am dragging myself about all day and sleep 9-10 hours daily—should I ask my doctor to switch me back?

    I think Synthroid is not always the way to go. I prefer natural dessicated thyroid such as NP or Nature Throid. Synthroid does not always convert to T3 in people like me. Also, should we not have the four T hormones and calcitonin which is in healthy thyroids? In my opinion, Synthroid and it’s generics are not the way to go despite being the gold standard. I think it is fine for some people but, not all people. We are not cookie cutter people. Also, we need more than just the TSH to diagnose. Don’t get me started! PS: One of my friends, who was once slim and beautiful, is on Synthroid and she looks all puffy and overweight. I’d suggest reading, Stop the Thyroid Madness by Janie Bowthorpe. Also, she has a site on FB.

    I used Synthroid for several years and went back to Armour Thyroid when it came back on the market. I really feel a lot better and don’t have to worry about timing or other restrictions simply by taking the pill when I wake up in the morning and waiting for an hour before eating breakfast.

    I started taking Synthroid in 2012. Within 2 weeks I felt much better. Some people have reported that the generic is not as effective/consistent. There is a lot of information on the internet. Be discerning about what you read. I have always taken my thyroid medication at night without incidence. I also started on a low dosage. It’s good that you found out about it. Best to you🙂

    I used to take my armour thyroid pill early in the morning along with my blood pressure pill. However, two pharmacists told me that was not a good idea and that I should wait at least 45 min. or more after taking my armour before taking any blood pressure pill.

    To take levothyroxine on an empty stomach, I have developed this habit: in the evening, I put the pill in a very small bowl (like that used for dipping sushi in soy sauce) and put it on my night table, along with a glass of water. This works for me because I almost always have to use the bathroom during the night, so I take it then. In the morning, I can verify that I took it because the bowl is empty.

    People’s Pharmacy is a wonderful resource – thanks for all you do to improve our understanding of medications and how to use them!

    I found taking levothyroxine at bedtime was too stimulating, & I didn’t sleep well. Taking it first thing in the morning has been best. When I started refraining from eating for at least half an hour and not taking calcium for at least 4 hours, I was able to reduce my dose and still have appropriate hormone levels.

    So these same guidelines apply for desiccated thyroid?

    I take Tylenol before bed to reduce pain so I can get to sleep. Can I
    take synthroid at the same time?

    My warning against taking Synthroid with Quercetin. Doing so skewed my thyroid test. I stopped the combination, and my thyroid test now is in the normal range!!

    This article confuses me. I have been on levothyroxine for years and have always been told by my Dr. and pharmacy that it should be taken with a full glass of water first thing in the morning upon rising. Also, my instructions state that I must wait an hour before eating. Sometimes that is inconvenient because I am usually hungry and look forward to that first cup of coffee.

    However, that’s a small price to pay if my med will work correctly.

    I take my thyroid med when I get up in the middle of the night to use the bathroom. I put out the pill with my glass of water on the bed-side table. I also take my GERD medicine at the same time. It’s usually around 3:00 AM but not always; sometimes an hour more or less from the night before. But it’s always within the recommended time frame.

    First of all, I take Armour Thyroid, which is better for the body. I take my thyroid dose at around 3:00 am, as I typically get up to urinate around that time. This strategy works perfectly: empty stomach, at least two hours after or before eating (essential for complete absorption), no mineral interference.

    My endocrinologist explained to me that she believes taking synthroid in the morning before breakfast is best because it is absorbed better on a more completely empty stomach than just 2 or 3 hours.

    I rarely, if ever, sleep through the night. So I solve the empty stomach problem by keeping a 7-day sorter on the nightstand, and when I wake in the middle of the night, I take a moment to reach over and take my synthroid with a drink of water. Easy peasy.

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