Drug & supplement interaction

Vitamin C + Levothyroxine Sodium

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

Moderate Interaction
The bottom line Moderate

Vitamin C has a moderate interaction with Levothyroxine Sodium. Vitamin C can increase levothyroxine absorption.

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

Vitamin C and Levothyroxine Sodium

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

Moderate

LEVOTHYROXINE (Synthroid, others)

Vitamin C can increase levothyroxine absorption.
Two clinical studies in adults with poorly controlled hypothyroidism show that swallowing levothyroxine with a glass of water containing vitamin C 500-1000 mg in solution reduces thyroid stimulating hormone (TSH) levels and increases thyroxine (T4) levels when compared with taking levothyroxine alone. This suggests that vitamin C increases the oral absorption of levothyroxine, possibly due to a reduction in pH.
Severity Moderate Likelihood Probable Evidence B

Interaction 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..

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

Here's the gist with your levothyroxine. Vitamin C makes the stomach a little more acidic, and that acid actually helps your body absorb more of your thyroid hormone. In two small studies in people whose thyroid levels were hard to control, taking levothyroxine with vitamin C dissolved in water lowered TSH and raised T4, meaning more of the medicine got into the body.

Why this matters: levothyroxine is dosed very precisely, so a bump in absorption could nudge you toward too much thyroid hormone (think racing heart, jitteriness, trouble sleeping, or feeling overheated). This isn't a reason to panic, and food-level vitamin C is unlikely to cause trouble. But if you take high-dose vitamin C regularly, mention it to your pharmacist or doctor so they can check your levels and keep your dose steady.

References
  1. Skelin M, Lucijanic T, Amidzic Klaric D, et al. Factors Affecting Gastrointestinal Absorption of Levothyroxine: A Review. Clin Ther. 2017 Feb;39(2):378-403. 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

Vitamin C Also Interacts With Other Medications

Vitamin C has 100 moderate, 106 minor known drug interactions in our database — the Levothyroxine Sodium 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 Vitamin C

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

From our Q&A

Questions About Vitamin C or Levothyroxine Sodium

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Vitamin C or Levothyroxine Sodium, 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 Sodium

This page covers Vitamin C 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 Vitamin C as Part of a Dietary Supplement Product? Check It for Interactions

We hold 36,382 real supplement products containing Vitamin C, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Vitamin C. Your product may carry other ingredients that interact with Levothyroxine Sodium too, on top of Vitamin C — 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 Vitamin C 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 Vitamin C
Most looked up

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

29 days ago today
Medication Levothyroxine Sodium
Top 5%

#132 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 Vitamin C

What is Vitamin C?

  • Common cold and immune support
  • Antioxidant support
  • Skin health and collagen formation
  • Wound healing
  • Preventing or treating scurvy
  • Improving iron absorption

Vitamin C (ascorbic acid) is an essential nutrient your body needs but cannot make, so you must get it from food or supplements. It's important for immune function, collagen, and acts as an antioxidant, but taking large doses doesn't prevent colds for most people and may cause stomach upset. Most people get enough from a balanced diet, so check with your pharmacist or doctor before taking high-dose supplements.

Read the full Vitamin C monograph & all interactions
Keep checking

Other Drugs & Vitamin C

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

0Major
100Moderate
106Minor
2,623No known interaction
Moderate

100 interactions

Showing 60 of 100 moderate interactions — see all 100 on the Vitamin C page.

Minor

106 interactions

Showing 60 of 106 minor interactions — see all 106 on the Vitamin C page.

No interaction 2,623 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 Vitamin C and Levothyroxine Sodium Together: Common Questions

Can you take Vitamin C with Levothyroxine Sodium?
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 Vitamin C and Levothyroxine Sodium 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

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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.