The thyroid medication levothyroxine should be taken on an empty stomach at around the same time every day. You should avoid eating or drinking for 30 minutes to one hour after taking it.
There are variations in how and when you should take other kinds of thyroid medication. Some may need to be taken at specific times of the day or with or without food. You may also need to avoid certain other medications that can interact with these drugs.
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Taking Hypothyroidism Drugs
Medications used to treat hypothyroidism work best when you take them at the same time every day. Some common medications that are taken for hypothyroidism include:
Some foods, other medications, supplements, and medical conditions may impair how well your body absorbs these medications, and inadequate absorption can make them less effective.
Different forms of thyroid medicationThe liquid or gel cap form of levothyroxine may be better absorbed than levothyroxine pills.With natural desiccated thyroid medications, debate exists over whether taking itsublingually(under the tongue) gets it into the bloodstream faster.
Different forms of thyroid medication
The liquid or gel cap form of levothyroxine may be better absorbed than levothyroxine pills.With natural desiccated thyroid medications, debate exists over whether taking itsublingually(under the tongue) gets it into the bloodstream faster.
Don’t Skip Doses
Hypothyroid medication should be taken every day. Do not skip or delay doses. Missing even a day or two of thyroid medication can cause symptoms.
To be consistent, try to pair taking your medication with something you do every day, such as brushing your teeth. That can help you establish the habit.
If you’re forgetful, try setting an alarm on your phone.
Missing a Dose of LevothyroxineIf you take thyroid replacement hormones (levothyroxine) after surgery or radioactive iodine, you can take two pills at the same time if you forget one.While this is safe, it’s better if you remember to take it every day.
Missing a Dose of Levothyroxine
If you take thyroid replacement hormones (levothyroxine) after surgery or radioactive iodine, you can take two pills at the same time if you forget one.While this is safe, it’s better if you remember to take it every day.
If you take thyroid replacement hormones (levothyroxine) after surgery or radioactive iodine, you can take two pills at the same time if you forget one.
While this is safe, it’s better if you remember to take it every day.
Take Levothyroxine at the Same Time on an Empty Stomach
Healthcare providers often recommend taking levothyroxine in the morning. If you follow that advice, take it on an empty stomach with a full glass of water.Then avoid food and drink, includingcoffee, for at least an hour.
Liothyronine can be taken with or without food.
Some recent research supports taking thyroid medication at bedtime to maximize absorption. If you take a combination T3/T4 therapy or desiccated thyroid, you might have difficulty falling asleep.
Talk to your healthcare provider to figure out thebest time for you to take your thyroid medication, with consideration of your lifestyle and other medications and supplements you’re taking.
Changes Over TimeYour proper dose of thyroid drugs may change over time. If you develop new or worsening symptoms, see your healthcare provider—even if you’re not due for a visit.
Changes Over Time
Your proper dose of thyroid drugs may change over time. If you develop new or worsening symptoms, see your healthcare provider—even if you’re not due for a visit.
Switching Brands or Manufacturers
The amount of levothyroxine in a tablet can differ between manufacturers. For example, a 100 mcg tablet may contain between 95 mcg and 105 mcg of hormone. Different brands and generics may also contain various other ingredients that can affect absorption.
Switching brands of levothyroxine or changing to a generic may affect your symptoms or side effects.
This is why it is important to make sure your pharmacist fills your prescription with medication from the same manufacturer every time you order it. A pharmacy can make substitutions without your healthcare provider’s knowledge unless your provider writes “dispense as written/no substitutions” on your prescription.
Storing Your MedicationStorethyroid medicationproperly. Don’t expose it to moisture orheat. Avoid storing it in the bathroom.
Storing Your Medication
Storethyroid medicationproperly. Don’t expose it to moisture orheat. Avoid storing it in the bathroom.
Food Interactions
Food can bind with thyroid medication. That can change how fast it dissolves and how it’s absorbed in your intestines.
