Levothyroxine and milk

[Sunflower1-]

Hello everyone,hope you all had a nice Christmas.I am still very early into my levothyroxine/thyroid journey -but need to know is it ok to have cereal with milk one hour after taking levothyroxine?I keep reading that milk/calcium containing products lower the effects of levothyroxine.Some say you can eat these products after four hours but that seems like an awful long time and would end up being closer to lunch time.I really want to take my levothyroxine at night but can hardly find any information on taking it with utrogestan (I keep finding conflicting evidence,some say it's ok,some say no,some say leave an hour).Please could you help me with.Thank you so much.

[greygoose]

Rather depends on how much milk you have on your cereal. I'm sure you don't pour on a whole pint, do you?

Calcium tends to bind with thyroid hormone so that it cannot be absorbed. But, if you always have the same thing for breakfast, same amount of milk one hour after your levo, then any malabsorption will show up in your blood test results and your dose can be adjusted accordingly. So, it wouldn't matter.

But you cannot take your levo with utrogestan. Levo needs to be taken entirely alone, at least two hours away from all other medication/supplements - four hours for some. So, unless you can take your utrogestan some other time, you cannot take your levo at night.

[Sunflower1- in reply to greygoose]

Thank you for replying.I have oats every morning, probably half a cup of milk.I am not on my optimum dose of levothyroxine yet so need to have another blood test the beginning of January.So I just carry on eating my oats as part of my routine and my medication will level out the hormones (that is what you said)?I do take blood pressure medication, painkillers and vitamin d and hour after levothyroxine,I am assuming that is ok- basically I'm still trying to figure out what works.I stopped taking iron because it gives me tummy ache but have pate on toast three times a week-i stopped magnesium as it knocked me out but eat pumpkin seeds for that,b12 just made my urine super bright and online it said that's because i have too much so i stopped that-it seems that supplements gave adverse effects but food is ok to give me what i might need without side effects.

I haven't done the online test kit yet as I am waiting until I'm on my full dose of levothyroxine.

[SlowDragon Administrator in reply to Sunflower1-]

virtually all vitamin B complex turns urine bright yellow/green ….that’s normal

What were your last B12 and folate results

Vitamin D tablets or gels should be at least 4 hours away from Levo but time gap doesn’t apply to vitamin D mouth spray. Tablets or gels should be with high fat meal to aid absorption….so that’s usually evening meal

What was last vitamin D result. How much vitamin D are you taking

Magnesium best taken at bedtime or early evening as it often relaxes or helps with sleep (at least 4 hours away from levothyroxine)

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

Many members take Levo in middle of night if usually get up for the loo

verywellhealth.com/best-tim...

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

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

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

[Sunflower1- in reply to SlowDragon]

Hi,thank you for replying.I have not taken a blood test to confirm I am low in anything -basically I am trying to add things to my diet that will help get rid of the constant fatigue/lack of motivation.My levothyroxine levels are not optimal yet as I'm still on the journey if six week testing and then adding more levothyroxine.When first diagnosed my TSH was 27 but T4 normal 11.8 and I had no symptoms of being hypo but in the past(20 years ago) I have been first hyper which resolved itself after taking medication for a while-then it went under active but also resolved itself (no medication just supplements)then they tested again recently as it hasn't been checked for years and now it's 27 TSH T4 normal 11.8 I think but since starting levothyroxine I have developed many symptoms of being under active.My last test showed I think 13.4 TSH and my T4 up to 13(starting levothyroxine at 50) so I'm on 75 now and due a blood test soon I thought I should wait until optimal before doing all the test kits,not sure if that's correct.

[SlowDragon Administrator in reply to Sunflower1-]

I would request GP test vitamin levels now or alongside thyroid levels after 6-8 weeks on 75mcg

GP should have tested them at diagnosis

Plus TPO and TG thyroid antibodies

Assuming antibodies are high they should then also run coeliac blood test too

[greygoose in reply to Sunflower1-]

So I just carry on eating my oats as part of my routine and my medication will level out the hormones (that is what you said)?

Yes, that's what I said.

I do take blood pressure medication, painkillers and vitamin d and hour after levothyroxine,I am assuming that is ok

No, I'm afraid it's not OK. The BP medication and pain killers should be at least two hours away from levo, and vit D four hours.

I stopped taking iron because it gives me tummy ache

Were you taking vit C with it? That helps.

i stopped magnesium as it knocked me out but eat pumpkin seeds for that,

I think you'd have to eat a hell of a lot of pumpkin seeds to get enough magnesium. You need extra if you're taking vit D because the magnesium helps converting the D into a form that the body can use. If you don't take magnesium, you will deplete your stocks - which probably are sufficient anyway - and without it the vit D won't do you much good, even if you have good levels in your blood.

b12 just made my urine super bright and online it said that's because i have too much so i stopped that

Not the B12, no. It's one of the other Bs in a B complex that does that. Can't remember which one off-hand. But, no, it doesn't mean you have too much anything. That's just what it does.

it seems that supplements gave adverse effects but food is ok to give me what i might need without side effects.

Well, I wouldn't call any of those 'adverse' effects. But the problem is, you can't rely on food to give you enough nutrients to keep you well. If you're hypo you probably have low stomach acid, which means that you can't digest your food and absorb nutrients very well. Which is why we hypos all take so many supplements. Without them, our bodies just aren't going to be able to use the hormone we're giving it to the full effect.

[helvella Administrator]

Milk does interact with levothyroxine.

But do not miss the cereal aspect. Many cereals interact and affect absorption for a range of reasons. Fibre content being a major issue. And many substances used to fortify cereals, like iron, very definitely interact.

Which is also so easy to miss - partly because if you switch makes, even if they seem very similar, the fortification might be different.

Three vaguely similar chocolate flavoured cereals available from one retailer:

Rice, Sugar, Glucose Syrup, Fat Reduced Cocoa Powder, Salt, Cocoa Mass, Barley Malt Extract, Flavourings, Niacin, Iron, Vitamin B6, Riboflavin, Thiamin, Folic Acid, Vitamin D, Vitamin B12

Whole Grain Wheat (80.7%), Sugar, Invert Sugar Syrup, Barley Malt Extract, Fat-reduced Cocoa Powder (1.5%), Cocoa Powder (1.0%), Cocoa Mass, Salt, Bulking Agent: Calcium Carbonate, Molasses, Flavouring, Iron, Vitamin B3, B5, B9, B6, B2

Oat Flakes, Sugar, Rice Crisp (10%) [Rice Flour, Sugar, Calcium Carbonate, Malted Barley Extract], Rapeseed Oil, Dark Chocolate Curls (8%) [Sugar, Cocoa Mass, Cocoa Butter, Emulsifier (Lecithins), Flavouring], Wheat Flakes, Fat Reduced Cocoa Powder, Flavourings.

Two add iron; one doesn't.

Two add calcium carbonate; one doesn't.

Two add vitamins; one doesn't.

These all make it very difficult to come up with definitive answers.

Despite being able to find some information, actual levels of interaction, whether simulated for experimentation or real-world, are hard to find.

I know nothing of whether utrogestan interacts.

[jimh111]

I take my levothyroxine a couple of minutes before porridge with milk and have noticed no effect. Trials tend to use very high doses of levothyroxine and so may not be representative of real life. I would give it a try, your blood tests will show if there is a problem.

(Also, fruit juice can aid absorption due to its acidity.)