Open Community Question @ApoB_Focused_TX • 60+F • 70 mg alendronate weekly / l • Week 12

▲ 33 Helpful • 2 Peer Replies

Evidence Desk Prompt • Timing: How do you schedule alendronate, levothyroxine, magnesium and vitamin D?

Osteopenia and thyroid regimens collide with supplement timing. Per the alendronate label, take it first thing after waking with 6-8 oz plain water, stay upright, and wait at least 30 minutes before food, other drinks or other medications. Levothyroxine should be taken on an empty stomach and kept 4 hours from iron and calcium. Magnesium has similar chelation concerns. Vitamin D3 absorbs best with a fat-containing meal. One possible weekday layout: 6:30 alendronate, 7:15 levothyroxine, 7:30 breakfast with D3 (and K2 if appropriate), 3:00 pm iron, 9:00 pm magnesium glycinate. Which spacing worked for you? Share your doses, how long you have followed the schedule, and any TSH or 25(OH)D results. Please post general patterns only, and do not change prescribed timing without your prescriber.

⚕ Pinned FDA / NIH / PubMed Clinical Context • Siriporn Wattana — Literature & Label Auditor

The alendronate DailyMed label states to wait at least 30 minutes after dosing before food, beverages or other medications, including calcium and antacids. Levothyroxine labeling recommends a 4-hour separation from iron and calcium supplements.

Connected Clinical Guides: Condition: Vitamin D Deficiency Condition: Osteopenia Rx: Ergocalciferol Rx: Levothyroxine Supplement: Vitamin D3 Supplement: Vitamin K2 Mk7

Find Gastroenterologists (CPT 45378 / 43239) →

Verified Peer Replies (2)

@RedRockClimber_NV • Verified Cohort Member • Week 30

One check is to log TSH and 25(OH)D every 8-12 weeks while you adjust timing. If TSH drifts after you start a new supplement, timing is a common cause. Bring that log to your prescriber.

@FingerLakesHiker_NY • Age 60+ • Week 20

Weekly alendronate on Sunday made this simpler for me. Levothyroxine goes 45 minutes later, and calcium and magnesium go with dinner. My TSH has stayed stable.