Dr. Izabella Wentz, PharmD

Thyroid Pharmacist

Is Your Medication Gluten Free

Is Your Medication Gluten Free?

Medically reviewed and written by Izabella Wentz, PharmD, FASCP

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The benefits of following a gluten-free diet with Hashimoto’s have been well described.

Many people have taken the plunge of going gluten free and are carefully checking labels to ensure that their foods do not contain any gluten ingredients, but gluten can also be found in medications and can sabotage your healing.

There are no current laws that require medication manufacturers to specify if their products contain gluten. Many progressive manufacturers have started labeling their products, but not all. This is why we need to do our research.

Some labels may list ingredients like wheat, gluten, barley, etc. on the actual label which are obvious, but others may not list any of the above and may have “hidden” sources of gluten.

Medication and Supplement Ingredients That Could Contain Gluten

  • Starch, or Pregelatinized starch, or sodium starch glycolate – Can be derived from potato, corn, tapioca or wheat
  • Dextrate – Can be derived from potato, corn, tapioca or wheat
  • Dextrin – Can be derived from potato, corn, tapioca or wheat
  • Dextr-Maltose – A sugar that may be obtained from barley malt
  • Maltodextrin – A starch that can be derived from potato, corn, tapioca or wheat
  • Sodium Starch Glycolate – A starch that is usually derived from potato, but may come from any starch source
  • Caramel Coloring – Barley malt may be used in its production

Check Your Medicine Cabinet

Although I avoid Advil due to its propensity to contribute to intestinal damage, I used it this past winter when I came down with the flu, and none of my other remedies worked.

The last time I needed to use Advil was before I went gluten free, so I was surprised to have discovered that there are multiple formulations of Advil with gluten in them! Specifically, Advil Liqui-Gels, Advil Menstrual, Advil Migraine, and any Advil product with a film coating contains gluten.

Additionally, I’ve also cut soy out of my diet and was surprised to find Advil along with many ibuprofen and acetaminophen products contain soy in the form of vegetable fat, stearic acid, and magnesium stearate.  Highly refined soybean oil is used.

Beware, as many labels do not specify whether a product is gluten/soy/dairy free.  Many times the information is not included in the ingredients section.  Usually, there is a 1-800 number on the bottle. Give them a ring! Better safe than sorry…

Prescription Medications

Many prescription medications can also contain gluten. As most prescription medications are dispensed in pharmacy bottles, most of us do not get to scan the ingredient list.
Work with your pharmacist. He/She can provide you with the package insert that contains the list of ingredients, the manufacturer’s phone number, and if you are extra nice, the pharmacist may even call the manufacturer for you.

Luckily, most thyroid medications are gluten free, but we need to be careful with the various generic brands of levothyroxine (only 1 is gluten-free), as well as liothyronine.

Gluten-Free Thyroid Medications

  • Levothyroxine (Mylan brand only)
  • Nature-Throid
  • Tirosint
  • WP Thyroid (formerly Westhroid Pure)

The following medications do not have any gluten-containing ingredients, however, they are not tested for gluten content and cannot be certified as gluten-free:

  • Levothyroxine (Lannett brand)
  • Armour Thyroid*
  • Levoxyl
  • Synthroid
  • Cytomel

*Note: Armour does contain sodium starch glycolate, which can be derived from wheat or corn.

Some commonly used medications that contain gluten include the following:

  • Ambien CR (sleep aid)
  • Amitiza (constipation)
  • Trivora-28 (birth control)
  • Maxalt MLT (migraines medication)
  • Fosamax D (osteoporosis)

I also recommend the following website as a resource; it is managed by a clinical pharmacist and full of gluten-free medication resources:

http://www.glutenfreedrugs.com

However, as the pharmacist in charge of that website has thousands of drugs to track through calling the pharmaceutical companies, this source may not be updated as quickly.

Lifestyle interventions may be helpful for reducing or eliminating the need for some of these medications, but you should never stop medications with checking with your doctor first. Work with your pharmacist to find alternative medications.

To learn more about optimizing your thyroid medication, download my free eBook below!

Other Contaminants

Many people with Hashimoto’s are sensitive to multiple ingredients like dairy, soy, corn, eggs. Tirosint and Nature-Throid have the fewest additives as far as thyroid medications go. You can also work with a compounding pharmacist to have a special thyroid medication made for you without any ingredients that are going to sabotage your health.

