Question:
can my gastric bypass affect how my thryoid medication is absorbed

I have been on sythroid, then armor thyroid and I am now taking levothyroxine. For all intents and purposes my thryoid is non functional according to my lab results. I take my medication early in the morning on an empty stomach with plenty of water and wait at least 3 hours before drinking or eating anything.    — arizonadoll2002 (posted on September 8, 2011)

September 8, 2011
Greetings ArizonaDoll2002. Your lack of information at your OH personal site makes it a real challenge to give you any meaningful information. Synthroid is the perferred medication. Armour whatever it is, can be problematic. My own physician as well as the pharmicist strongly encouraged me NOT TO EVEN CONSIDER Armour whatever it is called. Levethroid is what I was on. What I do know is, it is critical to regularly get your blood work tested: I do so 3 times a year. Unfortunately, also for having thyroid issues, it is my personal experience the doctors are so affraid of negative effects of prescribing too much thyroid medication, they deliberately work at a snail pace on upping the dossage. When my own thyroid became problematic back in 1999, and I lost my voice for 2 1/2 years, the dosage level was pathetically low. I kept complaining and compaining, and the dosage would be increased at about the weight of an eyelash. Finally, out of desperation (as well as the firing of the doctor I had), I absolutely doubled the dosage for 6 weeks. I figured, I had to help myself. I figured i wouldn't hurt myself if I doubled the dosage for 6 weeks and then got tested. Well, I doubled the dosage. I had new tests. I saw the lead doctor (remember I'd fired one of his underlings.) He said, "Things are looking pretty good. So, I fessed up and told him I'd doubled the dosage. He took that in stride and increased the dosage even more. Now, I am absolutely not recommending this for you! I don't know your age, your height, your weight, etc. You don't have sufficient information at your OH site for anyone to give you meaningful information. I'm just telling you what worked for me. In 1999 I was 62. When I got the right dosage, I regained my voice. However, I am still plagued all the time with chronic fatigue, and I have had no respite from this. My friend, I hope this information does help you. Blessings, OH Support Group Leader and Support Group Coach, Christine Gibson. My OH Group site is inactive but it is my intention to get it going again: I've been recovering for quite a while from debilitating pain and a total hip replacement. If anyone who lives in the Greater Seattle area is interested in a proactive support group, let me know. www.ObesityHelp.com/group/BellevueWA.
   — Christine Gibson

September 8, 2011
Wow, Christine really gave you a good and thorough answer! All I can tell you is that I was on synthroid, had RNY four years ago and am on the same synthroid meds. I have blood work twice a year but everything is so good that my PCP may cut it back to once a year which is fine for me. I had type 2 diabetes before surgery and my HA1C is now 4.9. It's always best to consult your RNY doctor with any questions concerning meds
   — Muggs

September 8, 2011
Good answers! It's important for the first year or so that you get bloodwork regulary (3-4 times / year) so that they can see how your body is changing. Your weight will change. Your ability to absorb medicine will change. How your body changes will be different from anyone else. Just have your endo. keep up with your bloodwork and adjust appropiately. Good luck!
   — Jessica K.

September 9, 2011
Greetings fellow posters! Great answers. I just have to weigh in one more time. I neglected to discuss the malabsorption issue for those of us who have had the restrictive RNY surgery. 80% of our small intestines have been removed. Unless Jesus gives us new intestines, we will always be without 80% of our small intestines. The small intestines won't magically grow back! Jesus could do this, and we could pray to have such an incredible miracle. In the meantime, it doesn't matter whether you are 2 years out, 20 years out, or 50 years out, as is one of my friends with this malabsorptive surgery. It is the small intestines which nourish us. Because of the malabsorption, all our medications (unless the pills are very tiny) need to be in liquid form FOREVER!!!! Exception is vitamins -- they can be liquid or in pill form if the covering is a gell capsule. Otherwise, tablets and big pills simply pass through our small pouch and out into the toilet. Do you really want to waste money on what passes out of our bodies into the toilet? And, trust me, most doctors do not understand the malabsorption issue and have not been trained in it. I'll be posting information on this at my group site within the next several weeks which may help you. We are considered 50% malabsorptive. What does this have to do with the small thyroid medications? Yes, you could crush the pill, and swig it down with a glass of water grimacing all the while. But, those pills are so tiny. The blood work tells the story. Just take that pill upon arising with 8 oz. of water. Wait 1 hour (more time is not necessary) before you eat. Also be sure you don't mix your liquid drinks with your meals: keep 30 minutes before and 30 minutes after without liquids. Body works better. I can never remember the specific tests necessary to check the appropriate thyroid level; but, if your surgeon is worth his or her salt, he or she knows. If anyone really wants to know, I can go and check what I get done and let you know. So, yes, you are malabsorptive and will remain so for the entire rest of your lifetime (my 50 year veteran friend, is in her 90s and still going strong -- she is also tiny, tiny, and never regained any of her excess weight. Besides, she is an absolute delight and her mind is so sharp!); but, the testing of the thyroid is so precise, this is not a concern for you. In my own situation, I switched to Synthroid from Levethroid because I continued for these past 12 years to have brittle fingernails besides the constant fatigue. Switching to Synthroid gave me great nails -- for about 6 months. Now, they are sort of stronger than they were. I have no answers on the fatigue and am working on that through positive affirmations. Blessings, everyone. Hope someone in the Greater Seattle area contacts me so we can get our support group going again. www.ObesityHelp.com/group/BellevueWA. But, I'm always available for anyone who needs some advice or encouragement or even to discuss a royal funk. Blessings!
   — Christine Gibson

September 21, 2011
I am on synthroid also for the last 20 years or so. Whenever I have switched to a generic or other mark, I have always had hair loss. I had RNY in January and my doctors have not changed my Synthroid dosage, though the last blood test indicated that possibly I may need more in the future. My internist in the U.S. said in June that most people with this surgery don't have to change their thyroid medicine dosage.
   — jobrasil