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January 24, 2023 10 min read

When it comes to managing hypothyroidism, getting the right medication and dosage is essential. But what many people don't realize is that certain foods can interfere with thyroid hormone replacement medications like levothyroxine. In order to get the most out of your treatment, it's important to be aware of which items might throw off your thyroid levels.

The good news is, there are plenty of tasty options that won't interfere with your medication! So grab a fork and read on to find out which foods you should steer clear of when taking thyroid hormone replacement medications – and some delicious alternatives you can enjoy instead!

What is thyroid hormone replacement medication?

Thyroid hormone replacement medication is used to treat an underactive thyroid gland, also known as hypothyroidism. The thyroid gland, located in the neck, is an important gland that produces two main hormones: thyroxine (T4) and triiodothyronine (T3). These thyroid hormones regulate your metabolism, body temperature, heart rate, and more.

When the thyroid isn't producing enough of these hormones, your metabolism slows down, and your body won't be able to function correctly. You'll feel run down, sluggish, cold, and anxious. Thus, you need thyroid hormone replacement medication to restore balance and get your metabolism back up and running.

There are two main types of thyroid hormone replacement therapy: synthetic and natural. Synthetic options include levothyroxine (the synthetic version of T4) and liothyronine (the synthetic version of T3). However, some patients may not respond well to these synthetic options because they only provide one of the two main thyroid hormones.

Natural desiccated thyroid (NDT) or desiccated thyroid extract (DTE) is an older treatment option but it is preferred by many patients because it provides both T4 and T3 hormones. A study found that 48.6% of people being treated for hypothyroidism preferred DTE, compared to 18.6% who preferred LT4. NDT also improved patients' symptoms and helped with weight loss. The only downside is that some doctors don't prescribe NDT, and it may be difficult to find in pharmacies. But thankfully, you can buy desiccated thyroid online.

What foods interfere with thyroid medication

How should you take your thyroid medication?

Taking your thyroid medication the right way is important in order to enjoy its full benefits. To ensure you're getting the most out of your medication, here are a few things to keep in mind.

  • Before taking medicine, you should carefully read the instructions for use. Make sure you take the correct dose and the correct brand of medication prescribed by your doctor.

  • It's generally recommended to take thyroid medication on an empty stomach to optimize its effectiveness. Specifically, levothyroxine should be taken at least 60 minutes before or 3 hours after eating. NDT, on the other hand, can absorb well regardless of food intake, but your doctor may still advise you to take it on an empty stomach.

  • Take your medication the same way and at the same time every day. Doing this will help you maintain stable thyroid hormone levels in the blood. You will not feel any improvement in your hypothyroidism symptoms if you take medicine sometimes in the morning and sometimes in the evening.

  • If you miss a dose, try to take it as soon as you remember. However, if it's close to the time for your next dose, it is better to skip the missed dose and continue with your regular schedule.

  • It's normal to miss a dose occasionally. However, it's important to make every effort to take your thyroid medication daily for optimal results. Setting reminders and having a consistent routine can help ensure you don't miss a dose.

  • Certain medications and supplements can interact with thyroid hormone replacement medication. The interaction can reduce the effectiveness of the medication or increase your risk of side effects. It's best to take them 4 hours apart from your thyroid medication to avoid any potential interaction.

  • Don't change your dose without your doctor's supervision. Taking a higher dose can cause you to have too much thyroid hormone and lead to symptoms of hyperthyroidism, while too low may not effectively manage your symptoms. You should have regular blood tests to have your medication dose adjusted in time if your hormone levels rise or fall abnormally.

  • Don't switch your medication without talking to your doctor first. Even switching to another brand of the same medication at the same dose can affect its effectiveness. This is because different brands may have variations in their formulations and the way they are manufactured, which can impact their absorption and effectiveness.

Keep in mind that a thyroid disease like hypothyroidism is permanent, so you may need to take the medication for life. Thus, it's important to take it correctly so you can manage your condition effectively.

Why should you take your thyroid medication on an empty stomach?

Taking your thyroid meds without food can be a hassle at first, but it's worth the effort. After all, taking your medicine correctly will ensure that your body gets the full benefits of the medication. When taken with food or right after eating, foods can interfere with how well your body absorbs these medications. An empty stomach ensures that nothing is blocking the way for proper absorption and utilization of the meds in your system.

