I take levothyroxine (Synthroid), a thyroid hormone to treat hypothyroidism. Are there supplements or foods I should avoid, or be taking, due to this drug?

I take Generic Levothyroxine 50mcg ans Armour Thyroid 60mg I also take Alpha Lopoic Sustain 300mg, B12 all in morning. I take Chromium Picolnate, Zinc, Cal & Mag in late afternoon and night.

Funny I also take it during the night when I wake up. Works for me.

I have been on thyroid meds for more than 50 years. The most recent years I've been taking Unithroid 175mcg daily. At first taken in the morning, but my blood levels fluctuated, leading my Endocrinologist to recommend that I take it in the evening. I found it hard to stick to a time, so I now take it during the night when I usually wake up. This works for me.

I have been taking SYNTHROID for many,many years. Always around 3 a.m.
It does not interfere with my sleep--- the only drawback is that, as a diabetic, I may need to raise my blood sugar around that time --- a box of apple juice. This results in taking SYNTHROID later.... closer to breakfast. Still, this is a minor inconvenience. My tests have always been satisfactory...

I have been taking 60mg of NP Thyroid in the morning and 50mcg of Levothyroxine at night. My Integrative medicine Doctor says my numbers have never looked so good.

My TSH levels have remained stable taking the generic over a period of years.

Just to clarify - when you write "Synthroid... and other thyroid hormone drugs for hypothyroidism (underactive thyroid) can be affected" you are including Armour Thyroid in that group? Thanks!

I have been taking Levothyroxine since I had a thyroidectomy 43 years ago. I take my thyroid medication first thing every morning at least 1 hour before breakfast with a full glass of water. However, I do have coffee before eating breakfast. My doctor checks my thyroid levels every year during my annual checkup. My dosage has stayed the same all these years.

When I had a total thyroidectomy many years ago at Mt. Sinai Hospital in NY, by the chief on ENT, he made a point of telling me to always use Synthroid and to avoid any of the generics. I have followed his advice all these many years and will continue to do so.

This is a recent study on levothyroxine: https://pubmed.ncbi.nlm.nih.gov/35226058/
Here are some of my concerns about their conclusions:
The authors of this article1 argue their analysis of users of just 3 -- Mylan (now Viatris), Sandoz, and Lannett -- out of the 14 or more levothyroxine tablet manufacturers during the study period, supports the current prescribing of generic levothyroxine. I believe their argument is flawed.

Sandoz no longer “manufactures” or distributes l-thyroxine. It most recently retailed l-thyroxine supplied by Cediprof (Neolpharma). Previously, MOVA manufactured its product. Lannett used to distribute Jerome Stevens Pharmaceuticals manufactured l-thyroxine but now distributes Cediprof’s version under its own name. The Mylan manufacturing plant in Morgantown, West Virginia, where its l-thyroxine manufacturing was considered impeccable, is now closed secondary to cost cutting. Mylan declines to say, for “confidential” reasons, whether it is now manufactured domestically or outsourced overseas (personal communication). To assert there should be no concerns about substituting one generic l-thyroxine for another based on just 2 of 12 current manufacturers, much less when there are significant changes affecting both of them, is unsupportable.

The authors argue that the use of generic levothyroxine is “reassuring.” Yet, as recently as 2021, the FDA required Acella to recall 38 lots of l-thyroxine secondary to subpotency. In 2020, the FDA required Acella to recall 13 lots of l-thyroxine for superpotency.2 In 2018, Westminster Pharmaceuticals was required to recall 38 lots of l-thyroxine.3 In both 2017 and 2014, Mylan recalled lots of l-thyroxine. In 2016, a forced switch of 350,000 Dutch patients off their brand name product resulted in 63% of those taking >100 mcg/day having abnormal TSH results.4

The generic pharmaceutical industry can be cutthroat despite price fixing allegations. Mylan, Sandoz, and Lannett have all been warned by the FDA in recent years over their manufacturing practices. There are regular reports, which are likely greatly underreported, of various deficiencies in other generic manufacturers.5 Without consistent sourcing, site manufacturing, and quality control no one can be assured that any generic is consistently bioequivalent, much less free of contaminants, either to itself or other generics.

Your mileage may vary, but for me, brand Levoxyl works best. It's the only brand that hasn't had recalls for impurities or problematic dosing. I had been on generics for many years, but began having wild swings in my TSH, and crazy symptoms (hair loss, nervousness, exhaustion, random and immediate allergic reactions to food, brain fog... the list went on). My wonderful husband scoured the web and discovered that every generic and even brand Synthroid had had recalls. I've been on Levoxyl for three years now, and my TSH has been stable the whole time. As an earlier poster noted, the brand name is worth the extra money.

