Your tablet comes first
This page is about an underactive thyroid, hypothyroidism, where you take a thyroid hormone tablet such as levothyroxine every day.
The American Thyroid Association says the most important thing is to take it the same way, every day (American Thyroid Association).
When to take it
The best time to take thyroid hormone is usually first thing in the morning on an empty stomach, because food in the stomach can change how much of it you absorb (American Thyroid Association).
Some people find bedtime easier. That is a decision for you and your doctor.
Coffee and chai
Then there is coffee. In a small study the ATA summarised:
- espresso taken at the same time as the tablet cut how much was absorbed (ATA, coffee study);
- the effect was gone when the coffee came 60 minutes later (ATA, coffee study).
That study was on coffee, not chai. But chai made with milk brings calcium with it, so treat it like breakfast and keep it for after the gap your doctor gives you.
Calcium, iron and soya
Iron, calcium and soya can all lower how much of the tablet you absorb (American Thyroid Association).
The British Thyroid Foundation suggests keeping supplements at least four hours away from levothyroxine (British Thyroid Foundation).
If you start or stop a calcium or iron tablet:
- tell your doctor (ATA, hypothyroidism);
- ask them to set the timings with you.
First thing
Your thyroid tablet, on an empty stomach, the same way every day.The gap your doctor gives you. In the coffee study, 60 minutes later made no difference (ATA, coffee study).
After the gap
Chai, coffee, milk and breakfast.At least four hours after the tablet (British Thyroid Foundation).
Later
Calcium or iron tablets, and soya.
Iodised salt, and no seaweed or iodine drops
In an Indian kitchen the simple answer is iodised salt.
Your thyroid needs iodine to make its hormone, and too little iodine is one cause of an underactive thyroid (ATA, hypothyroidism).
The ICMR-NIN guidelines ask everyone:
- to use iodised salt (ICMR-NIN guidelines);
- to keep added salt to 5 g a day at most (ICMR-NIN guidelines).
Iodine supplements and kelp
If you already take levothyroxine, the British Thyroid Foundation says you do not need iodine supplements, and it advises avoiding kelp and sea moss (British Thyroid Foundation).
More iodine is not more help.
Do I need to stop cabbage and gobhi?
No. A katori of cabbage sabzi or gobhi with your roti is a normal amount.
Goitrogens
Cabbage, cauliflower and their family get called goitrogens, and that word frightens people.
The British Thyroid Foundation says you would have to eat a very high amount of them before it is a real concern.
On a normal diet the risk is very low (British Thyroid Foundation).
Soya
Soya is different. The same foundation says soya interferes with levothyroxine absorption (British Thyroid Foundation).
So if you take levothyroxine it suggests avoiding soya, and if you do eat it, keeping at least four hours between soya and your tablet (British Thyroid Foundation).
Thyroid, weight and tiredness
The ATA says that for most people about 5 to 10 pounds, roughly 2 to 4.5 kg, of weight gain may be related to the thyroid (ATA, thyroid and weight).
- Most of it is salt and water (ATA, thyroid and weight).
- Treatment brings weight back to where it was before the thyroid slowed down (ATA, thyroid and weight).
- Once your levels are normal, your ability to gain or lose weight is the same as anyone else's (ATA, thyroid and weight).
So if the weight stays after your reports are back in range, the thyroid is no longer the reason.
It is the usual work, and that is where a nutritionist can help:
- a calorie gap you won't feel as a punishment;
- protein at every meal;
- fibre from dals, millets and vegetables.
Tiredness
Feeling tired is one of the signs of low thyroid hormone, and the ATA notes that too little medicine can leave you tired, cold or constipated (ATA, hypothyroidism).
If you are still worn out on your tablet:
- tell your doctor;
- get your levels checked before you blame your food.
You can read what TSH on your report means in the glossary.
The first call is free
Tell Puja what's going on and she will tell you honestly whether she can help.
What goes on the plate
No food here is a thyroid medicine. They are the everyday foods to build meals around when weight is part of the picture.
The reason after each one is that food's own rating for weight loss, from its food page.
- RagiGood choiceAs a roti or a porridge.3.5 g of fibre per 100 kcal keeps you full for longer.
- JowarGood choiceAs a roti.3.1 g of fibre per 100 kcal keeps you full for longer.
- Moong dalGood choiceA katori at lunch or dinner.2.9 g of fibre per 100 kcal keeps you full for longer.
