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Can I take Levothyroxine with Coffee in the Morning?

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

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

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 thyroid medication with their morning coffee.

They do not consider coffee as food, but rather they think it’s a beverage like water; also they were not 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?

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 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. 

So, unfortunately, the bad news is that taking your thyroid medicine with coffee is not a good idea, whether it is regular or decaf coffee.

The gel and solution form of thyroid medicine does better than the tablet form but overall it is a good idea to take the thyroid medicine with water.

Waiting for at least 1 hr before drinking your coffee after your thyroid medication is highly recommended!

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

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Coffee and Thyroid Medicine

References :

  1. Benvenga S1, Bartolone L, Altered intestinal absorption of L-thyroxine caused by coffee.Thyroid. 2008 Mar;18(3):293-301. doi: 10.1089/thy.2007.0222. 
  2. Nicole M. Wegrzyn. Malabsorption of L-T4 Due to Drip Coffee: A Case Report Using Predictors of Causation. Journal of Academy of nutrition and dietetics. July 2016Volume 116, Issue 7, Pages 1073–1075, 1076
  3. Skelin M1, Lucijanić T2. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review.Clin Ther. 2017 Feb;39(2):378-403. doi: 10.1016/j.clinthera.2017.01.005. Epub 2017 Jan 30.
  4. Vita R1, Saraceno G. A novel formulation of L-thyroxine (L-T4) reduces the problem of L-T4 malabsorption by coffeeobserved with traditional tablet formulations.Endocrine. 2013 Feb;43(1):154-60. doi: 10.1007/s12020-012-9772-2. Epub 2012 Aug 30.
  5. Bernareggi A1, Grata E. Oral liquid formulation of levothyroxine is stable in breakfast beverages and may improve thyroidpatient compliance.Pharmaceutics. 2013 Dec 13;5(4):621-33. doi: 10.3390/pharmaceutics5040621.

Can I take Levothyroxine with Coffee in the Morning?

About The Author

Dr. Anshul Gupta, MD

I am Dr.Gupta, a Functional Medicine and Integrative Medicine physician. I like to write about Functional medicine approach to managing different diseases and want to empower people to reclaim their health through this modern approach. Come join me on this healing journey.

Can I take Levothyroxine with Coffee in the Morning?

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