Drug & supplement interaction

Ackee + Levothyroxine

Levothyroxine brand names: Euthyrox, Levothroid, Unithroid, Synthroid, Levoxyl, and others.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Ackee and Levothyroxine in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the label for Levothyroxine states a food rule worth keeping to, and the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Ackee and Levothyroxine

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Levothyroxine and Ackee in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

Worth understanding: our licensed dataset holds no drug-interaction record for Ackee at all — not against Levothyroxine, and not against any other medication we track. This verdict therefore rests on the absence of any recorded data, not on research that looked at this combination and found nothing. We cannot rule an interaction out.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Ackee safety at a glance

Ackee overall Use caution Ripe, properly prepared fruit is eaten as food, but unripe fruit and seeds are dangerously toxic.
Pregnancy Unsafe When the unripe fruit is ingested. There is insufficient reliable information available about the safety of the ripe fruit during pregnancy and breast-feeding;... Read the full pregnancy detail
Breastfeeding Unsafe When the unripe fruit is ingested. There is insufficient reliable information available about the safety of the ripe fruit during pregnancy and breast-feeding;... Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Levothyroxine and Ackee? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
What to actually watch for

No Interaction Found — But Data Suggests Ackee and Levothyroxine May Share Several of the Same Side Effects

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do. 3 of them are worth acting on rather than waiting out — marked below.

  • Seizures Worth acting on Additional detail

    Ackee

    “Orally, consumption of ripe ackee fruit is well tolerated. However, consumption of unripe ackee is unsafe.

    Serious Adverse Effects (Rare):

    Orally: Consumption of unripe ackee fruit can cause severe hypoglycemia and subsequent liver damage. Unripe ackee fruit can also cause Jamaican vomiting sickness, characterized by severe bouts of vomiting, followed by seizures, coma, and death.”

    Ackee · Natural Medicines adverse-effect record, reported in epilepsy.

    “Oral consumption of unripe ackee fruit results in toxicity called Jamaican vomiting sickness which includes acute onset of severe vomiting. This will usually subside but then be followed by another bout of vomiting, seizures, coma, and death within 12 hours.”

    Ackee · Natural Medicines adverse-effect record, reported in epilepsy.

    3 sources cited
    1. 30279. Joskow, R., Belson, M., Vesper, H., Backer, L., and Rubin, C. Ackee fruit poisoning: an outbreak investigation in Haiti 2000-2001, and review of the literature. Clin Toxicol (Phila) 2006;44(3):267-273. PubMed
    2. 30289. Golden, K. D., Kean, E. A., and Terry, S. I. Jamaican vomiting sickness: a study of two adult cases. Clin.Chim.Acta 10-15-1984;142(3):293-298. PubMed
    3. 94873. Katibi OS, Olaosebikan R, Abdulkadir MB, Ogunkunle TO, Ibraheem RM, Murtala R. Ackee fruit poisoning in eight siblings: implications for public health awareness. Am J Trop Med Hyg 2015;93(5):1122-3. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • A severe allergic reaction / Hives Worth acting on Additional detail

    Ackee

    “Urticaria and anaphylaxis has been reported after ingestion of ackee.”

    Ackee · Natural Medicines adverse-effect record, reported in urticaria.

    1 source cited
    1. 5610. Lebo DB, Ditto AM, Boxer MB, et al. Anaphylaxis to ackee fruit. J Allergy Clin Immunol 1996;98:997-8. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Stomach pain / Diarrhea Additional detail

    Ackee

    “Chronic oral ingestion of canned ackee fruit has been associated with cholestatic liver disease. In a case report, chronic ackee consumption resulted in cholestatic jaundice in a 27-year-old male. The patient presented with symptoms of steatosis, jaundice, pruritis, diarrhea and abdominal pain. Toxic hypoglycemic syndrome (THS) associated with consumption of unripe ackee can ultimately result in liver damage.”

    Ackee · Natural Medicines adverse-effect record, reported in alcohol-related liver disease.

