I happened to come across a post that said you should not take calcium and magnesium at the same time as your thyroid meds and secondly calcium and magnesium should not be taken together. I used the search box to look for more info but couldn’t find much.
So can I ask are both points correct and what is the rationale?
Many thanks in advance. I take T4 and T3 and calcium and magnesium.
Calcium and magnesium (and iron and aluminium) can bind to levothyroxine. If that happens, the thyroid hormone becomes impossible to absorb.
Therefore it is similar to reducing your dose of levothyroxine.
The Patient Information Leaflets are clear about calcium salts and oral iron:
The following may affect the way that levothyroxine works:
• medicines containing calcium salts
• medicines containing iron that are taken by mouth
medicines.org.uk/emc/files/...
I highly recommend you read the PILs completely. 
All the answers are about levothyroxine. Would calcium and magnesium bind with whole gland supplements, such as Metavive, and make the T4 and T3 content unavailable to use by the body?
If there's a leaflet that comes with the product. this info should be on it. If not, I'd get in touch with the manufacturers as they're the people who should know the answer
Wholly agree.
We tend to think of Patient Information Leaflets as being for pharmaceutical medicines. I'd argue the same level of information should be supplied for all products such as supplements and others with health claims. And that any information should be assessed by an independent third party.
Shouldn't have to contact the company but if needed, do so!
I have often been appalled that even basic English and typography is sometimes very poor.
Thanks.
It might be that the thyroid hormone in desiccated thyroid, being (we believe) bound to protein, would not be affected quite the same.
But I don't think we could safely assume desiccated thyroid wouldn't be affected.
I am not aware of any research in this issue.
helvella, can I ask one more question. I am possibly being daft but when calcium and magnesium is blocking absorption of the T4 would this also show up in blood test results as lower levels of thyroid or could the blood tests results indicate in range even though the body is not absorbing it due to taking calcium and magnesium at the same time as the T4? Many thanks.
As I understand, it would show as lower T4/T3 levels in the blood - the thyroid hormone+<calcium/magnesium> complex will just pass through.
Therefore, it acts as if your dose is reduced - but impossible to say by how much!
It’s also important not to eat calcium rich foods within four hours of levothyroxine
As shown on NHS website here
nhs.uk/medicines/levothyrox...
There are some foods and drinks that do not 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.
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
Or HRT patches..........
Thank you
Many thanks to you both.
“I highly recommend you read the PILs completely.”, helvella, guilty as charged for not doing so! I have been taking it for so long haven’t looked for ages.
May I just double check that it’s ok to take calcium or magnesium with T3, liothyronine? I have no inserts with this med to read.
Also are you able to comment on some people saying you should not take magnesium and calcium at the same time together? This is something I have not heard before.
It is very, very easy to not re-read PILs - but they do get updated from time to time.
The big problem with liothyronine is that much less research has been done. I'd make no assumptions about it being OK even if the PILs make no mention.
I hope the links in the document pasted below all work to take you to the documentation for whichever liothyronine products you are interested in!
UK Liothyronine Tablets and Oral Solutions
➖➖➖➖➖➖➖➖➖➖➖➖➖➖
Last updated 10/10/2020.
This is a list of currently marketed liothyronine tablets in the UK.
Please note that re-branding (whether by a manufacturer or as an ‘own label supplier’) – which has happened with several products – does not mean any change to formulation.
—————————————————————
🔹 Advanz (marketing authorisation holder) – branded Mercury Pharma (also branded Tertroxin but not marketed under that brand in the UK)
🏭 Custom Pharmaceuticals Ltd. (manufacturer)
🥛 contains lactose
20 microgram PL 10972-0033
🟢 PIL mhraproducts4853.blob.core....
🟣 SPC mhraproducts4853.blob.core....
—————————————————————
🔹 Morningside (marketing authorisation holder) – branded Morningside Liothyronine and Iraksin
🏭 Morningside Pharmaceuticals Ltd. (manufacturer)
🥛 contains lactose
5 microgram PL 20117-0323
10 microgram PL 20117-0324
20 microgram PL 20117-0270
🟢 PIL Morningside Liothyronine & Iraksin 5, 10 & 20 microgram mhraproducts4853.blob.core....
🟣 SPC Morningside Liothyronine & Iraksin 5 microgram mhraproducts4853.blob.core....
🟣 SPC Morningside Liothyronine & Iraksin 10 microgram mhraproducts4853.blob.core....
