How does gastroparesis affect the uptake of T3?

[Rhub4rb]

My stomach empties very slowly.. sometimes it just freezes and I get so dehydrated as no food is going down I have to go and get IV fluids. I take my T3 first thing on a completely empty stomach and again at about 2 after maybe a few mugs of herbal tea but no food. I then leave my vitamins until about 6 and eat at about 8.

I figure if I can stick to this routine (generally I only eat one meal a day as eating causes me so many problems) this is probably the best routine I can do?

How much does it affect absorption if there is still food in my stomach from the night before (I know this can happen as sometimes I'm sick in the morning and its basically undigested food - sorry for the tmi).

Also does the T3 need to leave the upper stomach before it can be absorbed?

If I forget to take a dose in the afternoon is there any point in taking it close to mealtime in the evening?

Thanks

[Judithdalston]

I had noted sometime ago that women in general have a slower digestion than men and even some ‘healthy’ ones ( so knowing all hypo complications probably not us!) can have food still in their stomachs 4 hours after eating; yours is obviously worse. Do you know why you have gastro problems? But you think that you at least sometimes have undigested food there in the morning after a single 8 pm meal...so perhaps your T3 dose ‘first thing’ might be compromised by food still in your stomach ( ie calcium, iron etc in food ‘wrap around’ hormones). You don’t say what your T3 dose is, I presume you don’t take Levothyroxine too ( why not, it would be easier to maintain some FT3 in system if you could use it?). Could you take your main T3 dose at 2 pm when your stomach is empty, do you need a second dose? Not sure if ‘fruit’ teas are suitable to drink with T3 dosing.

[Rhub4rb in reply to Judithdalston]

My gastro problems are due to T1 diabetes and internal nerve damage (though I have read it may be made worse by hypothyroidism).

My T4 level was 29 on 175mcg of T4 and I have always had 'normal' levels of T4 even before adding T4 meds but my rT4 was very high and my TSH 0.005 so I think I have enough T4. My T3 was 4.18 which is within normal range but I have family history of thyroid problems and every hypothyroid symptom going and I believe I have a problem with the uptake of T3. I have now completely stopped taking T4 (last time I did this was before a blood test for doctors when I was desperate for them to resume my higher dose of T4 and within 2 days could hardly move and sounded like a frog) and have had no negative symptoms at all. I am taking 50mcg daily of T3 and am definitely feeling a little better already. This morning I was able to get out of bed at 8 feeling more awake than I can remember feeling in a while (every morning is a fight to wake up, even if I'm going on holiday I can only just drag myself out of bed). Yesterday and last Monday I have got up early to go gym and do a body pump class,when I have not done a morning class for 17 years!

I'm going to stay on this dose and monitor for hyperactivity (my basel temp is still very low (45.4 this morning) and no other symptoms as yet. I plan to stay on this dose for at least 3 weeks and see how I feel at the end of it (unless I start showing signs of being overactive).

I am having a blood test done in a weeks time by my GP to test what they can, and this will have to show my T4 level dropping and T3 rising. What it won't show is how much T3 my body is able to use.

[Judithdalston in reply to Rhub4rb]

I had wondered whether it might be a diabetic problem ( i’m Insulin dependent due to sepsis/ acute pancreatitis) ... and nearly commented before that hypo/ Hashi’s can make any gut problems worse...so might be that. Like me on 50 mcg T3 only, tho I was on this T3 dose with 125 mcg levo. till a month ago... so thought I would need more T3 to compensate....still not sure if 50 mcg is ideal, or whether I need more...it can be tricky to judge. My basal temp. seems to have gone back down since on the 50 T3:125 T4 combo, yet pulse/body gone up! I tried the 2 and 3 dose daily of T4/T3 combo but couldn’t get the appropriate timing gaps between these, food/ drink/ medicines and supplements, so find 4-5 am dosing so much easier and don’t seem to get that ‘winding down’ feeling I did get a 4-5 pm I did on smaller doses both on combo and T3 only. My sleep has improved since ditching the levo. as couldn’t get to sleep till 3 amish ( fibro symptom), and went to loo 4-5 times nightly ( another fibro symptom) so got used to getting up more like 10 am...now wake up and listen to radio for an hour instead! Leg pain gone down too on T3 only. Hope it’s not just coincidence and getting to a permanent improvement, especially f I also remember to keep up the mins/ vits supplements. Good luck.

