# Stopped absorbing meds?!



## khaki (Dec 24, 2016)

Hi--I was diagnosed with Hashis 20 years ago and have been relatively stable on t4 + t3 meds for 20 years (definitely a a lot of tweaking with Hashis, but nothing like current status). I am extremely careful about taking my meds, always 4 hours after and before any food at all (around 2 am when I wake to go to the bathroom). I've always needed a relatively high dosage compared to my size/weight, but now it seems I am not absorbing my meds at all.

I had been on 150 mcg synthroid + 5 mcg cytomel when these labs were drawn:

1/26/2017 TSH: 0.373 .(27-4.2) FT4: 0.97 (.93-1.17)

Due to some major life changes, I did not have my labs done again until October. Then something went wacky (I don't touch soy or other goitrogenic foods, and I stated, I do not eat or drink anything 4 hours on wither side of my meds).
10/2/17 TSH: 70 ; FT4: 0.72
12/7/17 TSH: 73; FT4 0.7

My endocrinologist will NOT test FT3, and yes, I have in the past done my own labs but it really is inconsequential at this point. He has changed me to Tirosint 200mcg. He has also referred me to a GI specialist for evaluation of malabsorption.

Any wisdom or experience appreciated.


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## creepingdeath (Apr 6, 2014)

Do you have symptoms that correlate with those recent labs?

I know some people take their thyroid med's sublingually but I think that's with desiccated thyroid and not synthetics.


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## DarkPurpleAddy (Dec 6, 2017)

I wish I could say something helpful, but I'm still pretty new to Hashis life myself (or at least the part where I know about it at all). I'll just say that I hope everything gets sorted out and that you're okay. Good luck! :hugs:


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## joplin1975 (Jul 21, 2011)

Your labs are very much reflective of someone on cytomel, not malabsorption. Without free t3, its impossible to say.

I echo the question -- do you have symptoms?


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## khaki (Dec 24, 2016)

Sorry--I need to fix my settings to get notified with replies, I'm just seeing these! Thanks everyone. YES, definitely have symtoms. I have been feeling pretty awful for a several months but we were in the midst of a major life change (adopting a special needs toddler from China) so I kept assuming it was "just stress". Then I finally got labs done & that was the first of the crazy ness. I've been on both the synthroid 20 years, cytomel about 18 and never had labs anything like this.

Symtoms--constipation, freezing cold (more than my usual) and the biggest is extreme fatigue and inability to think! Really struggle to remember things or process like I usually can.

This is day 3 of tirosint and so far I can't say anything positive. I fall alseep quickly, and never wake rested.


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## joplin1975 (Jul 21, 2011)

Well, its really, really hard to say without that free t3 number (which I know you know already!). I would expect your free t4 to be a bit higher and given your symptoms, its reasonable to assume you are hypo.

(And congrats on the adoption!!!)


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## khaki (Dec 24, 2016)

thanks so much. If I can get to it (my health has fallen in priority as our new child has major medical needs), I may do the FT3 on my own. I've done it in the past and always fall just below mid range. Honestly, the cytomel has always suppressed my TSH and my typical labs are like the first ones I gave--low or suppressed TSH with very low normal Ft4. I skip both meds on day of labs. It seems crazy to imagine malabsorption after all these years, but these labs are crazy! I have an appt with a GI specialist next week. Really want answers but also hope that's not a rabbit trail!


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## Lovlkn (Dec 20, 2009)

> I may do the FT3 on my own. I've done it in the past and always fall just below mid range.


FT-3 and FT-4 both need to be pushing 3/4 range. Stress can eat up FT-3 and it sounds like your stress levels have increased


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## jenny v (May 6, 2012)

Yes, never discount the power of stress! If you've been running yourself ragged recently, both mentally and physically, your body will just suck up the medication faster than usual and leave you feeling hypo. I've found in times like that I need more T3 medication until I feel better. As stress levels hopefully go down, I monitor myself for hyper symptoms and decrease the T3 as needed. Hopefully, your doctor will work with you. Congrats on the new kiddo!


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