Ileostomy and thyroid medicine

[nanapops55]

Newly diagnosed with hypothyroidism. I also have an ileostomy. I’m wondering if there is any problem absorbing the medicine because of my ileostomy. I took 25 mcg’s for 6 weeks with no change in my numbers. Now taking 50snd not really feeling any difference.

[SlowDragon Administrator]

Standard starter dose is 50mcg and often people don't notice any improvements until after 6-8 weeks on each dose

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards, retesting 6-8 weeks later each time

This continues until TSH is under 2, FT4 in top third of range and FT3 at least half way in range

Typically that is usually at a dose somewhere between 100mcg and 200mcg

Very important to test vitamin D, folate, ferritin and B12 levels regularly. These need to be optimal for good thyroid function

Does ilostomy affect absorption of vitamins? In particular your B12 levels?

nhs.uk/conditions/ileostomy...

Have you ever had both TPO and TG thyroid antibodies tested? This is to see if cause of hypothyroidism is due to autoimmune thyroid disease diagnosed by high antibodies

[coco_glitter]

Hi NanaPops. Our bodies rely on good absorption to absorb thyroid hormones and provide adequate uptake of the hormones. I would check with your stoma nurse or your gastro consultant about this as it is specific to your gastro problem and probaby needs a more tailored approach.

[posthinking01]

Hi there - my late Mother had an ileostomy - was one of the first to have the operation in the 1960's - she had been a virtual prisoner in her own home because of a really bad case of ulcerative collitis she developed at aged 21 - after the operation at aged 46 - she was set free and travelled the world bless her - and having been at death's door over the years often being in hospital for over 6 months at a time in those days when she was ill with UC she lived until she was 93. Only telling you this because I will understand some of the difficulties you will experience with this condition - what foods can aggravate it and you have to learn what suits - my Mum was diagnosed with thyroid deficiency in her 80's even though she should have been at aged 50 (long story !) I take liquid thyroid which is easier to assimilate and I have lactose intolerance - I take Mercury Pharma one - wouldn't recommend the Teva one - what will happen with the tablet is that it could pass out of your gut too fast so you might not get the benefit plus the lactose won't be good - the liquid is lactose free. Hope this helps.

[Nini79]

Hi there,

I was just diagnosed recently too and also have an ileostomy due to ulcerative colitis. It was also a worry of mine regarding absorption of Eltroxin as sometimes tablets just pass right through me.

[helvella Administrator Thyroid UK in reply to Nini79]

UK levothyroxine products used to say that they could be dispersed in water and swallowed. That would way to avoid them passing through.

More recently, they do not advise this but instead suggest liquid levothyroxine products. However, it is unclear why the advice changed. I suspect that it is still a reasonable approach so long as nothing is left in the glass and all is swallowed. Discuss if possible.

[nanapops55]

I am going Thursday for a blood work checkup. I believe if my numbers don't change any my doctor will be addressing this. Last checkup my numbers went up so she upped my dose. I will let you know if there is evidence I am not absorbing.

[helvella Administrator Thyroid UK]

Don't miss the possibility of failing to absorb vitamin B12 as well.

nhs.uk/conditions/ileostomy...

Nini79