Therefore, you should take medicine at least 60 minutes before or at least 3 hours after eating. The reason for the longer waiting period after eating is that some foods can stay in your intestines for a long time, so you have to wait many hours after dinner for your stomach to empty.

Keep in mind that these recommendations are mainly made for levothyroxine. NDT is generally not affected by food and can be taken with or without food. Still, it's a good idea to talk to your doctor first, regardless of the type of medication you are taking.

What is the best time to take your thyroid medication?

While taking your thyroid medication in the morning is the most common practice, some people prefer taking it in the evening for convenience. Busy individuals might find it difficult to wait the recommended 60 minutes before eating breakfast to taking their medication. And, if they are taking other drugs or supplements, the time between taking those and thyroid medication needs to be at least 4 hours.

If you want to take your meds at night, you should wait at least 3 hours after your last meal of the night.

There have been several studies comparing the effectiveness of taking the medication in the morning versus the evening. Some researchers have found that taking it in the evening improves thyroid hormone levels, while others argue that there is no significant difference. Ultimately, the best option will depend on your lifestyle and your doctor's recommendations. It's important to discuss with your doctor which option works best for you and to stick to a consistent schedule.

What foods should you avoid while taking thyroid medication?

Taking your medication on an empty stomach means you should avoid all kinds of food at least an hour after you take your thyroid medication. However, there are certain types of food that you should especially stay away from. These foods can either interfere with your thyroid medication or have a negative effect on your thyroid health. This can lead to a worsening of your hypothyroidism, as shown by T4 and thyroid-stimulating hormone (TSH) levels in your thyroid function tests. 

In the complex workings of the endocrine system, TSH is secreted by your pituitary gland. Its role is to control the performance of your thyroid gland. If TSH is elevated, your body lacks thyroid hormone. Conversely, if TSH drops, your body has an excess of thyroid hormone.

You should be on the lookout for the following foods that can prevent you from taking advantage of your medication and maintaining a steady thyroid hormone and TSH level.

Soybeans and soy products

Soybeans and soy products are a staple in Asian cuisine due to their many benefits. However, they may have negative effects on thyroid function.

Several studies have demonstrated that the two main components of soy, soy protein and soy isoflavones, reduce thyroid hormone absorption. As a result, you might need to increase your dose of thyroid medication to achieve optimal thyroid function.

You don't actually need to avoid soy completely. However, it's a good idea to wait at least four hours after taking thyroid medication to consume any soy-containing products.

Cruciferous vegetables

Cruciferous vegetables such as cabbage, cauliflower, kale, etc., bring many benefits to human health. They are considered ideal nutritional supplements because they are rich in fiber, vitamins, and minerals. In particular, cruciferous vegetables are low in calories but provide a feeling of fullness to the user, so they are often used as dietary supplements to lose weight and promote health.

However, studies have shown that these vegetables can interfere with how your thyroid gland uses iodine. Iodine is an important mineral for healthy thyroid function and thyroid hormone production, so an iodine deficiency can worsen your hypothyroidism. This is because cruciferous vegetables contain goitrogens, which shouldn't actually be a concern for people with healthy thyroid function but may not be good for hypothyroid patients.

Moreover, for people with hypothyroidism, vegetables can be difficult to digest and cause bloating. These vegetables are often high in fiber and other indigestible carbohydrates. When these fibers ferment in the gut, they can lead to the production of harmful byproducts like serotonin and endotoxins. These byproducts put extra stress on the liver, which can make it harder for the body to convert T4 into T3, a crucial step in maintaining healthy thyroid function.

While you don't have to cut cruciferous vegetables out of your life, you do need to consider limiting your intake. Make sure to cook them properly to break down compounds that are harmful to the thyroid. This means that you should avoid juicing the vegetables. In addition, you shouldn't consume more than half a cup of cruciferous vegetables per day.

Fiber-rich foods

Fiber is an important nutrient that our body needs, but too much of it can actually complicate your hypothyroidism treatment. To ensure that you're getting the right amount of fiber without interfering with your medication, aim to consume no more than 25 to 38 grams of fiber per day. This is important to keep in mind when consuming foods like vegetables (cruciferous or not), beans, and legumes which are all rich in fiber.

