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How to Take Your Thyroid Medication Properly

How to Take Your Thyroid Medication Properly

No matter the formulation, thyroid hormone replacement medications are usually administered through a daily oral pill. Unfortunately, many may not be getting the most out of their medication due to poor practices regarding how their medications are taken. Part of the problem is that general guidelines of thyroid medication can be vague or confusing. Better understanding of the various factors that influence the thyroid and associated medications can help one get the most out of their prescriptions and treatment.

Know Your Medication

Treating a thyroid condition frequently involves thyroid-hormone replacement medication. The most common (but rarely optimal) treatment options are T4-only formulations such as Levothyroxine and Synthroid. Unfortunately, many do not experience significant results from medications that only provide T4. Other treatment options include T4 and T3 formulations and natural desiccated thyroid hormone. Treating a thyroid condition must always be customized to an individual’s health and thyroid function. It is important to identify one’s health and thyroid needs to allow for optimal treatment.

Before beginning any kind of drug treatment, it is important to identify the medication and be aware of its various interactions. It is essential to read the label of any medication you intend to take to ensure that it is the prescribed drug and dosage. While reading the label, also check the expiration and make sure that the new drug is not past its expiration date. Noting the number of pills in the bottle is also important because it can be difficult to get additional medication if the original prescription was under filled. If you have been prescribed a specific brand or type of drug, make sure that your prescription has not been filled with a generic substitute. There are many thyroid medications on the market that provide unique benefits and generic alternatives may not suitably treat one’s condition.

Thyroid Medication Guidelines

In addition to being aware of the influence of foods, medications, and many common supplements, it is important to know the general guidelines of properly taking thyroid medications. The following rules and tips will help one get the most out of their thyroid medication and optimize their treatment.

  • Take thyroid medication at least one hour away from food and minerals.
  • Take medication as directed and never miss a dose.
  • Make sure to take your medication on an empty stomach. Food that is already in the system blocks reception sites and can delay absorption of thyroid drugs and hormones.
  • Medication should be taken at the same time every day (usually they are taken in the morning). If you must take your medication with food, make sure you do so consistently.
  • Try to take your medication under the same conditions every day.

The basic guidelines above can help one avoid the most common pitfalls that people experience when taking thyroid medications. In some cases, optimizing how one takes thyroid medication can significantly improve its efficacy. Not only is it important to take one’s medication in the appropriate manner, but it is important to avoid negative interactions.

Substance Interactions

Thyroid medications can be influenced by other substances including prescription and nonprescription medications and various foods. Understanding how one’s medication interacts with other substances is critical to optimizing treatment and achieving better health.


One’s diet can influence the efficacy of thyroid medications. Foods containing high levels of iron, fiber, or calcium can reduce medication absorption. It is best to consume foods containing high levels of these substances at least two hours after medication is taken. Calcium fortified orange or apple juice, high iron foods like red meats and liver, and some high fiber foods like lentils or broccoli may negatively impact thyroid medication absorption.

Foods containing a high level of fiber can increase digestive movement and reduce the opportunity for nutrient and medication absorption. Although fiber is hugely important for proper health it is beneficial to not eat too much to allow for proper absorption of medications and other nutrients.

Coffee can also reduce thyroid medication absorption. A variety of studies have shown that coffee or espresso ingested at the same time or soon after taking thyroid medication can significantly lower absorption rate. It is best to wait at least an hour after taking thyroid medication to enjoy a cup of coffee.


Excessive use of antibiotics can result in long term health issues and cause fluctuations in absorption. Depending on the antibiotic, one may have to increase or decrease their thyroid dose due to irregular absorption. A study in Thyroid found that certain antibiotics notably reduced the absorption of thyroid treatments. Alternatively, other antibiotics increase absorption. For example, drugs and antibiotics in the quinolone family can negatively impact absorption and increase symptoms of hypothyroidism. In contrast, antibiotics such as rifampin can increase thyroid hormone absorption which may cause one to become overmedicated or hyperthyroid.

Because there are many possible drug and antibiotic interactions it is important to do research before beginning a new treatment. A general rule is to take medications at least six hours apart, which may decrease the impact of one treatment on the other. It is always best to discuss medications and possible interactions with a knowledgeable physician.


Supplements and foods containing increased levels of iodine, iron and calcium can inhibit medication efficacy.

Like iodine, iron and calcium both support the thyroid, but they can also negatively impact hormone absorption if taken in excess and at inappropriate times. It is important to recognize that many multivitamins and prenatal vitamins include iron and calcium. Antacids like Tums and Rolaids can also reduce absorption because they are primarily calcium. It is best to take these type of supplements four to six hours before or after taking thyroid medications.

Making the Most of Your Medication

Even though there is generally little guidance given regarding how to take one’s thyroid medication it is important that it is done correctly. By following the basic guidelines given above and avoiding possible absorption reducing interactions, one can improve the efficacy of their thyroid medication.

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