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Individuals with an underactive thyroid are classified as people with hypothyroidism and experience telltale symptoms of fatigue, weight gain, and depression. Among the different types of medication presently used for treating the condition, levothyroxine is considered as one among the more effective medications.  Levothyroxine, the synthetic form of the hormone thyroxine, is used to replace/supplement the hormone and is also used to treat goiter, certain types of thyroid cancer, and also as a diagnostic option.  Following sub section offer a detailed look at the medication and also offer answers to the common question – what can I eat for breakfast after taking levothyroxine?

What is hypothyroidism?

This refers to the condition where the thyroid gland does not produce enough thyroid hormones to meet the body’s needs. The gland, in the neck, produces hormones that is responsible for regulating the body’s metabolism – the process by which the body converts food into energy. Various reasons are attributed as responsible for hypothyroidism – autoimmune disorders, radiation therapy, surgical removal of the thyroid gland, and certain categories of medications.

Symptoms of hypothyroidism vary and depend on the severity of the condition. However, common symptoms include fatigue, weight gain, cold intolerance, constipation, dry skin, hair loss, muscle weakness, depression, and memory problems. Diagnosis typically involves a blood test to measure levels of thyroid-stimulating hormone (TSH) and thyroid hormones in the blood. Treatment for the condition involves medications, to replace the missing thyroid hormones.

What are the different forms of levothyroxine?

Available in different forms, including tablets, capsules, and liquid, the strength of Levothyroxine depends on the formulations. The tablets come in strengths ranging from 25 micrograms to 300 micrograms, and are small, round, and white, with a line down the middle, to break in half if required. The tablet form is typically taken once a day, preferably in the morning, on an empty stomach. Capsules contain levothyroxine in a gel form and are also available in various strengths. This form is typically prescribed for individuals with difficulties in swallowing tablets.

The liquid form, called levothyroxine sodium oral solution is a clear, colorless liquid in a small bottle with a dropper. This is typically used for infants and young children unable to swallow tablets or capsules.

Ideal dosage, strength and intake instructions for levothyroxine

The dosage, strength, and intake instructions for levothyroxine vary depending on the individual’s age, weight, medical condition, and other factors. Specific instructions are usually provided by healthcare providers, based on individualized needs, though there are general guidelines, applicable to most individuals, as listed here.

#1 Dosage: The medication is usually taken once a day, preferably in the morning, on an empty stomach. The starting dose for adults is generally 25-50 micrograms daily, with gradual increase over time as needed.

#2 Strength: The tablets are in various strengths, up to 300 micrograms, and the prescribed strength depends on the actual condition, severity and various other factors.

#3 Intake instructions: The medication is to be taken with a full glass of water on an empty stomach, 30 minutes before food. The gap is necessary as food, supplements, and other medications can interfere with the absorption of levothyroxine, thereby affecting the efficacy.

What can I eat for breakfast after taking levothyroxine?

As mentioned above, a gap of at least 30 minutes is required before any intake other than water, as certain foods and drinks high in calcium, iron, and fiber, can impact absorption of levothyroxine. Individuals can choose one of many options for a healthy breakfast that can be consumed safely without affecting the outcomes of levothyroxine, including:

  • Whole-grain toast with avocado or nut butter and fresh fruit
  • Greek yogurt with berries and granola
  • Oatmeal with nuts, seeds, and fresh fruit
  • Scrambled eggs with vegetables and whole-grain toast
  • Smoothie made with spinach, berries, almond milk, and protein powder

The right diet will be best determined by a healthcare affiliated dietitian, who will recommend a healthy and balanced diet factoring in dietary considerations related to levothyroxine medication.

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Mechanism of action of levothyroxine

It is time to understand the mechanism of action of the drug.  When taken orally, levothyroxine is absorbed into the bloodstream and transported to the body’s tissues. In the tissues, the synthetic hormone is converted into its active form, triiodothyronine (T3), by the enzyme 5′-deiodinase. T3 and T4 work together to regulate the body’s metabolism, but T3 is the more active form of the hormone. T3 works by binding to specific receptors on the cell membrane and within the cell, which activate genes involved in regulating metabolism. Levothyroxine increases the levels of T4 in the body, regulating the body’s metabolism and energy levels. This offers relief from the common symptoms of underactive thyroid.

What foods should be avoided when on levothyroxine?

As mentioned earlier, certain food products may interfere with the absorption of the medication, and it is therefore necessary to avoid certain foods, listed here.

  • Soy products can interfere with the absorption of levothyroxine. Individuals are to avoid soy-based products including soy milk, tofu, and soy protein bars.
  • High-fiber foods like whole grains, bran, and fruits and vegetables interfere with the absorption of levothyroxine. Individuals are to give gap of at least four hours after taking levothyroxine.
  • Calcium-rich foods can interfere with the absorption of levothyroxine. Individuals are to avoid calcium-rich foods including milk, cheese, and yogurt for at least four hours after taking the medication.
  • Iron supplements reduce the effectiveness of levothyroxine, and a gap of fours are required after intake of the medication before taking iron supplements.

Time for onset of action of levothyroxine

The onset of action of levothyroxine may vary depending on several factors, including the dose, individual metabolism, and severity of the condition. However, it typically takes several weeks for the full effects of levothyroxine to be experienced. Noticeable improvement in symptoms of hypothyroidism, may be experienced by most individuals in a few weeks. This includes improvements in fatigue and weight gain. However, normalization of the thyroid hormone levels may take many months for the patient.

Levothyroxine is not to be discontinued abruptly and the dosage is also not to be changed without medical supervision. Individuals need to undergo regular follow-up visits and rely on blood tests to monitor thyroid hormone levels for adjusting the dosage.