Never Drink Coffee With Thyroid Medication (Here’s Why)

How Coffee Causes Problems For Thyroid Medication (All Types)

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Recent studies show that up to 64% of Americans drink about a cup of coffee each and every day (1). 

This isn’t a problem by itself (although it could be as we will soon see) but it can be a major problem if you are consuming your coffee with your prescription medications. 

In particular, I’m talking about Synthroid (or levothyroxine which is the generic version of Synthroid). 

Synthroid is the most commonly prescribed prescription drug in the United States with an estimated 114 million prescriptions being filled in 2016 (2). 

And coffee has been shown clinically to potentially reduce the effectiveness of thyroid medication IF they are consumed at the same time. 

When you put these things together it’s easy to see why this is an important topic worth discussing. 

Does Coffee Negatively Impact your Thyroid Medication?


Never take your thyroid medication with coffee! Here’s why: this information applies to all thyroid medications. #thyroidproblems #thyroidmedication #thyroidtreatment #thyroid #coffee #levothyroxine

♬ original sound – Dr. Westin Childs

The answer is yes (not in every case, but in enough cases for there to be studies on the topic). 

Drinking coffee at the same time (or near the same time) as your thyroid medication has been shown to reduce how much of that medication you are absorbing into your body (3). 

This is a huge deal if you have thyroid problems. 


Because you can take all of the thyroid medication that your body needs by mouth but it does absolutely nothing for you if it doesn’t make it into your bloodstream. 

The only way it can make it into your bloodstream is if it’s absorbed by your intestinal tract. 

And thyroid medications, of all types, tend to be some of the most volatile prescription drugs on the market. 

Meaning, pretty much everything has some impact on whether or not you will absorb your medication. 

If you are someone who has been taking your Synthroid or levothyroxine or any other thyroid medication with your coffee, and you haven’t been feeling well, then this might be the reason. 

Simply waiting at least an hour after you drink your coffee may be the difference between feeling better or not (more on this below). 

But why does coffee interfere with thyroid medication absorption? 

We are not 100% sure but it probably has to do with the stimulatory effect of the caffeine found in the coffee. 

Caffeine, the major stimulant found within coffee, does exactly what it is supposed to. 

It stimulates your mind, it stimulates your heart, it stimulates your adrenal function, and it also stimulates your intestinal tract. 

This stimulation is the very reason why so many people love their coffee but it’s also the main reason why coffee probably inhibits thyroid medication absorption. 

Ever wonder why so many people have a bowel movement after they have a cup of coffee? This is why. 

But this stimulation of the gastrointestinal tract is NOT good for the absorption of your thyroid medication. 

The faster that your intestinal tract moves the shorter amount of time your medication will spend in your intestines. 

And thyroid medication, especially Synthroid and levothyroxine, takes a while for your body to break down completely. 

So, to paint a better picture here, you might be losing a small (or large) portion of your thyroid medication in your stool if you take it with your coffee. 


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How to Take Your Thyroid Medication

All of this begs the question:

How should I actually take my thyroid medication so I can avoid absorption issues?

It’s actually not that hard, but the problem is that there isn’t a single place where patients can get all of the information they need. 

Consider these guidelines to be that information and use these tips to help you absorb more of your thyroid medication when you take it:

  • Take your thyroid medication either FIRST thing in the morning or RIGHT before you go to bed – There have been studies that show that taking your thyroid medication at night is not only equivalent to taking it in the morning, some studies suggest that it might be better. 
  • Wait 4 hours before you take your thyroid medication IF you are taking iron or calcium supplements – Iron and calcium are notorious for binding to thyroxine (the active component of your thyroid medication) and rendering it inactive. Be VERY cautious if you use either of these supplements anywhere near the time of day that you take your thyroid medication. 
  • Wait 30-60 minutes before you take your thyroid medication IF you are taking other supplements – Other supplements, which include thyroid supplements, can also potentially interfere with thyroid medication absorption. Just be sure to wait 30-60 minutes and you should be good to go. This includes things like fish oil, vitamin D, and so on. 
  • Wait 60 minutes before taking your thyroid medication after you consume coffee – The general guidelines for coffee would be to wait at least 1 hour (or 60 minutes) before you take your medication. If you place your medication RIGHT by your bed with a glass of water you can take it basically RIGHT when you wake up and before you get ready for the day. If you are drinking your coffee right after this then you might try taking your medication at bed right before you go to bed. 
  • Wait 30-60 minutes before you take your thyroid medication after you eat breakfast – Food, in general, can also limit thyroid medication absorption (4). Be sure that breakfast isn’t also interfering with your medication schedule. This is another reason I like the taking-your-thyroid-medication-at-night approach because most people don’t eat RIGHT before they go to bed. Dinner is usually at 7 pm and bedtime is hopefully a few hours after. 

