Inside: Evaluating if taking coffee and levothyroxine is fine or not! Is Coffee bad for thyroid? How in hypothyroidism, coffee can interfere with the absorption of Synthroid. And finally — can you drink decaffeinated coffee and levothyroxine? 

If you have been diagnosed with hypothyroidism or underactive thyroid then the most common treatment is to support thyroid with levothyroxine/Synthroid.

Hypothyroidism is a very common condition and more and more people, especially females are on thyroid medications. 

Most of the time people will take their thyroid medication in the morning as has been suggested by their physicians.

Patients have been instructed to take thyroid medicine without any food, but a lot of time there is no discussion about what kind of beverage people should use to take their medicine.

I realised that several people were taking their morning coffee and levothyroxine/ synthroid together.

They just do not consider coffee as food, but rather they think it’s a beverage like water; also no one asked if they can you drink coffee with levothyroxine, neither were they instructed against the use of coffee, so they thought it was fine.

I mean who doesn’t like a good cup of coffee in the morning to start their day.

But the question is — can coffee interfere with absorption of thyroid medicine

 Thyroid Functional Medicine Doctor 

Does Coffee Reduce Potency of Levothyroxine? 

To find out if it’s okay to take levothyroxine with coffee research was conducted to see if taking thyroid medicine with coffee interferes with the levels of thyroid hormone.

In this study, people took thyroid medicine with water, or with coffee. What was seen here was that taking thyroid medicine with coffee decreased the levels of thyroid hormone levels in blood anywhere from 23%-53%.

This interference of coffee with levothyroxine can be significant and lead to undertreatment of the thyroid condition.

What was also seen that if the coffee was ingested 1 hr after taking the thyroid medicine it didn’t interfere with the absorption of the medicine? 

What about levothyroxine and decaffeinated coffee? 

The major absorption of thyroid medicine happens in the upper part of the intestine.

And there are certain medical conditions like celiac disease, atrophic gastritis, lactose intolerance which can interfere with the absorption of levothyroxine.

The thought process is that the reason that coffee interferes with absorption of thyroid medicine can be because of caffeine. As caffeine can lead to increased intestinal motility (or mobility) and can cause the medicine to pass through the intestinal tract quickly thus not having enough time for the medicine to get absorbed.

But instead, the researchers think the real reason for coffee interference with absorption with thyroid medicine is that coffee acts as a sequestrant of T4. What it means is — coffee might have several compounds which bind to T4 in the thyroid medicine and cause it’s inappropriate for absorption.

We still do not know which is the specific compound in coffee which does that. So drinking decaf coffee still can interfere with absorption of thyroid medicine and is not suggested. And the same applies if you are taking Armour thyroid medicine you still should not take it with coffee.

Are there Thyroid medicine alternatives which are safe with coffee? 

A study has been done by taking levothyroxine tablets and coffee. But now there are other formulations available like gel and liquid formulations. Tirosint is available in both solution and gel form. These formulations were developed for people who have issues with absorption because of medical conditions. This study compared the use of gel and liquid formulation with coffee. The results showed that the liquid formulation did better than the gel formulations but the difference was very minimal, so they concluded that both the formulations can be ingested with coffee.

Now in no way, I am suggesting that you should switch to these formulations or these formulations are better for your thyroid. But in case you are on these formulations then it is safe to take them with coffee as compared to the tablet formulations like Synthroid, armour or nature thyroid. 

Can I take Thyroid Medicine with Tea? 

Since writing this post several people have reached me out to ask whether instead of coffee it is fine to take the thyroid medicine in the morning with tea or not.  So again the research suggests that taking the thyroid medicine with it also interferes with the absorption of the medicine.  Whether it is green tea or regular black tea they both interfere with the absorption of thyroid medicine.  Again the exact mechanism of that is still unknown,  but it is believed to be certain phytochemical compounds in which again interfere with the absorption. 

Can I take Thyroid Medicine with lemon water? 

Another question I get is taking the thyroid medicine with lemon water in the morning.  We do not have any research study that has looked at lemon water and thyroid medicine.  but I feel that to be on the safe side it is good to avoid lemon water and just take your medicine with regular water and then later on you can add lemon water or Lemon Tea in your breakfast. 

 So in conclusion what this means is that it is very important that you know how to take your thyroid medicine.  Food and beverages affect the absorption of thyroid medicine so even though you are taking the medicine it might not be reaching your body in the correct dosage.  I am surprised that with a simple change of not taking the medicine with any food or coffee several of my patients have actually felt better.  So the best way to take thyroid medicine is to consume the medicine as soon as you wake up with a glass of plain water and then wait for an hour or longer before you drink your tea coffee or eat your breakfast. 

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Recommended Reading —

How much Vit B12 should you take for Hypothyroidism.

The Association Between Gluten and the Development of Thyroid Disease.

Thyroid Irritable Bowel Syndrome.

6 Benefits of Garlic for your Thyroid Disease.

Research-Based Hashimoto’s Diet