Levothyroxine and coffee

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Levothyroxine and Coffee: Understanding the Interaction

Introduction to Levothyroxine and Its Use

Levothyroxine (LT4) is a synthetic thyroid hormone commonly prescribed for the treatment of hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone. It is crucial for patients to maintain proper thyroid hormone levels to ensure metabolic balance and overall health .

Coffee's Impact on Levothyroxine Absorption

Coffee and Levothyroxine Tablets

Several studies have shown that coffee can significantly interfere with the absorption of levothyroxine when taken in tablet form. This interaction can lead to suboptimal thyroid hormone levels, making it difficult for patients to achieve the desired therapeutic outcomes 128. The primary mechanism behind this interaction is that coffee can reduce the intestinal absorption of levothyroxine, leading to decreased bioavailability of the drug .

Liquid Formulations and Coffee

Recent research has indicated that liquid formulations of levothyroxine may mitigate the malabsorption issues associated with coffee. Studies have demonstrated that liquid levothyroxine solutions, such as ThyquidityTM, maintain comparable bioavailability whether taken with coffee or in a fasting state 345. This suggests that liquid formulations bypass the gastric dissolution phase, which is affected by coffee, thereby providing a more consistent absorption profile 47.

Clinical Recommendations

Timing of Levothyroxine Administration

To minimize the interaction between levothyroxine and coffee, it is generally recommended that patients take levothyroxine on an empty stomach, ideally 30-60 minutes before breakfast or any coffee consumption 19. This practice helps ensure maximum absorption of the drug.

Alternative Formulations

For patients who find it challenging to adhere to the timing recommendations, switching to a liquid formulation of levothyroxine may be beneficial. Studies have shown that these formulations are less affected by coffee and other breakfast beverages, potentially improving patient compliance and therapeutic outcomes 345.

Conclusion

The interaction between levothyroxine and coffee is well-documented, with coffee significantly reducing the absorption of levothyroxine tablets. However, liquid formulations of levothyroxine offer a promising alternative, as they appear to be less affected by coffee, ensuring better absorption and more stable thyroid hormone levels. Patients and healthcare providers should consider these findings when managing hypothyroidism treatment to optimize therapeutic efficacy.

Sources and full results

Most relevant research papers on this topic

Levothyroxine Interactions with Food and Dietary Supplements–A Systematic Review

Levothyroxine ingestion in the morning and at bedtime is equally effective, but interactions with coffee, soy products, fiber, calcium, or iron supplements can decrease its absorption.

Systematic Review

2021·

46citations

·A. Wiesner et al.

Tea consumption affects the absorption of levothyroxine

Long-term tea consumption, like coffee, interferes with the absorption of levothyroxine, reducing its effectiveness for hypothyroidism patients.

Non-RCT

2022·

6citations

·Ying Lai et al.

RF23 | PSAT259 Comparable Bioavailability of a Novel Levothyroxine Solution when Administered with Coffee

Thyquidity oral solution shows comparable bioavailability when administered 5 minutes before coffee or under fasting conditions, overcoming the interference from coffee seen with tablets.

RCTRigorous Journal

2022·

0citations

·Kris Washington et al.

Oral liquid levothyroxine treatment at breakfast: a mistake?

Oral liquid L-T4 formulations can reduce the problem of L-T4 malabsorption caused by coffee when taken 30 minutes before breakfast.

Observational StudyRigorous Journal

2014·

40citations

·C. Cappelli et al.

Oral Liquid Formulation of Levothyroxine Is Stable in Breakfast Beverages and May Improve Thyroid Patient Compliance

Levothyroxine oral solution is stable in breakfast beverages after 20 minutes, potentially improving thyroid patient compliance.

Non-RCT

2013·

26citations

·A. Bernareggi et al.

A Thyroid Hormone-Independent Molecular Fingerprint of 3,5-Diiodothyronine Suggests a Strong Relationship with Coffee Metabolism in Humans

3,5-Diiodo-L-thyronine ( 3,5-T2) has a strong positive association with coffee consumption, suggesting a strong link between coffee consumption and beneficial health effects.

Non-RCTLarge Human TrialRigorous Journal

2019·

11citations

·M. Pietzner et al.

A novel formulation of l-thyroxine (l-T4) reduces the problem of l-T4 malabsorption by coffee observed with traditional tablet formulations

Soft gel capsules of l-thyroxine (l-T4) reduce coffee-associated malabsorption, making them suitable for patients unwilling to change their eating habits.

Non-RCTRigorous JournalHighly Cited

2013·

82citations

·R. Vita et al.

Conditions and drugs interfering with thyroxine absorption.

Food, dietary fiber, and espresso coffee can interfere with levothyroxine absorption, while malabsorptive disorders and common drugs can also affect it.

Highly Cited

2009·

218citations

·Llanyee Liwanpo et al.

Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review.

Gastrointestinal disorders, certain drugs, and certain foods can hinder levothyroxine absorption, requiring monitoring and separating administration.

Systematic ReviewHighly Cited

2017·

98citations

·M. Skelin et al.

Medications and Food Interfering with the Bioavailability of Levothyroxine: A Systematic Review

Many medications and foods can impair the bioavailability of levothyroxine, requiring awareness and dose adjustment for optimal treatment.

Systematic Review

2023·

7citations

·Hanqing Liu et al.

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