Conditions and drugs interfering with thyroxine absorption

Best Pract Res Clin Endocrinol Metab. 2009 Dec;23(6):781-92. doi: 10.1016/j.beem.2009.06.006.


Food, dietary fibre and espresso coffee interfere with the absorption of levothyroxine. Malabsorptive disorders reported to affect the absorption of levothyroxine include coeliac disease, inflammatory bowel disease, lactose intolerance as well as Helicobacter pylori (H. pylori) infection and atrophic gastritis. Many commonly used drugs, such as bile acid sequestrants, ferrous sulphate, sucralfate, calcium carbonate, aluminium-containing antacids, phosphate binders, raloxifene and proton-pump inhibitors, have also been shown to interfere with the absorption of levothyroxine.

Publication types

  • Review

MeSH terms

  • Aluminum Hydroxide / adverse effects
  • Animals
  • Antacids / adverse effects
  • Biological Availability
  • Calcium Carbonate / adverse effects
  • Celiac Disease / physiopathology
  • Coffee / adverse effects
  • Dietary Fiber / adverse effects
  • Drug Interactions
  • Female
  • Food
  • Gastritis, Atrophic / physiopathology
  • Helicobacter Infections / physiopathology
  • Humans
  • Intestinal Absorption / drug effects*
  • Lactose Intolerance / physiopathology
  • Malabsorption Syndromes / physiopathology
  • Thyroxine / pharmacokinetics*


  • Antacids
  • Coffee
  • Dietary Fiber
  • Aluminum Hydroxide
  • Calcium Carbonate
  • Thyroxine