Drug & supplement interaction

Terminalia + Levothyroxine Sodium

Levothyroxine Sodium brand names: Tirosint-Sol, Thyquidity, Ermez.

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

We found no known interaction between Terminalia and Levothyroxine Sodium 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 Sodium states a food rule worth keeping to.

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Interaction report

Terminalia and Levothyroxine Sodium

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 Sodium and Terminalia 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.

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.

Terminalia safety at a glance

Terminalia overall Use caution Generally well tolerated short-term in studies, but long-term safety and quality vary by product.
Pregnancy Avoid Not enough safety information; avoid use during pregnancy.
Breastfeeding Avoid Not enough safety information; avoid use while breastfeeding.

Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Levothyroxine Sodium and Terminalia? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Levothyroxine Sodium

Interactions in our licensed database are recorded against drug classes, not just single drug names. Levothyroxine Sodium is filed under 3 classifications — including thyroid hormone, oral drugs. Terminalia has documented interactions with 7 drug classes — the most serious being anticoagulant/antiplatelet drugs (moderate), antidiabetes drugs (moderate) and chlorzoxazone (parafon forte, paraflex) (moderate) — and none of Levothyroxine Sodium’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Terminalia Does Interact With Other Medications

Terminalia has 933 moderate known drug interactions in our database — Levothyroxine Sodium isn’t one of them. If you take anything else, check it against the full list below.

Moderate 933 No known interaction 1,897 (incl. Levothyroxine Sodium)
Taking anything else?

Check Another of Your Medications Against Terminalia

Covers the 2,830 medications we’ve checked against Terminalia. Pick one to open its full report.

What to actually watch for

What Levothyroxine Sodium’s Own FDA Label Lists

This is not an interaction — none of it involves Terminalia. These are the most notable effects listed in the ADVERSE REACTIONS section of Levothyroxine Sodium’s own FDA label, for the medication by itself. Knowing the drug’s own list makes it easier to work out the likely cause if something new turns up while you take both. 10 of them are worth acting on rather than waiting out — marked below.

  • A change in thyroid levels Worth acting on
  • Bone thinning Worth acting on
  • Muscle weakness Worth acting on
  • A heart attack Worth acting on
  • Heart failure Worth acting on
  • Wheezing Worth acting on
  • Shortness of breath Worth acting on mentioned in 5.3% of FDA reports for Levothyroxine Sodium
  • Seizures Worth acting on
  • Chest pain Worth acting on
  • A severe allergic reaction Worth acting on

Showing the 10 most notable of 32 label-listed effects — ranked by how unusual each one is across medicines generally, with serious effects weighted up.

From the ADVERSE REACTIONS section of the FDA label for Levothyroxine Sodium. Read the label on DailyMed › Where a percentage is shown, it is the share of 312,551 voluntary FDA FAERS reports for Levothyroxine Sodium that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Terminalia’s licensed record lists no adverse effects our clinical vocabulary could match, so there is no Terminalia side to compare — that is a limit of the record, not a statement that Terminalia has no side effects.

How to take them

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

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

Everything else you take

See Every Supplement That Interacts With Levothyroxine Sodium

This page covers Terminalia only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Levothyroxine Sodium 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).

Open the Levothyroxine Sodium interaction page

One more smart check

Taking Terminalia as Part of a Dietary Supplement Product? Check It for Interactions

We hold 306 real supplement products containing Terminalia, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Terminalia. Even though Terminalia itself has no known interaction with Levothyroxine Sodium, another ingredient on your label might. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Terminalia and Levothyroxine Sodium 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 Terminalia
Top 25%

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

29 days ago today
Medication Levothyroxine Sodium
Top 5%

#126 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 Terminalia reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Terminalia and Levothyroxine Sodium records this page draws on were last updated June 22, 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 Terminalia

What is Terminalia?

Terminalia
  • Heart health and circulation
  • Digestive problems (constipation, diarrhea)
  • Cholesterol support
  • Antioxidant and anti-inflammatory support
  • Immune support

Terminalia is a group of traditional Ayurvedic tree species (most notably Terminalia arjuna) used for heart, digestive, and general wellness purposes. Some small studies suggest possible benefits for heart and cholesterol health, but the evidence is limited and not strong enough to recommend it as a treatment. Talk to your pharmacist or doctor before using it, especially if you have a heart condition.

Terminalia arjuna · Combretaceae · Bark, fruit, and leaves (depending on species) · Capsules, tablets, powder (churna), bark extract, decoction/tea

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

Terminalia: dosing

There is no official or well-established standard dose for Terminalia. Doses used in studies vary widely depending on the species, the part of the plant, and the type of extract.Because of this, the best advice is to follow the directions on the product label and not exceed the recommended amount. A pharmacist or doctor can help you decide whether a product is appropriate for you and review the label. Avoid combining multiple supplements that contain Terminalia, since this can increase your total dose without you realizing it.

