 [ Symptoms ] do you have to take thyroid supplements on an empty stomach 30 minutes before eating  i have been taking levothyroxine for 20 years one pharmacist says it is best taken on an empty stomach 30 mins before eating so it gets into the system more quickly another says after the first few days of therapy it does not matter if you take it on an empty stomach or not my meds and meals schedule is very complicated and this one thing would actually make a difference for me can i take it with breakfast andor with other meds or had i better take it on an empty stomach before breakfast [ Disease ] this can be due to peripheral neuropathy get vitamin b6 and b12 tested associated brain problems should also be kept in mind get a mri of brain to rule out these possibilities start on vitamin supplements