Attention Thyroid Patients: Coffee Can Interfere With Thyroid Medication Absorption
Attention thyroid patients: your morning coffee may be interfering with proper absorption of your thyroid medication. I know, say it isn't so! You're already tired from being hypothyroid -- now they want to take away your coffee? The findings were reported in a recent article in the journal Thyroid. What the researchers found is that in addition to some of the more commonly known issues with absorption of thyroid hormone (i.e., calcium, iron, and food taken at the same time as thyroid medication can interfere with absorption), coffee also interferes with the intestinal absorption of levothyroxine. In the study, patients took their levothyroxine (i.e., Synthroid, Levoxyl, Levothroid, Unithroid), with espresso or coffee, and researchers found that the coffee/espresso reduced the rise of the T4 after taking the medication by at least 25% to as much as 57%.
What Should You Do?
At this point, the evidence is strong enough to suggest that you should not take your thyroid hormone replacement medication with coffee. Ideally, take your thyroid medication, and wait an hour before you have your coffee.
If that's not possible, then you may want to talk to your doctor about taking your levothyroxine medication at night. Not only has it been shown in some studies to improve absorption, but it also is easier to take your medication at night, and avoid any impact from food, supplements -- or a cup of coffee -- taken in the morning. Find out more about taking thyroid medication at night.
WHAT ELSE SHOULD YOU KNOW ABOUT TAKING YOUR THYROID MEDICATION?
Read How to Take Thyroid Medication
Source: Benvenga, S. et. al. “Altered Intestinal Absorption of L-Thyroxine Caused by Coffee.” Thyroid (volume 18 Issue 3, pages 293-301), March 2008
Photo: clipart.com
Comments
I wonder if tea also interferes. I don’t drink coffee, but I often have a cup of hot tea with no milk or sugar while waiting the hour until I can eat breakfast.
I need my coffee in the morning! Taking the medication at night seems to interfer with the wisdom that it works best on an empty stomach. Your stomach isn’t empty if you’ve been eating all day. I wonder if it’s better to take at night or in the morning slightly before my coffee.
I was told that as long as you take your medication at approx. the same time and with the same amt. of coffee or any other liquid your levels can monitored and medication adjusted accordingly. I have always taken my meds with coffee in the morning,and have had good numbers for the past 3 years without a dosage adjustment. Just be consistant.
Good comments about Armour I wish I lived in the US. That med is not available for us in Canada. I started taking my thyroid meds at night 6 months ago because I was put on iron supplements and had a consult with a pharmacist who recommended the change. I find it super easy to just keep my thyroid meds in my nightstand and take at night since our stomachs empty in 2 hours no worries even if we have been eating all day. With all that said I have noticed a HUGE change. I feel so much better and my test results have reflected that as well. I’m still having some problems with my iron levels and my doc has been able to now focus on that specifically because my thryroid is not an issue. I wasn’t part of a study but man when you feel better because of a little change in the time you take you meds it’s great. I”m thrilled.
Cheers
I have had thyroid disease for almost 40 years. Had it about 10 years before they finally discovered what was going on. I have had every symptom i have read about-dosages been changed so often. Was on Snthyroid for number of years until they came out with generic and then i think-that is when all my problems began as far as so many different other symptoms-in the hospital several times in about 4 months-when finally one doctor said needed to see an endocrinologist and they told me needed to be on branded medication instead of generic. Seems to be solving the problem. It is good to get in where can see what other people have experienced. Dee
I take my Synthroid in the middle of the night when I get up to go to the bathroom. I keep my pill in a little bowl and glass of water on my night table. This way, my bloodstream is free to utilize my Synthroid totally and gives me the freedom to have whatever for breakfast!
The study doesn’t mention the temperature of the coffee. Heat can destroy or reduce effectiveness of thyroid meds so perhaps it’s the heat factor. Also, the sampling of people is tiny. Other factors to consider are coffee contains magnesium and soluble fiber — but on the other hand, caffeine has a stimulatory effect on the thyroid so I would think that would counteract these factors. I NEED my coffee in the AM…I am not convinced enough by this study to stop my practice of swalling my AM armour and cytomel with water while I wait for my delicious coffee to brew.
I do the same Gail
And that seems to work for me too.
Kelly Mac, I get my desiccated thyroid medicine from Canada. It is called “Thyroid”, and I believe the company that makes it is Erfa or something like that. It is just like Armour, actually, I like it better.
As an unabashed java junkie, I will do ANYTHING but stop drinking coffee. That being said, I also don’t like to take any medicine with coffee.
