Levothyroxine Interactions: Foods to Avoid, Drugs, Alcohol

Levothyroxine is a widely prescribed medication for hypothyroidism, a condition where the thyroid gland doesn’t produce sufficient thyroid hormones, resulting in various health issues. 

It acts as a replacement therapy for those suffering from an underactive thyroid, restoring normal thyroid hormone levels in the body. 

These levels are paramount for energy production, metabolism, and overall well-being.

Levothyroxine, while highly effective in treating hypothyroidism, can interact with specific foods, drugs, and medical conditions. 

This article will cover Levothyroxine interactions and provide practical advice on managing them.

What Drugs Interact with Levothyroxine?

Understanding how Levothyroxine interacts with other drugs is crucial for managing your medication effectively. 

Here are some drugs that may interact with Levothyroxine:


Antacids that contain aluminum or magnesium can reduce the absorption of Levothyroxine. To ensure your medication is absorbed properly, it’s advisable to administer Levothyroxine at least 4 hours apart from antacids. 

This time gap prevents interference and allows your body to absorb both medications effectively.

Calcium Channel Blockers

Some medications prescribed for heart conditions, known as calcium channel blockers, may interact with Levothyroxine. 

These interactions can affect how your body absorbs and utilizes both medications. To address this, it’s essential to consult your healthcare provider if you are prescribed both Levothyroxine and calcium channel blockers. 

They can recommend appropriate dosage adjustments or alternative medications to manage your heart condition while ensuring the effectiveness of your Levothyroxine.


Anticoagulant medications, commonly referred to as blood thinners, may interact with Levothyroxine. 

This interaction can potentially influence your thyroid function. To manage this, your healthcare provider will closely monitor your thyroid function and adjust your Levothyroxine medication as needed. 

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Foods to Avoid When Taking Levothyroxine

When it comes to managing your Levothyroxine medication effectively, it’s crucial to be mindful of certain foods that can potentially interfere with its absorption. 

Here are some key foods to avoid when taking Levothyroxine:

Soy Products

Soy products contain compounds called goitrogens that can hinder the absorption of Levothyroxine. 

Goitrogens are substances that can disrupt the normal functioning of the thyroid gland, making it harder for your body to utilize Levothyroxine effectively. 

It’s wise to avoid soy-based foods or consume them at least 4 hours apart from your medication. Common soy products include:

  • Tofu
  • Soy milk
  • Edamame
  • Soy sauce


Walnuts contain compounds that can potentially interfere with the absorption of Levothyroxine. Specifically, they contain high levels of fiber and polyphenols, which can affect the medication’s absorption. 

To optimize the effectiveness of your medication, it’s advisable to either avoid excessive walnut consumption or ingest walnuts at least 4 hours apart from your Levothyroxine dose.

High-Fiber Foods and Fiber Supplements

High-fiber foods and fiber supplements can potentially reduce the absorption of Levothyroxine, studies show. 

Fiber, while generally healthy, can bind to Levothyroxine in the digestive tract, preventing it from being fully absorbed into your bloodstream. 

To counteract this effect, consider taking your medication on an empty stomach—either 30 minutes before eating or 4 hours after a meal. 

High-fiber foods to be cautious of include:

  • Whole grains
  • Bran cereals
  • Certain fruits and vegetables

Calcium-Rich Foods and Supplements

Calcium has the ability to bind with Levothyroxine in the gastrointestinal tract, which can diminish its absorption. 

This is why it’s crucial to steer clear of calcium-rich foods, dairy products, and calcium supplements when taking your medication. 

Waiting for at least 4 hours before consuming these calcium-rich products is advisable. 

Common calcium-rich foods and beverages include:

  • Milk
  • Cheese
  • Yogurt
  • Calcium-fortified orange juice

Iron Supplements

Iron supplements can also hamper the absorption of Levothyroxine. Evidence shows iron competes with Levothyroxine for absorption in the digestive system. 

If you require iron supplements for your health, make sure to separate them from your Levothyroxine medication by at least 4 hours. 

This way, you can ensure that both medications are effectively absorbed by your body. Common iron supplements include ferrous sulfate and ferrous gluconate.