Some of the foods that can affect the absorption of your medication include:
If you make any of the following changes to your diet while taking thyroid medication, consult your healthcare provider:
Drug Interactions
Many different medications interact with thyroid medications. They include prescription and over-the-counter products.
Go over your possible interactions and what to do about them with your healthcare provider and pharmacist whenever you start a new medication. You may be advised to take these drugs at a different time from your levothyroxine, or your thyroid hormone levels may need to be monitored more closely.
Supplement Interactions
Many dietary supplements can interfere with the absorption or action of thyroid hormones and may affect thyroid test results.
Some of the more common ones include:
If you are taking thyroid medication, talk to your healthcare provider before taking supplements.
Pregnancy and Breastfeeding
See your healthcare provider right away if you become pregnant while taking medication to treat low thyroid levels. Your dose will likely need to be increased.
Your health team may want to keep a closer eye on your thyroid levels while you’re expecting.
It’s considered safe to take your hypothyroid treatment while breastfeeding. Studies show minimal amounts get into the milk.
How to Give Thyroid Medication to Children
Medical Conditions
A number of medical conditions may affect the absorption of thyroid medications and change the effectiveness of your medication.
Some of these include:
If you have any of these conditions, your healthcare provider may want to test your thyroid levels more frequently.
Polymorphisms (genetic differences) can lower the effectiveness of thyroid hormone in some people. One example is differences in a gene called iodothyronine deiodinase 2 (DIO2). DIO2 affects how your body converts T4 into T3, which is the active form of the hormone.
Potential Allergies
While uncommon,allergic reactions or sensitivitiesto thyroid medications are possible.
For example, the brand Synthroid contains:
Always let your healthcare provider and pharmacist know about your medicine and food allergies or sensitivities.
Taking Hyperthyroidism Drugs
Taking medication for treating hyperthyroidism (overactive thyroid) is simpler than taking medication for treating hypothyroidism. Still, you should keep some considerations in mind to ensure your medication is working as well as possible.
Take With or Without Food
Both Tapazole (methimazole) and propylthiouracil (PTU) can be taken with or without food. Taking Tapazole with food or milk can help prevent an upset stomach.
Forgetting Your Medication
Consistently taking your medication is important. The guidelines regarding missed doses depend on what kind you’re taking.
Medication Interactions
Some drugs can interact with hyperthyroidism treatments. These include:
Be cautious with over-the-counter cold medications or any drugs with a stimulant effect. It’s always a good idea to check in with your provider or pharmacist before taking a new medication or supplement, even if it’s over the counter.
If You’re PregnantIf you get pregnant or suspect you are while taking Tapazole (methimazole or MMI), stop your medication and contact your healthcare provider immediately.
If You’re Pregnant
If you get pregnant or suspect you are while taking Tapazole (methimazole or MMI), stop your medication and contact your healthcare provider immediately.
Adverse Reactions
It’s possible to have serious side effects from anti-thyroid drugs. Be on the lookout for potential symptoms.
Rare, but serious reactions include:
If you develop agranulocytosis, it’s important to avoid exposure to people who are sick. Also, be sure to stay up-to-date on immunizations.
Summary
Thyroid drugs work best when taken correctly. Certain drugs and supplements, and some medical conditions can make you absorb more or less of the drug. Check with your provider any time you change your medication or supplement regimen. Watch for negative side effects and drug interactions.
For hypothyroidism drugs, ask what time of day is best to take them and be consistent about the time. If you get pregnant, you may need to increase your dosage.
For hyperthyroidism treatments, make sure you don’t double up on natural T3 drugs. That can cause an overdose. You need to take Tapazole and PTU consistently. Figure out ways to remind yourself so you can be consistent.
15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Pirola I, Formenti AM, Gandossi E, et al.Oral liquid L-thyroxine (L-t4) may be better absorbed compared to L-T4 tablets following bariatric surgery.Obes Surg. 2013;23(9):1493–1496. doi:10.1007/s11695-013-1015-y
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