I am 2.5 years out from gastric bypass.  I had a total thyoidectomy last December and still have not been able to get my synthroid regulated. Right after surgery they put me a .1mg and over the next 9 months raised the dosage a .25 at a time until I got to  .2 mg.  At that point my TSH level was still over 50 (very high - normal is .25 to 5, I believe).   My Dr sat me down two months ago and said that I'm having a total medication failure and she was at a loss what to do. She didn't know why that was happening. I reminded her of my gastric bypass.  She raised my dosage to .3 and it seemed to work  (my TSH went up to 3).  Yesterday I did the TSH test again..and it was again elevated... so she raised it again by .25mg.    So, my question out there... is anyone else having this problem with absorption? If so, what are you doing about it?

Hi Tinker, I'm not sure if this will help you out or even apply to you...I have been taking Synthroid for almost 20 years and I had some 'regulation' issues after surgery. Luckily, I read on this board that someone discovered chewing the Synthroid helped her with absorption. She even said they were sweet tasting, so I gave it a try. The pill is so small I never would have thought about chewing it, but maybe the coating on it is strong and just passes thru our systems without releasing it's benefits. I don't know...but I DO know that after starting to chew mine, my labs fell right back into acceptable readings. I don't even know who to credit with the chewing advice, but it certainly works for me, it IS a tasty little pill, and I wish the very best for you. My advice: if you aren't chewing your pill, try doing so. Good Luck, Sue

Great idea.  Thanks!  I'll try it . It makes sense that the coating could be the problem.  Hopefully I can get back to normal TSH level.  Thank you

Sue, I have had the same problem as Tinker and I am excited to try your idea about chewing my Synthroid. My TSH flucates from hypo to hyper and back again and I have severe atypical symptons. I can actually predict my TSH before my blood test from the symptoms I am having. I will try the chewing. I also just did "Ask a Medical Expert:" and the doctor suggested 2 smaller doses a day. I haven't tried it yet.
Crossing My Fingers, Bluetale.

Hey, Tink! As the other poster said... you might want to chew or crush your synthroid to see if it is better absorbed.  (They crush them for children who cannot swallow pills.) Make sure that you aren't taking your synthroid along with your vitamins or any stomach acid reducing meds.  That will affect absorption.   Leave time in between.  Also, keep off soy products. Good luck! Kathy

Congratulations to both of you.  You have done great.

Buckeye Gal

Kathy,  Why no soy products? I have this synthroid thing too happening.. I use alot of soy products.. maybe that is part of my issue? Can you advise why? Donna

Speak to your endocrinologist.  I believe that soy can affect absorption of thyroid meds.  From a CNN article of Hypothryoidism:

Proper absorption of levothyroxine Certain medications, supplements and even some foods may affect your ability to absorb levothyroxine. Talk to your doctor if you eat large amounts of soy products or a high-fiber diet or you take other medications, such as:

• Iron supplements
• Cholestyramine (Questran)
• Aluminum hydroxide, which is found in some antacids

I've actually had the opposite thing happen and my medication was reduced since I had GB ... Make sure you take your med on an empty stomach and don't eat for an hour afterward.  That is what I do.  If you are already doing that, then I guess your dr will have to increase your meds until your TSH levels normalize.  I wish you much luck ... It stinks to be hypothyroid! Hugs, Annette

Annette, I've had my synthroid decreased twice since surgery.  My doc explained that it wasn't that my thryroid was functioning better, just that there was SO much less of me body fat wise for it to metabolize through...  Medicating a 212 pound person instead of a 410 pound person...  I've gone from 150 mcgs to 112.  It almost had to be raised this last set of labs though as my numbers went the opposite direction (longer period of malabsorption?) and while I'm still within the normal range, I'm closer to needing an increase...  Maybe I'll consider the chewing of the pills, though I've not chewed or crushed ANY med since surgery... It DOES stink to be hypothyroid though...  You got that right baby! Lea

I don't have that issue, butmany times ppl take their synthroid with vites that basically cancel it out. It doesn't like iron or calcium.

If you get up at night, you might want to take it then, which automatically isolates it from any potential unfriendlies.

WOW--You learn something new everyday!  I NEVER IN A MILLION YEARS would have thought of synthroid malabsorbing.  I think I am pretty good as far as my levels go, but, I think I will give the pill chewing a try.  What could it hurt??   Good luck and I hope these suggestions will resolve you thyroid issues! Hugs

I forgot to mention  that soy products interfere with the absorption of thyroid medicatio.  If you use soy products (soy milk or veggie burgers, etc) you should wait a couple of hours to do so after taking your synthroid. annette

OMG... I had no idea.. that is probably my problem... right there..  I take my pill when I get up.. and then about an hour later I was having a soy protein drink for breakfast.  OMG... I can't say it enough.... 

On the subject of SOY.  Please be careful.  I've been vegetarian most of my life and a heavy consumer of soy.  I am also Hypothyroid.  I read a book, The Thyroid Diet, by Mary Shomon and learned that soy was bad in large quantities, particularly for someone that is hypo.  Sooo.... I cut all soy out of my diet in a bold move.... all of a sudden my body started to fully absord my dosage of levothryoxine and I went from hypo to hyper and wound up in the emergency room.  So please gradually take soy out of your diet and discuss it with your endocrinologist first.  My battle is ongoing and I'm back to being hypo.  I had thyroid cancer and a total thyroidectomy this year and we still can't get my dosage right.  My TSH levels are at 20 and I'm exhausted all the time.  I've tried taking my medication at night and taking it with orange juice which is suppose to help.  Thanks to this board I will now try chewing my medication.   I don't take it with vitamins, calcium or iron and I take it on an empty stomach.  For whatever reason I'm not absorbing it properly and I'm on a large dosage.  Good luck to you!

I thought I was alone with this problem.. but after reading some of the response you have received I am amazed ... I am at an OMG state.. I use soy... all the time.. most of my diet is soy and I had no idea.. the chewing thing... I had thought of but hadn't tried..  just... OMG...  I had my thyroid removed in May.... and my dr says it's like I haven't taken any of the med. This may be the answer.....  OMG>.... Donna

I'm glad you have some answers. I hope soy is your problem so that you can resolve your absorption issue.  I don't eat any soy so I know that this won't be my issue but I'm hoping that that chewing the tablets will resolve my issue. 

Donna, I almost didn't post the soy thing b/c I thought that you probably "hated" soy (many people do ...), but I personally like it.  It can interfere with the absorption ... It's not to say you cannot have soy, but wait a while to injest it.  Many people do not realize that it binds to the thyroid medication and prevents it from absorbing in some people.  Hope that info helps you ...  Annette

Be careful as you try these suggestions because you may get too much synthroid. Watch for signs of overdosage like nervousness, heart palpatations, fast heartbeat etc.

Thanks. I am not planning on doing anything before I discuss it with my endo and my surgeon. It so happens that the surgeon who did my GB also removed my thyroid. Next time I see them I'll bring up the idea of crushing or chewing the pill to see if they agree.  Becky