Does it really matter? When taking either Synthroid or Levothyroxine, the goal is to achieve consistency and avoid fluctuations in thyroid hormone levels (and variable control of symptoms). The best way to achieve consistency is to keep your prescription bottle on your bedroom side table and take it upon awakening with water. Swallow the capsule/tablet whole; do not cut, crush or chew it. Then it is recommended to wait a full 30-60 minutes before eating breakfast, or drinking coffee, to allow the medication enough time to absorb into your system. If you miss a dose of this medicine, take it later in the day at least 3 hours after a meal or, alternatively, skip it and take a double dose the very next day. Also be aware that thyroid medication efficacy may be altered by some of the most common over the counter medications such as antacids, vitamin, calcium and iron supplements, and some cholesterol lowering drugs. For this reason, it is recommended to separate dosing by a minimum of 4 hours. Do not stop taking your medicine or change your dose without first checking with your prescribing provider. Do not keep outdated medicine (or medicine that you no longer need) and ask your healthcare professional how you should dispose of any medicine you do not use. The amount of medicine and the number of daily doses that you take depends on the strength of the medicine. Prescribing appropriate thyroid hormone replacement medications should be managed by a highly trained thyroid medical professional.