Does Levothyroxine Interact with Alcohol?

Moderate alcohol consumption is typically considered safe for those taking Levothyroxine. The key lies in moderation, with recommended limits being up to one drink per day for women and up to two drinks per day for men. 

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What Foods to Eat While on Levothyroxine

While it’s important to be aware of foods to avoid when taking Levothyroxine, it’s equally essential to recognize the foods that can actually support your thyroid health and enhance the effectiveness of your medication:

Fruits and Vegetables

A diet rich in fruits and vegetables provides your body with essential vitamins and minerals, including iodine, which is vital for thyroid function. 

Incorporating a colorful variety of produce into your meals can help ensure you receive these nutrients. 

Some iodine-rich options include strawberries, cranberries, and seaweed. These foods not only contribute to overall health but also support your thyroid’s proper functioning.

Lean Protein

Protein is an essential component of a balanced diet, and specific protein sources can be particularly beneficial for thyroid health. 

Lean meats like chicken and turkey, fatty fish like salmon and trout, and plant-based sources such as legumes all provide quality protein. 

These foods can bolster your overall metabolism and support healthy thyroid function, complementing the effects of Levothyroxine.

Whole Grains

Whole grains like brown rice and quinoa are excellent additions to your diet while taking Levothyroxine. 

They offer sustained energy and are a good source of dietary fiber without interfering with Levothyroxine absorption. 

Fiber-rich whole grains help maintain healthy digestion and can contribute to overall well-being.

Incorporating these thyroid-friendly foods into your diet can promote not only the effectiveness of Levothyroxine but also your general health.

Lean protein
Whole grains
High-fiber foods
Calcium-rich foods
Excess alcohol

Levothyroxine Condition Interactions

While Levothyroxine is a valuable medication for managing hypothyroidism, it’s essential to recognize that it may not be suitable for everyone, especially for people with specific medical conditions. 

Here are some important considerations regarding Levothyroxine and its interactions with certain health conditions:

Heart Conditions

People with a history of heart conditions, such as coronary artery disease or arrhythmia, should exercise caution when taking Levothyroxine. 

It’s crucial to ensure that your healthcare provider is fully aware of your heart condition. This transparency allows for proper monitoring of your thyroid hormone levels and overall health. 

Your healthcare provider can make necessary adjustments to your Levothyroxine dosage to ensure it is safe and effective in the context of your heart condition.


Levothyroxine can have an impact on blood sugar levels, potentially requiring adjustments in diabetes medication. 

If you have diabetes, it’s essential to maintain vigilant monitoring of your blood sugar levels while taking Levothyroxine. 

Liver or Kidney Disease

People with liver or kidney disease may have unique considerations when it comes to Levothyroxine therapy. 

These conditions can affect the way your body processes medications, including Levothyroxine. As a result, you may require different Levothyroxine dosages to accommodate your specific health needs. 

It’s imperative to consult with your healthcare provider to assess the appropriate Levothyroxine dosage and ensure it is safe and effective for you. Regular monitoring of your thyroid function is also essential to track any changes in your condition.


Levothyroxine is a valuable medication for managing hypothyroidism, but it necessitates careful consideration of various factors, including dietary choices, other medications, and underlying medical conditions. 

To ensure the optimal effectiveness of Levothyroxine, follow your healthcare provider’s instructions, take it on an empty stomach, and be mindful of potential interactions with foods and other drugs. 

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  1. Sherman, Steven I., and Susan E. Malecha. “Absorption and malabsorption of levothyroxine sodium.” American Journal of Therapeutics 2.10 (1995): 814-818.
  2. Wallace, Allison W., and Guy W. Amsden. “Is it really OK to take this with food? Old interactions with a new twist.” The Journal of Clinical Pharmacology 42.4 (2002): 437-443.
  3. Zawiah, Mohammed, et al. “Food-drug interactions: Knowledge among pharmacists in Jordan.” PloS one 15.6 (2020): e0234779.
  4. Messina, Mark, and Geoffrey Redmond. “Effects of soy protein and soybean isoflavones on thyroid function in healthy adults and hypothyroid patients: a review of the relevant literature.” Thyroid 16.3 (2006): 249-258.

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