From the FDA Drug Label
Administer levothyroxine sodium tablets as a single daily dose, on an empty stomach, one-half to one hour before breakfast with a full glass of water to avoid choking or gagging Administer levothyroxine sodium tablets at least 4 hours before or after drugs known to interfere with levothyroxine sodium absorption Instruct patients to take levothyroxine sodium tablets only as directed by their healthcare provider Instruct patients to take levothyroxine sodium tablets as a single dose, preferably on an empty stomach, one-half to one hour before breakfast with a full glass of water to avoid choking or gagging.
The instructions for taking levothyroxine are to take it as a single daily dose, on an empty stomach, one-half to one hour before breakfast with a full glass of water. It should be taken at least 4 hours before or after drugs known to interfere with levothyroxine sodium absorption. Patients should follow the instructions of their healthcare provider and take the medication as directed. 1 1 1
- Key points:
- Take levothyroxine on an empty stomach
- Take it one-half to one hour before breakfast
- Use a full glass of water to avoid choking or gagging
- Take it at least 4 hours before or after certain drugs
- Follow the healthcare provider's instructions
- Important considerations:
- Levothyroxine absorption may be affected by certain foods and drugs
- Dosage adjustments may be necessary based on individual patient factors
- Patients should notify their healthcare provider of any changes in their medical condition or other medications they are taking
From the Research
Levothyroxine should be taken once daily in the morning on an empty stomach, 30-60 minutes before eating breakfast, as recommended by the most recent guidelines 2. To ensure optimal absorption, take levothyroxine with a full glass of water and wait at least 4 hours before taking other medications, supplements, or foods that can interfere with absorption, including calcium supplements, iron supplements, antacids, and foods high in fiber. The typical starting dose ranges from 25-125 mcg daily, depending on age, weight, and severity of hypothyroidism, with adjustments made based on thyroid function tests usually checked every 6-8 weeks until stable, as suggested by recent studies 3, 4. Consistency is crucial—take levothyroxine at the same time each day and never skip doses. If you miss a dose, take it as soon as you remember unless it's almost time for your next dose. Levothyroxine works by replacing the thyroid hormone your body cannot produce naturally, regulating metabolism and energy production. Some key points to consider when taking levothyroxine include:
- Store the medication at room temperature away from moisture and heat
- Be aware that symptoms may take several weeks to improve as thyroid hormone levels gradually normalize
- The goal of treatment is to normalize signs and symptoms, as well as to achieve thyroid-stimulating hormone (TSH) concentrations within the reference range, on an individual basis, as stated in recent research 5
- Combination therapy with liothyronine (LT3) may be considered for some patients with persistent symptoms, but the evidence is still limited and more studies are needed to fully understand its benefits and risks, as discussed in a recent study 6.