Hi everyone!
I'm looking for breakfast ideas. I take levothyroxine at 7am, so within the next 4 hours I know to avoid multivitamins and anything containing calcium and vitamin d. I also understand I should avoid walnuts and grapefruit, and other things I just haven't remembered right now. I also understand to wait 30- 1 hour to eat/ drink anything other than water.
My question is, what do you all who take levothyroxine have for breakfast?
Suggestions appreciated!!!
Not sure wether this is an avenue for you, but i take mine in the night, when I wake up at some point. Often around 5. I still avoid cheese for breakfast, but at least I am not having to wait for my breakfast. Only works if you wake up regularly I guess, probably not a great solution, if you vary the times a lot.
Suggestions:
Take levo at bed time instead of in the morning.
Don't have breakfast at all. Wait until mid-day to eat. That way you can reduce the 'eating time slot' and increase the fasting time, which is supposed to be better for you!
Depends on you. I have often have yoghurt a couple of hours after levo.
I have 2 friends on levo who take their tablets with their breakfast and have no problems. It might mean that they are on a slightly higher dose than they could be but as they have no symptoms now they are on levo they don't worry.
I just leave an hour until I have breakfast/ take B complex/ Selenium & I’ve been fine! I have porridge or muesli with almond milk.
I leave 4 hours until I take iron supplements. I take magnesium before bed,
Ive also read that if you take calcium tablets, you're advised to leave 4 hours after Levo too.
I would advise you get your thyroid & vitamins checked regularly & post results on this forum, to ensure that all are optimal (I use Medichecks for both).
I take levothyroxine at 7am, so within the next 4 hours I know to avoid multivitamins and anything containing calcium and vitamin d.
Leave a four hour gap for calcium (although best to avoid calcium if you can), vit D, iron, magnesium and oestrogen. For other supplements just two hours will do.
Multi-vits are best avoided completely, for all sorts of reasons.
I also understand I should avoid walnuts and grapefruit
Why? Who told you that?
I also understand to wait 30- 1 hour to eat/ drink anything other than water.
An hour is best.
Personally, I like crumpets and ginger tea for breakfast. With lots of butter! 
There's just so much info out there that it makes something that should be simple, confusing. That's why I like this forum. Everyone speaks from experience here and its so helpful!
Here's what I've read/ heard about grapefruit, etc. I've heard it/ read it in multiple places, but from everyone else's experiences, doesn't seem to be accurate.
I agree about multivitamins, I'd rather get my nutrition from food.
Thanks for the response!!!
nytimes.com/2019/03/08/well...
I know you can’t have grapefruit with some medications to lower blood pressure, but didn’t know of interaction with Levo.
Well, I can't read that without creating an account, and I don't want to do that. Can you just tell us what it says, copy and paste or something?
I agree about multivitamins, I'd rather get my nutrition from food.
We'd all like to be able to do that! But when you're hypo you often just can't. Hypos often have low stomach acid meaning they have trouble digesting and absorbing nutrients. None of us take supplements for fun. But, multi-vits are useless at best, and down-right dangerous at worst. Get your vit D, vit B12, folate and ferritin tested and see if they're low, and supplement accordingly. The thyroid hormone you're taking cannot be used correctly by the body if nutrients are suboptimal.
I don't have an account either....
Here's a copy and paste version:
The effect of grapefruit on levothyroxine is the opposite: Drinking grapefruit juice — or orange juice — can inhibit uptake transporters and reduce the drug’s absorption. The effect does not last as long, but can lead to under-treatment of the thyroid condition.
Levothyroxine tablets should be taken only with water and on an empty stomach first thing in the morning, and you should wait a full hour before eating or drinking anything else, said Dr. James Hennessey, director of clinical endocrinology at Beth Israel Deaconess Medical Center in Boston. “Anything but water can potentially lead to malabsorption of levothyroxine,” he said.
Supplements and other drugs can also interfere with absorption. You should wait at least four hours after taking levothyroxine before taking antacids or vitamins or supplements containing iron or calcium. Regular consumption of foods that contain soy, walnuts or dietary fiber can also reduce the absorption of levothyroxine.
Hmmm… Not impressed by Dr Hennessey!
We all know, I imagine, that thyroid hormone should be taken with water only, and nothing else for an hour to maximise absorption. But, that doesn't mean you shouldn't drink grapefruit juice at all, ever. After an hour, you can drink what you like - and if you can drink coffee after an hour, I'm pretty sure you can drink grapefruit juice.
Most vitamins you can take after two hours, it's just vit D that you have to leave for four hours. And, that's probably because it's more than a vitamin, it's a pro-hormone.
Soy does not affect your absorption of levo/T3 at gut level. What is does is impede the uptake of thyroid hormone by the cells. And, it can do that whenever you eat it - leaving 1 hour or even four, is not going to change that. So, soy is best avoided completely.
Excess dietary fibre can rush the hormone through the gut too quickly for it to be properly absorbed.
But, walnuts? What's wrong with walnuts? If he's thinking 'goitrogens', he's way off the mark.
I've also heard that grapefruit and levo have negative interactions. But a paper from 2004 says:
'In conclusion, repeated consumption of grapefruit juice had a minor effect on the absorption of levothyroxine in healthy subjects. A clinically relevant interaction between grapefruit juice and levothyroxine appears unlikely.'
