What is an empty stomach?

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DEAR DR. GOTT: I have two related medical questions that I have always wondered about. First, what does it mean, exactly, to take medication on an empty stomach?

I take prescription medication (Synthroid) daily due to hypothyroidism and it is to be taken on an empty stomach. How long must I have gone without eating before taking the medication to be considered to have an empty stomach? Also, how long must I wait after taking the medication before eating again? That is, if my stomach is empty when I take my pill, can I eat right away or must I still wait a period of time before eating so that I still have an empty stomach?

Secondly, I have a related question that my doctor cannot answer so I thought I would ask you. What is the proper way to prepare for a yearly TSH blood test? If I take my Synthyroid daily at 6 am should I take it the morning of my TSH blood test or should I wait until after the blood draw? Will the results be must different if I do or do not take the medication just prior to the TSH blood draw?

I have always wondered if I take the medication at 6 am just prior to a 7:30 am blood draw if it is measuring the amount of TSH actually in my system or if it is just measuring the pill I took. The results do matter, as you know, because my dose could be adjusted based on the results.

Thanks for any information or guidance you can give me.

DEAR READER: Let’s start with the easiest question first, which is, coincidentally, your first question.

Synthroid, as your doctor and/or pharmacist should have told you, is ideally to be taken first thing in the morning. You should take it with water 30 minutes before eating breakfast. You should also avoid taking it with calcium supplements or calcium-rich foods or consuming these foods 2 hours prior or 4 hours after taking the medication because the calcium can decrease the body’s ability to absorb the hormone.

Medications that specify that they be taken on an empty stomach should be taken at least 2 after eating or ideally, in the morning after a full night’s sleep and not having eaten for 8-10 hours. You should also take them with water instead of juice, milk, coffee, etc., and wait to eat about 2 hours before eating unless otherwise stated on the prescription instructions.

As for your question regarding when to take your medication on the day of a blood test, I cannot give you an answer. I suggest you ask your question to someone at the facility that handles your blood work. They would be the most likely source to know if the test is altered by how close the medication was taken to the time of the blood draw. Let me know what they say and I will print a follow up with your results which will hopefully help others such as yourself.

Readers who are interested in learning more can order my Health Report “Thyroid Disorders” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from my website, www.AskDrGottMD.com.

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