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Thyroid UK
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Levothyroxine and Dairy

For those like me who were not aware of this, it was drawn to my attention yesterday that dairy products should not be consumed within 4 hours of taking levothyroxine.

Cows milk interferes with absorption of levo. See link below:

endocrine.org/news-room/cur...

I was diagnosed in 1994 with hypothyroidism and prescribed levo. Nobody told me this in all these years, yet it's on the NHS website:

beta.nhs.uk/medicines/levot...

Click on No 8, Common Questions: Is there any food or drink I need to avoid?

It's also mentioned on the British Tyroid Foundation Thyroid and Diet Factsheet

btf-thyroid.org/information...

I cant believe that in the last 24 years I've never come across, or had this information pointed out to me. Considering all the research I've done I don't understand how I've missed it. None of the GPs or Endocrinologists or private doctors I've seen have mentioned it either. I have done a search on here but could only find a reference to Levothyroxine and calcium 5 years ago which seems to be more about supplements.

I knew not to have caffeine for an hour after meds and have followed that but I always have milk in my coffee.

So for anyone else who's missed this information I felt I should post it.

62 Replies
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Having a little drop of milk in your coffee will have a minimal effect on your thyroid hormone. I have milk in my tea and butter on my bread! And sometimes cheese for breakfast. All one hour after taking my T3+T4. I don't feel any effects of lowered absorption. :)

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That's a relief. I was afraid I was going to have to give up the metabolism-supporting pasture-fed butter on my morning toast.

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Good lord, no! Don't give that up, that's one of the good fats. :)

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I usually take my levothyroxine a few minutes before morning porridge made with skimmed or semi-skimmed milk and have not noticed any effects. The study with cow's (sic) milk may give misleading results because they gave the patients 1000 mcg levothyroxine. Such a large dose may be difficult to absorb and there may be much less effect on normal doses. I'm not sure where the four hour requirement comes from, levothyroxine is fully absorbed after about two hours.

greygoose. A little milk in your coffee is OK but a little coffee in your milk is a problem! See ncbi.nlm.nih.gov/pubmed/183... .

Generally these effects are minor and provided you are consistent the absorption rate will be consistent and will be automatically factored in when your dose is adjusted (hopefully paying attention to symptoms).

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I have no idea what you mean by that remark. I don't drink coffee, and the OP said that she knows not to drink coffee until an hour after her levo. I would certainly not recommend anyone take their levo with their coffee! Besides, your remark does not make sense!

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Sorry, you wrote 'Having a little drop of milk in your coffee will have a minimal effect on your thyroid hormone' so I mistook this to mean you believed it was OK to have coffee with levo. I just wanted to point out in a lighthearted way that it's not a good idea to have coffee with levo.

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You should have looked back from there to see that the OP had already said that she knew not to take coffee with her levo. I was just following on from there! Of course I know you don't have coffee with levo! How could you possibly think otherwise after all these years?!? I'm hardly a newbie!

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I'm sorry, I struggle to remember people's history although I can remember the science stuff, bit of a goldfish memory especially for names.

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Well, I'm really offended that you don't remember me! I've argued with you so many times! lol

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I remember you, not least because the last reply you gave me was nice! I'll drop out now as I'm drifting off topic.

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Oh, no! Please go on! Can't hear too many nice things about myself. People usually want to tell me how awful I am! :)

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We really do need the little laughing emoji they have on facebook! lol. I love ya :D

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Thank you, Shiny, I love you too! I think we also ought to have the very angry one, and the amazed (how can an endo be so stupid?) one. lol

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And again I'm looking for the laughing emoji! hahaha

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lol

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I've a question re coffee& meds with thryoid, if you can? Dairy elimination, known coffee is no good however, if it's something I'm trying to eliminate, would a cup several hours after, armour mix? What is a suggestion on tea? Milk substitute? Ok or no? Thanks, I'm really using your suggestions, and I've had amazing results, better than anything else, you've got my vote for A+ info knowledge, I've been misinformed by so many, to finally find somewhere to ask/receive multiple answers of advice is worth so much, I'm so grateful and appreciate any/ALL who take their time to reply, thank you, greygoose!!

