What lifestyle modifications should I advise to a patient diagnosed with hypothyroidism to improve their overall health?

When advising a patient diagnosed with hypothyroidism on lifestyle modifications to improve their overall health, focus on aspects that support their treatment and general well-being:

• Medication Adherence and Timing: Advise the patient to take their levothyroxine medication on an empty stomach in the morning, before other food or medication, to ensure optimal absorption ¹.
• Dietary and Supplement Interactions: Explain that certain foods and drinks, such as milk, coffee, grapefruit juice, soya products, and papaya, can impair the absorption of levothyroxine if taken simultaneously ¹. It is also important to advise leaving an interval of four hours between taking levothyroxine and other potentially interfering drugs, including multivitamins and other over-the-counter medications ¹. Additionally, inform them that high consumption of biotin from dietary supplements may lead to falsely high or low thyroid function test results ².
• Weight Management: Note that weight gain may increase levothyroxine requirements, implying that managing weight can be beneficial for treatment efficacy ¹.
• Information and Support: Offer advice on reliable sources of information and support, such as the British Thyroid Foundation leaflets ('Your guide to hypothyroidism' and 'Your guide to thyroid function tests') and the NHS information leaflet ('Underactive thyroid (hypothyroidism)') ¹. This empowers patients to understand and manage their condition.
• Symptom Expectations: Advise the patient that symptoms may lag behind treatment changes for several weeks or months ¹,². Reassure them that even if thyroid function tests are within the normal range, changes in levothyroxine therapy may improve symptoms for some people ¹,².
• Related Health Conditions: If the patient has a diagnosis of autoimmune thyroid disease, consider testing for coeliac disease, as this can impact overall health and potentially levothyroxine absorption ¹,².