How Long After Levothyroxine Can I Drink Coffee or Tea?

Wait 30 to 60 minutes after taking levothyroxine before your first coffee, and a full hour is the safer choice. The NHS gives the same 30 to 60-minute window for any drink with caffeine, including tea.

You don't have to give up coffee. Only the timing matters.

How strong is the evidence? Moderate for the rule itself. The prescribing information says to take levothyroxine on an empty stomach, and the NHS says to take it 30 to 60 minutes before tea or coffee. The research on coffee in particular is thinner. It rests mainly on one small Italian study, which the American Thyroid Association guideline accepts as showing that coffee reduces absorption, and a 2021 systematic review called the coffee evidence limited, though pointing the same way. The only test of a 60-minute gap was in that same small study.

What coffee does to levothyroxine

The main evidence comes from endocrinologists in Italy (Benvenga 2008). They described eight women whose TSH stayed higher than expected while they swallowed their pill with coffee or espresso. They then measured absorption in six of these women and in nine volunteers, in three ways:

How the pill was taken	What happened to absorption
With water	The baseline
With coffee	Down by roughly a quarter to a third, and slower
With water, then coffee 60 minutes later	About the same as water alone

In lab tests, coffee seemed to hold on to levothyroxine, though more weakly than known binders such as dietary fiber. The ATA guideline notes that coffee may do the same thing in the gut.

Why does a quarter to a third matter? Your dose is set from blood tests. If coffee takes a different bite out of it each morning, your levels move around, and it gets harder for you and your doctor to find the right dose. TSH is the test that shows this (what TSH measures).

Black coffee, milk, decaf and tea

• Black coffee is not an exception. The study used coffee and espresso, and in the lab tests it was the coffee itself that held on to the hormone, so leaving out milk and sugar doesn't solve it.
• Milky coffee is no gentler. In a small study of 10 healthy volunteers, milk on its own lowered levothyroxine absorption when taken with the pill (Chon 2018). A latte brings both.
• Decaf has barely been studied. We found no good research on decaf and levothyroxine. Since coffee itself seems to bind the hormone, the safe default is to treat decaf like any drink other than water and keep it out of the wait.
• Tea is in the NHS advice. The NHS names tea alongside coffee. Research on tea is thin. One small study from Taiwan followed 37 people who drank tea, coffee or both within an hour of their pill. When they moved those drinks at least 4 hours away, their TSH fell, and the tea drinkers' results looked much like the coffee drinkers' (Lai 2022; evidence: Emerging). Herbal teas have barely been studied. The simple rule: water only during the wait.

Making it work if you love your morning coffee

The aim is to make the pill the first thing in your routine and the coffee the reward at the end of the wait.

• Pill first, kettle second. Keep the bottle by the kettle or coffee maker so the pill is the first thing you touch. Then shower and dress. Much of the hour passes on its own.
• Have your coffee somewhere else. If your commute takes 30 to 60 minutes, take the pill before you leave and have coffee when you arrive.
• Make the wait count. A walk, getting the kids ready, or emails can fill the gap better than watching the kettle.
• Use a timer. Thyroid Coach shows a countdown on your Lock Screen after you log your pill, and tells you when coffee is fine, so you don't have to guess.

Food follows the same rule. How long after levothyroxine you can eat explains the 30-versus-60-minute question in more detail, and the full levothyroxine routine covers the rest of the day.

Can't wait for coffee? Ask about bedtime dosing

If you need coffee the moment you wake, there is another option to discuss with your doctor. The ATA guideline says levothyroxine can be taken at bedtime, 3 or more hours after your evening meal (ATA guideline). Then your morning coffee is free.

Randomized trials back bedtime as an option. One found it gave slightly better thyroid levels than a dose 30 minutes before breakfast (Bolk 2010); another found a fasting morning dose gave the lowest TSH, with bedtime in between (Bach-Huynh 2009). The ATA says bedtime "may be the next best choice" when an hour before breakfast isn't practical.

