This I hope, may help anyone who has Hashimoto's, or both Hashimoto's and Pernicious Anaemia
I have discovered that taking my thyroxine tablets with a teaspoon or so of apple cider vinegar (acidic) or similar, crunching tablets with the cider vinegar in my mouth before swallowing, is working for me, and seems to be aiding absorption. If you want to try this and are avoiding gluten, don't use ordinary malt vinegar. I follow this with my morning black coffee (milk can also affect absorption). The result is that I am thinking much more clearly, and have more energy generally which lasts throughout the day. More recently, along with the foggy mind, my energy levels have dropped considerably in the afternoon.
I have two autoimmune illnesses, Hashimoto's and Pernicious Anaemia. I take 200mgs Levothyroxine daily, and have a B12 injections every 4 weeks. Some weeks ago I saw a post on this site which provided a link to a research paper which explained the results of tests of absorption of different types of thyroxine in relation to levels of stomach acid. (Many thanks to the poster of this post).
The paper was actually proving that a new type of thyroxine gel capsule could be absorbed more easily by people with low stomach acid, than Synthroid or Levothyroxine. My blood test results suggest that I am taking too much thyroxine, and when my doctor questions this I explain (and he agrees) that I'm not experiencing any of the symptoms which could suggest that I'm having too high a dose, (high blood pressure, rapid heart rate, palpitations, weight loss etc.)
More recently I have not been able to think clearly, low on energy, tired etc. symptoms which could be explained by low B12 or low thyroxine. However I have recently read that the Parietal Cells which are destroyed by anti intrinsic factor antibodies, hence preventing absorption of B12, also produce Hydrochloric acid, so it would be reasonable to infer that if you have Pernicious Anaemia, or you know that you have low stomach acid for any reason, you may not be able to absorb Leovothyroxine or Synthroid efficiently. Hence my experiment with the apple cider vinegar. I will update results just before my next B12 injection, when I usually experience return of a number of PA symptoms, to see if what I believe to be a greater absorption of thyroxine helps to improve my metabolism to an extent that the absorption of the B12 I am given by injection, is also improved. I hope this helps anyone who has absorption problems, and all best wishes to all who are living with either or both Hashimoto's or PA.