Controversy: Is Coffee Bad For Your Thyroid?

Have you ever chased your thyroid meds with a cup of coffee? (I can’t be the only one who has done that!) Did you know that, for some people, coffee may interfere with the absorption of their thyroid medication? ^[1]

A while back, I went to dinner with a friend of mine whom I hadn’t seen for some time. Despite being under the care of the best doctors around and taking thyroid medications, she was still experiencing several thyroid symptoms (including dry skin, weight gain, hormonal imbalances, hair loss, and cold intolerance).

Usually, the first question that comes to mind when a person is experiencing these kinds of symptoms is, could this person benefit from a T3-containing medication? But, she was already taking Nature-Throid, which is a T4/T3 combination medication that has improved the lives of so many people with Hashimoto’s.

It turns out, she was unknowingly impairing the absorption of her medications with her morning coffee.

“Why didn’t anyone tell me that I’m not supposed to take my thyroid medications with coffee?” she exclaimed.

Sometimes we don’t know what we don’t know, and I hope that this article will empower and inform you about some of the things you may (or may not) have heard about coffee — like its effects on the thyroid and the absorption of most thyroid medications, as well as possible contaminants and other implications for those with Hashimoto’s.

I used to think that coffee and caffeine intake destroyed our adrenals, but in recent years, I’ve realized that many of us become dependent on caffeine because our adrenals are compromised ‒ and there are steps to healing that don’t always need to involve cutting out caffeine.

This post will answer the following questions I’ve received from my readers:

• How does coffee impact my thyroid medication?
• Should I avoid coffee if I have a thyroid condition?
• Does coffee cross-react with gluten?
• Does coffee contain mold and toxins?
• Do I have to quit coffee to heal my adrenals?
• Can coffee contribute to estrogen dominance?
• What’s the best way to cut out coffee, and are there any alternatives?
• Is coffee Autoimmune Paleo-friendly?
• Izabella Wentz, do you drink coffee/caffeine today?

1. How Does Coffee Impact My Thyroid Medication?

Many people (including yours truly!) love coffee. But, one of the things that many people don’t know is that coffee can impair the absorption of thyroid medications, and thus, it needs to be spaced out from thyroid medications. ^[2] Food, in general, can impair the absorption of thyroid hormones — especially soy, grapefruit juice, cottonseed meal, walnuts, and dietary fiber ‒ so this is why it’s always recommended to take thyroid hormones on an empty stomach, with a glass of water. ^[3]

A person with normal digestive function can take thyroid medications 15-30 minutes prior to breakfast and have the medications be well absorbed, but some people may need to postpone breakfast by a minimum of 60 minutes after taking thyroid medications, for proper absorption. (Tirosint may be an exception!) ^[4]

As far as coffee and thyroid meds go, Italian researchers found that their first-thing-in-the-morning-espresso-loving patients did not absorb their thyroid medications correctly. This is because coffee lowers the intestinal absorption of both inorganic and organic compounds, and seems to physically interact with thyroid medications. ^[5]

In another Italian study, one person who was drinking espresso within 10 minutes of thyroid medications, had a consistently elevated TSH between 13 μIU/mL and 18 μIU/mL. ^[6] The same person, on the same dose of medication, was later made to wait one hour to have her coffee, and took her medication with a full glass of water instead. With this new change, her TSH was now testing between 0.03-0.1μIU/mL (i.e. optimal!) every time she had it tested. (The researchers followed her for another 15 months.)

While most of the studies on coffee and thyroid hormone absorption have been done with levothyroxine, anecdotally, people taking T3 and natural desiccated thyroid hormones can also have a problem with absorbing them if they’re taking them with coffee.

Interestingly, an additional group of Italian researchers found a way for their espresso-loving thyroid patients to have their coffee with their thyroid medications. They found one specially formulated thyroid medication that may withstand the effects of coffee ‒ Tirosint. ^[7] Research has found that both the gel caps and liquid forms of this T4 medication are unaffected when taken with coffee (unlike tablet formulations). ^[8] This is great news for those of us who need our morning cup of coffee, thanks to active kids! 🙂

Thus, if you are taking other forms of thyroid medications, I recommend keeping your thyroid medications at your bedside, so you can take them as soon as you wake up, at least 30-60 minutes away from your morning cup of coffee and breakfast.

The Bottom Line:

• Coffee can affect the absorption of thyroid medications. Most people taking thyroid medications need to wait 30-60 minutes after taking their medications to have their morning coffee.
• Tirosint, a unique gelcap and liquid formulation of levothyroxine, is the only thyroid medication clinically shown to have adequate absorption with coffee. ^[9]

2. Should I Avoid Coffee If I Have a Thyroid Condition?

This isn’t a one-size-fits-all answer.

