Why is it recommended to take thyroid medication on an empty stomach?

[birdie]

I've been on thyroid medication for 15 years or so and have normally taken it on waking up, allowing 20 mins before my morning cuppa. I've never really understood why it's recommended on an empty stomach. I'd be delighted to hear your views 🤔

[radd]

birdie,

It is important to take thyroid meds on an empty stomach because foods may delay or reduce the absorption of thyroid hormone, but also bind with it making the meds unavailable for use.

It is important to take your pill on an empty stomach with a glass of water, 1 hour before food, 2 hours before supplements and 4 hours before calcium, iron or vit D supplements.

A cup of tea after twenty minutes is fine.

[greygoose in reply to radd]

Except if it has milk in it.

[BonnieT]

I've been told to take it on an empty stomach with plenty of water (I try for 5-8 oz.) an hour before eating. I only drink black coffee or tea so that is all I may have before the hour is over. No milk.

[HIFL]

This might answer your question: tiredthyroid.com/blog/2014/...

"Some thyroid patients don’t do well on levothyroxine or T4, even though the pills provide what their own body would produce if it could. Chemically, the pills are levothyroxine sodium, and stomach acid is essential to cleave off the sodium. Once this happens, what is left is simply T4, identical to what our bodies produce. Yes, synthetic T4 is bioidentical, but only after the sodium cleaves off. However, many thyroid patients are deficient in stomach acid for various reasons, which means they get minimal T4 out of a levothyroxine sodium pill. Gastric acid is highest on an empty stomach, which is why patients should take their pills on an empty stomach before breakfast.

Low gastric acid could be from gastric bypass surgery, antacids, Helicobacter pylori infection, autoimmune gastritis, or other conditions. Those who need high doses of T4 (more than 150 mcg) but show low or normal T4 levels may not be fully absorbing their dose due to low stomach acidity. Taking their levothyroxine with Vitamin C [1], over-the counter hydrochloric acid pills, or even a little apple cider vinegar mixed with water may help. These supplements naturally increase acidity: Vitamin C is otherwise known as ascorbic acid and vinegar is known as acetic acid. Of course, this still doesn’t address the need for some T3, but that’s another issue."

[Ruthi]

Caffeine can bind to thyroxine too, so tea is also a bit questionable. I drink green decaff.

[Joyia]

I have slice fresh organic lemon in boiled water, lovely refreshing drink to start the day although I do swallow my Levo with a glass of plain water.