11 Tips to Optimize Thyroid Medication Absorption

You were diagnosed with hypothyroidism. You have your medication. You’re taking it as directed by your doctor/pharmacy. Great. That’s a very good start, however, most of us with hypothyroidism have multiple issues going on at once. It’s like a domino-effect.

Your thyroid is a powerful gland. When it works well, you metabolize nutrients. Your body uses your food as energy and absorbs the nutrients from your food. That is a big deal.

However, when you have hypothyroidism, your body is not able to metabolize your food efficiently. You are not producing enough T4 (thyroxine), which in turn means you are not producing enough T3 (triiodothyronine, the active thyroid hormone).

TSH is the main indicator used by most doctors. I (among many others) personally feel that TSH monitoring is extremely outdated and not thorough enough. Thyroid Stimulating Hormone (TSH) is actually a pituitary hormone. Think of your pituitary gland as an alarm clock for your thyroid gland. Normally, your pituitary gland will detect that there is not enough thyroid hormone in your system and will produce TSH (the alarm sound) to make your thyroid produce more T4 (thyroxine). Well, when you have hypothyroidism, your thyroid pushes the snooze button causing your TSH to go up. This is a good indicator for hypothyroidism, however, it’s not giving a clear picture of everything else going on…But it doesn’t stop there. T4 has to go to work. T4 will go convert to T3. Then, T3 goes and metabolizes the food you eat.

Let’s talk about T3. T3 (triiodothyronine) is that magic hormone that metabolizes what you’ve eaten and gives you that longed for energy. Of course, you can’t have T3 without T4. What many people don’t know is that T4 converts into T3 primarily in the liver (and in other organs such as the heart, muscles, and gut). So to optimize the conversion of T4 to T3, it is not surprising that these organs also need to be in good shape.

I find it very annoying that most endocrinologists don’t factor in T4 and T3, but that’s another post. I thankfully have a doctor who works with me. She does look at TSH as the main indicator, but orders free T4 and free T3, per my request. I definitely encourage you to find a doctor who will respect you as his or her patient. That is so important and a critical factor in advocating for your health. If they treat you rudely when you have questions or requests, run!

Since learning more about thyroid health, I have found that my TSH is now nearly optimal, which satisfies my doctor, however my free T4 and free T3 have me concerned as they are barely within that range. I feel like this is one of the main reasons why people don’t feel “fine”, but the doctor says they’re fine. “Your TSH looks great. Let’s review in 6 months.” Of course, this made me want to know how I can optimize my levels on my own.

***Most T4 hormones bind to proteins in the blood meaning they’re inactive, leaving a few free T4 hormones, which will convert into T3. Like T4, most T3 molecules will bind to proteins in the blood making them inactive, leaving free T3 to do the actual metabolizing.

Obviously, raise your T4 levels, you need to have your thyroid medication. That’s definitely step one and, of course, it can take time to take effect. Your body needs time to completely adapt to your medication. Here are some tips to optimize your T4 absorption and T3 conversion:

1. Take your thyroid pill at least 1 hour before you eat. That is a universal rule that is found on the bottle of your medication. Please don’t ignore that. Your body absorbs T4 best on an empty stomach. If you choose to take your medication before bed, make sure it has been at least 4 hours since the last time you ate or drank anything other than water.

2. Space out your supplements at least 4 hours from the time you take your thyroid pill. There are specific vitamins and minerals that will inhibit your absorption, primarily iron and calcium. Multivitamins or even individual supplements generally have higher doses that you would naturally get by the food you eat. The iron and calcium bind to T4, therefore making it impossible to absorb them.

3. As with your multivitamins and various supplements, you should take any other prescription medication 4 hours before or after your thyroid medication. Of course, your doctor/pharmacist will have the best plan for you.

4. Drinking water. There’s a no-brainer. Drink water as opposed to sodas or juice. This really is good for your whole body. It really is what it’s cracked up to be. It keeps your organs hydrated and working well.

5. Drink dandelion root tea. This is great for detoxing your liver. I know after eating mostly junk for the majority of my life, my liver filtered a lot of toxins. Detoxifying your liver regularly will help it function at its best.

6. Another one for the liver – beet juice. Hear me out, ok? Beets are touted as super foods for good reason. They help speed up the process of breaking down toxins. Thankfully, in this day and age, there are many more palatable products with beet juice as the main ingredient. When you go to the bathroom and you see red coloration along with your stool, you’re not dying. It’s the beet juice.

7. Make sure you’re getting enough zinc and selenium. These are essential for T4 to convert to T3.

8. Reducing stress sounds like an oxymoron. You are tired. You may not feel up to doing all the things you need to do. It’s way easier said than done. Personally, as I stated in previous posts, I regularly do Pilates and Yoga. Just a 10 minute video on YouTube every day can be beneficial. I also take melatonin to make sure I’m getting enough sleep. Make sure you get some “you” time. Even if that means going in the bathroom to do a skin routine or scroll Instagram. I’ve also had success with magnesium citrate to calm my anxiety.

9. Get your probiotics! Get your gut health in check. My absolute favorite way to get probiotics is by drinking kombucha. However, if that’s not your thing, there are other ways to get it like capsules and sauerkraut (I recommend Wildbrine brand in the refrigerated section. Do not get the canned shelf-stable variety.) I have yet to try kimchi, but that’s another one.

10. Living a Paleo lifestyle , or even implementing the Autoimmune Protocol, if necessary. If you suffer from chronic inflammation, you’re going to have poor T4 to T3 conversion. When your body is inflamed, it can cause your thyroid hormones to stop working! Scary. The paleo diet and lifestyle is naturally anti-inflammatory. It eliminates gluten, dairy, refined sugars, soy, legumes, and harmful toxins. In time, you will start to feel better and your body will thank you.

11. Last, but definitely no least, replace conventional household and hygiene products with non-toxic/less-toxic ones. A lot of the harsh toxic ingredients in conventional products are endocrine disruptors, which can make it harder for your thyroid hormones to work properly. Try to eliminate as many toxins in your home as possible. I started this process with replacing my hygiene products first. After I replaced all my shower, skincare, and feminine hygiene products, I started switching to less-toxic household cleaning products. Some of my favorite brands are…

  • Skin Care: Nourish Organics, Trader Joe’s skincare products, Yes To, Andalou, Honest Beauty, Josie Maran, Coola, Tula, and Beauty Counter
  • Makeup: Tarte Cosmetics, Honest Beauty, Ilia, Josie Maran, and Beauty Counter, Dazzle Dry
  • Hair Care: Trader Joe’s hair products, Alaffia, Andalou, Beauty Counter, Monat
  • Personal Hygiene: Cora feminine products, Rael feminine products, fluoride-free toothpaste (Redmond’s, Hello, Dr. Ginger’s), Native deodorant, Primally Pure deodorant, Skylar perfumes
  • Household Cleaning: Branch Basics, Norwex, Biokleen, Ecos, Better Life, distilled vinegar, baking soda

There you have it. I hope these tips help you go from just surviving to thriving!


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