<<Disclaimer: Verify this information before applying it to your situation.>>

Summary of responses to my question regarding problems associated with thyroid
replacement medication absorption related to accidental gluten ingestion:

Four respondents have been taking Synthroid from 3 to 15 years and have
experienced no problems.  Two of those stated that they didn't believe levels
could be afftected by inflammation after a gluten ingestion episode.  One
noted that "While I have not directly asked the physician or the pharmacist
about absorption when I have a problem because of some inappropriate intake,
my discussions have left me with the impression that what happens on a given
day or two is not likely to produce a significqnt impact on becuase of the
thyroid.  Any problem I have with inappropriate intake will be short lived
because I do follow a GF diet and any error would be the result of hidden
glutens rather than deliberate action on my part.  This means that the issue
will self correct in a short time.  My impression is that thyroid replacement
medication taken during periods when my intestine is not fully absorbing will
be of a short enough duration to have little or no impact from any change in
my thyroid condition.  However, I have no science to back this up and have
not directly raised it with my physician."

Three respondents were able to cut thyroid med dosage after beginning a
gluten free diet and have had no problems from infrequent gluten ingestion
accidents.  Another person was able to reduce dosage of Synthroid but "I get
a low grade fever and am very tired when I don't have enough synthroid and
have noticed that it usually happens aften an "episode."

Another respondent was unable to stabilize thyroid hormone levels for thirty
years but has now stabilized after being on a gluten free diet.  This person
was able to reduce thyroid replacement dosage significantly (500 mcg to 300
mcg)

One respondent has heard of many problems with Synthroid unrelated to gluten
ingestion and suggests that many people may do better with Armour.  She
suggested checking archives at maelstrom.stjohns.edu/archives/thyroid.html

Another respondent had no success using Synthroid but has had better results
with Cytomel.

One respondent said, "In the last 8 months, my Synthroid dose has been raised
3 times, and my TSH levels are still running at 15-20 - meaning that I'm not
getting enough thyroid hormone.  This is after almost 20 years on a steady
dose.  It makes me wonder what is going on in my gut."

Recent posters to the National Graves Foundation Bulletin Board
(http://www.support-group.com/cgi-bin/sg/get_links?  graves) (2/11 posting)
have commented that people who are post RAI with Graves Disease may have
unique responses to thyroid replacement.  Another person received information
from Knoll pharmaceuticals that levothyroxine therapy should be separated by
several hours from ingestion of any soy products.  It is not known if there
is a minimum amount of soy that affects the levothyroxine absorption.


For those who asked, Synthroid is gluten free.

Also, this bit of prescribing information from www.synthroid.com:
"Studies involving radioiodinated T4 fecal tracer excretion methods,
equilibration, and AUC methods have shown that absorption varies from 48 to
80 percent of the administered dose.  The extent of absorption is increased
in the fasting state and decreased in malabsorption syndromes, such as sprue.
Absorption may also decrease with age.  The degree of T4 absorption is
dependent on the product formulation as well as on the character of the
intestinal contents, including plasma protein and soluble dietary factors,
which bind thyroid hormone making it unavailable for diffusion.  Decreased
absorption may result from administration of infant soybean formula, ferrous
sulfate, sodium polystyrene sulfonate, aluminum hydroxide, sucralfate, or
bile acid sequestrants."

Thanks to everyone who responded.

Kiva