Supplements

In addition to medications, supplements can also contain fillers that may be detrimental

I have a few supplements companies that I like to use…

Pure Encapsulations is a pharmaceutical grade brand that has extremely tight quality control and manufacturing guidelines. Each product undergoes rigorous testing by a third-party laboratory to verify label claims, potency, and purity. All the products sold by Pure Encapsulations are free of gluten, dairy, soy, additives that may impair absorption.

I wish you all the best in your healing journey!

PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free by going to www.thyroidpharmacist.com/gift. You will also receive occasional updates about new research, resources, giveaways and helpful information.

For future updates, make sure to follow us on Facebook!

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Disclaimer: The information contained herein is for informational purposes only and should not be construed as medical advice. Please consult your physician for any health problems and before making any medical or lifestyle changes.

Lifestyle changes can result in improved thyroid function and/or an increased absorption of thyroid hormone medications, leading to a lower required dose and possible symptoms of hyperthyroidism at a dose that was previously stable. Please discuss lifestyle changes with your physician and ensure that your thyroid function is monitored every 6-8 weeks while making lifestyle changes. Symptoms of overmedication include, but are not limited to: rapid or irregular heartbeat, nervousness, irritability or mood swings, muscle weakness or tremors, diarrhea, menstrual irregularities, hair loss, weight loss, insomnia, chest pain, and excessive sweating. Do not start, change, increase, decrease or discontinue your medications without consulting with your physician.

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Comments

  1. Hello, Dr. Wentz,
    I’ve only been on Synthroid. As a pharmacist, do you recommend changing brands or sticking with the “if it ain’t broke don’t fix it” concept? I’m a little apprehensive about changing anything. I don’t have celiac but I am sensitive to gluten and avoid it in my diet (I get respiratory symptoms and fatigue). Thanks! =)
    Reply

  2. Hi Michaela,
    My understanding is that gluten sensitivity is a spectrum and those with Celiac disease are the most sensitive. Cross contamination can be an issue for those with Celiac disease. Those with gluten intolerance have varying amounts of sensitivity and may not react to the small amounts that people with Celiac do.
    Synthroid does not have any gluten containing ingredients, rather the manufacturer may make other gluten containing products that may contaminate the Synthroid, therefore they can not guarantee that Synthoid is gluten free.
    In most cases, and especially for someone who is doing well on a medication, I would not switch because of gluten sensitivity and cross-contamination potential.
    If you had Celiac disease and were not getting better, that would be another story!
    Of course these are my general opinions from a pharmacology perspective, and should not substitute medical advice…
    Reply

  4. I had my thyroid removed completely due to cancer in September 2013. I am on Synthroid, brand nec, 175 mcg and I still do not have the right numbers. More recently my head has been itchy and tingling and my hair is falling out bad. I have started the gluten free, soy free and dairy free. While I am not sure if I feel any better, I am not able to lose weight or maintain energy. I am on vitamin supplements, but at this point it seems I should be getting better and not worse. My doctor just brushes it all off. Any suggestions?
    Reply

    • Izabella Wentz’s book, Root cause has many ideas of things to try. Suzy Cohenn’s book Thyroid Healthy, has many natural supplements that can be helpful. Having come through an incredible health journey myself, I would just encourage you to keep looking into this. Health (I found) is very complicated; one never knows when a profound breakthrough is right around the corner!

      Reply

  5. Hi Izabella,
    I have a question on the Advil, etc. For someone steering clear of so many medications due to autoimmune disease as well as food sensitivities, in the event of the flu or injury that might need some help to get through, what can we turn to that would be safe enough for our autoimmune condition as well as the common food sensitivities like soy, corn and other fillers that can cause problems? I would like to know that I have something hanging around that might be safe to use. Thank you and again for the wonderful job on this article and your blog! You are helping soooo many sufferers, I don’t think you have any idea! Thank you, Thank you! Maureen
    Reply

