Levothyroxine and Magnesium Glycinate, timing-sensitive.
Magnesium supplements, particularly magnesium oxide and magnesium hydroxide (antacid forms), can reduce levothyroxine absorption by forming chelate complexes or by raising gastric pH. The magnitude of the interaction is less than calcium or iron but still clinically relevant.
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At a glance
- Substances
- Levothyroxine and Magnesium Glycinate
- Pair type
- Timing Sensitive
- Evidence (highest tier)
- Moderate
- Source citations
- 5 sources
- Stack Score effect
- −5 to your Stack Score (per scored timing-sensitive row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Timing Sensitive · Moderate evidence
Timing Sensitive
What is happening. Magnesium supplements, particularly magnesium oxide and magnesium hydroxide (antacid forms), can reduce levothyroxine absorption by forming chelate complexes or by raising gastric pH. The magnitude of the interaction is less than calcium or iron but still clinically relevant.
Mechanism. Magnesium ions can form chelate complexes with levothyroxine in the GI tract, reducing absorption. Magnesium-containing antacids also raise gastric pH, which can further impair levothyroxine dissolution and absorption.
Recommendation. Separate levothyroxine and magnesium supplements by at least 4 hours. Take levothyroxine in the morning on an empty stomach, and magnesium later in the day or at bedtime.
Minimum separation. 240
Sources (5)
- Liwanpo L, Hershman JM. Conditions and drugs interfering with thyroxine absorption. Best Pract Res Clin Endocrinol Metab. 2009;23(6):781-792. PMID 19942153
- Ross DS. Treating hypothyroidism is not always easy: When to treat subclinical hypothyroidism, TSH goals in the elderly, and alternatives to levothyroxine monotherapy. Journal of Internal Medicine. 2022. PMID 34766382
- Mah J, Pitre T. Oral magnesium supplementation for insomnia in older adults: a Systematic Review & Meta-Analysis.. BMC Complementary Medicine and Therapies. 2021. PMID 33865376
- Veronese N, Dominguez LJ, Pizzol D et al.. Oral Magnesium Supplementation for Treating Glucose Metabolism Parameters in People with or at Risk of Diabetes: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials.. Nutrients. 2021. PMID 34836329
- Veronese N, Pizzol D, Smith L et al.. Effect of Magnesium Supplementation on Inflammatory Parameters: A Meta-Analysis of Randomized Controlled Trials.. Nutrients. 2022. PMID 35277037
Stack Score
How this pair moves the number.
Effect on the composite score
If both Levothyroxine and Magnesium Glycinate are in the same stack, this pair applies −5 to your Stack Score (per scored timing-sensitive row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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