Gluten-rich foods

Gluten is a protein found in foods such as wheat, barley, and whole grains. If you have been diagnosed with both celiac disease or gluten intolerance and hypothyroidism, it's important to limit your intake of gluten. The reason is that gluten can irritate the small intestine in individuals with celiac disease, which can interfere with the absorption of thyroid hormone replacement medication.

Despite the fact that celiac and hypothyroidism are two different diseases. A study found that patients with celiac disease were more likely to develop autoimmune thyroiditis, which is a major cause of hypothyroidism, and vice versa.

Processed foods

Ultra-processed foods usually contain a lot of sodium, which is not great for people with hypothyroidism. Without having enough thyroid hormone, you are more likely to have high blood pressure. And sodium will only increase your risk.


Alcohol is a popular drink, but it can be harmful to both those with normal thyroid health and those with hypothyroidism. In particular, alcohol can inhibit the conversion of T4 to T3, resulting in a decrease of thyroid hormone in the bloodstream. Additionally, it raises estrogen levels in the body, which can lead to an underactive thyroid, goiter, or an enlarged thyroid gland. If you have hypothyroidism, you should cut out alcohol completely or drink in moderation. Otherwise, symptoms of hypothyroidism, such as fatigue, weight gain, hair loss, and constipation, may continue.

Can I drink tea after thyroid medicine?

The type of liquid you pair with your thyroid medication has an effect on its effectiveness. It may be tempting to take your thyroid medication with a cup of tea, especially if you're taking it in the morning, but if you want to get the full benefit from your meds, it's best to stick with plain old water.

So can you still drink tea at all?

Yes, you can still enjoy your favorite cup of tea. However, you need to wait for at least 60 minutes after your thyroid medication. Some types of teas may even be beneficial for you. For example, chamomile tea can help alleviate constipation, which is a common symptom of hypothyroidism. However, you may want to reduce your intake of teas that contain caffeine, like black tea and green tea.

What about coffee?

Many people often start their day with a cup of coffee. But if you take thyroid medication, it's important to be aware of the potential interactions between coffee and your prescription.

Coffee contains caffeine, which can block the absorption of your thyroid medication. Therefore, to keep things running smoothly, it's best to wait at least an hour after taking your daily dose before enjoying a steaming cup of joe – or other caffeinated beverages you love.

Do drugs and supplements interact with thyroid medications?

Certain medications, especially those containing calcium, magnesium, aluminum, and iron, can decrease the absorption of thyroid medication. An example is an antacid. In addition, you should also pay attention to the following drugs:

  • Antibiotics, such as rifampin and ciprofloxacin

  • Antidepressants, such as fluoxetine and amitriptyline

  • Ulcer medications, such as Carafate

  • Antacids, such as Omeprazole, Ranitidine, and Pepto-Bismol

  • Cholesterol-lowering drugs, such as colestipol and cholestyramine.

You should take these medications at least 4 hours apart from your thyroid medication. It's important to know that as many as 201 drugs are known to interact with thyroid medications. Therefore, this is not a complete list of drugs you should be careful of. Always tell your doctor about all the medications you're taking, including supplements and herbs, so they can guide you on the best way to take your meds.

Conclusion: some foods can interact with your thyroid medications

If you're taking medication to manage your thyroid health, it's important to know how certain foods can interact with your medications. The key is moderation. Eating too much of the wrong food can affect how your thyroid medication works and may even be bad for your overall health. But that doesn't mean you should swear off these items forever; just eat them in balance with other healthier foods and enjoy the benefits they provide. Plus, always make sure that you wait at least 60 minutes before or 3 hours after taking your thyroid medications to enjoy these foods.

It's not only important to avoid foods that may negatively impact your thyroid health but also to incorporate foods that are beneficial for your thyroid function. Iodine-rich foods such as seaweed, fish, and dairy products are great options to support your thyroid health. Additionally, including foods high in selenium and zinc, such as Brazil nuts and oysters, can also help support the health of your thyroid gland.

And if you don't want to wait before eating your breakfast, you can consider taking NDT instead. According to some studies, the absorption of NDT is not significantly affected by food, which means that it can be taken with or without food. However, it is important to note that the absorption of any medication can vary from person to person, so it is always best to follow the instructions provided by your healthcare provider.

VitaliThy, a natural desiccated thyroid you can buy online, is a great option if you want to avoid food interactions and the need to wait before or after meals. Many people find it a great option to manage their thyroid disorder.

Wojciech Majda
Wojciech Majda

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