    3 sources cited
    1. 12418. Larson J, Vender R, Camuto P. Cholestatic jaundice due to ackee fruit poisoning. Am J Gastroenterol 1994;89:1577-8.
    2. 5602. Anon. Toxic hypoglycemic syndrome - Jamaica, 1989-91. MMWR Morb Mortal Wkly Rep 1992;41:53-5.
    3. 12416. McTague JA, Forney R Jr. Jamaican vomiting sickness in Toledo, Ohio. Ann Emerg Med 1994;23:1116-8. PubMed

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

  • Vomiting Additional detail

    Ackee

    Recorded for Ackee in the same Natural Medicines adverse-effect record shown under Seizures above.

    Levothyroxine

    Listed in the ADVERSE REACTIONS section of the FDA label for Levothyroxine. Read the label on DailyMed ›

Reported for Ackee but not commonly for Levothyroxine: low blood sugar, liver problems and yellowing of the skin or eyes.

Effects for Levothyroxine come from the ADVERSE REACTIONS section of its FDA label; effects for Ackee come from the Natural Medicines adverse-effect record, quoted above. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Ackee in Pregnancy & Breastfeeding

Pregnancy And Lactation Unsafe

When the unripe fruit is ingested. There is insufficient reliable information available about the safety of the ripe fruit during pregnancy and breast-feeding; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

How to take them

Some Levothyroxine Products Have a Food Rule — Ackee Should Not Break It

At least one FDA label for a product containing Levothyroxine says to take it on an empty stomach. Most supplements — Ackee included — are taken with a meal, so the easy mistake is swallowing both together at breakfast. Where that rule applies, keep Levothyroxine on its own and move Ackee to a meal later in the day.

This may not be true of your version. Food instructions belong to the product, not the ingredient: two Levothyroxine products can carry different directions, and extended-release forms often differ from immediate-release ones. The label we read is quoted below — check the directions on your own box or bottle, or ask your pharmacist, for how to take the exact product you were given.

A food rule is not an interaction — it is about how much of the medicine you absorb. The directions that came with your own product, and your pharmacist, outrank anything on this page.

From our Q&A

Questions About Ackee or Levothyroxine

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Ackee or Levothyroxine, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Levothyroxine

This page covers Ackee only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levothyroxine page lists 50 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Tiratricol (major), Acetyl-l-carnitine (moderate), Alpha-lipoic Acid (moderate) and Ascophyllum Nodosum (moderate).

By severity: 2 major · 39 moderate · 9 minor.

From our pharmacist’s overview on the Levothyroxine page

“Levothyroxine replaces a hormone your body measures in tiny amounts, so small shifts in its blood level show up in how you feel, and I treat this list with genuine care. Nearly everything on it does one of two things: blocks the pill from being absorbed in the gut, the way everyday minerals like calcium do by binding it into complexes,…”

Reviewed by 2 · Jul 18, 2026

Open the Levothyroxine interaction page

How much people look this up

Where Ackee and Levothyroxine Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Ackee
Steady interest

#1,194 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Levothyroxine
Top 10

#2 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Ackee reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Ackee and Levothyroxine records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Ackee

What is Ackee?

Ackee
  • Food source (cooked ripe fruit)
  • Traditional digestive remedies
  • Folk treatment for fever
  • Traditional wound and skin care
  • Folk use for aches and pains

Ackee is best known as a food — the national fruit of Jamaica — but only the fully ripe, properly prepared aril is safe to eat. Unripe ackee and its seeds contain natural toxins that can cause severe, sometimes fatal poisoning, so there is no good evidence supporting it as a medicinal supplement. If you eat ackee, use only ripe, commercially canned or properly prepared fruit.

Blighia sapida · Sapindaceae · Ripe fruit (aril); seeds, leaves, and bark used traditionally · Fresh ripe fruit, canned fruit, traditional decoctions of leaves or bark

An interaction check asks whether these two react with each other — it does not ask whether Ackee is a good idea for someone in your situation. Here is what our Ackee record says about it on its own.

Ackee: dosing

There is no established medicinal dose for ackee, and it is not recommended as a supplement. When eaten as a food, only the fully ripe, properly cleaned and cooked aril should be consumed, and seeds should never be eaten.Because there is no standardized or proven medicinal dose, and because of the real risk of poisoning, do not use ackee as a remedy.

From our Ackee monograph — the full record covers uses, side effects and every documented interaction.