- Masoor dalGood choiceA katori, or in a dal palak.3.2 g of fibre per 100 kcal keeps you full for longer.
- Kala chana (whole Bengal gram)Good choiceBoiled, or in a chaat.8.8 g of fibre per 100 kcal keeps you full for longer.
- Spinach (Palak)Good choiceIn dal or as a sabzi.Only 24 kcal per 100 g, so you can eat a full portion.
- Cabbage (Bandh gobi)Good choiceCooked as a sabzi, in normal amounts.Only 22 kcal per 100 g, so you can eat a full portion.
- Cauliflower (Phul gobi)Good choiceSame as cabbage.Only 23 kcal per 100 g, so you can eat a full portion.
- Guava (Amrud)Good choiceAs a fruit between meals.Only 32 kcal per 100 g, so you can eat a full portion.
- Boiled eggGood choiceIf you eat eggs.9.1 g of protein per 100 kcal helps you stay full and keep muscle.
- ChickenGood choiceIf you eat chicken.13 g of protein per 100 kcal helps you stay full and keep muscle.
What to keep small
Nothing here is banned. Some are about timing, the rest just make weight harder.
- Coffee, chai and milk with your tabletKeep these for after the gap your doctor gives you (American Thyroid Association; ATA, coffee study).
- Calcium and iron tablets close to your thyroid tabletKeep them at least four hours away from levothyroxine (British Thyroid Foundation).
- SoyaIf you take levothyroxine, the British Thyroid Foundation suggests avoiding it, or keeping at least four hours between soya and the tablet (British Thyroid Foundation).
- Kelp, sea moss and iodine dropsNot needed if you take levothyroxine, unless your doctor prescribes them (British Thyroid Foundation).
- GheeLimitA measured teaspoon, not a pour.One teaspoon (5 g) is about 44 kcal, so measure it.
- Gud (jaggery)LimitIt is still sugar.4.2 g of sugar in one teaspoon (5 g).
- Biscuits, namkeen, bakery snacks and packaged juiceThe ICMR-NIN guidelines ask us to keep foods high in fat, sugar and salt, and ultra-processed foods, to a minimum (ICMR-NIN guidelines).
Questions people ask
Can I drink tea after my thyroid tablet?
Yes, after a gap. In the coffee study the ATA summarised, coffee taken 60 minutes after the tablet made no difference (ATA, coffee study).
Keep chai for after that gap too, and check the exact time with your doctor.
Is cabbage bad for thyroid?
Not in normal amounts. The British Thyroid Foundation says you would need to eat a very high amount before it is a real concern (British Thyroid Foundation).
Should I stop soya with hypothyroidism?
If you take levothyroxine, the British Thyroid Foundation suggests avoiding soya, because it interferes with how the tablet is absorbed.
If you do eat it, keep at least four hours between soya and the tablet (British Thyroid Foundation).
Do I need iodine tablets for hypothyroidism?
Not if you take levothyroxine, says the British Thyroid Foundation (British Thyroid Foundation). Use iodised salt in normal amounts, up to 5 g a day (ICMR-NIN guidelines).
Why am I not losing weight with thyroid?
Once your levels are normal, the ATA says losing weight works the same as for anyone else (ATA, thyroid and weight).
If the scale still won't move, look at the food and the routine, which is where a nutritionist can help.
Where this comes from
Every number and medical fact on this page comes from one of these, and each one is named where it is used.
- American Thyroid Association: Thyroid hormone treatment
- American Thyroid Association, Clinical Thyroidology for Patients: coffee and levothyroxine absorption
- American Thyroid Association: Hypothyroidism (underactive)
- American Thyroid Association: Thyroid and weight
- British Thyroid Foundation: Diets and supplements for thyroid disorders
- ICMR-NIN: Dietary Guidelines for Indians (2024), English booklet
- Indian Food Composition Tables 2017, National Institute of Nutrition (ICMR)
Food numbers are from the Indian Food Composition Tables 2017, National Institute of Nutrition (ICMR), as shown on each food page.
This is general guidance, not medical advice. Follow your doctor on any medicine, its dose and its timing.
Where to go next
Puja works with thyroid alongside weight loss. Read how she works on weight loss, or see all her plans.
To see what a full day looks like, open the weight loss sample diet charts or the full list of sample diet charts.
Words from this page, explained
Want this worked out for you?
Send Puja your thyroid reports and tell her when you take your tablet. She will build your day around it on a free call.
Questions go to WhatsApp. Prefer to call? +91 88826 96344