Thyroid UK
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Caffene intake v Levotroxyn

I had been taking Levo 150mgs around 8.3Oam daily & after an hour or so had been taking my morning starter cup of strong tea. There is no reference in the patient leaflet that caffeine can tremendously interfere with the dosage - reduce the effects of the medication significantly! I started reading up further on this to discover Levo shouldn't be taken for at least SIX hours after tea coffee or chocolate!! That would mean of course that I couldn't have my starter cuppa until 2.30 in afternoon!!! Now the same would apply to evening time if taking the med at bedtime - a 6 hour gap to be left - looks like afternoon tea at 4 pm would be the cut off point if one has decided to take the dosage at night. What really annoyed me was that there is absolutely no reference to caffene on info leaflet. I had been having blood tests done 3 monthly since I started the med about 16 months ago & each time my med had to be increased by 50mg. Possibly the intake of caffene both morning & night may have had a bearing on reason for necessity to increase med. Any comments on the caffene issue?? It is worth to vmcheck out.

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Meg17,

Taking Levothyroxine an hour before, or two hours after, coffee or tea should be sufficient for absorption not to be compromised.

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That's what I had thought initially - 2 hours should be sufficient. However when dosage had to be increased I became curious & did further research. I have the article saved on screen desktop.

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Meg17,

Your stomach will be empty 2 hours after eating or drinking coffee so why is that not sufficient? What is there to affect absorption after 2 hours?

Most people are started on low doses because thyroid hormone needs to be introduced slowly and gradually. It is usual for dose to be increased until TSH is low-normal and FT4 in the upper range.

How credible is the article you read? A lot of stuff on the internet is rubbish.

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See Livestrong. com article re ref to 6 hrs gap before caffene intake. If wrong info included in this article then authors must be asked to remove & update it.

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Meg17,

Or you could just ignore it?

Give me the link to the article and I'll have a look but I don't have time to trawl through all their articles until I find it.

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Article 522342 - Caffene - v Levotroxyn

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Meg17,

The author hasn't included references to the articles in Clinical Thyroidology and Pharmacy Times so I'd take the recommendation to allow 6 hours between Levothyroxine and caffeine with a large pinch of salt.

livestrong.com/article/5223...

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The authors cannot just fling a figure in the air without some foundation as could be ordered to edit their article immediately. What about the literature enclosed with the Levotrixyn No mention of caffene interaction either. I guess the pharmacuticle co must be contacted re this issue to clarify it one way or the other.

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Meg17,

Why not ask the author to substantiate what she wrote by providing links to the studies which say take Levothyroxine 6 hours away from caffeine.

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Yes good idea!

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About your dose - why was your Levothyroxine increased by 50mcg? Usually it is increased by 25mcg at a time.

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Dosage was based on blood reading hence the increase

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Yes, Hypothyroid patients usually start low on 50mcg. Then it is increased gradually by 25mcg till on full dose. However retesting and dose increase Sould be at 6 to 8 weeks intervals (some guidelines say 3 - 4 weeks).

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If you are concerned about caffeine, have you considered switching to decaf tea and coffee?

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No as I dont like decaff. Then the chocolate!! Any decaf chocolate on market?

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One thing to consider... If you always have your strong tea the same strength, at the same time, then your dose will be adjusted to allow for that. It's consistency that is the important thing.

Why are you so upset about your dose being increased? That is perfectly normal. We all start low and have our dose increased slowly, that's what you have to do with all hormones - and levo is a hormone, it's not a drug. Very often there are things in our life-style that mean we need to take a bit more, most of us have absorption problems, anyway.

As I see it, there are two things you can do. Either shrug it off and continue as you always have, or do your own experimenting. Try taking your tea at different times, and see if it has any effect on the way you feel. If it doesn't, no problem. If it does, then change the time you take your levo accordingly. That's what I did with magnesium; But, personally, I just think it's a load of rubbish! I don't take my tea very strong, but I do like milk in it. I have the same routine every morning, so my dose has been built around it, and everyone is happy. :) It's not worth using your precious energy on something so unimportant.

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Well you may not think it is important but I do - thank you for the lecture!

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Thank you for the sarcasm. :)

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Meg17 Welcome to the Forum. When you have been here for a few years you will soon realise the wisdom given by greygoose - and will become accustomed to her no nonsense approach and common sense. She is one of the Stars here on the forum and keeps us all up to speed and in line :-)

Enjoy your coffee and tea :-) - I have my coffee one hour after taking my meds ....

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Oh thank you Mars😊

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I have coffee usually one half HR. After Levo.Doc said it was fine.

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Is that one and a half hours afterwards or half an hour ? Not sure Doctor knows best if he is saying half an hour !

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I knew nothing about this..my doctorsister never mentioned it and I've been on it 27 years..I like cocoa and bits of caffeine all morning..glad I read this.

Thank you.

Jacky

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Hi Jacky neither did I as the patient info leaflet for Eltroxyn hasn't any ref to caffene prob why your Dr didn't mention it. Found out by accident myself - had been going by the leaflet doing all things right yet when I had blood rechecked dose had to be increased each time was searching for answer to why & came across this. The next retest result should be interesting! Anyhow best of luck.

