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Take Synthroid with water only on an empty stomach. Take Synthroid 4 hours before or after. taking iron or calcium supplements, or antacids. Soy, cottonseed meal, walnuts, fiber, and. grapefuit juice can affect the absorption of Synthroid.
Failure of the serum T 4 to increase into the upper half of the normal range within 2 weeks of initiation of SYNTHROID therapy and/or of the serum TSH to decrease below 20 mU/L within 4 weeks should alert the physician to the possibility that the child is not receiving adequate therapy.