How to Effectively Take Your Thyroid Hormone Medication

by Mary Shomon Patient Advocate

When you are hypothyroid, your doctor will prescribe a thyroid hormone replacement drug to provide the hormone your gland is unable to produce on its own. Well-known brands of levothyroxine — the most commonly prescribed drug — include Synthroid, Levoxyl, and Tirosint. Here are some guidelines to help ensure that you take your prescription thyroid medication correctly.

Customer receiving prescription from pharmacist

Always double-check your prescription

When you go to the pharmacy or receive your prescription thyroid medication by mail, you should always review the bottle and related printouts to confirm that you have both the correct medication (and brand, if relevant) and the correct dose. It’s always a good idea to review the actual pills as well. Unless your doctor has changed your dose, the color should remain the same even if the pharmacy has changed the brand. And don’t forget to check the expiration dates of medications.

Prescription drug bottle on countertop

Store your thyroid drugs properly

In order to ensure that your thyroid drugs remain effective, you need to store them properly. Manufacturers, pharmacists, and experts recommend that you store thyroid medication away from moisture— this means that you should not store your thyroid medication in your bathroom — and at room temperature. Also, be careful to keep your medication away from excessive heat, such as leaving it in a hot car or mailbox.

Black coffee and pills

Take your thyroid medication in the morning

Most prescribing information recommends that you take your thyroid medication first thing in the morning. Ideally, you should take it on an empty stomach and wait at least an hour before eating and/or drinking coffee, both caffeinated and decaf.

Supplements in daily pill box in front of bottles

Avoid interactions with iron and calcium

You need to wait at least three to four hours after taking your thyroid medication before you take any foods or supplements that contain iron and/or calcium. This includes milk, calcium-fortified beverages, antacids, and supplements. The iron and calcium in foods and supplements can negatively interfere with your ability to effectively absorb your thyroid medication.

Woman taking a pill

Take your thyroid medication at bedtime

If you take thyroid medication at bedtime you can eat, drink, and take supplements in the morning while avoiding any impairment of your thyroid hormone medication’s absorption. Some studies show that taking your thyroid medication at night may also result in improved absorption. Discuss with your practitioner before switching, and if you do, consider getting retested within three months to ensure that you don’t need to adjust your dosage.

Sick young man leaning on the wall

Consider thyroid medication for people with allergies, digestive issues, or absorption problems

If you’re allergic to dyes and fillers, have a digestive issue or condition (such as celiac disease, inflammatory bowel disease (IBD), or Crohn’s disease), or have other issues that could affect your ability to absorb your medication, then you may want to discuss Tirosint with your practitioner. Tirosint is a brand-name, hypoallergenic, form of levothyroxine, available in gel-caps and a liquid, that was designed to improve absorption of thyroid medication in people with allergies and absorption problems.

Dietary fiber

Be careful and consistent about fiber

You should be aware that making significant changes to the fiber level in your diet can affect your absorption of thyroid medication. Higher levels of dietary fiber can reduce your absorption, so be careful about making a dramatic change to your fiber intake. If you do make a change, consider being tested to see if you need a dosage readjustment.

Woman choosing between supplements

What about taking thyroid medication sublingually?

Some people claim that they’re able to bypass interactions with food, coffee, and supplements by taking their thyroid medication sublingually, waiting for the pill to dissolve under their tongue. Note that according to thyroid drug manufacturers, there is no scientific evidence to back up this practice.

Nurse Preparing Weekly Pill Organizer

The key is consistency

No matter how you decide to take your thyroid medication, the key is consistency. Aim to take your medication at the same time and in the same way each day.

Young woman holding a pregnancy test

An important note if you become pregnant

If you become pregnant, it’s important for you to continue taking your prescribed thyroid medication. Thyroid hormone replacement drugs are safe during pregnancy and are essential to the healthy development of your baby. If you don't already have a plan in place to increase your dose after confirming your pregnancy, you should see your physician right away for thyroid blood testing, as your dosage will probably need to be increased.

Mary Shomon
Meet Our Writer
Mary Shomon

Mary Shomon is a patient advocate and New York Times bestselling author who empowers readers with information on thyroid and autoimmune disease, diabetes, weight loss and hormonal health from an integrative perspective. Mary has been a leading force advocating for more effective, patient-centered hormonal healthcare. Mary also co-stars in PBS’ Healthy Hormones TV series. Mary also serves on HealthCentral’s Health Advocates Advisory Board.