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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.
Common Synthroid side effects may include: 1  leg cramps, muscle weakness; 2  headache; 3  feeling nervous or irritable; 4  diarrhea; or. 5  skin rash, mild hair loss.