As for natural forms of thyroid, like Armor: I personally know three people who've been rushed to the ER due to the crazy unstable dosing of those pills. I'm grateful I've never been advised to take it.

Have been on Synthroid for 42 years after a complete thyroidectomy at age 22! Tried the generic form once and had reactions, went back to the Synthroid. It is worth the extra cost.

I take (Triosint) it is a pure form levothyroxin. Triosint is made in Switzerland and has no additives. It is expensive my insurance company keeps threatening to put me on generic drug. I also use Armour which has been a life saver, as it gave me more energy. I take my medication when I usually get up to use the bathroom about 3 am. It is important to take it at least an hour before I eat. Calcium infers with the defectiveness of these drugs. I hope this helps someone.

What the study did not look at, and which is major new issue with generics, are the inactive ingredients, which not only can differ from one manufacturer of generics to another but also from generics to the brand. Some inactive ingredients could have problematic side effects. There was a first major study of these published within the past year, which caused the FDA to convene a panel to look into the issue. The. COVID hit. There was a second study on possible toxicity published a few month ago.

I know that I cannot take generic versions of many meds where I can take brands or authorized generics. I would suggest that people pay close attention to this emerging issue if they’re considering switching from a brand.

Thank you for this information, which I follow when taking supplements. Of course I always check ConsumerLab.com before buying and taking any supplement.

A note about generic levothyroxine: 30 years ago I was started on Synthroid, then with an insurance change was moved to a generic levothyroxine. About a decade ago, I started having odd food reactions (hives after eating say, organic romaine lettuce, which had been harmless to me the prior day). Thanks to a clever allergist, it was determined that I was being overmedicated by the generic levothyroxine (my TSH was well below normal) - despite there being no change in my supplements, dosage, diet, weight, etc. It was causing me to react to food the oxidation of food that wasn't absolutely fresh, even a day after purchase of fresh foods, or opening a jar or bottle of prepared foods. I'm ever grateful to him.

Fast forward to a couple of years ago, and I had an actual thyroid episode, again the result in overmedication, despite my generic levothyroxine dose having been lowered, and lowered and lowered. Grasping at straws, I asked my doctor to put me on the more expensive Synthroid brand, and have had zero incidents since then. My heart doesn't feel as if it's going to beat out of chest, I don't have the shakes and the flop sweats, etc.

Some sleuthing by my husband resulted in the discovery that *every single manufacturer of the generics I had been on had had recalls, recalls and more recalls because of inaccurate levothyroxine dosing.* As the one taking the medication, was I ever notified? No. In fact, when presented with this information the online pharmacy shrugged it off, and continue to use these manufacturers despite their terrible practices.

Your mileage may vary, but no more generics for me.

Regarding CL's latest 10/2020 comment about switching from generic to branded and vice versa, it's worth noting that a big risk of taking the generic is that many insurance plans require patients to fill prescriptions via 90-day mail orders, and mail-order pharmacies routinely change the sources of their generic drugs. Reading into the CL comment, this means that your dose of thyroid medication could vary from one refill to another. This risk is another reason to seek out the branded versions.

This is an older CL post but I thought I'd share my experience regarding Nature Throid. Within the last decade, I switched from Levothyroixine to Nature Throid and although I seemed to feel better and had fewer hypo symptoms, those years when I was on Nature Throid, my TSH/T3 and T4 numbers were not stable. It seemed that each year or every other year, I had to have my Nature Throid dose adjusted.

What greatly interested me, however, was the fact that the Nature Throid is not part of the Medicare Part D formulary because it is not considered the standard treatment for hypothyroidism. When I research this issue, I find that the company producing it and similar desiccated thyroid products refuse to submit their products to testing to get properly approved by FDA. Why is that? I believe, based on my own experience, that the desiccated products are inconsistent in their levels of thyroid hormones, which is why the producers avoid getting them formally tested and approved.

After several years of using Nature Throid, I switched to Synthroid (NOT the generic of it) and I feel so much better. My eyebrows have grown in thicker too (which I've never had happen in years of using Nature Throid or Levothyroixine). It's my belief it's because the Synthroid is stable in its dosage and this has been more beneficial to me than getting scattershot amounts of T4 and other hormones in the Nature Throid.

This is my personal belief and experience but it would be insightful to have someone like CL look into the back story of the desiccated hormones and whether the true dosage varies from lot to lot.

My neurologist prescribed R-lipoid acid under the Doctor's Best label. Would it interfere with levithyroxine as well?

I took Synthroid for over 20 years and felt terrible the whole time. I could not get a doctor to prescribe the natural thyroid. I finally found a doctor a year ago that prescribed Armour Thyroid and the change has been amazing.
I lost weight, my brain works again, I have energy and my hair is growing back. Please look around until you find a doctor that listens. It will save your life.