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Great advice Greygoose

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My big worry is milk too. I have been having a milky coffee 1 1/2 hours after taking NDT, then an hour later I have porridge half water half milk. I couldn't drink coffee for over 10 years due to interstitial cystitis, now I'm on better treatment I can tolerate it, but only if it's made with milk. So there's the caffeine issue and milk.

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But as I said, if you are consistant with it, you dose will be adjusted to account for it. 1 1/2 hours should be long enough for the NDT to be out of your stomach by the time you have your milky coffee. I shouldn't worry about it, if I were you. :)

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I was worrying about the protein in milk and absorption, I seem to remember it being a problem? But now I've rediscovered coffee, there's no way I'm not drinking it lol!! I do keep my morning routine much the same to work around the NDT, but then I dose 3 more T3 at intervals after 4 hours. Honestly who doesn't sometimes take a T3 with coffee or tea occasionally? It's so hard when you're out especially. I"ve taken T3 straight after a sandwich and a cuppa in M& S or wherever, and it hasn't made the slightest difference 😀 We all have to live our lives.

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Yes, I understand, milk contains calcium, which binds with thyroid hormone and prevents absorption. But, only if they meet in the stomach. In 1 1/2 hours, the NDT is out of the stomach, so they won't come into contact. There's no reason why you shouldn't drink your milk with coffee after 1 1/2 hours.

But, in answer to your question, I have never taken any thyroid hormone with anything, myself. Ever. But, then, I take all my hormone in one go, whatever it is. Taking your T3 with a sandwich and a cuppa will mean that you don't absorb it, so not much point in taking it, really, is there. :)

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Thanks Grey, I knew there was something, ok it's the calcium, not the protein.

Sometimes there's just no choice but to have food when you're out. I live miles from anywhere, and every drive is a long drive, and the first thing I do is get some lunch! I know when I need a T3, I get sweaty, palpitations, feel nausea and go cold. I can hand on heart say these horrible symptoms go even if I eat or drink with T3, I know it's not ideal though. At home you have more control, and I pace myself accordingly with dosing. I have put all my bladder meds to late evening now, and they should be 3 times a day. At the moment I'm in severe pain so taking gabapentin all through the day and night, have been for 3 months solid, but that's another subject re absorption!

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Gosh! Sounds very complicated. Have you ever tried taking your NDT and all your T3 at the same time? If you take enough in one go, to saturate your cells, the T3 will stay in them for several days, and you might not get these troughs when you feel you need more. It would make your life a hell of a lot easier!

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But that's OK helcaster, isn't it? As you say, you are waiting 1 &1/2 hours.

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Sorry, meant to say that worrying could do us more harm than what we are eating and drinking. Especially with the ok time space after Levo.

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I hope so Mary, I do seem to crave milk and drink quite a lot, maybe it's because it has iodine in it, I'm trying to justify my addiction!

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Maybe you're low in calcium?

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My bone health was tested about 5 years ago Grey, and it was good, actually better since starting thyroid meds, which didn't impress the endo. He told me I was risking my bone health taking T3, he tried to hide the results from the letter he sent me, but I got them from my GP!! I've always had a lot of dairy, I eat Greek yogurt, drink kefir, but the hot milky drinks is a new thing. There are so many restrictions in diet with interstitial cystitis that I think being able to drink coffee again is just fantastic! I drank only water for 10 years, so you can guess how pleased I am. But yes my consumption of dairy has gone through the roof this last year. I just got through 4 pints of milk 1 1/2 days! I must cut down.

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Yes, I can imagine. :) There's nothing like a hot drink in the morning - especially in the winter! Even if I don't have breakfast, which I don't always fancy, I do like a hot drink of something.

I've never heard of anyone craving milk before. I wonder what it is...

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Grey, I have terrible trouble waking up in the morning, and I so missed my caffeine hit. It really is a great start to the day, hot drinks I really missed.

I did sometimes have red bush tea, no caffeine nor acid, it tastes ok and didn't hurt my bladder, but I missed the hit!

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I can imagine. :(

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It is just a case of getting facts clarified. Just trying to get a simple answer to a simple question. Not a case of worry worry worry! There's a big diff between 1 hrs gap & 6 hrs!!! gap before intake of caffene following Eltroxyn dosage😉that's it no big dea😎

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Meg, I often take a T3 with a cup of coffee or tea, sometimes things just don't work out with your dosing. I honestly haven't felt any different. I dose NDT and T3 at 4 hourly intervals thereafter. It does get hard to fit it all in. I don't ever compromise though on waiting a good hour or two after my morning NDT.

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Thyroid treatment is VERY individual - so go with what suits you best .... lots of trial and error - no hard and fast rules. If you want to learn more about the folk here you can click onto their names and have a read. Only takes a couple of minutes 😊

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But, Meg, you got a simple answer from Clutter in her first response. Yes, there is a big difference. And, quite honestly, once you know more about thyroid, you'll see that six hours is rubbish. :)

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