Proper Ingestion Helps Stabilize TSH Values

If you notice labile thyroid-stimulating hormone (TSH) values in a patient receiving levothyroxine therapy for primary hypothyroidism, ask how he or she takes the medication. Levothyroxine should always be taken on an empty stomach (usually first thing in the morning) with water only; no other fluids, food, or medications should be consumed for 30 minutes afterwards. Incorrect ingestion of levothyroxine is a major cause of variable TSH readings, which result in frequent and unnecessary dosage adjustments. In addition, patients don't feel well because they never achieve euthyroid status.