A small 1989 study reported that coffee consumption was protective against thyroid disease (autoimmune thyroiditis and thyroid cancer). ^[10] However, a 2017 meta-analysis of over 1,000 thyroid cancer patients determined that coffee did not have an effect on thyroid cancer. ^[11] A 1984 study in humans did not find coffee to have any effects on thyroid hormone levels, while a 1983 study done with newborn rats given high doses of caffeine, showed that it did stimulate TSH and T4, and caused a miscommunication between the thyroid and the pituitary gland. ^[12]

Of note, another study reported that the dose of caffeine required to produce endocrine effects in humans would need to be at minimum 500 mg, or 5 cups of coffee, in one sitting! ^[13] (Note: One is not likely to get this amount of caffeine from coffee, though it’s plausible that a person taking caffeine pills for weight loss or energy, or energy drinks, may be exposed to these amounts. However, these high amounts are also tied to cardiac issues, so I do not recommend caffeine pills or energy drinks.)

Therefore, unlike gluten and dairy, coffee is not something that necessarily needs to be avoided by most of those with thyroid conditions (as long as it does not cause any reactions indicative of a food sensitivity like GI problems, headaches, skin issues, etc.).

That said, some people may have conditions and predispositions where they may benefit from avoiding coffee, short-term or long-term, for a variety of reasons. The caffeine in coffee has an effect on our heart rate, metabolism, wakefulness, adrenal health, and urine concentration. ^[14]

If you have an overactive thyroid, anxiety, insomnia, headaches, frequent urination or palpitations, you may benefit from cutting back or even eliminating caffeine from your diet.

Generally, hyperthyroidism increases one’s heart rate and is overly “stimulating” for the body. ^[15] In the case of hyperthyroidism, we want to avoid any natural stimulants like caffeine, as well as pharmacological preparations (like the decongestant pseudoephedrine and amphetamines) that are used for ADHD or narcolepsy.

Sometimes, our symptoms can be worsened or even induced by caffeine excess. One of my clients complained of migraines, insomnia, anxiety, and frequent urination. Upon reviewing her diet, I learned that she was drinking 8 cups of espresso a day ‒ some were even as late as 8pm!

The coffee was too stimulating for her, making her anxious and unable to sleep. It also depleted too much magnesium, which had caused her migraines. ^[16] The recommendation was to wean off the coffee and start a magnesium supplement ‒ one of my go-tos for migraines ‒ and within a few weeks, her migraines, insomnia, bladder, and anxiety issues had resolved.

But it’s not just coffee ‒ the caffeine in green tea, matcha tea, black tea, soda, and yerba mate can produce the same symptoms. Interestingly, you may find that you have a different tolerance for various caffeine-containing substances. In addition to the varied amount of caffeine in such substances, the other compounds found in these substances tend to affect how a person reacts to the caffeine. I have some clients that get panic attacks from green tea, coffee, and matcha, but tolerate black tea and yerba mate. Others can drink coffee but get anxious from black tea.

If you love coffee, but have had an adverse reaction to the caffeine, trying decaf coffee may be an option. (Public Service Announcement: Never stop caffeine cold turkey! #thingsIlearnedthehardway)

Another option is to change how the caffeine is absorbed in your body. The anxiety produced by caffeine is often due to spikes in caffeine levels all at once, followed by a crash when all of the caffeine is dumped out. Drinking your caffeine with fat, à la “Bulletproof Coffee,” is a way to smooth out and extend the absorption of caffeine in the body.

If you’re not dairy-sensitive, you can try Dave Asprey’s original Bulletproof coffee recipe, using grass-fed butter as your fat. Please note that butter still contains dairy proteins, and some people may still react to tiny amounts of dairy proteins from grass-fed butter, cream, and even ghee. (Clarified ghee is the least likely option to be reactive, as the milk solids and dairy proteins have been removed.)

If you happen to be dairy-sensitive like 80 percent of my Hashimoto’s patients, there’s still a way to make caffeine absorption smoother, with different fats. You can use coconut milk, coconut oil, or Bulletproof MCT oil, and not just in coffee ‒ all of these can be used in tea as well.

A special note: start low and go slow with adding fat into your caffeine ‒ too much fat, too fast, can produce a side effect known as “disaster pants,” as coined by Dave Asprey. 🙂

The Bottom Line:

• You do not need to avoid coffee long-term if you have Hashimoto’s or thyroid disease; however, you may benefit from limiting/eliminating caffeine or adding fat to your caffeine if you have anxiety, insomnia, urinary frequency, or migraines.
• You may want to avoid all stimulants, including caffeine, if you have hyperthyroidism.
• Decaf coffee may be an option if you love the taste but don’t tolerate the caffeine.

3. Does Coffee Cross-React with Gluten?

There’s some potential for coffee to cross-react to gluten, but there’s a caveat ‒ it’s not likely to be because of the coffee, per se, rather it’s because the coffee may be contaminated with gluten.

In their groundbreaking 2013 study “Cross-Reaction between Gliadin and Different Food and Tissue Antigens,” Aristo Vojdani and Igor Tarash found that instant coffee had a 23 percent cross-reactivity with gluten, while instant café latte created an 82 percent cross-reaction with gluten. ^[17] (The higher the percent of reactivity, the stronger the gluten cross-reaction to the product.) The researchers determined that some of the “reactivity” in instant café latte could have been produced by the dairy proteins in the latte. Dairy protein is a known, highly cross-reactive food for gluten, and according to my survey of 2,232 people with Hashimoto’s, 79 percent of people with Hashimoto’s feel better dairy free as well.