If you follow these tips then you should limit the chance that there is any interference in absorption. 

Now, this doesn’t mean that you will necessarily feel great just by following these guidelines. 

On the contrary, there are many people who need a different type and dose of thyroid medication to get back to 100% but this should definitely help you. 

Tirosint vs Levothyroxine and Coffee

What if you are someone who HAS to have their coffee in the morning and it’s the only time that you can take your medication? Is there a way to take your coffee and your thyroid medication at the same time?

The answer is yes, but it will require a little bit of work on your part. 

This can be done by simply switching which type of thyroid medication that you take. 

Each thyroid medication (and there are several of them) has different advantages and disadvantages. 

Likewise, some are more easily absorbed than others. 

In particular, the gel/liquid formulations of levothyroxine and Synthroid are very easily absorbed by the intestinal tract. 

Medications that fit into this category include Tirosint and Tirosint-Sol

These medications are considered to be levothyroxine/Synthroid equivalents in that they both contain the exact same active ingredient (thyroxine) but they carry an additional bonus. 

That bonus is the fact that they do not contain very many fillers or binders. 

For instance, Tirosint has only 3 inactive ingredients and 1 active ingredient (5). 

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Tirosint-Sol has only 2 inactive ingredients and 1 active ingredient (6). 

You can compare this to Synthroid which has at least 7+ inactive ingredients and 1 active ingredient (7). 

All of these ingredients play a role in how quickly your body can absorb and break down your thyroid medication. 

In general, the fewer inactive ingredients the easier it will be to absorb them (not universally true for all cases). 

In addition, there have actually been clinical studies that show that taking coffee with liquid levothyroxine does NOT seem to affect serum T4 levels (8). 

As an added bonus, Tirosint can also be taken with breakfast (making it great for certain people) without interfering with serum T3 and T4 levels (9). 

Just because you CAN take your medication with coffee doesn’t necessarily mean that you should, however. 

Coffee and Adrenal Health

I understand that coffee may be a mainstay for many of you and it’s something that you may not think you can live without. 

But, is it something you should consider taking a break from?

The answer may be yes. 

Coffee not only has a potentially negative (notice I said potentially) impact on your thyroid and medication absorption but it also may affect other hormone systems in your body. 

The caffeine found in coffee has a stimulatory effect on your body and may help increase the secretion of certain adrenal hormones from your adrenal glands (10). 

Hormones such as norepinephrine and epinephrine, otherwise known as adrenaline, are increased after caffeine consumption. 

These catecholamines impact a number of important cells in your body including heart cells, brain cells, and so on. 

It’s felt that the release of these metabolites probably plays a significant role in why consuming caffeine leads to increased alertness and focus. 

But there’s one potential problem with this. 

Constant consumption of caffeine may put a supraphysiologic demand on your adrenal function. 

Put another way:

Caffeine may be trying to force your body to create more adrenaline and hormones than is healthy for your body. 

In addition, consuming caffeine is great but it can have a negative impact if it’s constantly used to keep yourself awake during the day due to decreased sleep at night. 

This sort of scenario is one in which you are robbing Peter of paying Paul. 

Eventually, this will catch up to you and when it does you may experience a crash in your energy levels which will not be alleviated by further coffee/caffeine consumption. 

The exact mechanism for why this occurs is not well understood but it probably has something to do with the amount of stress that your body can safely tolerate and the constant pressure from outward sources that stress and other hormones place on your body. 

When your stress load becomes too high for what your body is capable of reacting to, you may start to experience symptoms consistent with adrenal fatigue or burnout syndrome. 

