Is it important to take thyroid medication on an empty stomach?

Thyroid medications are a critical part of managing conditions like hypothyroidism or hyperthyroidism. Often taken in the morning, these medications are designed to regulate hormone levels and ensure proper body function. However, the timing of meals after taking thyroid medicine can significantly influence its absorption and effectiveness.
Patients are often advised to take these medicines on an empty stomach, but the question of how long to wait before eating remains a source of confusion. Understanding this timing is essential to ensure optimal benefits from the medication and to avoid potential interactions with certain foods or beverages.
Dr Abizer Mankad, consultant, internal medicine at Saifee Hospital, Mumbai, tells , “Thyroid medicines are very essential in the control of metabolism and energy levels in the human body. However, taking these medicines requires proper procedures, especially concerning the intake of foods.”
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Why is it important to take thyroid medication on an empty stomach, and how does food affect absorption?
Dr Mankad informs, “Thyroid medicines should be taken on an empty stomach since food and specific drinks will impede the drug’s absorption. When adminered with food, particularly those containing much fibre, calcium, or iron, less is absorbed into the intestines; hence the amount of thyroid hormones in the bloodstream is reduced than what would be expected. It may mean persing symptoms of hypothyroidism such as fatigue, weight gain, and brain fog.”
Coffee may reduce absorption up to 30% (Source: Freepik)
Optimal time elapsed before meals
To get the best absorption, Dr Mankad says, it is usually advisable to wait for at least 30 to 60 minutes after the intake of thyroid medication before one can eat. “This is long enough for the body to break it down and absorb the medication without any interference from the food. In fact, a study shows that waiting for an hour may be better than 30 minutes in terms of complete absorption,” he adds. 
Types of foods and beverages that should be avoided immediately after taking thyroid medication
Certain foods and drinks can significantly hinder thyroid medication absorption and should be avoided for a few hours after taking it. According to the doctor, these include:

Calcium-rich foods (dairy products, fortified juices)
Iron-rich foods (red meat, spinach, fortified cereals)
High-fibre foods (whole grains, beans, cruciferous vegetables)
Soy products (soy milk, tofu, edamame)
Coffee (may reduce absorption up to 30%)

“Water is the best option to take with thyroid medication, as it does not interfere with absorption,” notes Dr Mankad. Story continues below this ad
Does the timing of meals or the type of thyroid condition affect the guidelines for waiting to eat after medication?
While the traditional recommendation is morning intake on an empty stomach, it is acceptable to take thyroid medication at night, if taken at least three to four hours after the last meal. “Also, in hypothyroidism, Hashimoto’s disease, or post-thyroidectomy patients, there might be a need for stricter fasting rules to ensure stable levels of thyroid hormones,” explains Dr Mankad.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.