Queries re absorbsion issues Levo and Lio

[smilingjane]

Morning all

I am wondering if anyone can tell me where levo and lio are absorbed, is it the stomach or intestines?

I cannot absorb B12 due to intestinal surgery , (ilium), and also have absorbsion probs with vit D though not sure if that's absorbed in the stomach? In which case I have absorbsion problems in my stomach also.

Do many people out there have liquid Levo ? Is this taken due to absorbsion issues?

Thank you for your thoughts and experiences in advance.

Jane 😊

[SeasideSusie Remembering]

Smilingjane

Lots of articles/studies if you Google, but here are extracts from two of them

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

Absorption and Bioavailability

Levothyroxine is mainly absorbed in the small intestine, more specifically through the duodenum, jejunum and ileum.10,11 Very little is absorbed in the stomach. Consequently, patients with shorter small intestines (bowel resection) have reduced absorption and require higher levothyroxine doses.1

From edm.bioscientifica.com/view...

Background

Oral levothyroxine (LT4), used to treat hypothyroidism, is absorbed through the intestinal mucosa at the level of the duodenum, jejunum and ileum. Only a fraction of the ingested dose is absorbed, depending on a number of factors including the age of the patient, dietary habits, malabsorption and interference of other drugs.

Can't find much information about liothyronine except

glowm.com/resources/glowm/c...

Pharmacokinetics

Absorption: About 95% is absorbed from the GI tract.

[smilingjane in reply to SeasideSusie]

OMG

This is an absolute revelation.

I have been Ill for a while, unable to work pretty much bed bound...

If Levo isn't absorbed adequately would that be apparent in b.test results do you think? or would the tests look okay and not show a lack of absorption?

Thank you so much for the info and links.

Jane 😊

[SeasideSusie Remembering in reply to smilingjane]

smilingjane

If Levo isn't absorbed adequately would that be apparent in b.test results do you think? or would the tests look okay and not show a lack of absorption?

Well, this isn't my area of expertise - absorption - so I only know what's in those quotes but I think what we have to remember is that the blood test shows what's in the blood sample at the exact moment it's extracted from the vein, so to me that means it's not showing what's been absorbed and reached the cells. This is probably why so many people have what are considered to be good results but they are still symptomatic. Does that make sense (sometimes my brain knows what I mean but it doesn't always read that way 🤣 ).

There's probably lots more info out there and other articles which you could find to explain it more.

[smilingjane in reply to SeasideSusie]

Ha! me too 😉

That does make sense

Thank you so much again

Jane 😊

[SlowDragon Administrator]

Poor gut function and malabsorption issues common with Hashimoto’s

Low stomach acid is extremely common...many members look at improving low stomach acid with apple cider vinegar with mother ,...Or by taking Betaine HCL

Another article on malabsorption issues and levothyroxine

academic.oup.com/edrv/artic...

Vitamin D mouth spray by Better You is good as avoids poor gut function of Hashimoto’s

When were vitamin D levels last tested

As you have B12 injections are you also taking daily vitamin B complex

[smilingjane in reply to SlowDragon]

Hi SD

Thanks for your response. I take the Thornes basic recommended on here and the D + K3 also. (Better you)

I am having a raft of tests next month, inc Ferritin, D etc.

And have some C. Vinegar so will start that too.

My next endo appointment is 2 weeks after tests in Oct or earlier if I can.

I will talk to him then about absorbsion issues.

Thank you again

Jane 😊

[SlowDragon Administrator]

Low stomach acid can be a common hypothyroid issue

Links

nutritionjersey.com/high-or...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

Protect your teeth if using ACV with mother

healthunlocked.com/thyroidu...

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

[smilingjane in reply to SlowDragon]

Wow that's a lot of info

THANK YOU

[SlowDragon Administrator in reply to smilingjane]

Can see on your profile you suffer from restless legs

Do you supplement magnesium?

Often helps with restless legs ...recommended to supplement magnesium if taking vitamin D supplements

Magnesium best taken afternoon or evening (must be four hours away from levothyroxine)

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

[smilingjane in reply to SlowDragon]

SD

Yes, I take it early evening. Got a large bottle but it was an online impulse buy. Must check the contents. It's one of those where they throw in other vits for good measure .

Ha! B6 and Zinc with the mag, just looked now. So that's 2 lots of B6 with the Thornes B Basic. I will check out the correct Mag to use. Mind you the Zinc will be doing me good and a bit extra B6 probs wont harm?

I have some mag oil for legs. I have only being using one or the other daily. Would you agree with that?

Thank you!

[smilingjane in reply to smilingjane]

I will say re RLs on case any other sufferer is reading. Magnesium didnt hit the spot with me.

The only thing that helps me us Oxycodone. V. low dose has been a godsend. It had got to the stage where I was affected 24/7

There was no respite. it affects my arms too. I was at a stage where I couldn't sit or lie down at all.

If anyone wants to share any experience or wants any advice re this please dont hesitate to PM me.

Sorry to go off topic!

😊

[smilingjane in reply to SlowDragon]

Thank you!

[SlowDragon Administrator]

Presumably you have B12 injections?

it’s recommended also to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and may improve B12 levels between injections

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

B12 injections during Covid crisis

pernicious-anaemia-society....

[smilingjane in reply to SlowDragon]

Yes - b12 SI every other day - looking forward to seeing some benefits ....

still waiting after 6 weeks 🤨

[jimh111]

The blood test will show how much has been absorbed. if your fT4 is OK you have no problem absorbing levothyroxine. Liothyronine is more easily absorbed as it is a smaller molecule.

[smilingjane in reply to jimh111]

Hi Jim11

Thanks for getting back.

The blood test will show what has been absorbed ... that's good ..... in the bloodstream, though not necessarily the cells and organs?

Interesting about the Lio being a smaller molecule, didnt know that ...

Jane 😊

[jimh111 in reply to smilingjane]

T3 is just one iodine atom smaller than T4 but levo has an absorption rate of roughly 50% and lio 95%. T3 and T4 are transported into cells actively by transport proteins, my guess is that it almost always works. I don't buy the 'not getting into cells' viewpoint. It may be that patients have reduced deiodinase or resistance to thyroid hormone but they are different issues.

[smilingjane]

Ah ... that's reassuring and interesting.

I just need to get the T4 and T3 right.

Thanks for the information

😊