  6. Dr. Wentz,
    Even though this is an old post, I learned something very new today. Synthroid=Gluten. Man, more challenges and incentive to get off of it.
    You also mention that the “Country Life” brand is ” gluten-, diary-, soy-, corn-, yeast-, and sugar-free”. Please take a closer look. Some of their formulations appear to be Gluten free, some do contain Soy. On their website under “Commitments” you can read for yourself that they are working towards a goal but haven’t reached it yet:
    We at Country Life are committed to providing products that are non-GMO (not genetically modified). Within each category, we already have several non-GMO options. These products are marked NO GMOs” on the side of our labels. For the rest of our line, we are currently undergoing the process of reviewing every product we offer. Due to the fact we offer you over 600 products, with each containing as many as 30 ingredients to check, this intensive and comprehensive review is a very large undertaking. We are looking to complete our review within the next several years. Additionally, Country Life is working with the Non-GMO Project to define the industry standards for Non-GMO Products.
    Again, thanks for all you do and the inspiration you provide:
    Sincerely,
    Bob Pereira
    Reply

  7. As a celiac on Synthroid for years without problems, I recently learned the hard way that Synthroid is now cross contaminated with gluten even though the ingredients do not contain gluten. I became very sick after filling my last prescription and after investigation from a very helpful pharmacist, learned that the only current manufacturer of Synthroid (name brand) is Abbott and there is cross contamination. Lannett has a generic form of levothyroxine and all their products are gluten free so there is not a risk of cross contamination.
    If you are on Synthroid, beware of cross contamination.
    Reply

  9. Dear Dr. Wentz,
    Perhaps modify your above list of gluten-free thyroid meds? According to the website you suggested (glutenfreedrugs.com), Unithroid (Synthetic T4, Jerome Stevens Pharm, distributed by Lannett), is also gluten free. As for generics, I would suspect (but could not guarantee) that Lannett’s generic levothyroxine is also GF, as it is also made by JSP.
    Sincerely,
    Neil
    Reply

  10. Dear Dr. Wentz,
    Perhaps modify your above list of gluten-free thyroid meds? According to the website you suggested (glutenfreedrugs.com), Unithroid (Synthetic T4, Jerome Stevens Pharm, distributed by Lannett), is also gluten free. As for generics, I would suspect (but could not guarantee) that Lannett’s generic levothyroxine is also GF, as it is also made by JSP.
    Sincerely,
    Neil
    Reply

  11. Hi Dr. Wentz,
    I’m so happy I found this site! I have Celiac disease and am extremely sensitive to the slightest bit of gluten. I need to be taking 112 mcg of synthroid or another T4 medication, but can’t seem to find one that will ensure non-gluten ingredients. I’ve long suspected that my synthroid (sometimes I get generic) contains gluten, but can’t seem to find anyone to help me with this. I also take 5 mcg of cytomel. Does cytomel contain gluten? Please help me identify which T4 thyroid meds to take that are 100%, absolutely gluten free and how I can get them. It will change my life! Thank you!!! 🙂
    Best,
    Anette
    Reply

  12. Anette – I recently had to switch to a generic due to my insurance. I checked with my pharmacist to get the name of the manufacturer they used for their generic Cytomel (T3), looked on-line for the manufacturer’s email address for prescription questions and asked the manufacturer directly. I got an email back the same morning. I’d suggest you ask the manufacturer directly. I’d recently read Cytomel does have gluten in it, maybe they changed the formula? Otherwise, again I’d ask the manufacturer directly.
    Reply

  13. Hi Anette,
    I am having the same problem as you. I also have celiac and a total thyroidectomy in October 2013. Right now I a m on levothyroxine 100 (mylan) and I feel sick all the time. I just started to add the liothyronine 5 mg (mylan as well). I just read an article stating that Levoxyl is back on the market. I also heard it is better absorbed, therefore better for celiacs. I am awaiting a call from the pharmacist with more info on
    it…..hopefully it is gluten free!
    Best of luck and God bless you…..
    Jodi from NE Ohio
    Reply

  14. I found this thread very helpful, Thank you! BUT I noticed that you have Cytomel on the gluten free list. Not so. In contacting them their rep told me that they don’t give out info on the type of starch listed as an ingredient and that I should assume it is wheat starch. Hopefully the generic is better for Hashi patients.
    Reply

  16. My pharmacist told me that my levothyroxin tab by Mylan was gluten free. Do you feel this information is inaccurate? How can I double check?
    Reply

