Moderate interactionModerateSeparate by 4h

Magnesium oxide and Levothyroxine: interaction, severity and spacing

Magnesium oxide and Levothyroxine interact because magnesium salts bind levothyroxine and reduce its absorption when taken at the same time. Take them 4 hours apart. Moderate risk.

Last reviewed: 2026-09-20Reviewed by: StackingRight clinical review

The interaction in detail

Summary of the Magnesium oxide and Levothyroxine interaction
PairMagnesium oxide and Levothyroxine
TypeNutrient–drug interaction
SeverityModerate
Required spacing4 hours minimum
OnsetAt the time of dosing

Mechanism

Magnesium salts bind levothyroxine and reduce its absorption when taken at the same time.

What to do

Leave at least 4 hours between levothyroxine and magnesium.

How to fit both into one day

Levothyroxine
morningempty stomach

Levothyroxine needs an empty stomach and gastric acid for full absorption. Take it 30-60 minutes before breakfast with plain water, and keep calcium, iron and coffee at least 4 hours away.

Putting Magnesium oxide in the morning and Levothyroxine in the morning satisfies the 4-hour separation without disrupting either one's absorption window.

Magnesium oxide and Levothyroxine: common questions