The greatest problem with trying to get control of thyroid dysfunction after having gastric bypass is that nutrient deficiencies tend to compound following the bypass. It is much more difficult to get enough nutrients from the foods you eat, as well as from supplements, when there is very little stomach acid to process them.
The problem of nutritional deficiencies in patients before and after bariatric (gastric bypass) surgery has been known for decades:
There is no doubt you are not absorbing enough nutrients to make use of Levothyroxine (T4). Levothyroxine must be converted by vital nutrients already in place for it be converted into the active thyroid hormone T3. It is obvious you are lacking key nutrients to carry out that process.
Using an NDT product, which contains both T4 (38 mcg) and T3 (9 mcg) could be quite helpful to you. At the very least, it is a start by way to get T3 immediately into your body. While taking NDT you can address your nutritional deficiencies so that you'll eventually restore conversion of the NDT's T4 portion as well.
An integrative physician or holistic practitioner can get your body back in balance and get NDT for you. It appears you are in no condition to have a fight on your hands to get the thyroid hormones your body needs most. The vast majority of conventional medicine doctors are ignorant about NDT and T3 -- they often prefer to believe myth and legend instead.
Integrative, naturopathic physicians know the value of T3 and how the body is merely a ghost of itself without an adequate amounts in all cells. The gastric bypass surgery you had makes it even more difficult for you to maintain even minimal absorption of your current thyroid hormone replacement. This is a very common problem that occurs, especially with a person who is hypothyroid. Conventional doctors act like they don't know any of that. It's pretty sad. In the meantime, those with absorption problems continue to suffer needlessly as they cannot convert the T4 that's been prescribed. So the patient feels worse each and every day thereafter.
"Worsening Hypothyroidism and Multiple Nutrient Deficiencies Following Gastric Bypass: The Importance of Close Monitoring
" posted by Kirandeep Khangura M.D. The Conclusions were that:
The pharmacokinetics of levothyroxine and bioavailability in particular can be impaired based on the manner in which the medication is taken; levothyroxine is best absorbed in an empty stomach and is not to be taken with other medications
The gastric bypass procedure probably caused further alteration in absorption of thyroid hormone as also other nutrients: iron, calcium and vitamin D.
Following gastric by pass procedures it is important to follow patients for nutrient deficiencies, as shown here; they invariably occur with time
But conventional doctors don't follow-up on such things! And yes, it is obvious to anyone who has had gastric bypass that they can no longer absorb many vital nutrients. So one wonders why nutrients and hormones are not assessed prior to approval of gastric bypass surgery in the first place! This is where integrative/naturopathic/holistic physicians excel.
I hope this helps you. Healing Hugs!