In contrast, fresh espresso made from coffee beans did not produce any gluten reactions. Coffee powder, pure cocoa, and milk-free dark chocolate did not produce a cross-reaction to gluten either.

The Bottom Line:

If you have Hashimoto’s, celiac disease and/or are gluten-sensitive, you should avoid instant coffee, which may be contaminated with traces of gluten. However, drinking pure coffee is likely safe for individuals with gluten sensitivity and celiac disease, as long as you don’t have other types of reactions to it.

4. Does Coffee Contain Mold and Toxins?

There is some evidence that some brands of coffee may contain mold, which can be an issue for autoimmune and thyroid diseases, as well as those with mold sensitivities. (Learn more about mold as a potential trigger of Hashimoto’s here.) ^[18] In fact, one particular mycotoxin (a toxic metabolite of mold), ochratoxin A (OTA), is found in low levels in most coffee samples. ^[19] One study showed that out of 50 coffee samples, all of them were contaminated with OTA, and 40 percent of the samples had more than standard levels (2 μg/kg). ^[20] Ochratoxin A has previously been associated with kidney disease and tumors of the urethra in humans. ^[21] It has also been associated with cancer, brain damage, and hypertension, and can have immunosuppressive effects. ^[22]

Coffee, especially instant varieties, can also contain toxins like acrylamide. ^[23] Most people with Hashimoto’s have an overburdened liver and an impaired ability to eliminate toxins, which is why my healing protocol always begins with liver support and eliminating toxins. ^[24] Our food, water, personal care products (the list goes on!) assault our bodies with harmful toxins on a daily basis, so adding to that burden with contaminated coffee will only exacerbate the problem.

That said, there are brands out there that claim to be free of such toxins. Two of my favorites are Bulletproof Coffee and Danger Coffee. Both of these brands were developed by Dave Asprey, a Hashimoto’s patient who has made sure his coffee is free of gluten, mold, and toxins.

Danger is Dave’s newer patent-pending coffee. While regular coffee can deplete nutrients and dehydrate us, Danger is designed to remineralize your body with over 50 trace minerals, nutrients, and electrolytes. (If you want to give Danger Coffee a try, use code IZABELLA10 for 10% off at checkout!)

Four Sigmatic offers yet another option for coffee with a line of mushroom coffees. Their mushroom coffees combine 100 percent Arabica organic coffee with a variety of immunity-supporting mushrooms, including Reishi, to boost Secretory IgA levels (the respiratory and GI tracts’ first line of defense). ^[25]

Full disclosure ‒ Dave has sent me some of his coffee for Christmas in the past, but that’s not why I’m recommending his coffee. I also buy it myself when he forgets to send me free samples.

The Bottom Line:

Certain brands of coffee may contain mold, while instant coffee is likely to contain toxins that are harmful to thyroid health. Look for coffee varieties that have been tested for mold and toxins.

5. Do I Need to Quit Coffee to Heal My Adrenals?

One of the fastest ways to get into adrenal fatigue is through sleep deprivation… and one of the most helpful interventions to get out of adrenal fatigue is to get plenty of rest!

Caffeine in coffee and tea can prevent us from resting when we should be, and this can put our bodies in a fight-or-flight mode instead of a rest-and-digest setting. This can be counterintuitive, as we want to give the adrenals every opportunity to heal. Furthermore, a high intake of caffeine can impact cortisol levels. ^[26]

If you can’t function without caffeine, and are drinking multiple cups a day just to stay awake, this could be a sign that your adrenals are compromised and that you may benefit from weaning off and rebalancing to a healthier level.

But before you quit coffee cold turkey and hate me for the withdrawal you experience, without a notable boost in energy, I want to share something…

I used to think that people had adrenal issues because they were overusing caffeine, but I’ve come to realize that caffeine addiction is a symptom of adrenal dysfunction, and not necessarily the root cause.

I used to recommend quitting caffeine for one month, as part of an adrenal healing protocol… but then I realized that asking people who are already exhausted to quit caffeine, without providing them with the tools to support their energy, can lead to an exacerbation of adrenal symptoms, and can lead to even the most committed people “falling off the wagon” when trying to follow a protocol.

I developed the Adrenal Transformation Protocol to rebalance the adrenals by giving the body what it needs to build up energy levels first, so that within a few short weeks, you’ll likely find yourself naturally less dependent on caffeine, and you can wean off if you choose to!

Something quick that you can implement in your morning routine right away, is delaying your first cup of caffeine by 15-45 minutes in the morning (this will allow your adrenals to start rebalancing themselves in the morning), and moving your last intake of caffeine to earlier in the day, to allow for more restful sleep (general guidelines are no caffeine after 3pm with a 9 or 10pm bedtime).

To be clear, simply excluding caffeine won’t heal our adrenals in most cases, and we often need to repopulate our body with safety signals of rest, energy creation and emotional balance to restore the health of our adrenals by incorporating energy-producing foods, supplements and activities.

In addition to resting, I recommend relaxing and engaging in pleasurable activities like yoga, baths, creating art, and enjoying time in nature (whatever floats your boat!).