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You're welcome, Beachytoes. :)

I think it's perfectly alright to have a cup of coffee an hour after taking your levo. Even with milk. Same with tea.

Milk substitute? What did you have in mind? Not soy milk, for sure, but almond milk, should be alright - if you can tolerate it!

I don't have cows milk, I have goats milk, I believe that is easier on the stomach - though I could be wrong. Suits me, anyway. But I just have one cup of tea a day. I don't crave it at all hours, like my mum did, I prefer plain water. But, I do need a hot drink in the morning, to rinse out the tubes! lol

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greytgoose is brilliantly right! Coffee is OK one hour after taking levothyroxine pdfs.semanticscholar.org/87... .

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:D x

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Thankfully😰the coffee is of, I'd go to drinking it black! You're talking to a coffee lover, and I'll take water over anything else also....whew....once again thank you☕

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I use coffee-mate w tea&coffee. Not sure if u have/know what that is? Simply it's a milk/creme substitute. I've been able to take the armour 1-2 hr., earlier w full glass of water. I used to be a "big" coffee drinker. Since I've had bad problems with belly ache. The idea of hot coffee brought me near, vomit. It's only recent the tea is a good thing. Otherwise, I'm a big water drinker.

🦄thk you, ☕

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I know coffee-mate, yes. Ghastly stuff! Have you read the ingredients? If not, I suggest you do. :(

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Oh boy, ya say something else bad, will do, I'll not buy any more, all your advice is wizard like....i could ask u at least 100, this morning! This while topic is confusing, doom, makes me I'll like I've never felt. Thankfully you share😘

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Always, always read the ingredients. :)

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I’m afraid I always glug a cup of coffee with my NDT (sublingual which is also all wrong!) but can detect no difference even if I avoid the evil caffine and milk and swallow the NDT down whole with plain old water maybe that is laced with florouride (? not sure that is spelt right) and that steals the thyroxine too! Whatever after 4 years on NDT and coffee I’m alive and kicking!

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Fluoride has not effect on your thyroid hormone replacement. It just attacks to the iodine receptors in your thyroid, meaning that you become deficient in iodine. Nothing to do with Armour.

Also, you may still be alive and kicking with your method of taking your THR, but are you the best you could be? That's the question.

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Up at 4:30am, 23 mile cycle to work, 9 hours hard physical wk as gardener, 23 mile cycle home, 3 hours on allotment bed - 5 days a week...I do feel a bit tired by the end of the week and have a rest on Saturday just a few miles dog walking and maybe a 5k parkrun and all day at allotment Sunday after dog walk. I guess I might be able to squeeze another allotment session in Sat if I took my meds as I ought to do 😂🤣😂. I was always a bit hyperactive - pre diagnosis I used to cycle at least 150 miles on the weekend alone and that was all year round 😉. I do slow down a bit in the winter. I don’t think I want any more energy to be honest!! I sleep like a baby.

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OK, point taken! :)

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I did everything wrong before I joined this forum because doctors told me nothing. I was taking all of my meds at the same time with breakfast and milky coffee. I’m a dairy addict - can eat cheese til it comes out of my ears. No wonder I was never well on levo!!

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Snap. I’ve been taking levothyroxine sertraline and contraceptive I’ll altogether then having breakfast straight away. I’ve seen several GPs in past and Endo the other day but have only found out this info via here and other websites. Over the past 4 years I have felt awful on levothyroxine so it will be interesting to see the difference now I’m taking it separately and not eating for at least an hour after taking.

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Strangely I took my levo every morning with my coffee (black) for years before I knew better and never once had a problem. I now take with water 😀

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Do you feel any different for the change?

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Yes, worse sadly. But as I have a lot of other nasties going on at the moment I can't say it's that. 😕

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I still eat cheese till it comes out my ears and feel fine on NDT (but never did on Levo I think it is lack of T3 not dairy indulgence that is key here) - my fave is Cheshire cheese - divine - but I have yet to find a bad cheese!