🟣 SPC Morningside Liothyronine & Iraksin 20 microgram mhraproducts4853.blob.core....
—————————————————————
🔹 Teva – (marketing authorisation holder)
🏭 TEVA Gyógyszergyár Zrt. in Hungary (manufacturer)
No lactose ingredient
20 microgram PL 00289/2116
🟢 PIL mhraproducts4853.blob.core....
🟣 SPC mhraproducts4853.blob.core....
➖➖➖➖➖➖➖➖➖➖➖➖➖➖
Some non-UK Liothyronine Tablets
—————————————————————
🔹 Abdi Ibrahim (marketing authorisation holders – Turkey) – branded Tiromel
🏭 Abdi Ibrahim, Turkey (manufacturer)
🥛 contains lactose
25 microgram
—————————————————————
🔹 Ace (marketing authorisation holder – Netherlands) – branded Cytomel
🏭 Ace (manufacturer)
5 microgram
12.5 microgram
25 microgram
—————————————————————
🔹 Greenstone (marketing authorisation holder – USA) – branded Greenstone
🏭 Peptido GmbH in Germany (manufacturer)
No lactose ingredient
5 microgram NDC 59762-1206-1
25 microgram NDC 59762-1207-1
50 microgram NDC 59762-1208-1
🟢🟣 dailymed.nlm.nih.gov/dailym...
—————————————————————
🔹 Grossman Cynomel (marketing authorisation holder – Mexico)
🏭 Grossman subsidiary of Bausch (formerly Valeant) in Mexico (manufacturer)
25 microgram
—————————————————————
🔹 IBSA oral solution (marketing authorisation holder – Italy) – branded Liotir
🏭 IBSA Farmaceutici Italia S.r.l in Italy (manufacturer)
No lactose ingredient
5 microgrammi/ml
10 microgrammi/ml
15 microgrammi/ml
20 microgrammi/ml
🟢 PIL – farmaci.agenziafarmaco.gov....
—————————————————————
🔹 Mayne Pharma (marketing authorisation holder – USA) – branded Mayne Pharma (formerly Libertas, Perrigo and Paddock)
🏭 manufactured in Germany (manufacturer)
No lactose ingredient
5 microgram NDC 51862-320-01
25 microgram NDC 51862-321-01
50 microgram NDC 51862-322-01
🟢🟣 dailymed.nlm.nih.gov/dailym...
—————————————————————
🔹 Pfizer (marketing authorisation holder – USA) – branded Cytomel
🏭 Peptido GmbH manufactured in Austria and/or Germany
No lactose ingredient
5 microgram NDC 60793-115-01
25 microgram NDC 60793-116-01
50 microgram NDC 60793-117-01
🟢🟣 dailymed.nlm.nih.gov/dailym...
—————————————————————
🔹 Sanofi (marketing authorisation holder – France) – branded Cynomel
🏭 PATHEON FRANCE in France (manufacturer)
No lactose ingredient
25 microgram ANSM 34009 302 775 5 3
🟢 PIL (French) base-donnees-publique.medic...
🟣 SPC base-donnees-publique.medic...
—————————————————————
🔹 Sanofi Deutschland (marketing authorisation holder – Germany) – branded Henning Thybon
🏭 Sanofi-Aventb, Barcelona, Spain (manufacturer)
No lactose ingredient
20 microgram ZN 6085344.00.00
100 microgram ZN 6085344.01.00
🟢 PIL 20 (German) mein.sanofi.de/produkte/Thy...
🟢 PIL 20 (English translation – out of date) dropbox.com/s/ccfr0tnmr7nom...
🟢 PIL 100 (German) mein.sanofi.de/produkte/Thy...
🟣 SPC 20 & 100 (German) mein.sanofi.de/produkte/Thy...
—————————————————————
🔹 SigmaPharm (marketing authorisation holder – USA)
🏭 Sigmapharm Laboratories, LLC in USA (manufacturer)
No lactose ingredient
5 microgram NDC 42794-018-12
25 microgram NDC 42794-019-12
50 microgram NDC 42794-020-12
🟢🟣 dailymed.nlm.nih.gov/dailym...
—————————————————————
🔹 Sun Pharmaceutical Industries (marketing authorisation holder – USA)
🏭 Sun Pharmaceutical Industries Limited in USA (manufacturer)
No lactose ingredient
5 microgram NDC:62756-589-83, NDC:62756-589-88, NDC:62756-589-08, NDC:62756-589-18
25 microgram NDC:62756-590-83, NDC:62756-590-88, NDC:62756-590-08, NDC:62756-590-18
50 microgram NDC:62756-591-83, NDC:62756-591-88, NDC:62756-591-08, NDC:62756-591-18
🟢🟣 dailymed.nlm.nih.gov/dailym...