Make sure to nourish your body with food and nutrients (like magnesium, the B vitamins, vitamin C, and electrolytes), balance your blood sugar, and consider taking adaptogens.

Over the years, I’ve experienced my fair share of challenges with my adrenals, and so have my readers. Through thousands of hours of research and experimenting, I’ve discovered the best ways to support your adrenals and reverse symptoms, so you can get your life back. This is what led me to write my newest book, Adrenal Transformation Protocol. It outlines a targeted, yet simple 4-week program designed to help you balance your stress response, build up your resilience, and set you up with a foundation to stay strong and healthy through life’s turbulence.

The Bottom Line:

You do not have to completely avoid caffeine when working to heal your adrenals. As you build your energy back up, you will likely become less dependent on caffeine.

6. Can Coffee Contribute to Estrogen Dominance?

Hormone imbalances can contribute to Hashimoto’s (I go in depth on this topic in my book, Hashimoto’s: The Root Cause). A 2015 study on women with polycystic ovarian syndrome (PCOS) showed more Hashimoto’s thyroiditis, elevated thyroid stimulating hormone (TSH) and elevated thyroid antibodies, in the study participants with higher estrogen levels. ^[27] Estrogen dominance can happen when either estrogen levels in the body are too high, or progesterone levels are too low, so the ratio of estrogen to progesterone is high.

Here is where coffee comes into the equation. Caffeine can impact the adrenals and over time cause them to become weakened. ^[28] When the adrenals are weak, they tend to make less progesterone in favor of cortisol. This often leads to low levels of progesterone, which can lead to estrogen dominance. ^[29]

This can cause a dysregulated feedback loop since excess estrogen impacts both adrenal and thyroid function. When these two organs are weakened, it makes the estrogen dominance even worse.

In addition to the connection between estrogen and the adrenals, coffee itself can be an issue if you have estrogen dominance. A 2012 study that examined the impact of caffeine consumption on estrogen levels in black, white, and Asian women, found that 200 milligrams (about 2 cups of coffee) impacted estrogen levels. ^[30] Asian women had elevated estrogen levels. Black women also had elevated estrogen levels, but this wasn’t statistically significant; and white women actually saw slightly lower levels of estrogen. The study determined that, overall, caffeine consumption among women of child-bearing age can affect estrogen levels, and should be taken into account when considering estrogen-related disorders (like endometriosis, osteoporosis, and certain cancers).

Women who are in perimenopause, menopause, or other progesterone-deficient states, may want to consider how much caffeine they’re consuming, since this can lead to higher estrogen levels in relation to progesterone.

Additionally, estrogen increases thyroxine binding globulin and the need for thyroid hormone in women. ^[31]

If you are experiencing symptoms of estrogen dominance or know that your estrogen levels are high, it very well might be worth experimenting with reducing or eliminating caffeine. In fact, getting off coffee is one of the most helpful interventions for women with estrogen dominance, according to one of my besties, Magdalena Wszelaki, who happens to be the author of Overcoming Estrogen Dominance. Doing so can help lower cortisol levels, aid with balancing the adrenals, and improve one’s estrogen to progesterone ratio.

The Bottom Line:

If you know or suspect that you’re experiencing estrogen dominance, try cutting out caffeine (especially coffee) to see if you notice any symptom improvements.

7. What’s the Best Way to Cut Out Coffee, and Are There Any Alternatives That You Recommend?

Due to the possibility of experiencing serious withdrawal symptoms (which may especially be possible if you’ve been drinking a lot of coffee and for a long time), I do not recommend going “cold turkey.” Symptoms of caffeine withdrawal include headaches, nausea, irritability, diarrhea and even vomiting, and may be more pronounced if you eliminate caffeine quickly.^[32]

Instead, I recommend the 25 percent reduction method, over a period of four weeks. I have shared the method in my Adrenal Transformation Protocol book after it helped numerous participants of my popular Adrenal Transformation Program (an online group coaching program for adrenal health)! I also decided to include it for you in this article. I hope it helps. 🙂

The 25 Percent Reduction Method:

• Week 1 – reduce your regular caffeine intake by 25 percent, for one week
• Week 2 – reduce your regular caffeine intake by 50 percent, for one week
• Week 3 – reduce your regular caffeine intake by 75 percent, for one week
• Week 4 – reduce your regular caffeine intake by 100 percent

Please note: You still may get withdrawal headaches. I have found that magnesium supplements, Epsom salt baths, hot lemon water, and herbal coffee substitutes can help in the transition period.

Instead of caffeine, you may consider trying the following:

• Hot lemon water first thing in the morning and throughout the day, will wake you up better than any tea or coffee. It will also help support your stomach acid and your liver’s detox pathways. ^[33]
• Green juice will give you plenty of nutrients and energy in a broken-down, usable form. ^[34]
• Herbal teas and decaf coffee can be another option.
• Dandy Blend is a gluten-free herbal mix that tastes like coffee. (Note: While it does contain barley, the water extracts of it are gluten-free.)
• Rasa’s adaptogenic coffee alternative blends are packed with great-tasting herbs that provide lasting energy to nourish your adrenals, rather than tax them. They contain no common allergens — just organic, sustainable herbs — and they even have an Autoimmune Paleo option.
• MUD\WTR is a mushroom coffee alternative that contains a variety of mushrooms known for their health-boosting properties, and it has a delightful chai flavor.
• Four Sigmatic Mushroom Hot Cacao is a caffeine-free combination of mushrooms and antioxidant-rich raw chocolate.
• Pique Tea Crystals provide clean, sustained energy and six times the antioxidants of regular tea bags. They have some tasty, caffeine-free herbal options. Plus, their Reishi Calm Elixir provides Secretory IgA support, which may help boost your immune system’s defenses. ^[35]
• Spa water, which can be made by adding cut up cucumbers, strawberries, lemons, and/or limes to a pitcher of purified water, is a fun way to quench your thirst.

