I thought I knew what I was doing.....levothyroxine woes

Well you live and learn!

I thought i was taking my Levothyroxine properly only to find out today I may not be :-(

When I picked up my repeat prescription today the Pharmacist asked if I had time to have a quick chat about my medication and wellbeing. Apparently the NHS asks Pharmacies to do this from time to time. It only took 5 minutes and was very useful....

I learnt that I shouldnt take vitamin D or calcium supplements within two hours of taking my medication, including drinking milk or milk products. Good job I dont have cereal for breakfast and drink black coffee then. Ah hang on, I should actually take my medication with water not coffee as that may stop absorbsion ..... nooooo......! Neither should I take antiacids or iron supplements within that time period either.

Well what can I say? I wonder if i just forgot this? I honestly cant remember the doctor telling me all that, and actually I am sure it's not on the information leaflet. Oh and it's not on the little sticker that's always on the medicine box. You know, the one that says 'take before food', etc.

i blame my age, the fact I think I know what I am doing, and not quite being awake when i take the tablets. The moral of this story is.................

40 Replies

  • Not your fault. Many doctors don't seem to know the best time and how to take medications either.

    Virtually all medications including over the counters ones like pain killers and supplements should only be taken with water. As other fluids either inhibit absorption or speed it up.

  • I can't tolerate caffeine and discovered years ago that super strength paracetamol just as caffeine added. If you can tolerate it just have a coffee with your pain killer and save yourself some money on the higher priced super strength tablets.

  • I've always taken my levothyroxine and liothyronine immediately prior to my cereals with milk and had no problem. I think milk is only a problem if you also have a dairy intolerance.

    The really big one to avoid is coffee, this can have a big effect on levothyroxine absorption ncbi.nlm.nih.gov/pubmed/183... .

  • Ladyinpurple,

    I doubt you were ever told. I was given Liothyronine and later Levothyroxine via 2 different hospitals. I had no advice other than the Patient Information Leaflet and I thought 'take before food' meant take immediately before food.

    My understanding is that for maximum absorption Levothyroxine should be taken with water one hour before, or 2 hours after, food and drink, 2 hours away from most meds and supplements, and 4 hours away from iron, calcium and vitD supplements, and oestrogen.

    Taking coffee with Levothyroxine reduces absorption by up to 40%.

  • Glad the pharmacist and review were helpful.

    However I am deeply sceptical of the medicine reviews. The pharmacies get paid quite a lot of money for those five minutes. £28.


    Some people found them an absolute invitation to fraud:


  • I was just about to write that but you beat me to it! That's a lot of money . It is true that Levo should not be taken with anything other than water etc and I know from what people I know have said their doctors don't tell them this, I don't think I was ever told but I knew from using this site.

    What gets me is the 'official' way I'm told at the pharmacy it's time for my annual review - next time I'm going to say 'no thanks' - considering I get one from the GP as well.

  • I specifically asked my GP if it was ok to take my iron with levo and was told 'yes'. I already knew you shouldn't but just asked to see if she had any clue..

    I also asked the pharmacist and they said same as GP.

    Thank goodness for this website!!!

  • Pity the pharmacist didn't also point out that well published research shows that taking Levo at bedtime has been shown to give better results for many patients

    Must be taken at least two hours after eating or drinking and not with any other medications


  • I was told to take my levothyroxine half an hour before food, first thing in the morning?

  • I think the moral of your story is 'do your own research 'cause your GP doesn't know enough about the Thyroid to be trusted' :-D

  • In my experience the pharmacist is great at giving advice re drugs. If I have an issue the pharmacist always takes time to discuss it. If you don't ask you don't get😜😜

  • By the way how often should you get your thyroid levels checked ??

  • Should be every 6 weeks until you reach your optimal dose, then every 12 months if stable

  • Thanks for that ☀️☀️

  • The moral of this story is........always log into HU if you want to know anything....:)

  • Oh heck!! That means I'll have to wait 2 hours for breakfast?!?!?!

    I already take my thyroxine as soon as I wake up along with my painkillers the I generally lie for about an hour before I get up by which time I am gasping for a cup of coffee!!! Aargh!!

  • You might be fine having a cup of tea after 30 mins, some people are, but if you can wait 30 mins you can wait an hour. Most people say an hour before brekkie or brew

  • Thanks, i lie in bed for around an hour after taking levo and painkillers so souls be okay then. :-) will take calcium+bit D at night instead of morning.

  • You shouldn't be taking pain-killers with Levo. You shouldn't be taking anything with Levo. They will stop absorption of your Levo.

  • So how long after taking levo should I be waiting to take my other drugs? I am on quite a cocktail if meds as I have Rheumatoid Arthritis and Lupus?

  • At least two hours. You just can't take Levo with anything else except water, if you want to absorb it correctly.

  • Thank you Greygoose.

  • You're welcome. :)

  • Didn't know that been on the stuff years take the lot drop of water on with the tea! Oh dear new routine coming up.

  • Yes, I know! So much to learn. And doctors don't know enough to advise us on things like that. Thank god for forums like this!

  • Try taking them before bed. It makes life much easier!

  • I am usually trekking to the loo in the middle of the night and if the brain is functioning use such occasions to take the levo.Before bed would be more sensible but I tend to nibble at cheese late in the evening.

  • Thanks treepie, like you I usually have to make an early morning visit to the loo so will start taking it then - if brain is functioning!!

  • I take the pills out of the foil and place in a very small dish ( so i do not have to chase them) the night before with glass of water close by.

  • I'm the same, I have them in a wee dosing cup next to my bed. Otherwise hubby tuts and carries on at me rummaging around in my bedside drawer!


  • If you change to taking at bedtime, good idea to get your blood checked roughly two months later.

    You might find you don't need to take so much Levo, as you may get better uptake/absorption.

  • Wheat can also effect medication. I improved considerably after removing grains, sugar and dairy from my diet.

  • Like you, I'd never been told when to take my Levo, and only found out after joining this forum. I even specifically asked my endocrinologist when I trialled T3 whether I needed to take it with food or not, he said it didn't matter!

  • I switched to taking my levo last thing at night and all other medication in the morning :)

  • Do you feel any difference?

  • I just thought I would update you all and say that this morning I almost had hysterics waiting for my coffee!! I am an early riser but didnt realise I had got into such a routine with taking the tablets. I have always had a black coffee on rising and then waited for around an hour before having some gluten free toast (gluten free seems to be better for me though I am not coeliac) and another coffee :-)

    I think I may have to drink hot water and waft some coffee around so I trick my body into thinking I am actually drinking coffee? Somehow I dont think it will work, lol but watch this space......

  • Hot water is not as bad as you think! I drink it an hour after my meds..I prefer it to tea or coffee first thing as it's very refreshing..your body hopefully will adjust to it!

  • Ladyinpurple,

    You can take thyroid meds at bedtime if you make sure it is 2 hours after you last ate and drank anything other than water.

  • Not exactly true. The pharmacy increases their earnings by doing medicine use reviews (as the amount they get for dispensing a prescription is very small). They aren't asked to so them; they do them to get paid, but are only allowed to do them once a year per person, as it would be money for old rope otherwise. but they are quite right about calcium, iron and caffeine (which includes tea). GP probably didn't tell you and doesn't know (or care).

    I found this out from the inside as a trainer for a pharmacy.

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