The study found that the TSH level was for patients taking their medication with breakfast was higher (2.89) vs. those who fasted (1.9). mIU/L, p=0.028). The researchers concluded that taking levothyroxine with food is more likely to cause a variable TSH level, and therefore patients who take their thyroid medication with food need to be followed more closely.
According to the researchers, when patients need to maintain a speciﬁc targeted TSH -- for example, in thyroid cancer patients after surgery whose goal is to maintain a suppressed TSH -- taking levothyroxine while fasting is recommended.
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Perez, Camila, et. al. "Serum Thyrotropin Levels Following Levothyroxine Administration at Breakfast," Thyroid, Volume 23, Number 7, 2013