The Bottom Line:

• If you’re going to quit caffeine, don’t do it cold turkey! Use the 25 percent method I outlined above.
• There are lots of different alternatives to coffee and caffeine in the morning. Try a few to find your favorite!

8. Is Coffee Autoimmune Paleo-Friendly?

The coffee bean is technically a seed, so even decaf is off the menu with the Autoimmune Paleo (AIP) diet. That said, the Autoimmune Paleo diet is meant to be an elimination diet where you discover your reactive foods and allow your body a break from too many difficult-to-digest proteins, as you work on a comprehensive plan to heal your body.

The Autoimmune Paleo diet is meant to be used for 4-12 weeks, and is not meant to be a lifelong diet. Seeds are some of the least reactive foods in Hashimoto’s, so most people are able to reintroduce coffee successfully. That said, if you happen to be sensitive or allergic to coffee, you will want to exclude it long-term.

In my experience, for most people, dietary interventions can produce a tremendous amount of improvement, but do not heal all. We may also need to look at using protocols to address infections and toxins, such as herbal and supplement-based interventions, and even mind-body interventions!

I have a blog post on the Autoimmune Paleo diet that you can read for more information, and you can learn about the other synergistic protocols in Hashimoto’s Protocol if you feel stuck with just diet alone.

The Bottom Line:

As a seed, coffee is off the menu of the Autoimmune Paleo diet, but keep in mind that the Autoimmune Paleo diet is a short-term protocol, not a lifelong diet!

9. Do You Drink Caffeine, Dr. Wentz?

My readers often wonder what life looks like for me today, knowing that I have tried and recommended a lot of interventions, that I am living symptom-free with my Hashimoto’s in remission, and that I’m feeling healthy and happy on most days.

I grew up drinking caffeine. Children in Poland are given black tea in their bottles! My kindergarten breakfast consisted of coffee and bread. I fueled myself on soda during college and pharmacy school; and by my mid-twenties, I had a heavy duty caffeine addiction, drinking six to eight cups of black tea per day ‒ which led to anxiety, palpitations, and being an extremely light sleeper. Thanks to pharmacy school, I learned that soda was bad, so I quit soda, but I kid you not ‒ I used to drink black tea at bedtime until I was 28, and had no idea what it was like to sleep soundly until I moved my caffeine to earlier in the day, after my first consult with an integrative doctor who made this “crazy” suggestion to me.

I had to wean off caffeine completely during my healing journey, and stayed off of it for as long as eight months in 2012. Weaning off and even cutting back dramatically, changed my anxiety and sleep!

Since that time, I’ve mostly been able to balance my caffeine intake, but I did have a few relapses of drinking four to eight cups per day because of documentary and book deadlines. (I hope you loved The Thyroid Secret and Hashimoto’s Protocol – a lot of love, blood, sweat, tears, and late nights went into creating both of them! ❤️)

Although caffeine made me feel like Superwoman, I certainly was not. The combined stress, lack of sleep, and caffeine overload led to my own adrenals becoming compromised, and I had to wean off the caffeine and follow my original intensive adrenal-healing plan to recover (I slept for 12+ hours, for 30 days straight!).

My adrenals rebalanced after that, but I had to cancel and say no to a lot of commitments, to properly heal them! I would drink one to two cups of tea on a daily basis, and that amount kept me balanced and did not interfere with my health, until I had my son and became a sleep-deprived new mom!

My coffee consumption started four months into my son’s four-month sleep regression… For those of you without kids, the four-month sleep regression is when babies, even ones that started off sleeping well, start waking up every 1-2 hours, all night long! This regression can last anywhere from a few days to a few years — in our case, Dimitry didn’t sleep through the night until he was almost three, and by the time he was eight months old, I was completely exhausted and burned out.

After Dimitry’s sleep regression, I began to regularly drink coffee for the first time in my life. During those sleep-deprived “mama of a young child” days, I would drink one to two Bulletproof coffee almond lattes daily, and one to two cups of tea most days, to keep up with my toddler… because I was the one that woke up with him during the night.

My adrenals were flatlined, and I knew I had to find a more approachable way to heal them as a new mom. There was no way I was going to be able to cut out caffeine and sleep 12 hours a night! I also didn’t want to risk it with taking too many supplements, due to nursing.

So I found other ways to create energy and balance in my life. 🙂 My Hashimoto’s still stayed in remission, and the methods I used turned into an online program that has served thousands. They are now available in my new book, Adrenal Transformation Protocol.

