Tea before levothyroxine

[Sailing14]

Can you have an early cup of tea in the morning as long as you wait a couple of hours before taking thyroxine? Or is it better to avoid doing this?

I am not sure if it can affect absorption.

Thank you

[Aurealis]

my view is

Hypothyroidism is a condition for life

If you want a cup of tea, have one, but it’s best to have a standard routine if you can, so that your levels aren’t affected by the tea

If a cup of tea makes you happy, why not?

[Sailing14 in reply to Aurealis]

Thank you for your reply. I hope I can continue to have tea but I am not sure on why I am having symptoms and I am trying to see what will help.

[tattybogle]

This is my take on this :

i was diagnosed age 36 single parent with 2 little kids .. i decided there as no way i was spending the next 50 yrs with out a brew first in the morning.

Yes it is very likely that tea (and milk ) will reduce the amount to T4 you absorb into your blood from each tablet.

( note* ~ this is nothing to do with 'absorption into cells' , we are just talking about how much T4 gets from the stomach / small intestine into the bloodstream )

..... so any reduction in absorption from tea / milk is in effect...... a 'dose reduction'

BUT , as long as whatever you do with tea (and the timing of it), is the SAME EACH DAY , then the effect on absorption will be the same each day .. and therefore the effect is manageable.

Eg. if you take 100mcg tablet, we know that most of us only absorb approx 80mcg T4 from that tablet (even under ideal circumstances in the gut)

if you take tea with milk close to the tablet on one day, then that absorption might go down to eg 50mcg ( made up number)

if you do the same tea / same time gap, every day, then in effect you are on a stable dose of 50mcg.

...... and when you get blood tests, the blood will show the fT4 and TSH level for a stable "50mcg" dose.

...... and if that is not enough for you . (ie TSH higher than optimal / fT4 not high in range/ symptoms remain) ,, then your 100mcg prescription will be increased to eg. 125mcg ( or it should be, if you ask)

If you carry on taking same tea/ same time .. then from that 125mcg prescription you may absorb eg. "80mcg".

So..... (as long as the prescription IS increased appropriately) the only negative effect of having tea every morning is that you are prescribed eg. 125mcg, whereas without the tea habit , you would be prescribed less eg. 100mcg ... but the amount of T4 you absorb each day will still be eg. "80mcg" .

So OK, it's a 'waste' of levo .. but who cares ? (it cost's pennies ~ one pack of 28 is about a £1)

(and if you being really pernickity , it means you are eating a miniscule amount more filler than is strictly necessary)

The problem arises if you take tea one day ,then not then next , one day take it 10 mins before the levo , then an hour after the next , one day have milky tea , and the next black , (then a latte the day after that ) ........ if you are inconsistent , then you are going to absorb a different dose each day . which means blood tests will be all over the place and it will be hard to find a consistent dose for your needs.

I drink Rooibos tea (with a smidge of milk) WITH my levo.. i have done ever since was diagnosed in 2003 ..( because that is what i already drank anyway , it happens to be naturally free of caffeine and tannins ~ but if i was drinking builders tea at the time i would have carried on doing that too)

[Sailing14]

Thank you for your detailed response. That all helps me to decide on the best route when trying g to eliminate possible causes of my symptoms (i.e) malabsorption. I am hoping to trial liquid thyroxine. I have had tests to rule out stomach issues at the moment but not a caeliac test. Would a blood test confirm this? My thyroid results are normal and vitamins, but I do not feel well and that I am absorbing the medication at the moment.

[tattybogle in reply to Sailing14]

Ok , so , since you are still trying to rule out the cause of symptoms , (and may be going to try liquid levo, which is not at all cheap )then it make's more sense to stick consistently to the "take levo on an empty stomach and leave an hour before a cup of tea" rule for the time being .

My earlier reply was based on an assumption that you were not having significant problems with the absorption of what you were taking .

as far as i remember there is a blood test for celiac,, but it is not 100% conclusive.... ie. test can occasionally be negative but you can still have celiac .. i think ? the only 100% prof is an endoscopy and a biopsy .. but i'm not sure i've remembered that correctly.

