All kinds of medications work best when taken the right way. And if you have hypothyroidism, you've probably been told to take your thyroid hormone medication on an empty stomach and not to take it with certain foods. This may cause confusion and leave you with questions – how long should you wait after you've taken your pill before eating? Can you still enjoy a cup of coffee or a bowl of greek yogurt for breakfast after taking your thyroid medication?
So, to help you make sure that you're taking your thyroid hormone medication the right way, here's what you need to know.
Most doctors and thyroid manufacturers suggest that you should avoid eating for at least 30 minutes to 1 hour after taking thyroid medication. Since thyroid hormone pills dissolve quickly, it's best to swallow them with a full glass of water to avoid gagging. Moreover, you shouldn't drink coffee, tea, or even juice at the time that you're taking your meds.
It's important to understand that food and drinks can cause a shift in your body, such as changes in bile production, level of acidity, and blood flow to the gut. These changes may influence medication absorption. Therefore, what we eat and drink affects how our bodies react to medications and how well they work. In the case of thyroid medication, taking it with an empty stomach allows for maximum absorption and effectiveness.
However, it seems that this standard instruction is most important if you're taking levothyroxine. Natural desiccated thyroid (NDT) or synthetic T3 (liothyronine) usually absorb well regardless of eating.
After taking your thyroid hormone medication, you should wait 30 minutes to 1 hour before eating. This allows for your pills to dissolve and start being absorbed by your body in the small intestine.
American Thyroid Association recommends that you take your thyroid hormone medication first thing in the morning before breakfast for optimal and consistent absorption.
Of course, everyone has a different lifestyle. So if for some reason you can't or don't want to take your thyroid hormone medication in the morning, you can also take it in the evening at bedtime. The general rule is to wait at least 2 to 4 hours after your last meal before you take thyroid medication. Why? Because your stomach typically empties around an hour and a half to 2 hours after a meal. However, the type of food you eat affects how quickly it passes through your stomach. Some food can prolong the time it takes for your stomach to empty.
A study published on the publication of the American Thyroid Association reported that taking levothyroxine at bedtime can improve thyroid levels better than before breakfast. Other studies, however, didn't find a significant difference between evening and morning intake. Regardless, many people find taking their thyroid meds in the evening more convenient since they don't have to postpone breakfast.
Whether you prefer to take your thyroid medication as soon as you wake up or before you go to sleep, it's important that you establish a schedule that allows you to be consistent every day. The key is to take your meds at the same time and in the same way every day to maintain a steady level of thyroid hormone in your body.
If you forget to take your thyroid hormone medication at your usual time, you should take the missed dose as soon as you remember. But don't take the missed dose if it's almost time for your next dose. Unless specifically directed by your doctor, don't double up your dose either. Too much at one time isn't good for your body and may cause unwanted side effects.
The best way to be consistent is to an alarm on your phone, especially if you're busy and need help remembering to take your thyroid hormone medication.
Although eating too soon after taking your thyroid hormone medication is not dangerous, it may decrease the absorption of the medication. This makes your thyroid hormone medication less effective. As a result, you won't get its optimal benefit and may still experience hypothyroidism symptoms.
Having a healthy diet is important to manage hypothyroidism. The first things you want to add to your diet, if you haven't already, are sweet, ripe fruits that are easy to digest. They are packed with nutrients that are essential for good health. Therefore, eating plenty of fresh produce can help to boost your immune system and overall health.
Moreover, make sure you're getting enough iodine in your diet, as this can help prevent potential side effects from your medication. Plus, iodine is essential for the proper function of the thyroid gland as it's needed to produce thyroid hormones. Seafood is a great source of iodine. Besides, it's also packed with copper, zinc, selenium, and other trace elements, so you may want to consider adding it to your diet. Meats that are low in polyunsaturated acids (PUFA), such as beef, lamb, and goats, are great for your thyroid hormone levels as well.
Still, you need to wait 30 to 60 minutes before eating these foods. While the foods mentioned above are good for your body and may help with your thyroid hormone levels, they might still interfere with thyroid hormone medication absorption if you eat them too close to the time you take your meds.
Some foods can lower the absorption of your medication. These include:
Soy products contain isoflavones, which can interfere with the absorption of thyroid meds.
Cruciferous vegetables, such as cabbage and broccoli, contain goitrogens that may interfere with the production of thyroid hormone.
You might want to eat less other types of vegetables as well since they are often difficult to digest and could cause bloating. Moreover, excess fibre or any indigestible carbohydrates from vegetables may ferment in the intestines. Microorganisms fermenting in the guts also produce serotonin and endotoxins, which must be cleaned by the liver. And when an extra task is added for the liver, it doesn’t convert T4 into T3 as properly as it should, making you feel worse. Eating plenty of sweet and ripe fruit is enough since most vitamins that are in vegetables are in fruit, too.
Cow's milk may reduce the absorption of thyroid hormone medication. You should also avoid other dairy and calcium-containing foods, such as yogurt and cheese.
Fatty foods should be avoided as they can slow down the metabolism and make it harder for the body to absorb the medication.
Other food and beverages you need to avoid include coffee, tea, and high-fiber foods.
You don't actually need to eliminate these foods from your life. You can still enjoy them as long as you wait for at least 30 to 60 minutes after taking your thyroid hormone medications.
Just like you shouldn't have any food in your stomach when taking your thyroid hormone medication, it's also essential to avoid taking other medications at the same time. Like food, certain medications may interfere with the absorption of thyroid hormone medication, making it less effective. Some of these medications include:
Antacids, especially one that contains aluminum, calcium, or magnesium (drugs to treat stomach upset, indigestion, or heartburn)
Sucralfate (drugs to treat intestinal ulcers)
Raloxifene (osteoporosis drugs)
Cholestyramine or colestipol (drugs to lower high cholesterol levels in the blood)
In general, you should take these medications 4 hours before or after taking your thyroid hormone medication.
Aside from other medications, some dietary supplements can also impair the absorption or the effect of your thyroid hormone medication. These include iron supplements, calcium supplements, and Vitamin C. If you want to take these supplements, it's best to wait around 1 to 4 hours before or after your thyroid hormone medication.
Whether you're taking prescription or over-the-counter products, it's important to talk to your doctor about all other medications and supplements you use. They'll help you go over possible interactions and come up with the best solution.
According to Ray Peat, Ph.D., taking your thyroid hormone medication more than once a day might be beneficial for your thyroid gland and help regulate your metabolism better. He even suggests taking your meds with food to slow down the absorption and utilization of T3 hormones in your body. Since our body uses around 4 mcg of T3 per hour, it makes sense to split the dose. If you take your thyroid hormone medication on an empty stomach and you have low glycogen storage, your body might demand more glucose. It might result in stress reactions, which cause your body to secrete too much cortisol and adrenaline.
It's generally recommended to take your thyroid hormone medication on an empty stomach since food can decrease its absorption. After you take your meds, you need to wait 30 to 60 minutes before eating anything. You should also take your thyroid hormone medication at around the same time each day to maintain a consistent level of thyroid hormone in your body. The most popular times to take thyroid hormone medication are first thing in the morning and at bedtime.
In addition to food, certain medicines and supplements may also keep your body from absorbing your thyroid meds. This means that you won't experience any improvement in your hypothyroidism symptoms.
That said, there are some alternative ways of taking thyroid hormone medication you may want to consider. Ray Peat, Ph.D. suggests that taking your thyroid meds with food might be better for your body.
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