How to Properly Take Your Thyroid Medication

Japanese woman pouring medicine into hand
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When you are hypothyroid, your treatment is a thyroid hormone replacement drug, like the Synthroid, Levoxyl and Tirosint brands of levothyroxine, or natural desiccated thyroid drugs like Armour Thyroid and Nature-throid.

In order for your medication to effectively treat your underactive thyroid, it's important to take your thyroid hormone replacement medication properly.

When You Get Your Prescription

When you are picking up your prescription, the first step is to look at the label and the pills. There are several reasons for this step:

  • You want to double check that you are receiving the correct medication
  • You need to confirm that you are getting the correct dosage
  • You should make sure that the medication is not expired
  • You should confirm that you have received the correct number of pills.
  • Finally, if you are not on a generic medication, you should check to see that you have not inadvertently received a generic substitution. 

Double-Check Interactions

There are several hundred drugs that interact with thyroid medications. You should check with your doctor and pharmacist about any possible interactions. You can also review this list of thyroid drug interactions

Store Your Medication Properly 

Once you get your medication home, make sure that you are properly storing your thyroid drugs.

That means you should not store your medications in the bathroom or in a damp area. Also be sure that your medications are not exposed to heat for long periods

Remember to Take Your Medication

The first step in effectively taking your medication is actually remembering to take your pills each day, at around the same time.

You may need to try one of these creative ways to remember to take your thyroid medication

Taking Your Thyroid Medication

Here are some important guidelines that can help ensure that your medication is well-absorbed and has the intended action: 

  1. Most doctors feel that taking your thyroid hormone replacement medication first thing in the morning, on an empty stomach, allows for maximum absorption. 
  2. Wait at least an hour after your take your thyroid medication before you drink coffee, including decaffeinated coffee, or milk.
  3. Wait at least 1 hour after you take your thyroid medication before you eat. This allows for the best absorption of your medication.
  4. Wait at least 3 to 4 hours before you take any supplements that contain iron. Iron and calcium can interfere with the absorption of your thyroid medication.
  5. Be careful about taking calcium, calcium-fortified orange juice, and calcium-rich antacids at the same time as thyroid hormone. Allow at least 3 to 4 hours after taking your thyroid medication, so that absorption is not affected.
  6. Be consistent about a high-fiber diet. If you start or stop eating a high-fiber diet, you should have your thyroid levels rechecked after the change. More fiber in your diet can reduce your absorption, while going from a high-fiber diet to a low-fiber diet could potentially cause you to be overmedicated, due to increased absorption of your medication. 
  1. Watch for interactions with antidepressants and thyroid hormone. Zoloft, Paxil and Prozac, for example, can make thyroid meds more or less effective. Talk to your doctor about dosage adjustments.
  2. If you become unexpectedly pregnant, do not stop taking your thyroid hormone replacement medication. You should, however, see your doctor immediately to check whether you need an increase to your dosage, which is common in early pregnancy.
  3. If you are trying to conceive, have a plan in place ahead of time with your doctor to increase your thyroid hormone replacement medication dosage as soon as your pregnancy is confirmed.
  1. Don't stop taking thyroid hormone when you're breastfeeding. If you are on the correct dosage, it's considered very safe, as only minimal amounts reach the baby through your milk.

A Word from Verywell

It's important to know how to troubleshoot your thyroid medication if you are having any problems or challenges. Here are some tips. 

  1. If you absolutely must eat or have coffee as soon as you wake up, talk to your health care practitioner about whether you can take your thyroid medication at bedtime.
  2. If you are not responding well to your treatment, you should also talk to your doctor about whether to take your thyroid medication at night. There is some research that shows that thyroid medication taken at bedtime, as compared to first thing in the morning, may be better absorbed.
  3. Be aware that the Synthroid brand of levothyroxine contains several ingredients, including lactose, gluten, and acacia, that are known allergens. Some people who have sensitivities to these ingredients don't respond as well to Synthroid, but may do better with another brand.
  4. If you have significant allergies, you are not responding to pill forms of levothyroxine, or you have health issues that affect digestion such as irritable bowel disease, celiac disease, or Crohn's disease, ask your doctor about the Tirosint brand of levothyroxine. It is a specialty form of levothyroxine that is a hypoallergenic, liquid, gelcap form of levothyroxine, and is better absorbed that levothyroxine pills. 
  5. If you don't feel well on levothyroxine-only treatment, talk to your doctor about whether you might benefit from adding a T3 medication to your hypothyroidism treatment, or whether you are a candidate to take natural desiccated thyroid drugs. 


Clinical Practice Guidelines for Hypothyroidism in Adults: Co-sponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association Online