Why are you meant to take thyroid meds on an empty stomach?

[sulamaye]

I know that you're meant to take thyroid meds on an empty stomach for better absorption but why when so many supplements etc are absorbed better with food is it better to take thyroid meds without food? I often sugar crash after taking my T3 or T4.

[Clutter]

Sulamaye, The molecules in T3 and T4 bind to proteins in food and drink reducing absorption. Vit D needs fat to aid absorption so is better taken with food. Not sure about other supplements. Either food aids absorption or food protects the gut from the supplements and fillers.

[helvella Administrator Thyroid UK]

If your intake of most supplements and medicines were to vary by 5 to 10% it would probably make little difference. So mild interactions with food, which enhance or reduce absorption by this sort of amount are not usually that important.

That sort of variation in thyroid hormone absorption could be very significant. The impact of small variations is what caused the Teva levothyroxine to be withdrawn from the market.

Of course, where there is another impact (e.g. iron supplements are well-known to cause stomach discomfort and should be taken with food to reduce the severity of that discomfort) then compromises are sometimes needed. Perhaps taking something that can help stabilise blood sugar some time before the thyroid hormones would help? One example is oats - perhaps a bowl of porage two hours before?

Rod

[sulamaye in reply to helvella]

Thanks for the explanation. I often get reactive hypoglycaemia so have been known to sugar crash after meat only, which is crazy and my endo didn't believe me at the time, when do they ever? But I will try a bowl of muesli the protein and oats might help, but if there's anything left in my stomach after two hours wouldn't that bind with the thyroxines too?

[faith63 in reply to sulamaye]

Yes..i was told that slowed digestion from being hypo will contribute to absorption problems, but the milk in your cereal has calcium as well, which definitely causes absorption problems. Calcium and Iron..4 hours apart from thyroid meds. Milk and cheese also coat the stomach..even more problems anywhere near meds.

[helvella Administrator Thyroid UK in reply to sulamaye]

That is where we are into "compromise" territory. Better to leave it longer, but suffering from hypoglycaemia isn't good either.

I am not much of a believer in consistency being more important than keeping thyroid hormones apart from foods and drinks, I don't believe that people are as consistent about what they eat, drink and when as perhaps they think they are. But consistency is better than doing nothing to try to avoid problems.

Rod