[Rhub4rb in reply to Judithdalston]

Its so difficult when you so want it to not just be a coincidence and actually be signs that you're getting a bit better! I think I will need to up my dose from where I am. I am getting my blood taken on Monday and will see what my T3 level is. I am pretty sure I have a problem with the uptake of T3 and am not sure if this can be overcome by having more T3 in my system or if I need to get to the root of the problem.

[SlowDragon Administrator]

Have you tried taking T3 as 3 split doses, at 8 hours apart? Some of us find this gives more stable FT3 levels.

T3 is short acting, mostly used up after 12 hours. It's a long gap between 2pm and next morning

Personally I found it significantly better to take T3 waking(7am), 3pm and 11pm

Some people find a small dose of T3 at bedtime improves sleep, others don't like it

Graph showing why to take T3 over time since dose

healthunlocked.com/api/redi...

Research Paper data comes from

ncbi.nlm.nih.gov/pmc/articl...

[Rhub4rb in reply to SlowDragon]

No but I will try that. Would the late dose be significantly impacted if I still had food in my stomach from that nights meal? Sometimes my stomach empties really slowly and I wonder just how much this affects the absorption of the T3.

[SlowDragon Administrator in reply to Rhub4rb]

Difficult to say, normally we say 2 hours after an average meal, but 3 hours after a feast

Perhaps on your current 50mcg daily dose, experiment with taking 20mcg waking, 20mcg 3pm and 10mcg at bedtime

As you are type one diabetic are you on strictly gluten free diet?

[Rhub4rb in reply to SlowDragon]

I will try splitting it into 3.

No I am not I try but I don't always succeed.. I don't eat much with gluten in though, I gave up bread 20 years ago and don't hardly eat processed food. Its mainly the occasional trip to a coffee shop I'll slip up lol.

[Hidden in reply to Rhub4rb]

Hi is your blood sugar under control? Do you take insulin?

[Rhub4rb in reply to Hidden]

Yes I take insulin.. my hba1c is better than it has been for years at 6.6 but the worse my thyroid symptoms get the more out of control my blood sugars become.

[Hidden in reply to Rhub4rb]

I only asked as recently found that thyroid medications can raise blood sugar levels by 20 points and the insulin if given at the same time might alter the levels. Advice about taking insulin at different times to thyroid medication might help your endocrine balance. As your glucose balance seems well under control, may be it is an thyroid hormone imbalance. The website underneath has threads about insulin levels which may be of interest.

diabetes.co.uk/forum/thread...

As it takes a long time for your stomach to digest food through the colon, may be your stomach acid levels are too low? If there is any stenosis of the stomach sphincter, you can get oesophageal reflux. Guess you should look up your symptoms on NHS gastroparesis information website for information on symptoms and treatment. There are supplements taken to help stomach acid levels which your doctor can advise you about.

[SlowDragon Administrator in reply to Rhub4rb]

If gluten free is to be effective it does need to be absolutely strictly gluten free.

Each time we eat gluten it takes weeks/months to recover

Trying absolutely strictly gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

Susan Blum book The immune system recovery plan has whole chapter on type one diabetes

amazon.co.uk/dp/B075X17MS7/...

[Rhub4rb in reply to SlowDragon]

I have only just seen your reply! I just realised there is probably gluten in the gravy granules I have on a fairly regular basis.. Now thats something easily swapped for a gluten free alternative! I will have a read of the links now! Thank you

[SlowDragon Administrator in reply to Rhub4rb]

Gluten gets everywhere

I use to love yogurt coated fruit drops. Ingredients said gluten free.

But when I read more closely (after eating some) realised they had gluten free wheat fibre in.....needless to say they caused reaction 😟

waitrose.com/ecom/products/...

[Rhub4rb in reply to SlowDragon]

As a T1 diabetic I'm used to misleading food packaging and stuff claiming to be 'sugar free' just because the sugar in it isn't 'added'. I think this is partly why I've kidna side stepped this issue.. The things that are bad for us are in everything and they just make up different names for them!

[Hidden in reply to Rhub4rb]

glutenfreesociety.org

is a great uk website explaining all the autoimmune diseases that can be affected by gluten in the diet including thyroid, diabetes, fibromyalgia, endometriosis, types of arthritis. Information on sourcing different flours for baking, and anything you need to know about how going gluten free can help.