Effects of grapefruit juice on the absorption of levothyroxine bpspubs.onlinelibrary.wiley...
A lot of people feel an hour between meds and breakfast is enough even if breakfast contains dairy products. Just have to try and see.
I know everyone is different but I have reflux so taking tablets in the night or early morning and going back to sleep just irritate my gullet as they tend to just lie there. So I get up at 7.30 and take tablets and just wait until 9am to eat. If I work I take something in with me and a drink then.
You probably have low stomach acid.
I had no idea about leaving gaps for years. Took my Levo at 6am and had my breakfast including soya milk all the time I was working. When I retired, I found out about leaving a gap. So now I wait an hour. But sometimes I can’t and I just make sure I have coconut milk instead. I alternate soya and coconut now anyway.
I take beta blockers, flecainide and warfarin too so it’s all a bit of a juggle. Plus calcium tablets. It’s fine at home but becomes tricky when out and routine changes.
Soy milk is probably making you more hypo. It's a very bad form of milk to ingest - all forms of soy are bad. Soy stops the uptake of thyroid hormone at a cellular levels, so even if you've got good levels in the blood, it can't get into the cells. And, it doesn't matter what time you have it, the effect will be the same.
How do you know whether it is being absorbed at cellular level? If your thyroid function tests are within normal range. Is there another test that detects that?
From NHS website
nhs.uk/medicines/levothyrox...
Soya in food and supplements may stop levothyroxine working properly. If you regularly eat soya or take soya supplements your doctor might need to do extra blood tests to make sure you're getting enough levothyroxine.
Thank you. I had my thyroidectomy nearly twenty years ago and have used soya milk on my cereal all that time. Only use it at breakfast. I don’t eat soya as an item as such any other time. It might be in other foods as an ingredient incidentally. I use cows’ milk in tea and some coffees. More recently, I have drunk decaf coffee in coffee shops made with soya milk. But then I alternated with other non dairy. However, I went back to ‘skinny’ cows milk as I realised the coffee shop alternatives all had added sugar, unlike the unsweetened ones I have at home. Also, they were not fortified with calcium etc.
Like everything in life, it’s a bit of a minefield navigating interactions and the information out there.
🤷♀️😱
So I guess I’ll never know if I got to peak feeling well or not. As a primary school teacher, until three years ago I was permanently exhausted and stressed. Goes with the territory. Once you added bouts of atrial fibrillation to the mix and increasing additional medications, I have no idea which symptoms of not feeling particularly good were caused by what. AF is associated with thyroid issues for some people. At hospital visits for AF bouts with accompanying tachycardia, they would sometimes say I was under active and then other times over active. I’d have my dose changed up or down. Originally I took 125mcg for years. Then alternate days. Then 100mcg. Back to 125mcg (after last set of blood tests) Monday/Wednesday/Friday/Sunday
My hair started to thin out prior to my Most recent blood tests. I should have realised. But my other meds can cause that too such as the warfarin and the bisoprolol.
It has somewhat recovered, now I’m back to this increased dose.
The low calcium level was a bit of a shock, so I’m trying to increase that naturally while taking a small amount of supplement.
Who knows which part of my AF is caused by fluctuations in thyroid hormone levels? Nobody seems to know exactly. So I muddle along trying not to rock the boat and trigger AF episodes.
I just accept that I have good days and bad days and have no idea why. I try not to let it stop me doing the things I want. For a long time it did hold me back. Now I plough on.
No idea why I’m writing all this!!
If anybody reads it, well done for getting to the end of the ramble.
😂😂
Gillian
Af can be due to low Ft3 due to being under medicated or poor converter of Ft4 to Ft3
Often high Ft4 if poor conversion
Most medics think it only linked to being over medicated
Suggest you look at getting full thyroid and vitamin testing 6-8 weeks after increase in dose
Low vitamin levels are extremely common
Easier to take levo at bedtime. If you take it in the morning you only need to worry if you are not absorbing the levo, this would show up as low fT4 in a blood test. Coffee and bran can have a big effect on levo absorption but most other foods have minor effects. Only worry about it if you are not absorbing the levo. I take my thyroid medication two minutes before my morning porridge and fruit.
Actually even NHS website says no calcium rich foods within 4 hours
But if you always have same breakfast, then you may just need slightly higher dose levothyroxine to counteract the calcium
nhs.uk/medicines/levothyrox...
There are some foods and drinks that don't mix well with levothyroxine.
Drinks containing caffeine, like coffee, tea and some fizzy drinks, can reduce the amount of levothyroxine your body takes in. Leave at least 30 minutes after taking levothyroxine before you drink them.
Calcium-rich foods, such as milk, cheese, yoghurt and broccoli, can reduce the amount of levothyroxine your body takes in. Leave at least 4 hours between taking levothyroxine and eating calcium-rich foods.
Soya in food and supplements may stop levothyroxine working properly. If you regularly eat soya or take soya supplements your doctor might need to do extra blood tests to make sure you're getting enough levothyroxine.
Kelp (a type of seaweed) can contain high levels of iodine, which sometimes makes an underactive thyroid worse. Do not take supplements containing kelp if you're taking levothyroxine.
This morning I had bacon and eggy bread mushrooms and tomatoes
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