Thyroid patients, by the way, seem to be extremely sensitive to this condition most likely owing to the connection between thyroid function and adrenal hormone function. 

My recommendation for thyroid patients out there reading this is to try and cut back on your coffee/caffeine consumption, at least temporarily, to see if you can reduce the stress/strain on your body. 

At the very least, you will NOT want to take both Synthroid and coffee together but cutting back on your coffee consumption by 50% or more is probably a good idea as well. 

This will give your body a break and allow your body to reach a normal equilibrium on its own and without additional forces acting upon it. 

Putting it All Together

The main takeaway is this:

If you are taking Synthroid or levothyroxine for your thyroid then you should NOT be taking it with your morning cup of coffee. 

If you do, you risk limiting how much of that medication can get into your body which may affect your symptoms. 

Waiting at least 60 minutes after your cup of coffee is probably enough time to limit this effect. 

If your schedule doesn’t allow for this 60-minute break then you should look into other alternatives such as Tirosint or Tirosint-sol which are thyroid medications that can be taken with breakfast foods and morning coffee. 

With all this said, there is a legitimate case to be made against the use of coffee if you have thyroid disease as it may put extra strain on the body and lead to issues such as insomnia (both of which are bad for your thyroid). 

As always, there is no general consensus or rules to follow. You must find what works for your body through trial and error. 

Now I want to hear from you:

Have you been taking your medication with coffee in the morning?

Have you also been feeling poorly?

Or does it not seem to affect you?

Do you think coffee is causing any other issues in regard to your adrenal health?

Leave your questions or comments below! 











Never take your thyroid medication with or near coffee: here’s why

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About Dr. Westin Childs

Hey! I'm Westin Childs D.O. (former Osteopathic Physician). I don't practice medicine anymore and instead specialize in helping people like YOU who have thyroid problems, hormone imbalances, and weight loss resistance. I love to write and share what I've learned over the years. I also happen to formulate the best supplements on the market (well, at least in my opinion!) and I'm proud to say that over 80,000+ people have used them over the last 7 years. You can read more about my own personal health journey and why I am so passionate about what I do.

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69 thoughts on “How Coffee Causes Problems For Thyroid Medication (All Types)”

  1. I have a nontoxic goiter. Dizzy at times weight loss, some fatigue but generally ok. I take flovodine 5 drops every day. Your thoughts, please.

  2. I always take my Synthroid as soon as I wake up in the morning. I also almost always have 1-2 cups of coffee in the morning… I try to wait 30 minutes or so after taking Synthroid before drinking my coffee…sometimes it’s longer, sometimes it’s probably less. I have been on the same dosage for a few years now with no symptoms, so I think this is working alright for me. (Although now I wonder if I could get away with a lower dosage IF the caffeine is interfering with absorption.) I also don’t consume any other caffeine other than my morning coffee.

  3. Thank you for the information! I knew to wait for an hr after taking med to eat, but I did not know about the coffee — which I have been doing — maybe that is why the last few days I have been feeling bad 🙁

  4. I take 150mcg Eltroxin every morning, as soon as I wake. I make myself a coffee straight after that, and wait about half an hour before I have breakfast. As I have been advised by my GP.
    My main issue is that I can’t shift any weight anymore.
    Do feel tired during the day, but don’t have anymore coffees.

  5. Hi,

    I take my 112mcg of Synthroid upon waking, and then drink my coffee over an hour later, while I commute to work. How does taking my meds FIRST then drinking coffee 1+ hours later affect the absorption?


  6. But most of those who understand thyroid function find Synthroid a subpar medicine. I use straight t3 or desiccated thyroid. I have not noticed any difference in absorption based on taking with coffee or food and I’ve tested it several times. Does the caution only apply to Synthroid?

    • Hi Colleen,

      This caution would apply to all thyroid medications, to varying degrees, except Tirosint (and Tirosint-Sol). Your individual mileage may vary, but on the whole, I would recommend against taking any type of thyroid medication with coffee, any stimulant, iron, and/or calcium. We only have studies for Synthroid/levo and Tirosint, but my clinical experience suggests it extends to the others as well.

