For many, caffeine-containing beverages like coffee are a regular part of their day. And yet its relationship with medications, specifically levothyroxine, is not as well-understood. Levothyroxine is a common treatment for people who have an underactive thyroid, either from an imbalance in the body or from damage to the gland. The medication is known as a thyroid hormone replacement and is taken daily.
There is a concern about the effects of caffeine on individuals who are taking levothyroxine, as caffeine inhibits the body’s absorption of the drug. This can lead to the levothyroxine being less effective and the patient’s thyroid levels remaining too low. But what exactly is the connection between caffeine and levothyroxine, and can one safely drink coffee while on the medication?
The answer is not a simple yes or no. The effects of caffeine on levothyroxine absorption depend on the amount of caffeine consumed and the timing of when it is ingested relative to when the medication is taken. Generally speaking, it is best to avoid caffeine when taking levothyroxine, or to have it at least two to four hours apart. If a patient is taking levothyroxine for thyroid hormone replacement, a small amount of caffeine – such as a cup of coffee – is unlikely to impair its absorption.
Experts in the field agree. Endocrinologist Dr. Michael Goldman says, “It’s important to note that a large amount of caffeine (such as more than two to three cups of coffee) has been shown to impair the absorption of levothyroxine. So if you’re taking the medication and drinking more than a couple cups of coffee, it can interfere with your medication’s effectiveness.”
Despite this, a doctor may recommend that an individual’s medication be taken with a full glass of water or even out of the ordinary such as during breakfast, so as to reduce the chances of impaired absorption due to dietary factors such as caffeine and other food items. Because of this, it is important to always follow a doctor’s instructions.
Another thing to consider is that when caffeine is ingested it can cause the body to excrete more levothyroxine in the urine rather than absorb it through the digestive tract. So while drinking coffee may not directly impede absorption, it may still affect the individual’s overall thyroid hormone levels.
For individuals who are taking levothyroxine, it is likely best to limit or avoid caffeine, especially if higher doses of levothyroxine are required for treatment. Consulting with a doctor is the best way to determine an individual’s risk for impaired absorption and subsequent lowered thyroid hormone levels due to caffeine.
Frequency of Caffeine Ingestion
One important factor to consider when drinking coffee and taking levothyroxine is the frequency of caffeine consumption. If a person drinks coffee habitually, consuming multiple cups of coffee daily, they may be at higher risk for impaired absorption of levothyroxine.
If someone only drinks a cup of coffee or other caffeinated beverage once in awhile, the risk of impaired absorption is lessened. In this case, it may be better for the individual to drink a cup of coffee two or more hours after taking their levothyroxine dose. Even if a person does not drink coffee regularly, but still consumes the occasional caffeinated beverage, it is important to pay attention to the timing of caffeine consumption relative to the medication.
If individuals feel they need to have caffeine while taking levothyroxine, they should consider decaffeinated options like herbal tea or green tea. It is also important to be aware of the amount of caffeine consumed over time, as even low doses can have an effect when taken multiple times daily.
Symptoms of Low Thyroid Hormone Levels
If someone experiences sudden changes in their symptoms while taking levothyroxine and drinking coffee, they should seek medical attention immediately. Common symptoms of having too low thyroid hormone levels are joint aches, feeling tired often, sleepiness, dry skin and hair, and mood changes. Typically, after getting thyroid levels checked and adjusting the levothyroxine dose, most individuals can return to their normal activities.
It is important to pay attention to any changes in symptoms, including those that occur from taking levothyroxine and drinking coffee. The best course of action if a person notices changes in the presence of both is to speak with a doctor about adjusting their dose of levothyroxine and curtailing their caffeine intake.
Alternatives to Coffee
Alternatives to coffee are widely available and can be just as satisfying. For those who enjoy an energizing beverage in the morning, matcha is an excellent choice. Matcha is a type of green tea that has naturally occurring caffeine, but contains less than regular coffee. Additionally, matcha is rich in antioxidants and has been linked to numerous health benefits.
For those still seeking a caffeine kick, tea or kombucha are tasty alternatives to coffee. Some herbal teas also provide a mild boost of energy, while still avoiding the potential risks associated with drinking coffee when taking levothyroxine.
Alternatives to Levothyroxine
In some cases, a doctor may choose to prescribe a different thyroid medication rather than levothyroxine. This is typically done if the patient experiences adverse reactions to levothyroxine or has difficulty maintaining their prescribed dose. Common alternatives to levothyroxine include synthetic T3 (liothyronine) and natural dessicated thyroid.
The body functions differently depending on the medications consumed, meaning that individuals may have different reactions to certain medications than others. Consulting with a doctor is the best way to determine the best medication for each person. This is even more important for those taking a medication like levothyroxine, which has a direct effect on the entire body due to its function of replacing hormones in the body.
Managing Diet with Levothyroxine
In addition to avoiding caffeine, it is important to pay attention to other lifestyle factors when taking levothyroxine. Taking levothyroxine with iron-containing supplements or antacids can decrease the absorption of the medication. If a person must take both iron-containing supplements and levothyroxine, it is best to space them four hours apart or to take the iron-containing supplement at a different time than the levothyroxine.
It is also wise to avoid calcium supplements, dairy, and soy products with levothyroxine, as all of these can potentially reduce the absorption of the medication. To best ensure proper absorption, the medication should be taken on an empty stomach, thirty minutes before eating.
In addition to limiting certain food items, individuals may find that eating small, frequent meals throughout the day helps them manage their symptoms better than if they skipped one or two meals. This can help to ensure proper energy levels throughout the day and also help the individual to maintain their desired dose of levothyroxine.