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

Read the full Terminalia monograph & all interactions
Medication

About Levothyroxine Sodium

Most-Reported Side Effects for Levothyroxine Sodium

From FAERS, the FDA’s public side-effect reporting system (312,551 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Fatigue 26,585 reports
Nausea 22,605 reports
Headache 19,408 reports
Diarrhea 18,759 reports
Dyspnea 16,717 reports
Keep checking

Other Drugs & Terminalia

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

0Major
933Moderate
0Minor
1,896No known interaction
933 Moderate 1,896 No interaction
Moderate

933 interactions

Showing 60 of 933 moderate interactions — see all 933 on the Terminalia page.

No interaction 1,896 drugs checked — show the list

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

Showing the 60 most looked-up of 1,896 medications checked with no known interaction — see the full Terminalia list.

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

Terminalia References

The 9 references that drive our Terminalia 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. Sabu, M. C. and Kuttan, R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol. 2002;81(2):155-160. PubMed
  2. Rao, N. K. and Nammi, S. Antidiabetic and renoprotective effects of the chloroform extract of Terminalia chebula Retz. seeds in streptozotocin-induced diabetic rats. BMC.Complement Altern.Med 2006;6:17. PubMed
  3. Murali, Y. K., Anand, P., Tandon, V., Singh, R., Chandra, R., and Murthy, P. S. Long-term effects of Terminalia chebula Retz. on hyperglycemia and associated hyperlipidemia, tissue glycogen content and in vitro release of insulin in streptozotocin induced
  4. Senthilkumar, G. P. and Subramanian, S. Evaluation of antioxidant potential of Terminalia chebula fruits studies in streptozotocin-induced diabetic rats. Pharmaceutical Biology (Netherlands) 2007;45:511-518.
  5. Malik N, Dhawan V, Bahl A, Kaul D. Inihbitory effects of Terminalia arjuna on platelet activation in vitro in healthy subjects and patients with coronary artery disease. Platelets. 2009;20(3):183-1190.
  6. Varghese A, Savai J, Pandita N, Gaud RS. In vitro modulatory effects of Terminalia arjuna, arjunic acid, arjunetin, and arjungenin on CYP3A4, CYP2D6, and CYP2C9 enzyme activity in human liver microsomes. Toxicology Reports. 2015(2):806-16. PubMed
  7. Wu G, Dong Z, Dong J, et al. Effects of mongolian medicine Terminalia chebula Retz. on 6 CYP450 enzymes in rats. Int J Clin Exp Pathol 2020;13(12):3128-3138.
  8. Das A, Naveen J, Sreerama YN, Gnanesh Kumar BS, Baskaran V. Low-glycemic foods with wheat, barley and herbs (Terminalia chebula, Terminalia bellerica and Emblica officinalis) inhibit a-amylase, a-glucosidase and DPP-IV activity in high fat and low dose st
  9. Eltimamy M, Elshamarka M, Aboelsaad M, Sayed M, Moawad H. Effects of alcoholic extract of Terminalia Chebula dried fruit on blood biochemical profile in diabetic rats. J Diabetes Metab Disord 2022;21(1):159-170. 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 Terminalia and Levothyroxine Sodium Together: Common Questions

Is it safe to take Terminalia with Levothyroxine Sodium?
We do not list a known interaction between Terminalia and Levothyroxine Sodium. 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.
Should I take Terminalia and Levothyroxine Sodium at the same time of day?
At least one FDA label for a product containing Levothyroxine Sodium 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 Sodium on its own and move Terminalia 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.
How was the Terminalia and Levothyroxine Sodium combination checked?
Interactions in our licensed database are recorded against drug classes. Levothyroxine Sodium is filed under 3 classifications, and Terminalia has documented interactions with 7 drug classes — none of Levothyroxine Sodium's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Terminalia interact with any other medications?
Yes. Terminalia has 933 documented drug interactions in our database — Levothyroxine Sodium is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Levothyroxine Sodium interact with any supplements?
Yes. Levothyroxine Sodium has documented interactions with 50 supplements in our database — Terminalia is not one of them. The Levothyroxine Sodium 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

Terminalia monograph Uses, safety profile, and every drug interaction in one place Levothyroxine Sodium supplement interactions Every supplement checked against Levothyroxine Sodium, 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 9 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Levothyroxine Sodium and Terminalia?

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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.