Home > Hormone Reset > How to Properly Take Thyroid Medication
Let’s talk about how to take thyroid medication properly. For many, thyroid medications are beneficial – and, for those who don’t have a thyroid, it is essential.
In this article, I’ll talk about ten of the most common thyroid medication mistakes that I see the most often – and how to correct them. So, let’s dive in…
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Before we begin, I want to highlight the fact that many folks may be on thyroid medication when they really don’t need it. In these cases, being on it may not benefit why you have been prescribed it in the first place.
For more on that, I would really recommend you read some of my articles on de-prescribing thyroid medications as well as subclinical hypothyroidism. I hope it will help!
Let’s talk about some of the top mistakes you’ll want to avoid when it comes to your thyroid medication…
This might sound silly, but it happens often. Pharmacies may often give you substitutions, ones that are not correct. This comes down to the fact that, as a doctor, we can write prescriptions with a couple of options. They are:
In the first instance, a doctor is communicating to the pharmacist to dispense only the exact brand written down. And, in the second, they are giving the pharmacist the opportunity to dispense an appropriate substitute (as they saw it).
In theory, if a doctor writes DAW, it is only supposed to be that brand. But, studies have shown that thyroid medications are not always dispensed as written.
The strong concern here is that, for many people, changing thyroid medication brands can be a massive issue. It can even change the efficacy of the medication entirely.
While the active ingredients in these medications are all the same, no matter the brand, the inactive ingredients are not the same (the binders and the fillers).
When it comes to thyroid hormones, more than any other medication, there are a lot of inactive ingredients (and a tiny amount of active ingredients).
Key Insight: While it doesn’t mean that your thyroid medication won’t work, it does mean that it will work differently. And, disrupting this kind of consistency can be potentially quite harmful.
This can happen if you change brands, or if you are first given a generic medication.
If you see changes in your levels after refilling your prescription, this could be the issue at play. Be aware of staying with your brand.
You really shouldn’t adjust your pills if you aren’t feeling well. While it may be too true that some are taking too much medication, in general, that may not be the issue here.
Two things to consider:
If you do not feel well, you may need your medication adjusted. But, you shouldn’t do it on your own – touch base with your medical provider, get tested, and figure out what to do next.
Don’t take your thyroid medication with anything besides water. One of the major mistakes that people make when learning how to take thyroid medication properly, is that they take it with something besides water.
There’s a long list of nutrients, compounds, and more that can lead to thyroid hormones not being absorbed into the body. Water reduces this risk to zero.
This might sound obvious, but if you refill medication for a 30-day supply, it should only take 30 days. If you have some left at the end of 30 days, it means you’re missing a super important part of the process – taking your thyroid medication consistently.
Some kinds of thyroid hormones take 4-6 weeks for a steady blood level, and your body feels at its best when that is consistent. If you are taking different amounts or skipping days, it is not level and you are not giving your body a fair shake.
In short, your body works best with a super steady amount. Give your body a chance by giving it the opportunity to get a regular amount.
If you do miss a day, don’t double up. If you end up missing a day, please just try to do better tomorrow – because there really is no help in taking twice the medication in one day.
Two pills the next day is the opposite of consistent. It will create a drop-off and a surge, so you will want to remain consistent (as I mentioned in the point before).
Breaking up a pill or chewing it may feel like you are doing yourself a favor when it comes to absorption, but it is simply causing more issues.
Chewing creates an inconsistent absorption timeline in your body. You will want to maintain the same timeframe for absorption, so swallowing all at once is a must.
Key Insight: Sometimes, breaking up pills may be necessary. In cases like these, be sure to use a proper pill cutter and don’t break up pills in advance.
But, whenever possible, don’t break up or chew your pills! It also won’t taste good at all.
You need a solid hour of no food and no other pills to let your thyroid medication absorb properly. But, there is one happy exception.
There are some cases of liquid thyroid medication absorbing just fine, even after 15 minutes before a meal. If this is a problem for you, you are not alone, so you may want to consider this method.
Related to the point above, we also want to avoid coffee soon after taking your thyroid medication. While this is not a ‘never’ type of mistake, if you are struggling to get your medication to work – it may come down to the coffee.
Coffee may get in the way of absorption. So, you may have to consider one of two things:
Don’t leave your pills out where kids and animals can get to them. This is especially true for naturally desiccated thyroid (NDT). That’s because they can smell like dog treats!
Thankfully, dogs have a higher metabolic rate and make more thyroid, so they are generally not harmed – but, little dogs could be, especially if it happens often.
The same applies for children. While it may not be as harmful for dogs, in many circumstances, it can be very harmful and potentially deadly for children.
So, keep an eye on your thyroid medication and don’t leave them laying around.
If you are testing your thyroid levels, test your levels before – and not after – you take your medication. We call this the ‘trough’ versus the ‘peak.’
For any medication that you ingest and then test, there is going to be a high point and a low point. With thyroid medications, they are set for low levels.
If you are having a hard time getting your scores right, you really need to focus on when you are taking your pills. It may simply come down to timing.
Here is the routine that I encourage for taking your thyroid medication properly:
First thing in the morning, right after you get out of bed, and a solid hour before consuming anything else.
In addition, confirm the brand and the dosage with your doctor, your pharmacist, and yourself. You can even look up online the way your pills should look.
Keeping your animals and children in mind, a really helpful ritual is to put your pill out (inside the cap) before you go to bed.
Key Insight: You can even take your pill in the middle of the night. But, keeping it in the cap can tell you whether or not you took it – even if your memory slips for a moment.
Once an hour has passed, (spend that time exercising, taking a shower, going for a morning walk) then you can have your breakfast, your coffee, whatever you need!
This should be your main ritual.
Before we leave today, I wanted to quickly highlight another thyroid medication mistake that you may be making: not considering how much iodine you are getting in your diet.
Your thyroid relies on iodine, but it needs to be in the right amounts. Many people struggle with getting this amount right, and many of the symptoms are quite unpleasant.
If you are struggling with symptoms of too much iodine, or symptoms that feel like low iodine, I would love for you to check out the Thyroid Reset Diet.
In it, I map out real ways you can eat for the health of your iodine levels and your thyroid. It is practical, actionable, and designed for you to do it in a consistent way. I hope it helps!
P.S. Whenever you are ready, here is how I can help you now:
1. Schedule a Thyroid Second Opinion with me, Dr. C, Click Here for Details
2. Need A Thyroid Supplement Recommendation? Take My Thyroid Specific Formulations Quiz Now
3. Need a Personalized Supplement? Check out My Thyroid Specific Formulations
4. Download and use my Favorite Recipes Cookbook Here
5. Check out my podcast Medical Myths, Legends, and Fairytales Here
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet, The Metabolism Reset Diet and The Thyroid Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, diabetes, and regain energy. Learn more about the surprising story that started his quest.
Dr. Alan Christianson
Alan Christianson is a Naturopathic Medical Doctor (NMD) who is a board-certified Naturopathic Endocrinologist with a focus on thyroid disorders. He is the author of The Metabolism Reset Diet and the New York Times bestselling book The Adrenal Reset Diet.
He founded Integrative Health, a physician group dedicated to helping people with thyroid disease and weight-loss resistance regain their health.
He has been named a Top Doctor in Phoenix magazine and has appeared on national TV shows and in numerous print media.
Dr. Christianson resides in the woods by a lake in Northern Minnesota with his wife Kirin.
