Drug & supplement interaction

Propionyl-l-carnitine + Levothyroxine

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

Moderate Interaction
The bottom line Moderate

Propionyl-l-carnitine has a moderate interaction with Levothyroxine. Theoretically, acetyl-L-carnitine might decrease the effectiveness of thyroid hormone replacement.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Propionyl-l-carnitine and Levothyroxine

Here is the interaction we found between these two, with the evidence behind it.

Moderate

THYROID HORMONE

Why this applies to Levothyroxine

Levothyroxine falls under THYROID HORMONE — the group Propionyl-l-carnitine interacts with.

Theoretically, acetyl-L-carnitine might decrease the effectiveness of thyroid hormone replacement.
L-carnitine appears to act as a peripheral thyroid hormone antagonist by inhibiting entry of thyroid hormone into the nucleus of cells. Taking L-carnitine also seems to diminish some of the symptoms of hyperthyroidism. It is unclear if such an interaction would occur with propionyl-L-carnitine.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for your thyroid medicine: carnitine seems to work against thyroid hormone inside your cells, sort of blocking it from getting where it needs to go. In theory, that could make your levothyroxine work a little less well, so symptoms of low thyroid might creep back, things like tiredness, feeling cold, constipation, dry skin, or weight gain.

Now, the honest part: this is mostly seen with plain L-carnitine, and we don't really know if propionyl-L-carnitine (PLC) does the same thing. The evidence is on the weaker side and somewhat theoretical, so I wouldn't panic. Since levothyroxine needs steady, careful dosing, just give your pharmacist or doctor a heads-up before adding PLC, and watch for any return of low-thyroid symptoms.

References
  1. Benvenga S, Ruggeri RM, Russo A, et al. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Meta
  2. 12761 Benvenga S, Amato A, Calvani M, Trimarchi F. Effects of carnitine on thyroid hormone action. Ann N Y Acad Sci 2004;1033:158-67. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Propionyl-l-carnitine Also Interacts With Other Medications

Propionyl-l-carnitine has 18 moderate known drug interactions in our database — the Levothyroxine one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Propionyl-l-carnitine

Covers the 2,830 medications we’ve checked against Propionyl-l-carnitine. Pick one to open its full report.

From our Q&A

Questions About Propionyl-l-carnitine 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 Propionyl-l-carnitine 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 Propionyl-l-carnitine 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

One more smart check

Taking Propionyl-l-carnitine as Part of a Dietary Supplement Product? Check It for Interactions

We hold 57 real supplement products containing Propionyl-l-carnitine, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Propionyl-l-carnitine. Your product may carry other ingredients that interact with Levothyroxine too, on top of Propionyl-l-carnitine — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Propionyl-l-carnitine 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 Propionyl-l-carnitine
Steady interest

#1,251 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.

Supplement

About Propionyl-l-carnitine

What is Propionyl-l-carnitine?

  • Peripheral artery disease and leg pain
  • Heart and circulation support
  • Energy and exercise performance
  • Erectile dysfunction
  • Diabetic nerve pain

Propionyl-l-carnitine is a form of the amino acid derivative carnitine that the body uses to help turn fat into energy, and it is studied mostly for circulation problems like peripheral artery disease. Some evidence suggests it may help walking distance in people with poor leg circulation, but results are mixed and it is not a substitute for standard medical care. Talk to a pharmacist or doctor before using it, especially if you have a medical condition or take other medicines.

Read the full Propionyl-l-carnitine 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 & Propionyl-l-carnitine

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

0Major
18Moderate
0Minor
2,811No known interaction
Moderate

18 interactions

No interaction 2,811 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Propionyl-l-carnitine and Levothyroxine Together: Common Questions

Can you take Propionyl-l-carnitine with Levothyroxine?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Propionyl-l-carnitine and Levothyroxine interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

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

Still Have a Question About Levothyroxine and Propionyl-l-carnitine?

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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.