The Truth Behind Coffee and Thyroid Medication

Levothyroxine sodium or L-thyroxine (brand names: Synthroid, Tirosint, others) is a prescription thyroid medication that contains a synthetic form of the thyroid hormone thyroxine (T4). It is given to people with hypothyroidism (underactive thyroid) who do not make enough thyroid hormones in their body. 

Taking levothyroxine helps achieve ideal thyroid hormone levels. However, there are some restrictions on how to take thyroid medications. Many people wonder if drinking coffee with levothyroxine is okay. Coffee consumption affects the absorption of levothyroxine pills. However, if waiting an hour before drinking coffee is not an option, the potentially good news is that it doesn’t affect the soft gel and liquid forms of the medicine. Please continue reading to learn more.

Can you drink coffee while taking thyroid medication?

You can drink coffee while taking the thyroid medication levothyroxine; however, you need to be careful about the timing. Doctors advise taking levothyroxine on an empty stomach in the morning, 30-60 minutes before breakfast. This is because the presence of food and beverages in the intestines can interfere with the absorption of levothyroxine and make it less effective. Therefore, it is advised that you wait 60 minutes after your levothyroxine dose before drinking coffee. Learn what foods to avoid when taking levothyroxine. 

Note: Other thyroid medications for hypothyroidism, such as liothyronine, are less likely to be affected by food and beverages in the gut. However, doctors still advise taking it on an empty stomach. Antithyroid medicines (methimazole, propylthiouracil), which are used to treat hyperthyroidism (overactive thyroid gland), can be taken with or without food. 

Learn about 10 Medications That Should Not Be Taken With Food. 

How long should I wait to take medicine after drinking coffee?

Treatment guidelines recommend that patients take thyroid hormone replacement medicine on an empty stomach first thing in the morning. Therefore, you should wait 30-60 minutes after you take your levothyroxine on an empty stomach before drinking coffee or eating breakfast. If possible, it’s recommended that you wait 60 minutes. Find out, “How Long Does It Take for Levothyroxine to Work?”

Why can’t I drink coffee with levothyroxine?

You should not drink coffee with levothyroxine oral tablets because caffeine affects the absorption of your thyroid medication. Caffeine stimulates gut motility (muscle contractions in the digestive tract). It also has a mild laxative effect. This causes food and drugs, including thyroid medication, to move through the intestines rapidly before the drug has a chance to be fully absorbed. As a result, less of the medication enters your body. This makes levothyroxine less effective in treating your thyroid disease. 

Simply put, if you routinely take your levothyroxine tablets with your morning cup of coffee, it can result in altered intestinal absorption of the drug. Poor absorption of levothyroxine can cause the treatment to be ineffective, leading to the return of thyroid symptoms such as fatigue, weight gain, constipation, cold intolerance, dry skin, thinning hair, depression, and menstrual irregularities.

Check out our blog to learn, “What Are Some Signs My Thyroid Medication Is Not Working?”

Does caffeine affect the absorption of levothyroxine sodium oral solution?

Studies have been done to measure volunteers’ thyroid levels in blood samples after taking levothyroxine sodium oral solution. Findings confirm that caffeine does not affect the absorption of liquid thyroid medication, potentially offering the possibility to take levothyroxine with your morning coffee or breakfast.

New research has shown that the liquid formulation of levothyroxine remains stable in beverages such as black coffee, coffee with milk, tea, milk, and orange juice. The liquid solution is absorbed faster in the gut compared to the tablets. This minimizes the risk of food and drug interaction. Therefore, there is a reduced risk of the levothyroxine sodium oral solution affecting drug absorption compared to traditional tablet formulations.

Coffee drinkers can also take a soft gel capsule of levothyroxine; however, liquid thyroid medication is more effective in maintaining ideal thyroid levels compared to soft gel capsules.

Check out our blog to learn: “What Medications Should Not Be Taken with Caffeine?”

Should I switch to levothyroxine sodium oral solution?

The possibility of taking the liquid form of levothyroxine and consuming coffee at the same time or shortly thereafter offers convenience to patients. Because there is no lifestyle adjustment required in the morning routine, patients are more likely to adhere to thyroid disease treatment with liquid thyroid medication. 

Talk to your doctor about taking Tirosint-Sol (liquid formulation) or Tirosint (soft gel capsules) if you would like the convenience of consuming coffee shortly after taking your thyroid medication. You may be able to take levothyroxine sodium oral solution at the same dose with proper absorption.

Note: Switching between different formulations of levothyroxine can lead to fluctuating thyroid hormone levels. Therefore, doctors advise against frequent changes in the formulations of thyroid medications. However, if you think drinking coffee is interfering with how well your levothyroxine works, talk to your doctor about switching to levothyroxine sodium oral solution or soft gel capsules. You may need more frequent blood tests after making the change.

Should thyroid patients drink coffee?

There are conflicting results from research on the effects of drinking coffee on thyroid function and thyroid diseases. 

Some small studies have found that coffee has a protective effect against autoimmune thyroiditis and thyroid cancer. Other larger studies have found coffee has no effect on the incidence of thyroid cancer or thyroid hormone levels. Some animal studies have shown that coffee can cause miscommunication between the pituitary gland in the brain and the thyroid gland. Yet others have found drinking coffee can reduce the risk of subclinical hypothyroidism, and coffee consumption is not associated with a risk of hypothyroidism or hyperthyroidism.

What types of beverages should I avoid if I have hypothyroidism? 

If you have hypothyroidism (underactive thyroid gland), you should avoid drinking: 

• Alcohol: There is evidence that alcohol has a direct toxic effect on thyroid cells and suppresses thyroid hormone production.

• Breakfast beverages: Wait 30-60 minutes before drinking coffee, tea, milk, orange juice, grapefruit juice, and other beverages after taking your levothyroxine tablets in the morning. The presence of food or drinks in the gut can lead to altered intestinal absorption of your thyroid medication.

How to take levothyroxine: Tips for coffee drinkers

Bedtime dosing

Talk to your doctor about taking your levothyroxine tablets at bedtime instead of in the morning. You will need to make sure you don’t eat anything for 3-4 hours before you take your levothyroxine tablets. Studies have shown that there are no differences in thyroid hormone levels between morning and nighttime dosing of levothyroxine.

Decaf coffee

Consider switching to decaf coffee if you want to drink coffee at the same time as taking your thyroid hormones (levothyroxine). The key is to take levothyroxine on an empty stomach. While decaf coffee is less likely to speed up gut motility and interfere with the intestinal absorption of your thyroid medication, the same rule applies here. In other words, you should still wait 60 minutes to drink decaf coffee after taking levothyroxine.

Soft gel or liquid thyroid medication

If you don’t want to avoid coffee immediately after taking your thyroid medication, talk to your healthcare provider about switching to the soft gel or liquid formulation of levothyroxine. Caffeine is less likely to interfere with the absorption of liquid thyroid medicine. In addition, soft gel formulations are more effective in maintaining ideal thyroid hormone levels in people with gastrointestinal conditions such as H. pylori infection, chronic atrophic gastritis, celiac disease, gastroparesis, and those taking proton pump inhibitors (medications to reduce stomach acid production).