For many years the only thyroid medication I have taken is Nature-Throid. I take it first thing in the morning and as a sublingual for better controlled absorption. As I aged regular testing provided need for gradual small increases in dosage and at age 80 it is still doing a great job of keeping me active and feeling good. And yes, 35 years ago I had to push hard to get my MD at the time to even do the tests, let alone get him to prescribe some weird natural medication that my research had shown was the best way to go. My wife has also taken N-T for many years and it continues to work great for her also. Just get good thyroid testing with an informed interpretation. My doses work to keep TSH at about 0.9 for best results.

When I was on prescription lithium some years ago, my thyroid medication dosage had to be increased. When that was discontinued, my thyroid medication needed to be decreased.

I have used Ashwaghanda & bladderwrack for a year & my blood tests reveal a normal thyroid

Some patients on synthetic thyroid medications who are not doing so well on them, might consider Nature-throid or Armour thyroid, which is made from dessicated pig thyroid, contains several hormones, not just T4. Some patients do much better on this medication, and it's much cheaper, too.
But most doctors have to be pushed to prescribe it, and some do not know the conversion dose when changing from synthetic to the natural hormone.

Because of extreme fatigue (I am diabetic) my endocrinologist increased my dosage of Synthroid. It did not help the condition, but caused palpitations. Thyroid tests alerted me -- and research indicated the dosage was responsible. I asked the doctor to lower my Synthroid to a previous level, and the palpitations ceased.
Several posts here speak of PALPITATIONS. I suggest they evaluate their Synthroid dosage. Can't hurt!

I recently spent six weeks in a rehabilitation facility. The nurse came around at 5:00 a.m. to administer Synthroid on an empty stomach. She came back at 7:00 with my meds for high blood pressure. I decided a two-hour separation between the two types of drugs is a good idea; it allows the thyroid hormone time to be fully absorbed in an empty stomach and get into the bloodstream. Back at home, I wake up several times during the night to go to the bathroom. If it's near 5:00 a.m. or shortly thereafter, I take Synthroid. Occasionally, I oversleep and take it much later. But I always wait two hours before taking my other meds and eating breakfast. Sometimes, I have a cup of coffee between 5:00 and 7:00, but I seem to have palpitations if I drink coffee a long time before eating food or taking blood pressure meds.

I take Synthroid and need to discuss, with my endocrinologist, the time to take it. I get up at night to go to the bathroom, and was taking my Synthroid then. But I then got palpitations about four hours later. So I changed the time to take it, to after I got up. That stopped the palpitations, but I do like my morning coffee, so it's hard to wait an hour before coffee. And I'm not sure that's even enough time.

I take Synthroid and I am considering switching to a night dose. To take on an empty stomach, how much time is actually needed to wait after the last meal? I have heard several different times: 2 hours, 4 hours, 5 hours. ConsumerLab what is the standard?

After decades of stability, for the past few years, my thyroid tests have been up and down. varying up and down by about 25 mcg. Of course it was affecting how I felt as well, which was the worst part. I was having palpitations at night, and went from feeling manic to exhausted.

As it happened, I came across the following article about coffee interfering with thyroid medicine:

http://www.empr.com/case-studies/coffee-likely-culprit-in-patient-with-uncontrolled-hypothyroidism/article/494359/

After consulting with my doctor, I stopped taking the thyroid supplement in the morning with my coffee, and began taking it just before bedtime. Lo and behold, my thyroid needs went down, and I'm back to being at a stable dose of 150 mcg.

Good luck, and I hope this is helpful to others.

I take Alpha Lipoic Acid for blood sugar and neuropathy and also Levothyroxin for Hashimotos Thyroiditis.
I make sure my vitamins and supps are taken by noon. Levo is taken on an empty stomach before I go to bed- an hour or more after eating.
There should be no interference and from my thyroid lab results, no problem at all. Be sure to take your Thyroid med on it's own and way after food etc is absorbed and processed,

If you follow the citation link regarding aLA and thyroid (single study done in Germany, 1991), only the abstract is available on PubMed. It does not mention the number of patients involved but does describe that aLA was given with T4. It is not clear if these were hypothyroid patients or "normals". If these were normal people, then decreasing the conversion of extra exogenous T4 to T3 may be a good thing.
Unfortunately, as with a lot of the reported benefits of supplements, there is a lot of maybes and mights with potential side effects as well.
Hopefully the FDA will one day get more involved and demand higher quality studies.

The comments herein about alpha lipoic acid and acetyl L-carnitine indicate they are a hindrance, yet for a number of years they have been touted as wonderful supplements. I'm searching for the truth. Much of what I read about various supplements is contradictory from time to time.