When you take iron, a mineral your body needs to make red blood cells at the same time as levothyroxine, the synthetic thyroid hormone used to treat hypothyroidism, you’re sabotaging both. Iron binds to levothyroxine in your gut and blocks its absorption—so your thyroid meds stop working, even if you take them exactly as prescribed. This isn’t a minor issue. People end up with fatigue, weight gain, and brain fog—not because their dose is wrong, but because iron is stealing the show.
It’s not just iron. Calcium, antacids, fiber supplements, and even coffee can do the same thing. But iron is the most common offender, especially for women with heavy periods or low ferritin. You might be taking iron for anemia while also managing your thyroid—and not realizing these two are fighting each other. The fix isn’t complicated: take levothyroxine on an empty stomach, first thing in the morning, with water only. Wait at least four hours before taking iron. Or flip it: take iron at bedtime, at least four hours after your last meal and your thyroid pill. Either way, keep them apart. No shortcuts. No "I’ll just take them together and hope for the best."
Some people think splitting doses or using liquid forms helps. It doesn’t. The chemistry doesn’t change. Studies show even a 2-hour gap isn’t enough. Four hours is the minimum. If you’re on multiple supplements, write down your schedule. Put a note on your fridge. Set a phone alarm. Your thyroid doesn’t care about your convenience—it only cares about whether it gets the full dose. And if you’re confused about what else interferes, you’re not alone. Many patients don’t know that calcium in fortified plant milks or iron in multivitamins can trigger the same problem. That’s why checking labels matters. That’s why timing matters more than you think.
Below, you’ll find real-world advice from people who’ve been there—how they fixed their levels, what they tried that didn’t work, and how they built a routine that actually sticks. No fluff. No theory. Just what helps.
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