Are you taking your thyroid medication properly…are you sure?

Are you taking your thyroid medication properly…are you sure?

Following 3 years of taking thyroid drug for hypothyroidism consistently, I found an extraordinary new thyroid specialist and out of the blue found that I was taking my thyroid medicine all off-base. I was taking my medicine at the simple same time as nourishments, drugs, and enhancements known to meddle with the retention of thyroid prescription. However my past thyroid specialist and drug specialists never thought to reveal to me such imperative data.

I never again take a T4-just levothyroxine drug like Synthroid, which is a well known remedy for hypothyroidism in standard medication. I felt horrendous on T4 as it were. Some do incredible on these drugs however I simply didn't. Our bodies are altogether unique. I presently take normal dried up thyroid which contains both T4 and T3 thyroid hormones. My specialist has me partition my portion to two times every day to spread the effect of T3 in NDT to keep up my vitality for the duration of the day. I take half of my measurement before anything else when I wake up and the other half toward the evening a few hours separated from the nourishment, enhancements, and meds referenced beneath in this article. First address your specialist before changing how you take your thyroid medicine.

Composed by Kent Holtorf, M.D. 

In the event that you are hypothyroid and taking a medicine thyroid hormone substitution sedate, you may not know about the numerous tenets that should be pursued when taking your drug. Something you may not know is the means by which your different drugs, nutrients, supplement, and even nourishment decisions are meddling shrink thyroid medicine.

On the off chance that you are taking thyroid prescription, ideally your specialist or drug specialist has effectively imparted to you the most imperative things to recall:

  1. Go up against an unfilled stomach before anything else 
  2. Hold up one hour before having breakfast 
  3. Take it in the meantime every day 
  4. Never miss a portion 
  5. Try not to take your thyroid medicine in the meantime as your (espresso may bring down the assimilation of your thyroid medication)(1,2,3) 

These are essential prescription guidelines to pursue, nonetheless, there is a whole other world to the story when taking thyroid drug that you may not know about.

Thyroid master Mary Shomon expounds on how some thyroid patients may profit by taking thyroid prescription at night.(4) Speak to your specialist before making changes to how you take your thyroid medicine.

Numerous prescriptions, enhancements, and nourishments are essential to maintain a strategic distance from or not expend inside three to six hours of taking your thyroid medicine. These meddle with the body's capacity to assimilate and use thyroid drug successfully. At the point when an obstruction of assimilation occurs, genuine things can happen. You may end up under-sedated or even over-cured relying upon the substance causing the obstruction. All in all, which substances cause an ingestion issue?

Anti-infection agents 

On the off chance that you are taking thyroid medicine and you are endorsed an anti-infection, you will need to ensure that you think about how thyroid medications and anti-infection agents can interface, influencing the assimilation of your thyroid drug.

There are an assortment of reasons why you may need to take a bigger than-regular portion of thyroid hormone substitution drug—yet a standout amongst the most widely recognized reasons is that you are taking a medicine or over-the-counter prescription that influences retention of your thyroid prescription.

A few drugs decline the retention of thyroid medicine while others increment it.

An examination from the diary Thyroid found that the anti-toxin ciprofloxacin – known all the more regularly by brand names Cipro, Proquin, Ciproxin, Ciprobay, Cirpoxine, and Ciflox — essentially diminished the retention of the thyroid medication.(5) [Keep at the top of the priority list that a few specialists feel that the notice about ciprofloxacin applies additionally to comparative quinolone anti-infection agents, for example, levofloxacin (Levaquin), lomefloxacin (Maxaquin), monifloxacin (Avelox), norfloxacin (Norox-In), and ofloxacin (Floxin).]

This implies on the off chance that you are taking thyroid medications and an anti-microbial from the quinolone family, it could meddle with retention, and cause you to wind up significantly more hypothyroid.

Strikingly, the anti-microbial rifampin (likewise called rifampicin) — and known by brand names Rifadin, Rifamate and Rifater — altogether expanded the retention of the thyroid drug. This implies in the event that you are taking the anti-toxin alongside your thyroid hormone substitution drug, it could really make you move toward becoming overmedicated, or experience hyperthyroid manifestations.

Is there an answer? A few investigations have discovered that the effect might be limited if the anti-toxin and thyroid meds were dismantled no less than six hours. Be that as it may, it's not settled upon no matter how you look at it by doctors.

Your most logical option is to examine the issue with your expert at the time these medications are recommended (and before you get the remedy filled). There might be different anti-infection agents accessible for your treatment that are more averse to meddle with the viability of your thyroid treatment. To be sheltered, take anti-toxins 6 hours either previously or after your thyroid drug.

Note: Remember that in the event that you are endorsed an anti-toxin, you ought to likewise take measures to help secure your stomach related wellbeing.