I did have a strange flare-up in 2020 that caused me to have frequent, heavy periods, while I was still nursing my son. My bestie Magdalena Wszelaki, the queen of all things estrogen dominance, thought that too much caffeine could be contributing, and encouraged me to cut down on coffee.

I ended up weaning my son, trying progesterone, taking BeeYa Hormone Balancing Seeds, then cutting down my caffeine intake to one to two cups of black tea… and sure enough, this had helped to normalize my periods! Additionally, I have found Vitex and P5P helpful (more about that in my libido post). For a few scary months, my cycles were only 14 days long, but thankfully now they are back to being 27-28 days long like before.

Now that my beautiful boy sleeps a beautiful 11-12 hours each night, I sleep too, and don’t need coffee. 🙂

These days, I stick to black tea or yerba mate, no more than two cups per day, and before 3pm ‒ otherwise, caffeine affects my sleep. If my son is sick and I need to care for him (which often means throughout the night), I will drink a coffee on those days as well, and I enjoy it too. 🙂

The Bottom Line:

I do drink a limited amount of caffeine without feeling like it has a negative impact on my health, but I don’t drink too much of it ‒ if I drink too much, my adrenals get too stressed, and I start thinking I am Superwoman. Furthermore, after age 38, my hormones seemed not to like too much caffeine either. 🙂

The Takeaway

Coffee (and caffeine) consumption can work well when used in moderation for some people with Hashimoto’s, while others may need to avoid it. Like so many things in life, there is no one-size-fits-all approach, and you will need to determine what level of caffeine supports your own health goals.

If you are taking thyroid medications, you will want to make sure you wait at least 30-60 minutes before consuming your first cup of coffee, to make sure your thyroid meds are fully absorbed. The exceptions to this may be those people taking Tirosint or naturally desiccated thyroid medications.

If you are sensitive to gluten, you will also want to avoid instant coffee, which may cross-react with gluten. Knowing the source of your coffee can help you avoid mold and other contaminants, while those with adrenal issues ‒ which is many of us with Hashimoto’s ‒ will want to consider weaning from, or even eliminating, caffeine for a period of time, until the adrenals are healed.

Additionally, if you are on an AIP diet, you will need to avoid coffee for the duration of the diet, to determine if you are sensitive to it or not.

I hope this answers your questions about coffee and Hashimoto’s! I provide you with a lot more information on caffeine and healing the adrenals in Adrenal Transformation Protocol. If you have any other questions for me, please drop them below!

As always, I wish you only the best on your journey to health!

P.S. I love interacting with my readers on social media, and I encourage you to join my Facebook, Instagram, TikTok, and Pinterest community pages to stay on top of thyroid health updates and meet others who are following similar health journeys. For recipes, a FREE Thyroid Diet start guide, and notifications about upcoming events, be sure to sign up for my email list!