I have been prescribed Armour, and my prescription calls for me to take it twice a day, at least one hour before food. Perhaps those that take their meds in the morning can do an ‘early’ alarm, at least one hour before they eat breakfast, take the meds, and ‘nap’ until normal waking.
I have taken my thyroid meds an hour before I “officially” get up for a long time. However, I have also heard that if you are consistent’ i.e., take it with the same amount of coffee, tea, etc. every morning, your levels will be consistent. Tea also has caffeine so it must be considered just as you would consider coffee or cola drinks.
I take mine about 4:00 a.m. as I always have to go to the bathroom anyway. It made a big difference when I made the change… my labs now come back consistant… I take a lot of vitamins… I believe they work so I’m doing it… anyway too many things to interfer with my Synthroid so it’s better to take early. Lastly,I won’t take generics… the principle ingredients are the same but there are always variations. Your thyroid controls every cell in your body… why dink around with it? Gotta respect it! Since I turned 40 my weight is creeping up… even with meds I have to watch it like a hawk… don’t hawks eat sticks and twigs??? I can be a hawk… lol have a great day!
I’m an RN and used to work in the hormone business. First, most doctors don’t balance thyroid adequately, leaving patients hypothyroid and fatigued, second, according to the lab reports I’ve seen, most people with low thyroid also have low DHEA. Optimal is about 250+. Below 50 it causes fatigue you can’t sleep out of. Schiff brand is good. 25 mg. for women, 50mg for men.
Nancy,
I was told by my Dr. that DHEA was a dangerous supp to take due to the fact that it can change part of my estrogen supp to a cancer-causing chemical in the body.
This is not as bad as I expected from the title. Like others, I take my meds when I wake up in the middle of the night. Finally, there’s an advantage to the annoying pattern of waking up.
Is this report dealing with regular coffee or is decaf included as well? I would be interested in knowing if they studied both.
Does coffee interfere with taking armour thyroid pills or is just the synthetic medicine?
I always take my Levoxyl pill as soon as I wake up, on an empty stomach and with a full glass of water. THEN I wait for one full hour before eating, drinking or taking any other prescription meds or vitamin pills. It works for me!
I agree with Dee. Somehow after a move, I was changed to a synthetic, synthyroid. I gained weight, had aches in joints really bad, hair falling out, became dizzy all the time. Over six months symtoms showed up. I could not go anywhere. I was sent to Endocrinologist. He said I should not take synthetic. Within 2 days, my symtoms were gone. Back to Levoxyl for me.
To Kelly Mac - in Canada, medication very similar to Armour is called Thyroid. It is available at most pharmacies. You may want to talk to your GP about it - Erfa is the name of the company who makes it. It is dessicated thyroid just like Armour but has slightly different additives.
I’ve been taking Armour thyroid for 28 years now and I’ve never had to change my dose. I’m tested every 6 months and my levels stay consistent. I’ve always taken my thyroid pill at bedtime, right after I brush my teeth. My doctor told me that what I am doing is working so to continue to take the pills when I do. I eat an early dinner so my stomach is empty at bedtime.
I wonder if this applies for every type of caffeine product or if it is limited to coffee. I dont drink coffee because it messes my stomach up something awful, however I do get my morning caffeine through a coke or a pepsi. Go figure! this doesnt bother my stomach at all…maybe it has to do with them being cold and not hot? if anybody finds out if this is about caffeine or just coffee please let me know. My email is ceedee22ed@yahoo.com
From the VERY beginning (7 yrs. ago), I took my Armour at bedtime (10:30 p.m.). I typically eat my last meal at 5 p.m., and usu. DON’T snack or have coffee after that. My wt. remained the same for 4 yrs. after the onset of my Hashimoto’s Disease. Sadly, it bizarrely & quickly JUMPED all of a sudden at the 4th yr. I’m now up 10 pounds from my wt. at the onset of my disease. My TSH, Free T4 & Free T3 are great, my Thyroid gland is actually shrinking, and I have no nodules. I do aerobics 3xwk for one hr., and try to make sure I get protein (your body wt divided by 2.2 = total grams of protein needed per day), fiber and adequate progesterone levels. Bedtime dosing works for me!!! I love coffee, suffer regularly from fatigue, & I have to eat & do coffee immediately after getting out of bed…there was no other way 4 me except bedtime dosing. Also, my cholesterol & trigylerides are VERY low & excellent following a Lacto-Ovo Vegetarian diet with fish sometimes. How then, do I lose wt.? I had problems with Hypo-adrenalism on and off.
