... Levels are checked annually and ok (always in range).
I always take my dose in the morning with a large glass of water as soon as I wake up. For breakfast, I make myself a healthy smoothie consisting of almond milk, some greens (kale or spinach leaves), a bit of protein powder (usually shakeology), oats, wheat germs, some mixed berries, some mixed nuts.
I had previously read "be careful with calcium" so I switched from cow's milk to almond. I don't mind soy either but that has some implications?
The protein mix does no have multivitamins but it does have lots of "super foods" (which may end up as the same result).
I recently read that kale is a problem if combined with levothyroxine. I feel like I am running out of options.
I try to take the medication as early as possibly to be more than 30 min away from breakfast. So e.g. if I wake up at 4 am, I will take it with a glass of water and sleep for another 3 hours. Does that work? Or is it better to have the food closer together with medication? I am really confused and would like to find a way to take the levothyroxine in an effective manner while not having to give up my other healthy foods. What should I do?
Taking levothyroxine - questions on various food interactions: Been on a 0.05 mg dose for 5 years?
Question posted by Caroline1976 on 27 April 2014
Last updated on 3 May 2017 by tda1124
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3 Answers
I'm very interested in this conversation.
I have had thyroid issues for 20 years, hypothyroid. Since January I've been using the shakeology protein and love it. I started feeling very bad about a month ago.. thyroid issues.. made an appt and checked my thyroid, my TSH was 20.38 and I have felt terrible. I went to see a specialist today and he said the protein shake (vitamin D) could be depleting my absorption.
I go back in two weeks for lab results.
Just curious how this turned out for you
Hello Caroline. Time for you to do some reading and learn how to be an expert on your condition and medications you may take. When we learn what we can it helps us avoid problems. Starting with your questions are good. There is more to learn. There are foods that affect absorption as well as vitamins. Here are warnings from our drug checker. (It is above where the alphabet has the box under it, ok?)
And please don't stress over the rule of when to take. No need to wake up and then go back to sleep. Most people have it ready at the bedside with a glass of water next to the bed. Keep pill in a container, of course, not in the air. Drink the glass of water as usual. Then go get ready for the day. Shower, etc. Get dressed. Prepare your breakfast, read the paper. A half hour goes by quickly and you will be ready to eat. However, stay away from things in the manner listed below for your breakfast. You don't stop calcium or vitamins.
"There are 3 alcohol/food/lifestyle interactions with levothyroxine which include:
levothyroxine ↔ multivitamins with minerals
Moderate Drug Interaction
Using multivitamin with minerals together with levothyroxine may decrease the effects of levothyroxine. You should separate the administration of levothyroxine and multivitamin with minerals by at least 4 hours. If your doctor does prescribe these medications together, you may need a dose adjustment or special test to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
levothyroxine ↔ food
Moderate Food Interaction
The timing of meals relative to your levothyroxine dose can affect absorption of the drug. Therefore, levothyroxine should be taken on a consistent schedule with regard to time of day and relation to meals so as to maintain steady blood levels. In addition, absorption of levothyroxine may be decreased by foods such as soybean flour, cotton seed meal, walnuts, dietary fiber, calcium, and calcium fortified juices. These foods should be avoided within several hours of dosing if possible."
No alcohol with it or close to it when you take the pill. Sorry it didn't copy but you will find it as you read.
Hi endlessPred,
Thanks for your detailed answer.
So I am already doing what you were suggesting - have the pill in the container and a glass of water next to my bed. Taking this first thing I wake up whether I go back to sleep after or not. The half hour is not the problem. The problem are the multivitamins and minerals that are in the protein powder. It's nothing that is prescribed, I just think my smoothies are a quick and healthy breakfast. Yes I read about the drug and food interactions that you mention above and those are the "several hours". So I was wondering (since I don't want to change what I am eating and having the smoothie at another time of the day is just not practical) if I should take my medication at another time of the day and what would be a good one.
The simple answer is no. Thyroid meds are taken on an empty stomach, water only, and have to be taken the way it says. Thyroid support is for your health for the rest of your life. Smoothies come and go. My priority would be to have some other protein for breakfast like an egg or such. Definitely your choice, but you will find your numbers changing, your moods swinging and your skin so very dry by not following the prescribed diet. It will require more medication because the powders are not consistent in their makeup and not regulated. Therefore the amounts of vitamins and soy are irregular.
Also,,best to start checking the effect of too much soy in the diet and health risks in women. There are quite a few articles lately pointing out connections to real problems including cancer. As for the vitamins, one has to be careful not to overdue since too many are as problematic than not enough.
As you can tell, I am not in favor of these powder supplements. A fresh smoothy with berries and veggies is much better and easier to control without the challenge of amounts. Add some chia seeds or find flax seeds and you have something much better and healthier. There are plenty of ideas on the web.
How well you take care of your thyroid condition will give you a long and healthier life. Getting off balance takes weeks to correct and is a real problem. I wish you good health and hope you have some new ways of looking at this very common condition.
Hi endlessPred,
I thought about your answer and you are absolutely right, the levothyroxine level should be my priority. Was actually curious to find out if this multivitamin-enriched protein powder smoothies close (normally within an hour or two) of taking medication would have an effect.
Today I had a doctor's appointment to review my level. It was alarmingly high - TSH was three times the recommended maximum. My doctor suggested to increase my medication dose. I told her about the possible interaction and I had already stopped having the multivitamin-enriched powder for breakfast (smoothies yes, but just berries, greens, oats, yoghurt or almond milk) since they were last taking a blood sample. She confirmed that this could be an explanation, so they took another blood sample today. I will get the result next week and either the range is back to normal (or on it's way), or it's the same and I just need to take a higher dose. Thanks again!
Hi Carloine. Wondering how you are doing now. I am sure you appreciate the irony of taking something good isn't always the right thing to do at the time. I would take that smoothie in the afternoon when energy can be low. Sounds like a tasty pick me up. Enjoy it as the luxury it is, let me know how the TSH is going. :-)
Hi endlessPred,
Yes, I was also thinking of the irony. Well, interestingly my doctor called me a few days later and my levels were back in the recommended range. So it really must have been the multivitamins.
When I have smoothies in the morning, it's with lots of good fresh stuff but not the multivitamin-enriched protein powder.
Having it in the afternoon does not work with my schedule. I am at work all day and usually do something after whether it's going out, running errands or going to the gym - so I don't get back home until quite late in the evening and I need a proper blender to prepare my smoothie. I'll use up the remaining powder on weekends when it's easy to have several hours in between the thyroid medication and a late breakfast or snack. Won't buy shakeology again and switch to a protein powder that does not have multivitamins in it. Probably a better idea anyway.
Still feel tired but increasing the dose can't be the answer if my level is in range. My doctor does not recommend it and I believe she knows what she is doing.
If your levels are always in range what's the problem? It seems like what you're doing is working.
You have a point there. My last check up for the level was actually a year ago. Only recently read about the possible kale problem and I've only done the protein shakes for the past six months. Actually just got tested again a few days ago so once the results come back I should see if my shakes for breakfast have been influencing my medication.
Related topics
levothyroxine, interaction, dosage, food
Further information
- Levothyroxine uses and safety info
- Levothyroxine prescribing info & package insert (for Health Professionals)
- Side effects of Levothyroxine (detailed)
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