Does taking levothyroxine with honey reduce its absorption or effectiveness?

Taking levothyroxine with honey is not specifically documented to reduce absorption, but it is generally advisable to take levothyroxine on an empty stomach with water and to avoid any food or drink (including honey) for 30–60 minutes afterward to optimize absorption. Food in general can decrease or delay levothyroxine absorption, and official guidance highlights several foods and beverages that interfere, so separating the dose from any caloric intake is a prudent approach. ^{[1] [2]}

Why timing matters

• Levothyroxine (T4) is absorbed in the small intestine, and the presence of food can lower or slow this absorption. ^[2]
• Product labeling advises that certain foods can bind or reduce levothyroxine absorption (for example, soy, high‑fiber foods, cottonseed meal, walnuts) and that even grapefruit juice can delay absorption and reduce bioavailability. ^[1]
• Because these interactions exist, labels recommend consistent timing and taking levothyroxine away from food to maintain stable blood levels. ^[1]

What we know about honey

• Honey itself is not listed among foods known to bind or reduce levothyroxine absorption in official labeling, and there is no direct clinical evidence showing honey uniquely impairs levothyroxine. ^[1]
• However, taking levothyroxine with any food or calorie-containing drink can, in general, reduce absorption compared with taking it fasting, so mixing the tablet or solution with honey, or consuming honey at the same time, may lessen absorption to some extent. ^[2]

Best practice for dosing

• To be safe, take levothyroxine with plain water on an empty stomach, ideally 30–60 minutes before breakfast or any beverages other than water. ^[2]
• Keep your routine consistent day to day; consistency helps keep thyroid hormone levels steady and avoids dose adjustments caused by variable absorption. ^[1]
• If you prefer evening dosing, take it at least 3–4 hours after your last meal or snack for similar fasting conditions. ^[2]

Other foods and supplements to separate from levothyroxine

• Certain items are known to reduce absorption and should be separated from your dose by at least 4 hours: iron supplements, calcium supplements, aluminum/magnesium antacids, bile acid sequestrants, phosphate binders, and sucralfate. ^[3]
• Foods that may bind or interfere (soy products, high-fiber diets, walnuts, cottonseed meal) and grapefruit juice may also impact absorption, so keep timing consistent and away from your levothyroxine. ^[1]

Practical tips

• If you like honey in the morning, consider taking levothyroxine first with water, wait 30–60 minutes, then have coffee/tea with honey or breakfast. ^[2]
• If you accidentally take the dose with honey (or food), it’s usually okay; just return to your usual fasting routine the next day and let your clinician know if this happens frequently, because it can affect your thyroid lab results and dosing decisions. ^{[1] [2]}

Summary

• There is no direct evidence that honey specifically reduces levothyroxine absorption, but taking levothyroxine with any food or calorie-containing drink can decrease or delay absorption compared with fasting. ^{[1] [2]}
• For best effectiveness, take levothyroxine with water on an empty stomach and wait 30–60 minutes before consuming honey or other foods and beverages. ^[2]

Would you like help setting up a simple morning or evening routine so your levothyroxine is consistently taken on an empty stomach?