I think the study is too small of a sample to evaluate the potential problem. I noticed the study was taken in Italy, where perhaps the caffeine concentration could be higher? It studies the outcome of coffee or espresso; however the liquid measure, nor the caffeine content in the serving of coffee or espresso is indicated. 8 patients and 9 volunteers does not a study make. If you read the outcome of the study, is to assume the second measure is for water alone? ‘In patients and volunteers, the four outcome measures were similar in the water and water + coffee tests. In patients and volunteers, COMPARED TO WATER, coffee lowered AIRST4 (by 36% and 29%), PIRST4 (by 30% and 19%), and AUC (by 36% and 27%) and delayed TMIRST4 (by 38 and 43 minutes)’ Does that mean that WATER ALONE lowered AIRST4 by 29%, PIRST4 by 19%, AUC by 27%, and TMIRST4 by 43 minutes? I read the study over many times and I can’t figure it out. Can anyone help me out here?
Thanks, Mollie
I had read a long time ago that taking my Armour sublingual ,it doesn’t go thru your stomach /intestines . if you put it under your tongue & let it desolve…it goes thru your blood stream , & there should be no problem with the coffee etc.?
Just wondering. What about anti thyroid meds. I am going to start taking methimozole once a day. I take it with food. Would it be best with dinner. Or is it okay in the morning with breakfast. And, almost without saying, coffee.
I tried taking my Thyroid medicine at night, but it kept me awake the whole night!
I’m amazed that Kelly Mac wishes she lived in the US. I wish my family lived in Canada. My daughter has type 1 diabetes and she will age off my husband’s health insurance in 2 years. That is a very scary life issue!
I take my Cytomel(straight T3) buccally (between cheek and gums), and I dose 4 times per day including a dose at bedtime.
With buccal dosing I don’t think intestinal absorption is an issue of any concern. Certainly I don’t notice any interference from calcium taken at or near my thyroid doses.
I wonder if these study results apply at all to T3 only meds or to the direct T3 in dessicated thyroids like Armour.
sol
to Mama,
check with your health ins … I believe there is a provision for children with deisease that keeps that coverage in force … and never worry … keep your trust in God to provide all you need.
I take armour, a natural thyroid replacement, so I don’t have to worry, when I was on synthroid it nearly killed me..
Am taking Levoxyl 75mcg for hypothyroidism that was diagnosed under some pressure from me last January. (I had symptoms galore, but my TSH was “only” 5.8 [.50–5.0].)
Have tried to be careful about timing of meds, and considering the growing number of negative reports about coffee (which MAY have both good and bad things in it!!!), I rarely have it, and then only one cup in a day.
Instead, I have a cup of artificially sweetened cocoa in AM. Does anyone know if there are good reasons to suspect that has any effect on med’s absorption, or other effects?
Thanks.
I have always taken my synthroid at night. Although I am not a real “breakfast person” - I do not like waiting for an hour after getting up to eat. My numbers stay stable and I have been doing this for eleven years, after trying once or twice to change to mornings when conventional wisdom says I should take the medication. I also feel better when I take my medicine at night.
I think taking your thyroid meds at the same time, eating at the same time before/after your meds and drinking about the same amount/time of coffee each day, you have an established pattern. If your thyroid meds aren’t absorbed as well, your numbers will show it and you won’t feel as well. As a result, you may be on a higher dose of meds if you drink coffee each day compared to if you didn’t. If you change your routine, that will affect your absorbtion and thus, how you feel.
Thanks to Bren and Geri for the info about Armour in Canada. Just a quick question. Does my GP convert my does now to a comparable Armour? I was prescribed my meds by and endo do I have to include him or can I just speak to my GP? Thanks so much for the info this helps me manage my health much better and I can go back to the person who told me we can’t get it in Canada and pass on what you have said.
Mame I’m sorry to hear about your daughter’s health crisis and I was not trying to shoot you down and was just making a comment about my own personal position with thyroid meds please don’t make people feel bad about questing information because you are reading something and taking it personal. I do believe there is a solution for you and that you are afraid for you daughter which I can sympathize about.
Kellie, I sorry that you thought I was trying to make you feel bad about questioning information. I was only trying to tell you that American health care is awful and I was surprised that anyone would want to be under it. I have Canadian relatives and am familiar with both systems. My daughter’s graduate school options are NYC, Chicago or Toronto. She will probably go to Toronto and stay there.
When I had my thyroid nuked in 1996, my endrochonologist prescribed Synthroid.
