thanks a lot for all those replies guys i really appreciate it
T4 takes up to 6 WEEKS to stabilize in blood. So time of day you take T4 only medication is irrelevant. most people take it first thing in the morning.
A minority including myself elect to take T4 medication right before bed. I just ensure I don't eat anything an hour before, and abstain from cheese or milk after supper. I find it easier that way. A second benefit is that it helps me avoid temptation to eat right before bed which is bad for weight gain.
If I do happen to eat later in the evening, I just take the medication the next morning and adhere to the normal eating and avoid supplements time frames.
Although it may be true that a 12 oz serving of milk may have 450 mg of calcium, a "serving" of milk is, typically, a cup (8 oz), instead of 12 oz. A cup of milk has approximately 280 mg of calcium (per the carton in my fridge). In addition, I've never seen anyone use an entire cup of milk in their morning coffee. That would more like having "coffee with their milk"... Most people aren't going to use more than a tablespoon or two in their coffee. I, personally, don't even use an entire cup of milk in a bowl of cereal and have never had an issue...
Excerpts from the article - Patients Cautioned to Avoid Drinking Milk When Taking Daily Medication by Mary Shomon...
"Important news for the millions of people with hypothyroidism was released at ENDO 2017, the Endocrine Society’s 99th annual meeting in Orlando, Florida.
Deborah Chon, M.D., reported on results of a preliminary study that showed that cow’s milk can significantly reduce absorption of the most commonly prescribed thyroid hormone replacement drug, levothyroxine, when taken at the same time."
"Calcium supplements and calcium-fortified juice have been scientifically demonstrated to affect the absorption of levothyroxine, a drug used to treat hypothyroidism, an underactive thyroid. Given this known interaction, practitioners typically recommend taking levothyroxine and calcium at least three to four hours apart. Milk, however, had not been studied in depth until this research. According to the research abstract, cow’s milk contains approximately 450 mg of calcium per 12 oz. serving.
According to Dr. Chon, who is associated with the UCLA David Geffen School of Medicine and the Veterans Affairs Healthcare System in Los Angeles, California, “Decreased absorption means that patients may not get the full dose of thyroid hormone that they are prescribed.”
"How to take your thyroid medication:
These new findings add to the guidance on how to take your levothyroxine for optimal absorption. These recommendations include:
*Take your levothyroxine first thing in the morning, and wait an hour before eating. Taking food at the same time can slow or impair absorption of levothyroxine.
*Wait an hour after taking your levothyroxine before drinking coffee, including decaffeinated coffee. Coffee has the ability to impair absorption of levothyroxine.
*Wait at least three to four hours before taking calcium supplements, calcium-fortified orange juice, or iron supplements, given their ability to impair absorption of levothyroxine.
*Consider taking levothyroxine at bedtime. Research has shown that levothyroxine absorption may be improved by taking the medication in the evening. Nighttime dosing also allows you to eat, drink milk and coffee, and take calcium or iron supplements in the morning after waking."
Hi Kevin... It's correct that you should take your thyroid medication on an empty stomach and wait 30 minutes to an hour before eating/drinking anything else.
The reason your other doctor told you not to have milk is because milk has calcium and calcium inhibits the absorption of thyroid medications. Calcium is supposed to be separated from thyroid medications by 4 hours; however, that's calcium supplements, which, typically, have several mg of calcium per serving. I don't believe there's enough calcium in the little bit of milk one would put in a cup of coffee to affect absorption of your medication.
As for your breakfast, you could probably even go ahead and have milk on your cereal (I sometimes do), unless you're using quite a lot. The alternative is to have something else for breakfast, such as eggs, with toast or oatmeal with fruit, etc. If you can't have anything else, it's possible that your doctor could increase your dosage, slightly, to work around this.
There is no alternative for hypothyroidism - you must take medication for life - that's assuming you have Hashimoto's, which is an autoimmune thyroid condition that often runs in families, which, I assume, is what you mean by "genetic".