5 Surprising Things That Affect Your Thyroid Medication

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Your thyroid is a small butterfly-shaped organ that sits above your Adam’s apple. This endocrine powerhouse affects your metabolism, your heartbeat and your ability to stay warm, among other things. Unfortunately, thyroid disease is very common – more than 12 percent of all Americans will be diagnosed with some form of it in their lifetimes. An underactive thyroid (hypothyroidism) is more common than an overactive thyroid (hyperthyroidism): About 5 in 100 Americans are hypothyroid, while 1 in 100 are hyperthyroid.

Your Thyroid’s Daily Dose

Hypothyroidism is typically treated with a daily dose of replacement thyroid hormone. While this medication can help manage a sluggish thyroid, there are a number of outside factors that can throw your hormone levels out of whack, even if you’re actively treating them.

“Thyroid hormone medications are very difficult to absorb,” explains Shiri Levy, M.D., an endocrinologist at Henry Ford Health System. “They have to be taken on an empty stomach and a number of factors can interfere with absorption.”

Getting Back in Balance

When the delicate balance of thyroid hormones is upset, your whole body can be affected. You might feel more tired, be more likely to gain weight or navigate your days in a lethargic brain fog. It makes sense then to identify – and eliminate – some of the most common culprits that upset thyroid levels:

  1. Hormones. Whether you’re taking hormone replacement therapy or popping a daily birth control pill, taking other hormones at the same time as your thyroid medication can interfere with its effectiveness. “Hormones like estrogen and progesterone can bind to thyroid hormone and prevent absorption,” explains Levy. An easy solution? Take the two medications an hour apart.
  2. Multivitamins. Like hormones, minerals like iron and calcium can bind to thyroid hormone and inhibit absorption. A good rule of thumb: “Take your thyroid hormone first thing in the morning, on an empty stomach, and take multivitamins and other supplements at lunch, at least 4 hours later,” suggests Levy.
  3. Coffee. The caffeine or coffee itself isn’t a problem, but many people drink coffee with cream or milk. The calcium in dairy products can interfere with thyroid hormone absorption. Wait an hour after taking your thyroid medication to have your cappuccino or latte. Or start taking your coffee black.
  4. Autoimmune inflammation. The primary cause of hypothyroidism is Hashimoto’s disease, a condition where your own immune system attacks the thyroid gland. Doctors aren’t clear what causes Hashimoto’s, but some research suggests a viral or bacterial infection may be one culprit. While there are no current treatments for the autoimmune reactions, working with a knowledgeable physician can ensure you receive a proper diagnose and manage Hashimoto’s disease appropriately.
  5. Prescription medications. Many different types of prescription medications can interfere with replacement thyroid hormones, including drugs that treat breast cancer, depression, osteoporosis and diabetes. Read the fine print on all prescription drugs and ask your doctor or pharmacist if the medications you’re taking can interfere with your thyroid medication.

The key to maintaining healthy thyroid function is establishing a routine that maximizes absorption of your medication. Take your thyroid pill on an empty stomach and wait at least one hour before eating. Still not feeling 100 percent? Talk to your doctor about issues that mimic a sluggish thyroid, such as vitamin D or vitamin B12 deficiencies.


To find a doctor at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).

Dr. Shiri Levy is a board-certified physician who specializes in managing disorders of the thyroid, parathyroid, pituitary, and adrenal glands, lipids, osteoporosis and diabetes. She sees patients at Henry Ford Medical Centers in Novi and Detroit, and is the service chief of endocrinology at Henry Ford West Bloomfield Hospital.

Categories: FeelWell

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