As the months went on and he tested me quarterly for a while, he put me on decaf, he told me to stay away from orange juice in the morning as well, because both regular coffee and orange juice, he found, could negatively affect absorption.
Also, it must be taken alone.
No other medication should be taken less than 2 hours after taking Synthroid.
He taught me to take my Synthroid (”ideally”) at 9AM to give me more energy during the day, so that’s how I take it each day.
I’ve never tried taking it in the evening.
My solution to avoiding ALL thyroid-absorption interfering substances is to take my Armour when “nature calls” first thing in the morning… okay, so I’m 55 and this could be 5am… and I don’t “get up” for real until
7am… I am also diabetic, so I usually take my fasting blood sugar first, then take my thyroid hormone. This has helped me avoid
milk(calcium), coffee/tea and anything that may bind the hormone and keep it from being metabolized…..
Barbara, thanks for your thoughts. In order for a child to stay on the parents insurance they need to be not self supporting because of physical disability or mental retardation. My daughter has Type 1 diabetes, with appropriate heath cares, TG, she can work. She will have a very hard time finding anyone to insure her. That is one of the flaws in the American system. Mame
Kellie Mac,
I’m in Edmonton and take Thyroid. My GP knows nothing about it and isn’t interested in finding out, so I asked my pharmacist for the name of a doctor who prescribes it regularly. I now see both doctors and just keep my GP informed of what dose I am on for her records. The doc that prescribes Thyroid for me is an MD who prefers to ‘prescribe’ supplements and diet changes, but also detests the artificial thyroid drugs. He also prescribes things like compounded hormone creams. I now have to pay to see him though, since the AB gov’t has decided the drugs he prescribes are too alternative for them to cover visits for. Ask your pharmacist for a doctor recommendation.
I’ve always taken my armour under my tongue. I heard more of it is absorbed that way because it goes directly into the bloodstream, and because it bypasses the stomach, what and when I eat is not an issue.
Kelli Mac
I have had many friends, young and old, take a chewable iron tablet (GNC carries one as does Nutrition Now), they are grape flavored, and very low dose and guess what? Everyone who has tried them has had their iron levels go up to normal within a very short period of time. These are all people who had levels so low their Doctors wanted to give them blood to raise it up. They also were given scripts for those horrible iron pills that cause constipation, etc. and had little or no results and lots of problems. Why do they work? Probably because they are chewable and go to work immediately with NO side effects what-so-ever! Unlike those cement pills the drs. push. And these chewables are cheap. Try it. It will change your life. And its fun to see the look on the docs face when your results are good and he can’t understand how it happened!
Has anyone heard that they are taking Levothroid off the market? I just found out today when I tried to get my prescription filled. I am devestated because this is the only medication I can take. Anyone in the same situation?
its not true. are you sure that “you” heard this?
armour thyroid is the med they keep threatening to take off the market, but these are just rumors started by pharma salesmen.
i work at a pharmacy and hear this all the time. please dont scare people like that. many, including myself, are dependent upon thyroid preparations. i was really scared the first time i heard that rumor… about 10 years ago.
I chew my Armour thyroid. Bite down on it, let it dissolve. Gone in 10 seconds and doesn’t go thru the stomach. Some here say they dissolve it under tongue..yuck!! Bite down on it first. It crumbles easily. Presto - no coffee issues. It’s in your system already.
My doctor told me I could not eat or drink anthing (except water) until 1 hour after I have taken the medication in the morning.
I specifically asked if I could have coffee and she said no - 1 hour rule still applies!
Yikes,
Since I am middle aged, I must get up once a night to use the bathroom. That’s when I take my thyroid medicine…it’s usually between 3 and 4 am. This works out great and doesn’t interfere with morning coffee!
I’ve been taking Synthroid for several years & and I’m also a regular coffee drinker. From my personal experience, the hour wait in the morning isn’t that bad if you drink a couple glasses of water. I have a philosophy that doing about 10-15 minutes of stretching is a great way to get the absorption process going by getting blood to circulate, and the rest of the 45 or so minutes is a great time to do menial tasks like cleaning. At the end of an hour, you get to treat yourself to a great big breakfast in a clean house. Nothing wrong with that.
This article about coffee was very significant for me. I had been taking my Armour thyroid when I got up, usually having coffee within 20 minutes. Since I tend to wake up around 4 a.m., as a couple of other posters mentioned they did, 10 days ago I began keeping my Armour on my bedside table and taking it at that time. I usually wake up at 7. I can tell it’s making a difference! I feel more energetic, more focused and in a better mood.