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My dr., told zero, nada, this site and the wisdom, people who share for free, have special wings💐

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I find the lack of info given out quite astounding. Like you, I have been on levo for many years and only in the last year or so learned the milk thing.

What I find quite scary is the effect that ‘mucking about’ with your meds could have - my mum was diagnosed hypo many years ago and never took her meds!

No one tells you how serious it is, not any of the potential consequences should you go over or under.

All my gp said was “you’ll have to take these tablet for the rest of your life..”. Thanks, most informative!

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I think if you are fully optimised not just within range you ought to have a bit of wriggle room for slight variations in absorption. I was well informed about how to take the tablets but in my case it appears to make little or no difference but I realise it might be very different for others. I have read alarming percentages of reduction in absorption so docs really ought to stick to best practice advice to patients.

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15 years of no info: soya/dairy/gluten/hashi status - The only reason I don't scream with rage, is that I also found out that stress defeats thyroid too! I have been ill for years because of this lack of medical support/knowledge. Thanks for the update info and links

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Me too. For YEARS. Have gotten started 2 months ago on the right track with a new endo after being disinterestedly undertreated by my primary doctor. I am 74 and a retired nurse and STILL had a hard time finding effective treatment. Despite asking for other tests (freeT3, antibodies, Vit D, B12, Folate, and Ferritin, etc) she wouldn't order them-would only order the T4 and TSH!!! (I'm in the US and private testing is just beginning to take hold-previously very expensive as labs prefer to have doctors order tests as they can bill insurance and make more money). Needless to say she is no longer my primary physician. I'm beginning to feel better but still royally p*%#@$^ at having to feel so bad for so long.

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I think this is a really useful post, especially for people either newly diagnosed or new to this forum. I too was just told to take levo with absolutely no other information from my GP. It is only down to information and support from here that I have gained wellness.

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Have been on 100 levothyroxine for 16 yrs, no mention of avoiding dairy take my tabs with an actiMel drink followed by cereal with milk, no change in blood levels which are checked routinely and along with different probs I have. I will however, try and take it later than breakfast or an hour or two before and monitor the difference within myself

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I have just been told my hypothyroidism results indicate need to increase dose of Levothyroxin. However I looked up on web and saw I should not take meds with calcium. I have been taking it with two adcal tablets washed down with coffee! Am correcting this but have noticed my joints are aching. Am pretty sure I have arthritis but have been taking glucosamine with chondroitin for this over about ten years and it seems to have kept it in check until recently. Could it be the recent change in hypothyroidism results.

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It might be worth you copying this question into a new post. You will probably get more replies. Also you should post your latest Thyroid test results (in the UK we have a right to them) with the lab ranges.

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As you've been taking your levo with adcal, you probably aren't absorbing the vit D, either. And that could account for aching joints. See how you get on taking them separately. There should be a four hour gap between levo and calcium/vit D.

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Should be posted on bottle! When I picked up armour-compounding office, they told me to take w water....

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Maybe so, maybe so… But we live in an imperfect world.

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Arrrrrrrrrg. Another gem for GG: "4 hours between levo and VIT D?????" another mistake I'm making.. what about B12? should there be a gap too there? (there's no end to this!)

Thanks as always :)

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Assuming that B12 is sublingual or a spray - which it should be - no, you don't need to leave a gap. :)

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Ok, now I have to find sublingual or spray B12! Assuming this is commonly available.. 👍

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Yes. Most people take sublingual B12. You can find them on Amazon by Jarrow or Solgar. :)

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Thanks for the info.. Should I be looking at zinc as well?

