Does drinking coffee interfere with levothyroxine absorption, and how long should I wait after taking my dose before having coffee?

Drinking coffee can interfere with how well levothyroxine (thyroid hormone replacement) is absorbed, especially when taken close together. Evidence suggests that certain foods and beverages can reduce levothyroxine’s bioavailability, and espresso coffee has been noted among items that may impair absorption. ^{[1] [2]} Coffee’s effect appears most relevant with traditional tablet formulations, while soft‑gel or liquid formulations may be less affected. ^{[2] [3]}

Why coffee can be a problem

Levothyroxine is best absorbed in the small intestine when your stomach is empty. ^[4] When taken with or shortly before coffee, the drug may bind or transit differently, which can lower the amount your body absorbs and potentially lead to higher TSH (a sign your dose isn’t fully working). ^{[1] [2]} This is one reason official dosing instructions consistently recommend taking levothyroxine on an empty stomach. ^[4]

How long to wait before coffee

Most official instructions advise taking levothyroxine in the morning on an empty stomach, at least 30–60 minutes before any food. ^[5] Applying that guidance to beverages, a practical and commonly recommended approach is to wait about 60 minutes after your dose before drinking coffee to minimize absorption issues. ^[5] Some labeling also advises evaluating dose if levothyroxine is “regularly administered within one hour” of foods that affect absorption, underscoring the value of keeping that hour gap. ^[6]

Tablet vs. soft‑gel/liquid formulations

If waiting an hour is difficult, there is evidence that switching from traditional tablets to a soft‑gel capsule can reduce coffee‑related malabsorption. In small clinical observations, people who had elevated TSH when taking tablet levothyroxine near coffee saw TSH normalize after switching to soft‑gel capsules, even when coffee was consumed within 5 minutes. ^[3] In acute tests, coffee minimally influenced the pharmacokinetics of the soft‑gel formulation compared to tablets. ^[3] While this doesn’t mean coffee is harmless, it suggests soft‑gel or liquid levothyroxine may be more forgiving when timing cannot be optimized. ^[3]

Practical dosing tips

• Take levothyroxine first thing in the morning with a full glass of water, on an empty stomach. ^[4]
• Wait at least 30–60 minutes before coffee or breakfast; many people aim for 60 minutes for consistency. ^[5]
• Keep levothyroxine well separated (about 4 hours) from minerals that reduce absorption, such as calcium or iron, and from antacids. ^[7]
• If your schedule makes morning dosing difficult, you can consider consistent bedtime dosing at least 3–4 hours after the last meal, as long as it’s the same way each day; discuss this change with your clinician to keep labs and dosing accurate. ^[8]
• If TSH remains out of range despite careful timing, ask about soft‑gel or liquid levothyroxine, which may be less affected by coffee. ^[3]

Other foods and drinks that matter

Some foods are known to bind or delay levothyroxine absorption, including soybean products, dietary fiber, walnuts, and grapefruit juice. ^[1] To keep your dose stable, maintain consistent patterns and timing so your healthcare provider can adjust if needed. ^[4]

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Summary

• Coffee near the time of levothyroxine can reduce absorption, particularly with tablet formulations. ^{[1] [2]}
• Take levothyroxine on an empty stomach and wait about 60 minutes before coffee to help ensure reliable absorption. ^[5]
• If timing is challenging, soft‑gel formulations may lessen coffee’s impact and stabilize TSH. ^[3]

Comparison at a glance

Topic	Recommendation/Effect	Source
Coffee with tablet levothyroxine	May reduce absorption and raise TSH if taken close together	[1] [2]
Wait time before coffee	30–60 minutes after levothyroxine on an empty stomach; 60 minutes is a practical target	[5]
Soft‑gel capsule with coffee	Less affected by coffee; improved TSH control noted compared with tablets	[3]
Foods that interfere	Soy, dietary fiber, walnuts, grapefruit juice can reduce/delay absorption	[1]
Separation from minerals	Keep calcium/iron/antacids at least 4 hours apart from levothyroxine	[7]
Empty stomach dosing	Preferably in the morning, one‑half to one hour before food	[4]

If you’d like help tailoring a routine to your schedule or considering a formulation switch, feel free to share how you currently take your dose and your latest thyroid lab results.