—————————————————————
🔹 Uni-Pharma (marketing authorisation holder – Greece)
🏭 Uni-Pharma in Greece (manufacturer)
25 microgram
🟢🟣
➖➖➖➖➖➖➖➖➖➖➖➖➖➖
🔹 – identifies marketing authorisation holder (or equivalent in other countries)
🔸 – identifies ‘own label supplier’ products
🏭 – identifies manufacturers (where known)
🥛 – contains lactose
🟢 PIL – Patient Information Leaflet
🟣 SPC – Summary of Product Characteristics document
🟢🟣 – Single document combining typical PIL and SPC information
—————————————————————
Numbers refer to tablet dosages in micrograms.
Only products which definitely contain lactose are identified (🥛 contains lactose). Please always check other products. Where products are ‘own label supplier’, check the marketing authorisation holder for the specific product.
If there is anything inaccurate in this information, please let me know by Private Message, or on the forum:
healthunlocked.com/user/hel...
➖➖➖➖➖➖➖➖➖➖➖➖➖➖
This document is updated whenever I am aware of any changes or enhancements are needed. Please check the Last updated date. The current version is available as a PDF here:
dropbox.com/s/xlibro9l9jbfb...
The PDF version of this document has a QR code above this sentence. If your device has a camera and can interpret QR codes, this QR code should take you to the same place as the link and make it easier to download on devices, such as phones and tablets.
Dear Helvella,
I so appreciate the links to the package inserts you posted above. I take T3 liothyronine only, split-dose 4X a day. I hadn't realized that calcium-rich foods might interfere with its absorption, and am now not sure what to do about a daily serving or two (1/2 - 1 cup) of sheep yogurt. I don't take calcium tablets.
A related question about magnesium: I can't tolerate even tiny amounts of liquid magnesium taken internally, and was considering liquid magnesium sprayed onto sore knee joints. I was wondering if even a topical spray could interfere with T3 absorption. Any thoughts?
Thanks, my best,
Chrysalis56
I don't believe topical magnesium would have any impact on absorption.
The problem seems to be that the magnesium, calcium or whatever actually chemically associates or binds with the thyroid hormone in the gut. That means the thyroid hormone + <other substance> becomes a fairly stable unit or complex which cannot be absorbed.
Thank you very much, Helvella. I'll try the topical magnesium spray, and see if it helps my painful knee joints.
With best wishes,
Chrysalis56
I'd read that the calcium was the problem, so shouldn't be taken close to anything else. Although as you can buy magnesium and calcium together, presumably plenty of people don't. consumerlab.com/answers/how... has a bit of useful information.
Micki Rose suggests magnesium intake should be higher than calcium (2:1 M:C) and says don't forget the co-factors (Vit D3, Vit K2, boron, manganese). Cheers
Liothyronine should be taken well away from supplements
You can take T3 with levothyroxine
Thank you. I understand now that all supplements should be taken at a different time to both thyroid meds.
Magnesium is helpful for sleep, therefore better to take at night. I read somewhere that minerals should be taken at night and vitamins in the day. Probably plenty of disagreement to that. As has been said, wait at least two hours after taking thyroid hormone before taking any other tablets.
I got this reply rfom the UK supplier of Metavive (The Natural Health Choice Ltd)
"Most of the professional practitioners using this Metavive brand ask their clients not to take calcium supplements within 1 hour of the product. So, yes it would be probably be advisable to take any calcium supplements away from your Metavive, at least by one hour, or by four hours if you prefer."
Unfortunately, this doesn't actually answer the question. I'll just have to abide by the advice as there doesn't seem to be any research about it.
Have you had your calcium levels tested and found to be low? I ask because if your Vitamin D level is optimal you will get plenty of calcium from your diet. In fact, if you take a dose of 5,000 IU or more of Vitamin D, you also need to take Vitamin K2-MK7 which helps to route that dietary calcium where it is needed -- bones and teeth, rather than being deposited into soft tissues like blood vessels and breasts. Taking Calcium supplements if your blood level is not low can be harmful.
Vitamin D - do I take magnesium at the same time (lunch time) 
Whats the link between VitD and magnesium?
Should magnesium carbonate be avoided in thyroid disease …