[Sailing14 in reply to tattybogle]

Thank you for your reply. I will ring the GP to see what he advises on caeliac disease.

I usually have a cup of tea around 5.30 am as my husband goes to work early. I then take the thyroxine two hours later. Is it better to avoid the tea before thyroxine until absorption issues can be looked into?

[tattybogle in reply to Sailing14]

if you are asking a GP to investigate ?absorption issues and to consider prescribing liquid (which costs them a lot), the first thing they will ask is "are you taking it on an empty stomach".. and when you say no , they will tell you to sort that out first and come back for a retest when you have been taking it on an empty stomach for a while .. so at some point it's an issue you will have to address any way , and to be honest you might as well address it now by finding a way to take it on an empty stomach ,and get that question out on the way.

How about trying just hot water ( possibly with a little squeeze of lemon juice in it) when your hubby gets up and take your levo with it ? ..

hot water with lemon first thing it's supposedly very good for cleansing the liver (conversion of T4 to T3 mostly happens in the liver) , and there is plenty of research showing vitamin C actually improves the absorption of Levo, so personally i don't think the addition of a little lemon juice to the water is a problem with Levo .

healthunlocked.com/thyroidu... lemon-water-with-thyroid-meds

[Sailing14 in reply to tattybogle]

Thank you for your reply and helpful advice. I will try lemon and hot water with the thyroxine. My Endocrinologist said wait two hours before food afterwards. Would tea have been included in this advice due to the milk?

[tattybogle in reply to Sailing14]

partly due to the milk ,as calcium is known to lower Levo absorption.

partly due to the caffeine in tea ..... coffee has been shown to lower Levo absorption , and that may be due to the caffeine in coffee, and if so ,then tea may affect it too ... but nobody hads bothered to find out .

and partly because they don't know about the effect on absorption of ANYTHING (other than coffee /calcium /and iron) ....... because nobody has bothered to find out.

So they have to play it safe and say "nothing for 2 hrs"

[Sailing14 in reply to tattybogle]

Thank you. It is a condition that is very misunderstood by too many people. It is only when we experience difficulties, we realise how essential this hormone is.

To confirm, I do usually try to keep to a set time for taking thyroxine and because weekends are not an early start, it would be more difficult. Should I take the thyroxine and then wait the two hours for tea (I will try the lemon though with the thyroxine). Also, It is decaffeinated tea with milk. Is this the same?

[tattybogle in reply to Sailing14]

Also, It is decaffeinated tea with milk. Is this the same? Nobody knows

Yes wait 2 hrs for tea.. (if you weren't having problems i'd say wait 1 hour , but you are.... sooo you should be consistent/ strict for now .

try the "hot water/ lemon /Levo ... wait 2 hrs before tea" for a few weeks ... you never know, you might get to actually like it~ i did it for a few yrs (long ago before i was hypo when i lived with hippies lol ... hot water/ lemon .. walk to the river .... do tai chi for 45mins ... then walk home .....and then have breakfast .. i did make me feel really good i have to say .

[Sailing14 in reply to tattybogle]

Thank you. When you say wait two hours, do I not have anything before thyroxine in the morning and then wait for two hours afterwards before I eat?

Sorry. I am trying to get things right as you said, due to symptoms and feeling I am not absorbing the thyroxine at present.

[tattybogle in reply to Sailing14]

yes

[Sailing14 in reply to tattybogle]

Thank you.

[Auders in reply to tattybogle]

Tatty you don’t feel like setting up a hippy commune for us poor thyroid suffers do you? Sure there will be lots of takers x🙏

[SlowDragon Administrator]

Taking Levothyroxine at bedtime can improve absorption

verywellhealth.com/best-tim...

markvanderpump.co.uk/blog/p...

markvanderpump.co.uk/blog/p...

[Sailing14]

Thank you for your advice. I struggle to eat at exact times each night so take thyroxine in the morning, but I have been advised by the Endocrinologist to trial the evening to help with absorption. I will have to see if I can.

[Auders]

Wow, that looks absolutely beautiful, so calm and peaceful. We can all give you a hand with your wall too. May get a couple of bricks out of me on a good day x