Hi ,

How are you doing today?

Do you struggle with taking your thyroid medication on an empty stomach? Doctors usually recommend this because food and some supplements can interfere with absorption.

I know many people who set an alarm in the early morning just to take their pill, then try to go back to sleep. Often, they can’t. The result? Broken sleep and a disrupted breakfast routine.

A new study investigated whether a better approach might work. Researchers divided patients into two groups: one took levothyroxine in the traditional fasting state, while the other took it with breakfast, but with a 15% higher dose to account for reduced absorption. To achieve this increase, patients simply took one extra tablet per week.

After 24 weeks of follow-up:

• Thyroid function tests were almost identical in both groups.
• Over 93% of patients in the non-fasting group chose to continue with breakfast dosing rather than return to fasting.

This suggests that for many patients, a higher dose, non-fasting approach may be just as effective and more convenient. It could ease the burden of waking early, improve sleep, and reduce the stress of planning life around a pill.

But this isn’t a one-size-fits-all solution. Certain foods (like those high in calcium or fibre), supplements, and individual differences can still affect absorption.

Please do not change how you take your medication without consulting your doctor. This is not medical advice. If consistency is a concern, discuss this option with your healthcare provider to determine if it is suitable for you.

Best regards,

Shabnam

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Dr. Shabnam Das Kar, MD

Functional Medicine Doctor

Tiny Habits Coach

Email: info@drkarmd.com

Willems, Jeresa, et al. "Timing of levothyroxine ingestion in the INFINITY-study: a randomized controlled trial comparing dose-adjusted, non-fasting and fasting levothyroxine ingestion." Endocrine Abstracts. Vol. 110. Bioscientifica, 2025.