References

^[1] Benvenga S, Bartolone L, Pappalardo MA, et al. Altered intestinal absorption of L-thyroxine caused by coffee. Thyroid. 2008;18(3):293-301. doi:10.1089/thy.2007.0222
^[2] Benvenga S, Bartolone L, Pappalardo MA, et al. Altered intestinal absorption of L-thyroxine caused by coffee. Thyroid. 2008;18(3):293-301. doi:10.1089/thy.2007.0222
^[3] Wiesner A, Gajewska D, Paśko P. Levothyroxine Interactions with Food and Dietary Supplements-A Systematic Review. Pharmaceuticals (Basel). 2021 Mar 2;14(3):206. doi: 10.3390/ph14030206. PMID: 33801406; PMCID: PMC8002057.; Managing hypothyroidism: Myths vs. facts. Myths & Facts. https://www.synthroid.com/smart/synthroid-myths-and-facts. Accessed August 11, 2022.
^[4] Seechurn S, Sharma S, Oyibo S. Administration of Levothyroxine 45 – 60 minutes before breakfast improves biochemical availability as evidenced by reduced thyrotropin levels. Open Journal of Endocrine and Metabolic Diseases. https://www.scirp.org/journal/paperinformation.aspx?paperid=21496. Published August 2, 2012. Accessed August 10, 2022.; Benvenga S, Bartolone L, Squadrito S, Lo Giudice F, Trimarchi F. Delayed intestinal absorption of levothyroxine. Thyroid. 1995;5(4):249-253. doi:10.1089/thy.1995.5.249
^[5] Benvenga S, Bartolone L, Pappalardo MA, et al. Altered intestinal absorption of L-thyroxine caused by coffee. Thyroid. 2008;18(3):293-301. doi:10.1089/thy.2007.0222
^[6] Benvenga S, Bartolone L, Pappalardo MA, et al. Altered intestinal absorption of L-thyroxine caused by coffee. Thyroid. 2008;18(3):293-301. doi:10.1089/thy.2007.0222
^[7] Bernareggi A, Grata E, Pinorini MT, Conti A. Oral liquid formulation of levothyroxine is stable in breakfast beverages and may improve thyroid patient compliance. Pharmaceutics. 2013;5(4):621-633. Published 2013 Dec 13. doi:10.3390/pharmaceutics5040621
^[8] Fallahi P, Ferrari SM, Materazzi G, et al. Oral L-thyroxine liquid versus tablet in patients submitted to total thyroidectomy for thyroid cancer (without malabsorption): A prospective study. Laryngoscope Investig Otolaryngol. 2018;3(5):405-408. Published 2018 Oct 3. doi:10.1002/lio2.186; Vita R, Fallahi P, Antonelli A, Benvenga S. The administration of L-thyroxine as soft gel capsule or liquid solution. Expert Opin Drug Deliv. 2014;11(7):1103-1111. doi:10.1517/17425247.2014.918101; Vita R, Saraceno G, Trimarchi F, Benvenga S. A novel formulation of L-thyroxine (L-T4) reduces the problem of L-T4 malabsorption by coffee observed with traditional tablet formulations. Endocrine. 2013;43(1):154-160. doi:10.1007/s12020-012-9772-2
^[9] Bernareggi A, Grata E, Pinorini MT, Conti A. Oral liquid formulation of levothyroxine is stable in breakfast beverages and may improve thyroid patient compliance. Pharmaceutics. 2013;5(4):621-633. Published 2013 Dec 13. doi:10.3390/pharmaceutics5040621
^[10] Linos A, Linos DA, Vgotza N, Souvatzoglou A, Koutras DA. Does coffee consumption protect against thyroid disease?. Acta Chir Scand. 1989;155(6-7):317-320.
^[11] Han MA, Kim JH. Coffee Consumption and the Risk of Thyroid Cancer: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2017;14(2):129. Published 2017 Jan 27. doi:10.3390/ijerph14020129
^[12] Spindel ER, Wurtman RJ, McCall A, et al. Neuroendocrine effects of caffeine in normal subjects. Clin Pharmacol Ther. 1984;36(3):402-407. doi:10.1038/clpt.1984.195; Clozel M, Branchaud C, Tannenbaum G, Dussault J, Aranda J. Effect of caffeine on thyroid and pituitary function in newborn rats. Pediatric research. 1983;17(7):592-595. doi:10.1203/00006450-198307000-00015
^[13] Spindel E. Action of the methylxanthines on the pituitary and pituitary-dependent hormones. Prog Clin Biol Res. 1984;158:355-363.
^[14] Geethavani G, Rameswarudu M, Rameshwari Reddy R. Effect of Caffeine on Heart Rate and Blood Pressure. International Journal of Scientific and Research Publications. 2014;4(2). https://www.ijsrp.org/research-paper-0214/ijsrp-p2637.pdf. Accessed August 10, 2022.; Acheson KJ, Zahorska-Markiewicz B, Pittet P, Anantharaman K, Jéquier E. Caffeine and coffee: their influence on metabolic rate and substrate utilization in normal weight and obese individuals. Am J Clin Nutr. 1980;33(5):989-997. doi:10.1093/ajcn/33.5.989; O’Callaghan F, Muurlink O, Reid N. Effects of caffeine on sleep quality and daytime functioning. Risk Manag Healthc Policy. 2018;11:263-271. Published 2018 Dec 7. doi:10.2147/RMHP.S156404; Lovallo WR, Farag NH, Vincent AS, Thomas TL, Wilson MF. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacol Biochem Behav. 2006;83(3):441-447. doi:10.1016/j.pbb.2006.03.005; Rybak ME, Sternberg MR, Pao CI, Ahluwalia N, Pfeiffer CM. Urine excretion of caffeine and select caffeine metabolites is common in the U.S. population and associated with caffeine intake. J Nutr. 2015;145(4):766-774. doi:10.3945/jn.114.205476
^[15] Osuna PM, Udovcic M, Sharma MD. Hyperthyroidism and the Heart. Methodist Debakey Cardiovasc J. 2017;13(2):60-63. doi:10.14797/mdcj-13-2-60
^[16] Bergman EA, Massey LK, Wise KJ, Sherrard DJ. Effects of dietary caffeine on renal handling of minerals in adult women. Life Sci. 1990;47(6):557-564. doi:10.1016/0024-3205(90)90616-y
