As of: March 9, 2024, 6:11 p.m
By: Natalie Hull-Deichsel
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If it is difficult for patients to adjust to an ideal thyroxine dose, interactions with mineral water and nutritional supplements should also be considered.
Anyone who is diagnosed with a thyroid disorder such as hypothyroidism or Hashimoto's is usually treated with the hormone thyroxine in tablet form.
If the patient is well controlled with medication, complaints and symptoms can usually be alleviated.
However, there are various other medications such as the pill as a contraceptive or foods such as coffee that can influence the effect of the thyroxine tablets.
Even some types of mineral water and dietary supplements with magnesium, iron and zinc as well as preparations for heartburn can reduce the absorption of thyroxine from the intestine and thus its effectiveness.
Thyroxine for thyroid: Hormone reacts with mineral water, sports drinks and effervescent tablets
It is better not to take thyroxine with mineral water, but rather only with tap water.
(Symbolic image) © PheelingsMedi/Imago
Thyroxine, an artificially administered hormone to treat the thyroid, is one of the most commonly prescribed medications in Germany and the USA.
Although a study shows that a third of patients who take the thyroid hormone thyroxine due to hypothyroidism could stop taking it in the medium term, long-term therapy is necessary for the majority of those affected with thyroid disease.
Only then can symptoms such as fatigue, depression, hair loss and constipation be reduced or completely prevented.
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When taking their thyroxine tablets, patients with a thyroid disorder should always pay attention to possible interactions with other drugs that could prevent the absorption of the artificial thyroid hormones.
This also includes certain minerals.
According to Ärzte Zeitung
, calcium (Ca2+), magnesium (Mg2+), aluminum (Al3+), zinc (Zn2+) and iron (Fe2+/3+) are
not only found in over-the-counter, stomach acid-binding medicines for heartburn (aluminum hydroxide or antacids), but also Contained in mineral water with a high calcium content, numerous effervescent tablets, sports drinks, dietary supplements and osteoporosis medications.
To avoid interactions, there should be an interval of at least two or, better, four hours between taking thyroxine and the minerals.
Since dietary supplements can reduce the hormonal effect of thyroxine (levothyroxine or L-thyroxine) by about 20 percent, it is generally recommended: the daily dose of thyroid hormones in the morning, half an hour before breakfast, swallowed on an empty stomach and allowed to pass at least two hours before minerals be taken.
It is safest if, for example, you swallow thyroxine in the morning and preparations such as iron and zinc capsules in the evening.
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Thyroxine for thyroid: hormone interacts with calcium and magnesium
There is a risk of interaction with minerals such as calcium and magnesium through mineral water.
Both minerals are contained in dairy products such as cheese and yoghurt, effervescent tablets and some types of mineral water and influence the effect of L-thyroxine.
It is therefore best to take your thyroxine tablets with a glass of tap water instead of mineral water or milk.
Calcium salts are often prescribed for osteoporosis prophylaxis.
To avoid an interaction, you can take thyroxine in the morning - about 30 minutes before breakfast - and then take the calcium and magnesium with lunch and/or dinner.
Calcium and magnesium do not interfere with each other.
Thyroxine for thyroid: Do not take the hormone at the same time as zinc for colds
Zinc is often taken to strengthen the immune system, for colds and to support healthy skin and hair.
But zinc preparations should not be combined with thyroxine because they inhibit the effect of the thyroid hormone.
It is recommended to take zinc at lunchtime or in the evening about 30 minutes before eating, at least two hours apart from taking thyroxine, for example in the morning.
Thyroxine for thyroid: Do not take hormone with iron supplements
In cases of iron deficiency, iron supplements are often recommended and prescribed, especially during or towards the end of pregnancy, as the
Pharmazeutische Zeitung
summarizes.
Iron supplements should be taken approximately 30 minutes before breakfast, dinner or between meals.
If L-thyroxine is supplied to the body at the same time as iron sulfate, an interaction between the two can lead to a reduced effect of the thyroid hormone.
Both medicines containing iron and L-thyroxine should be taken on an empty stomach.
Thyroxine for Thyroid: Avoid heartburn medications that contain aluminum
Antacids containing aluminum, such as aluminum hydroxide, are prescribed for heartburn, for example.
Taking thyroxine and antacids at the same time leads to reduced bioavailability of thyroxine, which is why the thyroid hormone should generally be taken in the morning, on an empty stomach.
If you suffer from heartburn, wait at least four hours after your thyroxine dose and at least two hours after meals before taking stomach acid-binding preparations for heartburn.
This article only contains general information on the respective health topic and is therefore not intended for self-diagnosis, treatment or medication. It in no way replaces a visit to the doctor. Our editorial team is not allowed to answer individual questions about medical conditions.