Read the full Ackee monograph & all interactions
Medication

About Levothyroxine

What Is Levothyroxine Used For?

Brand names: Euthyrox, Levothroid, Unithroid, Synthroid, Levoxyl, Levo-T, Eltroxin, Estre, Levothyroxine, Novothyrox, Levolet

Levothyroxine replaces or supplements the thyroid hormone your body isn't making enough of. It's used for hypothyroidism — an underactive thyroid — in adults, children, and even newborns, whether the cause is the thyroid gland itself, the pituitary gland, or the hypothalamus in the brain.

It's also used alongside surgery and radioiodine treatment in people with certain types of thyroid cancer, to help suppress the hormone that can stimulate cancer growth. It is not meant for weight loss, treating benign thyroid nodules in people who have enough iodine, or for hypothyroidism during recovery from a temporary condition called subacute thyroiditis.

See full Levothyroxine drug information
Keep checking

Other Drugs & Ackee

Browse every other medication we’ve checked against Ackee — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
0Moderate
0Minor
2,829No known interaction
2,829 No interaction
No interaction 2,829 drugs checked — show the list

We also checked Ackee against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,829 medications checked with no known interaction — see the full Ackee list.

See the full Ackee interactions page
See every supplement checked against Levothyroxine, ranked by severity
Evidence & sources

Ackee References

The 8 references that drive our Ackee monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. Anon. Toxic hypoglycemic syndrome - Jamaica, 1989-91. MMWR Morb Mortal Wkly Rep 1992;41:53-5.
  2. Lebo DB, Ditto AM, Boxer MB, et al. Anaphylaxis to ackee fruit. J Allergy Clin Immunol 1996;98:997-8. PubMed
  3. Meda HA, Diallo B, Buchet JP, et al. Epidemic of fatal encephalopathy in preschool children in Burkina Faso and consumption of unripe ackee (Blighia sapida) fruit. Lancet 1999:13;353:536-40. PubMed
  4. McTague JA, Forney R Jr. Jamaican vomiting sickness in Toledo, Ohio. Ann Emerg Med 1994;23:1116-8. PubMed
  5. Larson J, Vender R, Camuto P. Cholestatic jaundice due to ackee fruit poisoning. Am J Gastroenterol 1994;89:1577-8.
  6. Joskow, R., Belson, M., Vesper, H., Backer, L., and Rubin, C. Ackee fruit poisoning: an outbreak investigation in Haiti 2000-2001, and review of the literature. Clin Toxicol (Phila) 2006;44(3):267-273. PubMed
  7. Golden, K. D., Kean, E. A., and Terry, S. I. Jamaican vomiting sickness: a study of two adult cases. Clin.Chim.Acta 10-15-1984;142(3):293-298. PubMed
  8. Katibi OS, Olaosebikan R, Abdulkadir MB, Ogunkunle TO, Ibraheem RM, Murtala R. Ackee fruit poisoning in eight siblings: implications for public health awareness. Am J Trop Med Hyg 2015;93(5):1122-3. PubMed

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Ackee and Levothyroxine Together: Common Questions

Is it safe to take Ackee with Levothyroxine?
We do not list a known interaction between Ackee and Levothyroxine. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Ackee and Levothyroxine have any of the same side effects?
Yes — our sources link each of them separately to 6 of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Should I take Ackee and Levothyroxine at the same time of day?
At least one FDA label for a product containing Levothyroxine says to take it on an empty stomach, and supplements are usually taken with a meal — so taking them together at breakfast is the easy mistake. Where that applies, keep Levothyroxine on its own and move Ackee to a meal later in the day. Food instructions belong to the product rather than the ingredient, so check the directions on your own box. This is about absorption, not an interaction.
Does Levothyroxine interact with any supplements?
Yes. Levothyroxine has documented interactions with 50 supplements in our database — Ackee is not one of them. The Levothyroxine interaction page linked on this page lists every one, ranked by severity.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Where next

Keep Exploring

Ackee monograph Uses, safety profile, and every drug interaction in one place Levothyroxine drug information The full plain-English guide to this medication Levothyroxine supplement interactions Every supplement checked against Levothyroxine, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 8 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Levothyroxine and Ackee?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.