There is no direct effect that I’m aware, although I still tell patients on thyroid replacement to continue to take their med at least 30 minutes before the beverage, and I closely monitor INR in patients on Coumadin the first 2 weeks of starting all beverages. Peter H. Jones, MD

I would agree with Dr. Jones. I would add that any weight loss may change medications that have a narrow therapeutic index but this would be independent for the replacement product. Christopher Case, MD