Different Medications 

While a considerable lot of these different drugs are required, there are time rules to pursue on the off chance that you are likewise taking thyroid medicine. Address your specialist or drug specialist on the off chance that you are taking:

  • Sucralfate (Carafate), a prescription frequently recommended for treatment of peptic ulcer ailment or gastroesophageal reflux ailment diminishes the retention of thyroid medicine and ought to be taken 8 hours prior or after. 
  • Cholestyramine and other cholesterol bringing down medications ought to be dismantled 4-6 hours from your thyroid drug. 
  • Raloxifene (Evista) for osteoporosis dismantle 12 hours. 
  • Antidepressants: Many particular serotonin reuptake inhibitors (SSRI) like Prozac, Zoloft, and Paxil decline the viability of thyroid drug. 
  • Hostile to seizure: Medications, for example, Tegretol, Dilantin, and Phenobarbital increment the digestion and may require your doctor to expand your thyroid portion. 
  • Insulin or an oral hypoglycemic medication take somewhere around a couple of hours separated to stay away from communication. 
  • Sevelamer – for kidney sickness 
  • Antiepileptic drugs – Rifampin, efavirenz, nevirapine, rifabutin and rifapentine 
  • St. John's wort 
  • Imatinib (Gleevec) – malignancy sedate 
  • Sertraline (Zoloft) 

Converse with your specialist or drug specialist pretty much all medications and enhancements that you are taking nearby your thyroid hormone substitution medicine, to ensure that your planning limits any obstruction or assimilation issues.


Curiously, taking iron or calcium supplements, while accommodating to your condition, can likewise influence the manner in which your body ingests your prescription. This incorporates multivitamins and pre-birth nutrients that incorporate iron. Notwithstanding going after an over the counter stomach settling agent like Tums or Rolaids (acid neutralizers that incorporate calcium carbonate or potentially aluminum hydroxide can fundamentally decrease thyroid drug assimilation), should be thought about, in the event that you are at present taking any sort of thyroid medicine, watch the 4 to 6 hour rule.(6)


Like enhancements, sustenances wealthy in iron, fiber, or calcium, for example, calcium strengthened squeezed orange or yogurt ought to be delighted in something like 2 hours prior or in the wake of taking your thyroid.

Commonly we look for changed specialists for various reasons. While your endocrinologist could be endorsing your thyroid medicine, the general family specialist you look for when wiped out with bacterial, viral, or possibly stomach issues is totally uninformed of some other solutions. Furthermore, we intermittently neglect to specify the over the counter medications we take, not giving the specialist the entire picture. It is in every case best to attempt and keep a rundown of prescription, including supplements, convenient to impart to each specialist that you see.

Perceptions of these time rules can have a colossal effect in keeping your thyroid organ and drug performing getting it done.

About Dr. Kent Holtorf 

Kent Holtorf, M.D. is the therapeutic chief of the Holtorf Medical Group with areas in Los Angeles, Foster City, Atlanta, and Philadelphia. He is additionally author and executive of the non-benefit National Academy of Hypothyroidism (NAH), which is committed to scattering of new data to specialists and patients on the determination and treatment of hypothyroidism.

Dr. Holtorf has by and by prepared various doctors the nation over in the utilization of bioidentical hormones, hypothyroidism, complex endocrine brokenness, and creative medications of incessant weakness disorder, weight reduction, fibromyalgia, and ceaseless irresistible maladies, including Lyme sickness.

He has been a highlighted visitor on various TV indicates including CNBC, ABC News, CNN, EXTRA TV, Discovery Health, The Learning Channel, The Today Show, The Doctors, Dr. Senior member Edell, Glenn Beck, Nancy Grace, Fox Business, ESPN, Rush Limbaugh, CBS Sunday Morning, Sean Hannity, So Cal News, and cited in various print media including the Wall Street Journal, Los Angeles Times, US New and World Report, San Francisco Chronicle, WebMD, Health, Elle, Better Homes and Garden, US Weekly, Forbes, Cosmopolitan, New York Daily News, Self magazine, among numerous others.


Benvenga, S., et al. Adjusted Intestinal Absorption of L-Thyroxine Caused by Coffee. Thyroid. 2008; 18(3):293-301.

Mazzaferri, E. Thyroid Hormone Therapy. Clinical Thyroidology for Patients: Summaries for Patients from Clinical Thyroidology. 2008; Vol 1, Iss 1.

Sindoni, An., et al. Case Report: Coffee Impairs intestinal Absorption of Levothyroxine: Report of Additional Cases. Hot Thyroidology. Article 5/09.

Bolk, N., et al. Impacts of night versus morning levothyroxine admission: a randomized twofold visually impaired hybrid preliminary. Curve Intern Med. 2010 Dec 13: 170(22):1996-2003

Goldberg, An., et al. Ciprofloxacin and Rifampin Have Opposite Effects on Levothyroxine Absorption. Thyroid. October

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