The maintenance of steady and predictable thyroid hormone levels in the blood is essential to health (see normal thyroid hormone levels). Patients with hypothyroidism need to take thyroid hormone by mouth as a medication each day. Dietary habits can influence how the body absorbs thyroid hormone.
Thyroid medication should be taken on an empty stomach, around the same time each day. Afterwards, we recommend avoiding eating or drinking for 30-60 minutes. Most of our patients take thyroid hormone in the morning upon waking. Breakfast, including any coffee or milk, can be eaten 30-60 minutes later. The second most popular method is to take thyroid hormone in the evening, at least 3-4 hours after any food intake. You should try to establish a routine that allows you to be consistent each day.
Certain medications and supplements decrease absorption of thyroid hormone and should be taken 3-4 hours after taking thyroid hormone. These include fiber supplements, calcium and iron supplements, proton pump inhibitors (omeprazole/Prilosec and lansoprazole/Prevacid), soy products, and multivitamins with minerals.
Unfortunately, even coffee can interfere with how you absorb thyroid hormone. We recommend waiting 60 minutes after you take thyroid hormone to drink coffee. If you are having trouble maintaining an empty stomach in the morning, please discuss this issue with your physician.
If you occasionally do not wait the full recommended time before eating or drinking, do not worry. This is not dangerous. Just do your best the next day.
The recommendations provided here help your doctors to dose your thyroid medication more accurately and decrease the need for frequent blood tests. If you are having trouble taking your thyroid hormone consistently, please speak with your doctor.
Taking your thyroid hormone at night is a fine option, but remember that it should be taken on an empty stomach and at least 3-4 hours after eating.
Missing a single dose of thyroid hormone is not dangerous, so please don’t panic! Please ask your doctor what they would like you to do if you miss a dose of thyroid hormone. In many cases, your doctor may ask you to take two doses the next day. In some instances, skipping a dose is okay.
Biotin has no effect on the thyroid, but it does interfere with thyroid lab tests. If you are going to have blood tests to check your thyroid function, please stop taking your biotin three days beforehand to have an accurate result.
Further reading & references