Two things to know first. The stomach needs to be empty at night too, so the evening tea or decaf counts; ask your pharmacist how long a gap they suggest. And talk to your doctor before switching, then keep to one routine.

If you've been taking it with coffee

If that has been you, it's an easy fix, not a failure.

Don't fix it silently, though. If your dose was set while coffee was cutting your absorption, moving coffee later could mean more of each pill gets in. In the Taiwanese study above, people who kept the same dose but moved coffee and tea away from their pill saw their TSH fall by the 3-month check (Lai 2022). Your doctor will want to know about the change, and may want to recheck your TSH.

The prescribing information lists signs to report that can mean too much thyroid hormone: a fast or irregular heartbeat, shakiness, nervousness, trouble sleeping, sweating or feeling too hot. Chest pain, or a very fast or irregular heartbeat, needs urgent medical help.

What to tell your doctor or pharmacist

• When you take your pill, and when you have your first coffee or tea.
• Whether that has changed recently, or you plan to change it.
• Whether you'd like to try bedtime dosing.
• Anything else in your morning, such as iron, calcium, antacids or a multivitamin. The label says to keep iron, calcium and antacids at least 4 hours away, not 60 minutes (iron and levothyroxine timing).
• If you are pregnant or think you might be, contact your doctor as soon as you know. It is time-sensitive, because pregnancy can change how much levothyroxine you need (prescribing information).

Your doctor or pharmacist knows your situation and has the final say on how you take your medicine.

If you're tired despite a careful routine, other causes are worth checking too: see still tired on levothyroxine.

Questions

Can I take levothyroxine with black coffee?

Not at the same time. Coffee and espresso cut absorption in a small study, and lab tests suggest the coffee itself binds the hormone, so going black doesn't help. Take the pill with water and wait 30 to 60 minutes, ideally the full hour.

Can I take levothyroxine with decaf coffee?

There is very little research on decaf. Because coffee itself appears to bind levothyroxine, the safe default is water only during the wait. Your pharmacist can tell you if they would treat decaf differently.

How long after levothyroxine can I drink tea?

The NHS gives the same 30 to 60 minutes for tea as for coffee. Tea has been studied far less than coffee, though one small study suggests it interferes in a similar way, so the full hour is the cautious choice.

How long after drinking tea can I take levothyroxine?

No guideline sets a gap for tea or coffee before the pill. The aim is an empty stomach, so the simplest fixes are to take the pill before your first cup, or to ask your doctor about bedtime dosing. Your pharmacist can suggest a gap if your routine needs one.

Sources

1. Benvenga S, et al. Altered intestinal absorption of L-thyroxine caused by coffee. Thyroid. 2008;18(3):293–301.
2. Jonklaas J, et al. Guidelines for the treatment of hypothyroidism: prepared by the American Thyroid Association Task Force on Thyroid Hormone Replacement. Thyroid. 2014;24(12):1670–1751.
3. NHS. Levothyroxine: a medicine for an underactive thyroid. Page last reviewed 6 July 2026.
4. AbbVie. SYNTHROID (levothyroxine sodium) tablets, prescribing information, revised February 2024. DailyMed, US National Library of Medicine.
5. Chon DA, et al. Concurrent milk ingestion decreases absorption of levothyroxine. Thyroid. 2018;28(4):454–457.
6. Bolk N, et al. Effects of evening vs morning levothyroxine intake: a randomized double-blind crossover trial. Arch Intern Med. 2010;170(22):1996–2003.
7. Bach-Huynh TG, et al. Timing of levothyroxine administration affects serum thyrotropin concentration. J Clin Endocrinol Metab. 2009;94(10):3905–3912.
8. Wiesner A, et al. Levothyroxine interactions with food and dietary supplements: a systematic review. Pharmaceuticals (Basel). 2021;14(3):206.
9. Lai YW, Huang SM. Tea consumption affects the absorption of levothyroxine. Front Endocrinol (Lausanne). 2022;13:943775.