  7. Hello Dr. Childs,
    Thank you for all the wonderful, clear and good information!
    I am on WP Thyroid after being on NatureThroid for a long while.
    I do a morning routine and wait 45 min to 1 hour to eat breakfast. I often have Matcha green tea, sometimes decaf coffee. Would you put Matcha green tea in a similar category to coffee? Also, I read somewhere that you should drink 8 oz of water with the medication. Do I have this correct? Thank you!

    PS – My weight has been stuck for a while. Recently my RT3 is high. So I will be taking SRT3. Hoping for some relief and some weight loss.

  8. I got a sample of Tirosint, which I really liked. But the dr. Would not give it to me a prescription. It was more costly. Insurance probably wouldn’t pay.

    • Hi Donna,

      Insurance doesn’t necessarily cover Tirosint but there are coupons and other programs you can use to make the price cheaper. In addition, it’s probably a good idea to at least confirm that your insurance doesn’t cover it rather than just automatically assume it doesn’t and miss out on the benefit if it does.

  9. I have quite a bit of pain after cervical spine surgery and arthroscopic knee surgery and my neurologist encouraged me to use coffee to help with pain management. This has been successful. I was having pretty bad fatigue issues and some other possibly related issues, I.e. higher renal count, higher sugar level. I was diagnosed with hypothyroidism in November 2017 and was taking 25 mg of levothroxin. In March I began 50 mg and started to drink coffee 30 to 60 minutes after my levothyroxin. I have gone from 155 lbs to about 140 since then and have been much more physically active and feel stronger. After reading your article I am considering taking my medication before bed.

  10. Hi Dr. Westin,
    I tried taking Levothyroxine 100 at night, but I was unable to sleep.
    I can’t wake up without coffee because I get up very early, so I try having thyroid medication as soon as I get up. I was diagnosed with Hashimoto’s 30 years ago. I don’t find that thyroid meds help me that much.
    Thank you!

    • Hi Margaret,

      No problem and thanks for sharing! It could be that your meds are not working properly because they aren’t being absorbed.

  11. I use to take my synthroid in the morning and waiting for my cup of coffee. Plus waiting to take my supplements until dinner. I switched to taking the synthroid at bedtime which allows me to have my coffee with breakfast and every other day take my cytomel after lunch. Still take supplements at dinner (5-6 pm) allowing at least 4 hours after calcium intake to take the synthroid. This has been working well for over a year now for me.

  12. Hi Dr. Westin… I found your info very helpful as I’m struggling with losing weight. It just won’t budge. Ugh!! I have stopped drinking coffee because of fatigue but I’m not really sure this is the problem. I was only drinking 1/4 cup 2 hours after Tirosint. My dosage is 50mcg. I feel I’m failing my self. I exercise everyday but not doing high impact. I’m going to try your meal plan. Thanks for listening.

  13. Hi Dr. Westin, I see that Alison asked a question above that you did not answer clearly. I have the same question but I will reword it. Is there a difference in taking thyroid med. 60 minutes before coffee, or drinking coffee first thing and waiting 60 minutes to take thyroid med? Thank you. I love your site and YouTube videos.

    • Hi PJ,

      Yes, there is a slight difference in that taking your thyroid medication AFTER coffee would be worse than the opposite.

  14. Hello Dr Westin,
    My Dr said it was ok for me to drink only black coffee with my levothyroxine. I have been doing this for 15 years, how will I know if it’s interfering? Everytime my Dr does my bloodwork all of my numbers are good, does that mean coffee is not interfering? Thank you so much.

  15. I am so glad I found this. Interesting read. I have been on 112 mcg for years. My now 19 yr old son is hypothyroid for the past several. He is also on psychotic meds. He has been home for a few months and loves his morning joe. However, recent labs show tsh elevated. Dr up med to 137 mcg. This week re tested and still up. So dr now up med to 150 mcg. Office not very helpful. I keep asking why? What is going on?

    • Hi Hope,

      Could be something interfering with the accuracy of the labs or it could be a genuine need for more thyroid hormone. Either way, it deserves some looking into to figure it out!

  16. Dr. Childs. I have been taking levothyroxine/ synthroid medication since about 2005. None, not one of my doctors ever told me not to take my medication with coffee. However, I try to wait about 20-30 minutes after my medicine, before I have my coffee. I also take medication for HBP. I beginning to think, this is why I am so tired after I drink my coffee. No energy. Fatigued most of the day. What do you suggest I do?

