The thyroid is the butterfly-shaped gland at the base of your neck. As part of the endocrine system, it produces hormones that regulate your body's energy use, along with many other important functions.
Hypothyroidism is the condition of the thyroid gland producing too little thyroid hormone. Our bodies require thyroid hormones for essential processes such as growth and metabolism, energy production, controlling heart rate, and digestive function.
Without adequate levels of thyroid hormone, you can suffer from several unpleasant symptoms, including:
- Weight gain
- Puffy face
- Muscle weakness
- Elevated blood cholesterol level
- Tender, achy, or stiff muscles
- Painful, stiff, or swollen joints
- Heavier than normal or irregular menstrual periods
- Thinning hair
- Slowed heart rate
- Impaired memory
- Enlarged thyroid gland (goiter)
Most people with hypothyroidism need to take daily thyroid hormone replacement medication. The right type and dose of thyroid medication can help improve these symptoms and improve your overall health and quality of life.
Typically, we recommend you test your thyroid every six months. When you start a new medication or change your dose, we recommend that you test more frequently to see how well your body adapts to the medication.
Finding the right treatment for you is essential and can take some time. We are all unique with individual sensitivities, and our bodies will not all react the same way to a specific medication or dosage. Work with a trustworthy thyroid doctor to make the process as easy and efficient as possible.
If you feel that your thyroid symptoms are not improving, or worsen, you should first look to see if anything in your daily routine affects how your medication is absorbed.
Seven things that can affect your thyroid medication
#1. If you take your medication with food
You should take your thyroid medication on an empty stomach. People usually take it at least one hour before breakfast. Still, some people take it before going to sleep if they eat an earlier dinner. Certain foods and nutrients, like calcium and iron, interfere with the absorption of levothyroxine in your gut. You will want to give your body the best chance to absorb equal amounts of the medication every day to maintain thyroid hormone balance. Always follow the instructions provided by your doctor.
#2. If you're inconsistent with your medication
Take your thyroid medication at the same time every day. Make it part of your daily routine—i.e., take your medicine before you wash your face or comb your hair. This consistency is more critical for T3-only and T4/T3 combination medications because T4-only medications are longer-acting in the body.
#3. If you experience weight changes
Many medications are prescribed based on your weight. Indeed, body weight is one of the main variables considered when your doctor prescribes your dose. Weight gain is a common symptom of hypothyroidism, and you may lose weight when you get proper treatment. Therefore, people often transition to a lower dose with weight loss. It is essential to let your doctor know of any significant changes in weight, as too much thyroid medication can cause heart irregularities, and too little medication can worsen hypothyroid symptoms like high cholesterol.
#4. If you switch between medications
Each thyroid hormone medication brand is a little different. While each medication brand contains a common active ingredient, the small differences in the pill makeup could influence the way your body absorbs and uses the drug.
Differences in pill makeup can include coatings, lubricants, fillers or diluents, preservatives, coloring agents, sweeteners, or flavoring agents. Common fillers for tablets and capsules include cornstarch or sugars like glucose and sucrose. In liquid formulations, glycerine and water are used to dissolve or suspend active ingredients. These non-active ingredients help to ensure that a drug has consistent and reproducible quality.
If you switch medications, it's important to retest your thyroid every four to six weeks and adjust your dosage as needed until your levels are stable.
#5. If you take other medication or supplements at the same time
Learn about possible interactions from other medications or supplements with your thyroid hormone. Calcium or iron supplements, antacids containing calcium or aluminum hydroxide, and other medicines may prevent your body from fully absorbing your thyroid medication. Talk to your doctor to learn how long you should wait to take those other supplements and medicines after you have administered your daily thyroid medication.
#6. If you take your medication with liquid other than water
Swallow your pill with any liquid other than soy milk, grapefruit or orange juices, or coffee; we recommend water! These drinks can impact how your body absorbs the medication. Grapefruit or orange juices can inhibit uptake transporters and reduce the medication's absorption. Similarly, studies show that coffee interferes with the absorption of T4 medication. This effect does not last long, but can lead to undertreatment of your thyroid condition.
#7. If your diet is rich in fiber
Overeating fiber in your diet can interfere with thyroid hormone medication absorption. However, we know that fiber is an essential part of a thyroid-healthy diet. Fiber helps maintain a healthy gut microbiome, controls weight, relieves constipation (which can be a troublesome symptom for people with hypothyroidism), and lowers your risk for heart disease and diabetes. Make sure to get plenty of fiber in your diet, but eat fibrous foods at least four hours before or after taking your thyroid medication to allow time for absorption.
A note from Paloma Health
We want you to feel your best! Paloma offers you the opportunity to work with a thyroid doctor to optimize your thyroid health from your home's comfort.