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Levothyroxine is a synthetic form of thyroid hormone used to treat hypothyroidism, a condition where your thyroid gland doesn’t produce enough hormones on its own. It’s usually taken once daily, on an empty stomach, and requires regular blood tests to make sure the dose is just right.
Levothyroxine works by replacing or supplementing thyroxine (T4) – a hormone that plays a key role in regulating your body’s metabolism, energy levels, heart function, and temperature. Taking levothyroxine helps restore normal hormone levels which can relieve symptoms like fatigue, weight gain, cold intolerance, and depression.
You may qualify for levothyroxine if you’ve been diagnosed with hypothyroidism, which means your thyroid gland isn’t producing enough thyroid hormone. Your healthcare provider will confirm your diagnosis with blood tests, usually checking your TSH (thyroid-stimulating hormone) and free T4 levels. If results show underactive thyroid function, levothyroxine may be prescribed to restore hormone balance.
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Levothyroxine is likely right for you if you’ve been diagnosed with hypothyroidism and your blood tests show low thyroid hormone levels—especially if you’re experiencing related symptoms like fatigue, weight gain, or feeling cold all the time.
Your healthcare provider will consider:
They’ll start you on a dose based on your age, weight, and health history, then adjust it over time based on follow-up labs and how you feel.
The best time to take levothyroxine is first thing in the morning, on an empty stomach, at least 30 to 60 minutes before eating or drinking anything (except water). This helps your body absorb the medication properly.
If that’s not possible, it can also be taken at bedtime, as long as it’s been at least three to four hours after your last meal. The key is to take it the same way at the same time every day to keep your hormone levels steady.
You should wait at least 30 to 60 minutes after taking levothyroxine before eating or drinking anything other than water. This gives your body time to properly absorb the medication.
Eating too soon – especially foods high in fiber, calcium, or iron – can reduce how well the medication works. For best results, take it consistently on an empty stomach and wait before having breakfast, coffee, or supplements.
Yes, you can generally drink alcohol while taking levothyroxine – but moderation is key.
Alcohol doesn't directly interfere with how levothyroxine works, but heavy or frequent drinking can affect thyroid function and liver metabolism, which might impact how your body processes the medication.
If you drink occasionally and your thyroid levels are stable, it's usually not a problem. Still, it’s a good idea to let your healthcare provider know about your alcohol use so they can monitor your thyroid function appropriately.
Levothyroxine can lead to some weight loss in people with hypothyroidism, but it’s usually just a return to your normal weight after correcting the hormone imbalance – not dramatic or rapid weight loss.
When thyroid hormone levels are too low, your metabolism slows down, which can cause weight gain. Levothyroxine helps restore normal metabolism, so some of that weight – especially from fluid retention – may come off. However, it’s not a weight loss medication, and taking more than prescribed can be dangerous.
The most common side effects of levothyroxine typically happen if your dose is too high and your body starts showing signs of too much thyroid hormone. These may include:
If you're on the correct dose, side effects are rare. But if you notice symptoms of over-treatment or under-treatment, your doctor may need to adjust your dosage. Regular blood tests help keep your levels in a healthy range.
Yes! With LifeMD, you can connect with a licensed healthcare provider from the comfort of your home within an hour. If appropriate, your provider may prescribe levothyroxine and send it directly to your local pharmacy.
For even more flexibility, a LifeMD+ membership gives you 24/7 access to care, same-day prescription refills, exclusive wellness perks, and easy access to lab testing — all designed to make managing your health simple and stress-free.
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