Keys to Taking Thyroid Medication Correctly

Taking a thyroid hormone replacement drug like Synthroid (levothyroxine) or Cytomel (liothyronine/T3) the right way can influence how well your body absorbs it. Failing to get the full dose of your medication can throw your hormone levels out of balance. In particular, it is important to know when to eat after taking thyroid medication.

Understanding your thyroid medication can help you effectively manage your thyroid disease. This way you can ensure that you're doing all you can to help your hormone replacement drug do its job.

This article will discuss the essential facts about thyroid medication. It will also provide tips on when you should take your thyroid medication.

Be Consistent

Hypothyroidism is, in most cases, a lifelong condition that must be strictly managed. It's important to take your prescribed dosage every day at the same time.

You should also be consistent about other issues. For example, you need to remember that you should take your medication on an empty stomach. You also need to know which foods to avoid in the first few hours after taking your medication. Talk with your healthcare provider to learn more about the right way to take your thyroid medication.

Some people find it difficult to get into a daily routine with their thyroid medication. Keeping your medication in the same place all the time may help. Setting an alarm on your cell phone may also help you remember to take your dose at the right time.

Continue to Take Your Medication

Some people decide to go off their thyroid medications altogether without talking to their healthcare provider. This can be particularly dangerous if you have a surgically removed or radioactive-ablated thyroid. It's also dangerous if your thyroid is atrophied or underactive due to Hashimoto's disease.

When you don't take your thyroid medications, you may experience symptoms of hypothyroidism along with a rise in your cholesterol and even your risk for heart disease.

In the past, some people believed that decreasing the dose of thyroid replacement might reduce the risk of heart-related issues. But the opposite may actually be true.

Pregnancy and Breastfeeding

Some women mistakenly think that thyroid hormone drugs are dangerous to a baby during pregnancy or breastfeeding. As a result, they wonder if they should stop breastfeeding their baby.

The opposite is actually true. Taking the appropriate dose of thyroid medication is essential for a healthy pregnancy and baby. And most often, thyroid hormone doses need to be increased when a woman learns she is pregnant.

If you feel nervous about taking medication during pregnancy, keep in mind that you are simply replacing a hormone that your body is not making in adequate amounts.

Eat at the Right Time After Your Dose

Ideally, you should take your thyroid medication in the morning on an empty stomach. Wait 30 minutes to an hour after taking your thyroid medication before eating. This helps ensure that the drug is properly absorbed in the intestine so you get your full dose.

Although it's generally better to take your thyroid medicine in the morning, you can take it at night if you prefer. Just make sure to take it at least three to four hours after you last ate. It is also important to be consistent about when you take your medicine, so if you choose to take your thyroid medicine at night, make sure to always take it at night.

Keep in mind, too, that some foods should only be eaten at least three to four hours after taking thyroid medication. Examples include calcium-enriched foods such as high-calcium orange juice and Greek yogurt, as well as fiber-rich foods.

Are Goitrogenic Foods a Problem?

Goitrogens are substances found in some foods that may have an anti-thyroid effect. However, experts don't agree on whether foods such as cruciferous vegetables can interfere with the overall effectiveness of your treatment.

Examples of foods that are highly recommended as part of a healthy, cancer-prevention diet include:

• Broccoli
• Cauliflower
• Cabbage
• Kale
• Berries
• Green tea

Don't try to completely avoid these foods, but you may want to spread them out so you aren't eating large amounts during any single meal. The same appears to be true with soy foods. Eating them in moderation when you have thyroid disease seems to be key.

Don't Drink Coffee With Your Thyroid Medication

Coffee can also interfere with the way your body absorbs thyroid medication. If you can't wait an hour to have your early morning coffee, there are a few options you may wish to discuss with your healthcare provider. Coffee doesn't seem to affect Tirosint, a gel-capsule or liquid form of levothyroxine.

If you are taking a different brand of levothyroxine and don't want to change, you can also talk to your healthcare provider about whether you can take your thyroid medication at bedtime.

Consider Other Medications You're Taking

Like food, other medications should be taken at least an hour after you take thyroid medications. This will help avoid any problems with absorption. But with some drugs, waiting even longer is important. For example, you should wait at least four hours before or after taking thyroid replacement medications before using antacids.

Many medications can interact with thyroid hormones, either increasing or decreasing the amount available to your body. Common examples include:

• Antidepressants
• Proton pump inhibitors
• Diabetes medications

HRT and Birth Control

Women taking estrogen—hormone replacement therapy (HRT) or the birth control pill—may need more thyroid replacement hormone. Estrogen increases the body's production of a protein that makes thyroid hormone inactive.

To compensate for this, the dose of thyroid hormone may need to be increased slightly. After you start or stop taking oral contraceptives or hormone replacement therapy, your healthcare provider should test your thyroid levels to determine if it is affecting how your thyroid works.

Be sure that the healthcare provider prescribing your thyroid medication and monitoring your thyroid disease is aware of these and any other drugs you are taking.

Be Careful When Switching Brands of Levothyroxine

Brand-name levothyroxine is typically consistent, in terms of potency, from refill to refill. That is not always the case, however, with different generics.

For some people, the variation in consistency from one maker of generic levothyroxine to another can have a negative impact on proper thyroid replacement. If you have this experience, you may want to ask your healthcare provider about writing a "dispense as written/no substitutions" prescription for a brand name levothyroxine.

If you do switch medications, either brand names or generics, it's important to follow up with your healthcare provider to have your thyroid tested. This is usually done six weeks after the change is made. Then your healthcare provider should check it about every six weeks thereafter until your levels are stable.

Don't Assume "Normal" Labs Means Your Dose Is Optimal

While the reference ranges for thyroid tests often give a thyroid-stimulating hormone (TSH) range of 0.4 to 5.0, the fact that 95% of people without thyroid disease have a TSH between 0.4 and 2.5 has led some researchers to believe a goal TSH in this range may be optimal.

A person who continues to have hypothyroidism symptoms with a high-normal TSH, for example, may benefit from getting their TSH closer to 1.0.

Also note that, for some people, it may be a good idea to check additional thyroid tests, such as T4, free T4, T3, free T3, and thyroid autoantibodies even if your TSH is normal.

Summary

Taking your thyroid medicine the right way can help your body effectively absorb it. Consistently taking it at the right time as well as avoiding food too soon after taking it are all important things you should remember.

It's also important to be careful when taking other medications along with thyroid medication. And if you switch brands or switch to a generic, you may need to get your thyroid levels tested.