  17. I’ve not seen mention if NP Thyroid. I take 60 MG each morning upon waking. I drink decaf coffee with cream 30 – 60 minutes later. Is this safe because of the decaf?

    • Hi Kelly,

      This information would apply to all thyroid medications including NP thyroid. I don’t recommend drinking coffee anywhere near when you take thyroid medication and there’s a good argument to make that you shouldn’t drink coffee at all if you have thyroid problems.

  18. I have been taking ur daily essential vitamins an hour after or little longer after my thyroid medicine(levothyroxine) seeings u take 4x a day and coffee 15 minutes to 1/2 hour after medicine and daughter and I both are tired and take ur T3 conversion booster

    • Hi Bonnie,

      It sounds like you are on the right track! I’d still try to give up on the coffee, though, if you can 🙂

  19. After begging my doctor she finally switched me from levothyroxine to Armour because it’s the only natural version my VA carries. Does the caffeine in coffee interfere with Armour as well? I drink fermented black tea (pu-reh) as well. It’s suppose to have more caffeine than regular black tea. Does the caffeine in tea effect thyroid meds?

    • Hi JoAnne,

      Yes, this information applies to all thyroid medications. And, yes, the caffeine in tea also has a similar effect.

  20. Hi doctor,

    I would like to try taking my levothyroxine at night before bed. Is it ok to take with other medications? I’m take trazedone about an hour before I go to bed. Would that effect the absorption of the levothyroxine?


    • Hi Deborah,

      I can’t give you medical advice regarding how to take your medication but I can tell you that many people take their thyroid medication at night without any issues 🙂

  21. Hey Dr. Childs, just got switched from 120mg armour to 90mg armour in am plus 10mcg cytomel in afternoon. No issues with armour in am as I take in the middle of the night but in terms of cytomel, I take it in the afternoon ( after drinking caffeine). How long should I wait after drinking and possibly before for my afternoon dose? Im a fellow doctor so caffiene throughout the day is a must for those long shifts! Thanks, love your insight!

    • Hi Dr. Napolitano,

      Ideally, you’d want to take it as far away from coffee or caffeine as possible. The issues with thyroid medication and coffee/caffeine mostly stem from issues with absorption due to the stimulating effect that caffeine has on the GI tract so it’s more about how quickly you personally metabolize caffeine (including tolerance) and its impact on your body. I would say at minimum to separate them by 4 hours if possible but, ideally, longer would be better. If Cytomel doesn’t keep you up at night then splitting up your dose of Armour in the am and Cytomel right before would work. That is usually my preferred method as long as it doesn’t interfere with sleep.

  22. Hi Dr. Childs
    I am currently on 0.2mg of Synthroid, my thyroid levels are consistently high and I feel tired, and crappy. I have a horrible time loosing weight, my doctor has put me on Contrave and now Ozempic at 50mg a week and have not lost a pound, combined with healthy eating. My Endo, just recently lowered my Synthroid dosage to 0.150mg, which seems to be right for the high thyroid levels, but doesnt seem to make sense with the way I feel and the impossibility to loose weight the past year? What is your advice on this?

  23. My thyroid was removed in August bc of suspicious nodules. Everything is ok….I take 88 of thyroxine in the am with 8 oz. Of water….I have breakfast and decaf coffee 1 hour later. I take my supplements and toporol 4-5 hours later. My weight is ok, my blood work is normal, TSH is low normal. I have occasional hot flashes, I am 76, and do not sleep through the night. Sometimes I feel odd, like I might have a panic attack. Since t4, t3, TSH and calcium is all normal range, what can I do to relieve the issues I am having ?

  24. Hi Dr. Westin, I wonder what do you reckon on decaf coffee?
    (I live with Hashimoto without noticiable flare-ups but with some effects on my gut, skin, etc.)

  25. Hello Dr. Childs,

    Last year I was on a high dose of Armor and I felt great for the first time in years. I noticed I did not need more than a morning cup of coffee. Coffee is the one substance/habit I have never been able to quit.