^[17] Vojdani A, Tarash I. Cross-Reaction between Gliadin and Different Food and Tissue Antigens. Food and Nutrition Sciences. 2013;4:20-32. doi:10.4236/fns.2013.41005
^[18] Balendres MAO, Karlovsky P, Cumagun CJR. Mycotoxigenic Fungi and Mycotoxins in Agricultural Crop Commodities in the Philippines: A Review. Foods. 2019;8(7):249. Published 2019 Jul 8. doi:10.3390/foods8070249; Agriopoulou S, Stamatelopoulou E, Varzakas T. Advances in Occurrence, Importance, and Mycotoxin Control Strategies: Prevention and Detoxification in Foods. Foods. 2020;9(2):137. Published 2020 Jan 28. doi:10.3390/foods9020137
^[19] Mislivec PB, Bruce VR, Gibson R. Incidence of Toxigenic and Other Molds in Green Coffee Beans. J Food Prot. 1983;46(11):969-973. doi:10.4315/0362-028X-46.11.969; Tozlovanu M, Pfohl-Leszkowicz A. Ochratoxin A in roasted coffee from French supermarkets and transfer in coffee beverages: comparison of analysis methods. Toxins (Basel). 2010;2(8):1928-1942. doi:10.3390/toxins2081928
^[20] Pakshir K, Dehghani A, Nouraei H, Zareshahrabadi Z, Zomorodian K. Evaluation of fungal contamination and ochratoxin A detection in different types of coffee by HPLC-based method. J Clin Lab Anal. 2021;35(11):e24001. doi:10.1002/jcla.24001
^[21] Malir F, Ostry V, Pfohl-Leszkowicz A, Malir J, Toman J. Ochratoxin A: 50 Years of Research. Toxins (Basel). 2016;8(7):191. Published 2016 Jul 4. doi:10.3390/toxins8070191
^[22] Malir F, Ostry V, Pfohl-Leszkowicz A, Malir J, Toman J. Ochratoxin A: 50 Years of Research. Toxins (Basel). 2016;8(7):191. Published 2016 Jul 4. doi:10.3390/toxins8070191; Bui-Klimke TR, Wu F. Ochratoxin A and human health risk: a review of the evidence. Crit Rev Food Sci Nutr. 2015;55(13):1860-1869. doi:10.1080/10408398.2012.724480; Bhat PV, Pandareesh, Khanum F, Tamatam A. Cytotoxic Effects of Ochratoxin A in Neuro-2a Cells: Role of Oxidative Stress Evidenced by N-acetylcysteine. Front Microbiol. 2016;7:1142. Published 2016 Aug 2. doi:10.3389/fmicb.2016.01142
^[23] Mojska H, Gielecińska I. Studies of acrylamide level in coffee and coffee substitutes: influence of raw material and manufacturing conditions. Rocz Panstw Zakl Hig. 2013;64(3):173-181.
^[24] Malik R, Hodgson H. The relationship between the thyroid gland and the liver. QJM. 2002;95(9):559-569. doi:10.1093/qjmed/95.9.559; Piantanida E, Ippolito S, Gallo D, et al. The interplay between thyroid and liver: implications for clinical practice. J Endocrinol Invest. 2020;43(7):885-899. doi:10.1007/s40618-020-01208-6
^[25] Kubota A, Kobayashi M, Sarashina S, et al. Reishi mushroom Ganoderma lucidum Modulates IgA production and alpha-defensin expression in the rat small intestine. J Ethnopharmacol. 2018;214:240-243. doi:10.1016/j.jep.2017.12.010
^[26] Lovallo WR, Farag NH, Vincent AS, Thomas TL, Wilson MF. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacol Biochem Behav. 2006;83(3):441-447. doi:10.1016/j.pbb.2006.03.005
^[27] Arduc A, Aycicek Dogan B, Bilmez S, et al. High prevalence of Hashimoto’s thyroiditis in patients with polycystic ovary syndrome: does the imbalance between estradiol and progesterone play a role?. Endocr Res. 2015;40(4):204-210.
^[28] Lovallo WR, Farag NH, Vincent AS, Thomas TL, Wilson MF. Cortisol responses to mental stress, exercise, and meals following caffeine intake in men and women. Pharmacol Biochem Behav. 2006;83(3):441-447. doi:10.1016/j.pbb.2006.03.005
^[29] Lam M. In-depth article on hormone imbalance symptoms and the Oat Axis. Dr. Lam Coaching – World Renowned Authority on Adrenal Fatigue Recovery. https://www.drlamcoaching.com/articles/hormone- imbalance-symptoms-and-the-oat-axis/. Accessed August 12, 2022.
^[30] NIH study shows caffeine consumption linked to estrogen changes. National Institutes of Health. https://www.nih.gov/news-events/news-releases/nih-study-shows-caffeine-consumption-linked-estrogen-changes. Published July 26, 2015. Accessed November 4, 2022.
^[31] Ben-Rafael Z, Struass JF 3rd, Arendash-Durand B, Mastroianni L Jr, Flickinger GL. Changes in thyroid function tests and sex hormone binding globulin associated with treatment by gonadotropin. Fertil Steril. 1987;48(2):318-320. doi:10.1016/s0015-0282(16)59363-7
^[32] Juliano LM, Griffiths RR. A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features. Psychopharmacology (Berl). 2004;176(1):1-29. doi:10.1007/s00213-004-2000-x
^[33] Zhou T, Zhang YJ, Xu DP, et al. Protective Effects of Lemon Juice on Alcohol-Induced Liver Injury in Mice. Biomed Res Int. 2017;2017:7463571. doi:10.1155/2017/7463571
^[34] Zheng J, Zhou Y, Li S, et al. Effects and Mechanisms of Fruit and Vegetable Juices on Cardiovascular Diseases. Int J Mol Sci. 2017;18(3):555. Published 2017 Mar 4. doi:10.3390/ijms18030555
^[35] Kubota A, Kobayashi M, Sarashina S, et al. Reishi mushroom Ganoderma lucidum Modulates IgA production and alpha-defensin expression in the rat small intestine. J Ethnopharmacol. 2018; 214:240-243. doi:10.1016/j.jep.2017.12.010

Note: Originally published in December 2017, this article has been revised and updated for accuracy and thoroughness.