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It's a good thing to try. But don't start both at once. :)

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I read a very good book lately that really opened my eyes regarding calcium. It seems we are all told bones need calcium but we are not told about all the other minerals needed in addition. Taking calcium supplements only means that we throw the remaining minerals out of balance causing calcium to be lodged in tissues which causes further problems. Bones don't need just calcium, they need potassium, magnesium, manganese, silica, iron, zinc, selenium, boron, phosphorus, sulfur and chromium. Bones are made of all these minerals and traces of 64 other minerals, not just calcium. we are all subjected to plenty of calcium already (think about fortified cereals, breads, etc) . . . . and people are getting sicker, please at least download the free E-reader sample of What Your Doctor Still Doesn't Know THE CALCIUM LIE II by ROBERT THOMPSON . . . . (its free) as this could be causing you the problems you have. GP's know very little about nutrition as it is the tiniest bit of the their training and there is so much knowledge out there. If this comment helps even one person who reads it, it was worth me sharing, Robert Thompson knows his stuff. His book is not just about calcium, it covers thyroid and how the entire body works. I recommend it ! (No, I am not selling it but it helped me greatly). : )

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Thank you so much for sharing this information Maggie.

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Thankyou for that info, I also diagnosed in early 90s and diet in any form has never been mentioned. Phfffft.

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I take my levothyroxine at night time, as I've read it has better absorption at night, and havnt got to worry about not eating things that potentially interfere with absorption. 😊

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Started doing the same.. seems to work better for me and as you say, less to f*%k up!

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A revelation to me, having been on Levo for 28 years, and usually having my breakfast with tea or coffee and milk 30 to 45 minutes after having taken first this med with water. I also used to take Adcal,but no longer do so, but take VitD at the same time as my breakfast, together with Omega 3 capsule and Turmeric capsule. I also have osteo-arthritis. So probably am doing everything wrong. My GP has changed the way I take Levo. One day 100mcg, the next 75mcg and so I alternate. Greygoose might like to give me advice. Thank you for your forum which I read daily,

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I noticed the following this March when I was given an extra 25 mcg of levothyroxin that the prescription proper included a note for this dose 'one to be taken each morning at least 30 minutes before breakfast, caffeine-containing drinks or other medication'. Yet the 100 mcg dose I had been taking for 12 plus years still said 'one to be taken in the morning'. I asked the pharmacist at the doctor's surgery why the difference, she said it was due to a drop down box that appeared on the computer programme for the GP to choose. Perhaps the logic being 25 mcg (and perhaps the 50 mcg dose too) is the starter dose to start good practice. The stuck on label on the packet for both dosages just had the ' take in morning' instruction. The pharmacist then said 'you should read the instructions inside': my Mercury Pharma instructions says on the second page ' the dose you should take will be on the label attached by your pharmacist. Swallow the tablets with plenty of water. You should usually take your tablets before breakfast..'. The Teva instructions interestingly are more explicit:' the tablets should be swallowed, with a drink of water, in the morning at least 30 minutes and preferably one hour before breakfast'. Neither mention problems re absorption re caffeine, calcium products, or the various vitamin/mineral supplements hypothyroid sufferers often take.

I started off on the Mercury ( didn't get on with the Teva) so had very little help from the start of taking Thyroid 'meds'. But certainly noticed the difference in blood tests changing from taking levothyroxin 'just before' breakfast to the middle of the night. But before I made this change I had had lots of help from trawling thru this forum- lots of regular advice re avoiding milk, iron, VitD etc tablets with our T4,T3, essential supplements...

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Thanks for this post.

I have my other medication for heart 2 hours after taking Levothyroxine.

I have breakfast 2 hours after taking Levothyroxine, it’s porridge with coconut milk (Koko) that’s fortified with calcium. Will this interfere with Levothyroxine?

Thanks.

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According to the NHS advice it will interfere with thyroxine absorption, if it’s within 4 hours of taking meds, but as has been pointed out in earlier posts, if you’ve been doing this regularly, it would have shown in your blood tests and your dose would have been altered accordingly. So I wouldn’t worry about it as long as that’s all the calcium you’re having.

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Honestly, after 20 years of taking thyroxine I don’t think it hugely matters - consistency is more important.

They do say very high fibre can interfere. So maybe but at the same time as museli every day, the odd time won’t hurt.

There WAS a difference when I took beta blockers and I needed 12.5 more.

I wouldn’t take calcium or iron tablets near thyroxine though.

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