    However, my Endo said the dose was too high (that I was now hyperthyroid) and over the course of this year my dosage was cut in half. It was brutal. Fatigue. Weight gain. And, I’m drinking four cups of coffee a day. My MD has thankfully added a bit of levothyroxine.

    But, I change my socks before going to bed: feet are always cold, and colder as the day goes on.

    Thanks for all your advice.

    • Hi Kiki,

      Unfortunately, dosing solely based on the TSH is usually a recipe for underdosing. Doctors, especially endocrinologists, will tell you that you are hyperthyroid long before you actually are. If you weren’t experiencing hyperthyroid symptoms then you were most likely not hyperthyroid. Which would make sense given your current hypothyroid symptoms at a “normal” dose (according to your endo, anyway).

      Please see this article for more information:

    • Hi Marie,

      It takes about 2-4 hours for your stomach to empty so the coffee taken at 6 am is still having some impact on absorption even if taken 1 hour later.

    • Hi Al,

      Decaf is certainly better but it doesn’t solve the problem as it still contains some caffeine. It’s just less of an issue.

  26. I only drink decaffeinated coffee. Is this going to affect my adrenals? I also take my thyroid meds at 0230 hrs every night. Does decaffeinated coffee interfer with T2 or Thyroid Grandulars/. I take those when I wake up in the morning.

    • Hi Caroline,

      It depends on the caffeine content of your decaf as most decaf coffees still contain some caffeine. Whether or not it will impact your other supplements/hormones depends on how quickly your body metabolizes caffeine. Some people are faster metabolizes and others are slower (tolerance also plays a role). But, to answer your question, T2 would be impacted in the same way as T4/T3 so it could still cause issues if taken close to coffee/caffeine.

  27. Hi Dr Westin,

    Thanks for your interesting and necessary divulgation! I have my T4 at night, right before bed on an empty stomach, and my T3 in the morning when I wake up and then I wait for an hour before breakfast. At lunch I take my vitamin D, fish oil and K2, and I am feeling better than ever! Important to separate thyroid meds from any form of caffeine, food, tea, other supplements, etc.

  28. Hi Dr Child’s,

    What are you thoughts on decaf coffee? I take my Levo around 8am, and like a decaf latte around 11am.

    Any effect on my adrenals or thyroid with this?

    Thank you!

    • Hi Sejal,

      Decaf usually has some caffeine so there will be some issues still, just fewer compared to fully caffeinated versions. The same would apply to your adrenal function as well. If your adrenal function is completely normal then there are ways that caffeine/coffee can be used to enhance your efficiency but most people end up taking it to the extreme and have a hard time using it in that way.

  29. I take NP Thyroid. Does the same apply?

    I drink coffee with my thyroid meds. I have no issues. My doctor said that whatever I do, do it consistently, and the blood tests will reflect how much medication I needed.

    • Hi Amy,

      Yes, it still applies to NP thyroid. What your doctor stated is essentially correct, but it’s not an ideal way to go about thyroid dosing. If you take your thyroid medication every single day with your coffee then your dose will need to reflect the absorption issues the coffee is causing but that leaves you open for less wiggle room when something down the line does happen (illness, inflammation, weight gain/loss, menopause, etc.). These factors will influence your dose and make it more difficult to recalibrate later.

      Also, there are always outliers. Some people can smoke all of their life and not end up with lung cancer but I don’t think anyone would recommend smoking because a few people can get away with it. I feel a similar way about taking thyroid medication with coffee, some people can get away with it but it’s generally not a good habit to get into.

  30. I take NP Thyroid. I usually wake up to pee around 3:30 or 4:00 A.M., at that time I take my NP with a big glass of water and go back to bed until 5:30 or 6:00 A.M. Is it do this…I know some meds you should not lay back down with.
    I usually have 1 cup coffee with a small amount of half and half between 6:30 A.M. and 7:00 A.m.
    Is this all o.k…….???

    • Hi Vicki,

      It all depends on how you are feeling! I wouldn’t recommend drinking coffee at all if you have a thyroid problem but some people can get away with it and others just refuse to quit for whatever reason.

  31. I like coffee and would hate to give it up but now only drink it when I really need that caffein pick me up when I have to be at work very early in the morning. Do you have a better idea than coffee to wake up? Tried
    an ice cold shower but not a lot of fun.


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