Taking your thyroid medication may appear to be an easy task – simply remember to take it each day, right?…
WRONG! What you might not realise is that there’s a little more to it than this.
For the purpose of this blog, I am predominantly focussing on Hashimoto’s disease. It is important to note that Grave’s disease shares a very similar connection.
There are a few things to keep in mind to ensure that the thyroid medication you’re taking is effective, and that your symptoms are well-managed. They include:
Food Interactions
Thyroid medication can be hampered by certain foods binding to it, thus reducing access to absorption sites in the gut, changing the rate at which it dissolves, and altering the pH balance of the stomach. These foods include:
- High-calcium foods (milk, yogurt, cheese, etc)
- Iodine rich foods (such as cranberries, cod, lobster and seaweed.)
- Goitrogenic foods (including brussel sprouts, radishes, cabbage and kale)
- High fat foods
- Any food containing soy
- And foods containing high amounts of fibre.
I’d recommend keeping away from these food groups for at least three hours after taking your medication. Another food I wanted to raise awareness about is grapefruit!
Grapefruit is a primary example of how certain foods can inhibit medication absorption. Grapefruit contains psoralens which inhibits the CYP3A4 enzyme. This enzyme metabolises more than 65% of all drugs, which is why it is really important that you understand which food may be impacting your medication!
When you eat grapefruit or drink grapefruit juice it will inhibit the breakdown of Levothyroxine (T4) or Liothyronine (T3), causing large increases in blood levels of this drug for up to 7 days after ingesting grapefruit!
I can’t stress enough just how important it is to always check how your food or supplements may be impacting your medication and whether it is safe to take. Never assume!
Supplement / nutrient interactions
Similarly to how the food groups above can interfere with medication absorption, certain dietary supplements can also bind to thyroid medication and inhibit absorption.
This can even impact thyroid test results! These supplements / nutrients include:
- Calcium
- Iron
- Biotin
- Vitamin C
- Iodine or kelp
Taking your thyroid medication first thing in the morning on an empty stomach, and multivitamins / other supplements at least 4 hours later with lunch is a decent rule of thumb. Just remember you might not want to take your B Complex or multivitamin later than midday, so be mindful of how this could impact your sleep.
If you’re taking supplements, it’s crucial to look at the individual ingredients to see if there are any potential interactions, and to notify your doctor about everything you’re taking (or plan to take).
Other factors impacting absorption
The final point I want to touch on is other factors to keep in mind when taking thyroid medication. If you suffer from any of the following conditions, it’s ESSENTIAL to seek help for them as they can seriously impact your medication absorption.
If your thyroid meds don’t seem to be making a difference, one of these conditions may be why:
- Lactose intolerance
- Celiac disease
- H pylori (and other gut infections)
- SIBO – which may need to be addressed and resolved first in order to see a difference with your thyroid health. Read more about this here.
It’s also worth noting that being on a proton pump inhibitors (PPIs) for conditions such as GERD, acid reflux or peptic ulcers, can also inhibit absorption of thyroid medication since they suppress gastric acid secretion.
So be sure to take PPIs and antacids at least 4 hours away from thyroid medication!
If you’re feeling overwhelmed and are in need of support on your journey to wellness, then book in for a free breakthrough session with me.
