Thyroid medication absorption

[besst]

Have some exciting news.........and information I am sure many of you in the Thyroid Community know.....

I was on a steady dose of Levothyroxine and TSH levels were perfect, then all of a sudden my TSH started to climb....went from 2.0 (where I feel best) to 7.8  (Normal is 0.3-5.5).  Saw my Endo, and he was ready to start fiddling with twice a day dose........slow release meds etc.......but I thought I might do some research.....
It seems the both Calcium and Soy really affect the absorption of thyroid medication.  This info is readily available on the internet, but I did not realize HOW important it is.  I had started having a huge bowl of greek yogurt every morning....about an hour after my dose, as well as eating a protein bar mid morning (around 4 hours past dose) that had soy .........long story short.......stopped eating both of these - soy entirely out of my diet, and yogurt only in the afternoon sometimes...........repeat TSH today only one month later.......went from 7.8 to 3.4.......bingo!!  :-)

[Barb135]

I know calcium supplements (and other vitamins/minerals) should be separated from thyroid med by at least 4 hours; however, I often eat yogurt or something with milk (cereal, protein shake, etc), for breakfast and have never had an issue.  I'm not sure the calcium level in a serving of dairy is high enough to make much difference.  However, we're all different, so these things don't affect us all the same.

I avoid soy products as  much as possible.

[AJWS6]

Wow ! that's interesting.  Thyroid disorder is very tricky.  Many varying factors, per individual.  My body functions best low TSH/low FT3,.  When my TSH elevates so does my FT3,.  I was wondering what caused my TSH to elevate from 1.5 to 6.2,.  I don't eat/drink soy, but I did start taking Centrum vitamins with 250mg calcium, prior to last labs.      

[gimel]

Thanks for giving us that feedback on calcium and soy.  In return, let me give you some useful info.  TSH is a pituitary hormone that supposedly reflects accurately the levels of the biologically active thyroid hormones; however, TSH cannot be shown to correlate well with either Free T3 or Free T4, much less with symptoms, which are the most important consideration.  

We refer to doctors that totally rely on TSH to diagnose and medicate a hypo patient as having the "Immaculate TSH Belief".  Unfortunately it doesn't work.  TSH is affected by so many things that at best it is only an indicator, to be considered along with more important indicators such as symptoms, and Free T3 and Free T4 levels.  

A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T3 and Free T4 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  You can get some good insight into clinical treatment from this letter written by a good thyroid doctor for patients that he sometimes consults with after initial tests and evaluation.  The letter is then sent to the participating doctor of the patient to help guide treatment.  In the letter, please note the statement, "the ultimate
criterion for dose adjustment must always be the clinical response of the patient."

http://hormonerestoration.com/files/ThyroidPMD.pdf

So if you haven't been tested for Free T3 and free T4, then you should make that a top priority.  I also suggest that you should find out if your doctor will treat clinically as described.  If not, then you need to find a good thyroid doctor that will do so., otherwise you will end up on a roller coaster, as your current doctor  adjusts based on TSH.  One other thought is that since hypo patients are frequently too low in the ranges for Vitamin D, B12 and ferritin, you should also have those tested as well.