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5 Lifestyle Habits That Decrease Thyroid Medication Efficacy

Updated: Sep 8, 2023

First things first: If you have been diagnosed with hypothyroidism, this is a condition where we DO highly recommend that you utilize pharmaceuticals. That's because thyroid hormone is essential for every single cell in your body to function and must be supplemented if your thyroid is under-functioning (ESPECIALLY if you are trying to conceive).

There are several pharmaceutical options that ought to be carefully chosen by your prescribing doctor according to a detailed thyroid panel. These include but are not limited to levothyroxine, desiccated thyroid, and liothyronine...

After being prescribed a medication, it's important to make sure you are not diminishing the effects of your new prescription by avoiding Five Lifestyle Habits That Decrease Thyroid Medication Efficacy:

  1. Food and drink: Thyroid medication is a bit selfish. If you take it too close to consuming any food or drink, except for water, then it’s likely that you are not getting optimal effects from it. So what is considered “too close”? Well, that depends on when you take your thyroid medication. Most people take it first thing in the morning. If this is you, then make sure not to eat anything within 30 minutes to 1 hour of taking your medication. One thing that a lot of people forget is that coffee, teas, and any other drinks except for water can decrease absorption. So, for my morning coffee drinkers, this may be the big thing that’s interfering with your medication absorption. We now know that an evening dose is just as effective as a morning dose and sometimes more manageable for people who have to take other medications in the morning. If this is you, then make sure to not eat anything 3

cozy tea setting surrounding by white blankets and yarrow

hours before taking your medication at bedtime.

  1. Compromised gut issues: If you struggle with bloating, flatulence, diarrhea, or constipation daily, then your gut is very likely compromised. This can decrease absorption of your thyroid medication AND all the necessary nutrients needed to make your thyroid hormone naturally. A compromised gut includes everything from low stomach acidity to celiac disease, parasites, and IBS. If this sounds familiar, step one is healing that gut (the specialty of most naturopathic doctors hint hint).

  2. Heartburn and antacid medications: Additional medications may interfere with absorption. The most noted ones are PPIs and antacids (both typically taken for heartburn and acid reflux). Both of these medications act by decreasing the function of your stomach’s cells which, unfortunately, also decreases the absorption of your thyroid medication.

  3. Birth Control: Another medication that decreases the efficacy of thyroid medication is oral estrogen-containing birth control. Your body makes a protein called thyroid binding globulin in response to estrogen. This protein prevents thyroid hormone from getting into cells to function. In other words, your thyroid or medication may be spot on...but your birth control could be rendering it ineffective. In addition, birth control pills deplete selenium, zinc, b vitamins, and the amino acid tyrosine, from our bodies. These are all vitamins and minerals that are necessary for proper thyroid function! That being said, in addition to supplementing with a high-quality multivitamin, it's important to speak with your doctor about which birth control is right for you.

  4. Competitors: Your thyroid hormone (T4) is made up of tyrosine bound to four iodine molecules. Iodine has a similar structure as fluorine, chlorine, and bromine which can all compete with iodine and decrease your body's ability to make thyroid hormone! Where do we find fluorine, chlorine, and bromine? Toothpaste, chlorinated water, and new cars are our biggest sources. Some simple lifestyle changes to mitigate the competition includes switching to fluoride-free toothpaste, using a water filter, and driving with the windows down in that new fancy car.

For more naturopathic information on thyroid health, check out our course on Hypothyroid.

Otherwise, stay tuned for more tips and tricks around thyroid health.

At IVY Integrative, you can work with one practitioner or build your own team of holistic practitioners! Reach your optimum health in-person or online. Check out our Get Started page to learn how to work with us!


Dr. Chelsea Leander ND, RH (AHG)


  1. Myers, A. (2018). The thyroid connection: Why you feel tired, brain-fogged, and overweight - and how to get your life back. New York: Little, Brown and Company.

  2. Ianiro, G., Mangiola, F., Di Rienzo, T. A., Bibbò, S., Franceschi, F., Greco, A. V., & Gasbarrini, A. (2014). Levothyroxine absorption in health and disease, and new therapeutic perspectives. Eur Rev Med Pharmacol Sci, 18(4), 451-6.

  3. Duntas, L. H. (2005). Oxidants, antioxidants in physical exercise and relation to thyroid function. Hormone and metabolic research, 37(09), 572-576.

  4. Rajput, R., Chatterjee, S., & Rajput, M. (2011). Can levothyroxine be taken as evening dose? Comparative evaluation of morning versus evening dose of levothyroxine in treatment of hypothyroidism. Journal of thyroid research, 2011.

  5. Santin, A. P., & Furlanetto, T. W. (2011). Role of estrogen in thyroid function and growth regulation. Journal of Thyroid Research, 2011. Changes in thyroid function tests and sex hormone binding globulin associated with treatment by gonadotropin.

  6. Ben-Rafael Z, Struass JF 3rd, Arendash-Durand B, Mastroianni L Jr, Flickinger GL

  7. Fertil Steril. 1987 Aug; 48(2):318-20. Increased need for thyroxine in women with hypothyroidism during estrogen therapy.Arafah BMN Engl J Med. 2001 Jun 7; 344(23):1743-9.

  8. Wentz, I., PharmD, FASCP. (2019, January 23). 14 Ways Birth Control Pills Rob Us of Our Health. Retrieved September 11, 2020, from

  9. Myers, A. (2018). The thyroid connection: Why you feel tired, brain-fogged, and overweight - and how to get your life back. New York: Little, Brown and Company.

  10. Beyondthyca. (2018, January 30). IODINE, FLUORIDE, CHLORINE, BROMINE: THE HEALTH EFFECTS OF HALOGENS. Retrieved September 27, 2020, from


This information is generalized and intended for educational purposes only. Due to potential individual contraindications, please see your primary care provider before implementing any strategies in these posts.



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