  17. Contact mylan almost all of my meds from mylan and they will confirm gluten free, also zygenics, apotox ( can’t remeber spelling) when I email them they usually call within 24 hours but these manufacturers seem to have a lot of if not all gluten free but please check with them
    Jessica
    Reply

  19. I too have celiac, and had a partial thyroidectomy. Before I even went for surgery ,my surgeon had all my meds compounding for me. As a person with celiac,I am true gluten free, no grains at all. I also have soy and dairy allergies. If you can contact a compounding company, your insurance will cover compounding medication because of allergies and sensitivities. I get my meds fed ex from a compounding company on Long Island. It was the best thing I ever did because I know my meds are all safe specifically for me.
    Reply

  20. Laurie, can you explain better about this company and the compounding, etc? I am celiac, newly diagnosed with thyroid issues (like I haven’t been complaining about it for years …) and I’m so nervous about meds. THANK YOU for any info.
    Reply

  21. Is Cytomel gluten free? I called Pfizer and they couldn’t confirm what ingredients were behind the starch (gluten, potato, corn etc)
    You mention it is listed as being gluten free but i’m not sure how long ago with was written as i know Cytomel got bought out. So my biggest concern is if they are just going to list starch and not stand behind what type of starch does that mean they can change the filler out as they want?
    Reply

  25. I take NP thyroid. I didn’t see it I your list. I really appreciate and enjoy your posts. Thank you!
    Reply

  27. I am on Liothyronine which is a T3 medication that you don’t mention. Do you know if this contains Gluten. I have been so much better without wheat and gluten in my diet.
    Reply

  28. I have just read Paul Robinson’s article on T3 only medication. I am taking this successfully too after decades of low functioning and a subsequent marriage failure too. When I took my health in my own hands as well this was when I began to recover well with all the nutrient support the thyroid needs. I did realise when I had a kind of anaphylactic shock attack after taking 3 doses of the smallest amount of Thyroxine 125mcgms, in the beginning, that it was my Adrenals that weren’t working and the hormone couldn’t be absorbed and was causing havoc in my bloodstream and I was in trouble. Your blog to some extent mirrors mine and I in great sympathy with you.
    Reply

  31. Hi Dr. Izabella,
    I’m wondering if the list medications containing gluten is updated? Specifically, Nature Throid and most recently NP Throid. What would you attribute many people with returning hypo symptoms with both medications? I was very successfully treated on Nature Throid for years. Then, due to returning hypo symptoms last year, switched to NP (also unsuccessfully tried Armour). Now with the new fillers in NP (company not admitting to the new fillers at this time) many people, including myself feel out of options. (NP looks, smells and tastes vastly different.) Is there anything you can suggest for us?
    Thank you

    Reply

  32. My dr. Changed my Synthroid from 50 mcg to 75mcg. I also take 15 mcg of liothorine T3. I was doing great until my Synthroid was raided to 75. Don’t understand. I’m tired costupated and not feeling well again. Not sure what to do. Any ideas?

    Reply

  33. Your article says Lannet brand of Levothyroxine is gluten free.
    And the Mylan brand is not.
    But when you go to gluten free medications link on your website it’s the opposite.

    Reply

  34. I have Celiac Disease and Graves Disease as well as many other autoimmune diseases (polymiositis, scleroderma, raynauds, etc). I am taking methimazole. I cant find anything that says this is gluten free and not on any gluten free lists. This could be why i have diahrea daily even after being gluten free for years! Is there another hyperthyroid med i can take instead of methimazole?

    Reply

    • Darcy – thank you for reaching out. ❤️ If you have concerns you could call the manufacturer or talk to your pharmacist. I recommend discussing possible medication changes with you practitioner.

      Reply

  35. Hi Dr. Wentz,

    I’ve been following your research for years and appreciate how you’ve helped me. Question for you… I have Grave’s Disease (radioactive iodine in 2007). My thyroid levels are off a good bit frequently. TSH and free T4 are usually normal, but T3, reverse and uptake are usually off. I currently take Tirosint 112mcg, but was wondering what your thoughts on combining Cytomel (T3) with this, or just taking Armour Thyroid since it contains T3/T4. I’d like to avoid gluten if at all possible!

    Thanks!
    Ben

    Reply

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