Freaking Out...need Help Interpreting Test Results

[pain*in*my*gut]

Ok, I got my results from my rheumy appt. last week. Here are my test results that were positive/elevated:

CCP Antibodies IgG/IgA 61 strong positive (0-19) Antibodies to CCP is the latest serological marker available for the diagnosis of RA. It is tested by ELISA and is more specific than Rheumatoid factor for the early diagnosis of RA.

TPO AB Thyroid Peroxidase 325 (0-34) iu/ml

Antithyroglobulin was normal, so is my TSH

Positive ANA 1:80, speckled pattern

CRP 8.8 (0-4.9)

I am scheduled for a gallium scan next monday to see if we can pinpoint the source of inflamation (elevated CRP). The thyroid test seems like it could be Hashi's, no?

Something is going on with me besides the Celiac, I just know it. I have been feeling very anxious over the last few weeks and shakey at times. Then an hour later I feel like somebody has unplugged me from the power socket and I can barely move I'm so tired. I have been having aches in the front of my neck (right in my thyroid area) that radiates into my upper shoulders and back. My TSH is normal, BTW.

Any thoughts?

[Gemini]

Ok, I got my results from my rheumy appt. last week. Here are my test results that were positive/elevated:

CCP Antibodies IgG/IgA 61 strong positive (0-19) Antibodies to CCP is the latest serological marker available for the diagnosis of RA. It is tested by ELISA and is more specific than Rheumatoid factor for the early diagnosis of RA.

TPO AB Thyroid Peroxidase 325 (0-34) iu/ml

Antithyroglobulin was normal, so is my TSH

Positive ANA 1:80, speckled pattern

CRP 8.8 (0-4.9)

I am scheduled for a gallium scan next monday to see if we can pinpoint the source of inflamation (elevated CRP). The thyroid test seems like it could be Hashi's, no?

Something is going on with me besides the Celiac, I just know it. I have been feeling very anxious over the last few weeks and shakey at times. Then an hour later I feel like somebody has unplugged me from the power socket and I can barely move I'm so tired. I have been having aches in the front of my neck (right in my thyroid area) that radiates into my upper shoulders and back. My TSH is normal, BTW.

Any thoughts?

Yes, it does look like you have Hashi's, as do I. Your antibodies can become elevated before your TSH tanks but what was the number for your TSH? Many doctors go by the old ranges, which allow TSH to be as high as 5.5 and still be considered normal. That doesn't work for most people and TSH should be at least 2.5 or lower.

The positive ANA is not a big deal. That is just a general test for inflammation and it can be elevated by Celiac, Hashi's or any number of autoimmune conditions. It just means that yes, you have inflammation going on. The fact that it is speckled can pinpoint to a number of AI issues, though, and RA may be one of them. I have Sjogren's Syndrome and my ANA is speckled. Your titer is not terribly elevated so once you get this inflammation under control, that ratio can go down closer to normal. It may take following the gluten-free diet for quite a while before that happens so don't sweat it too much.

Do you have any symptoms of RA? That is very important because having multiple AI issues can elevate tests, even when you do not have the disease itself. I have an extremely elevated RF, which has come down a bit in the 6 years I have been gluten-free, but I have absolutely no symptoms of RA whatsoever and don't worry about it. Do you have joint pain? If you have no symptoms of RA, then you may not have it at all and your elevated numbers can be from Celiac alone. Doctors still do not get this, which boggles my mind. How long have you been gluten-free?

I would say you definitely need to be treated for thyroid disease, as you are highly symptomatic, and be proactive with the doctors if they refuse because your TSH is supposedly normal. Have other testing done but if you aren't symptomatic for RA, don't let them tell you that you have it. You may not, as I have said. Take a deep breath and don't freak out...most Celiacs have wonky blood work at first and many (like myself) continue to have wonky blood work. I feel good and have no symptoms of anything, besides the AI diseases I already have. We'll guide you through the AI testing because some doctors just don't get it right!

[pain*in*my*gut]

Yes, it does look like you have Hashi's, as do I. Your antibodies can become elevated before your TSH tanks but what was the number for your TSH? Many doctors go by the old ranges, which allow TSH to be as high as 5.5 and still be considered normal. That doesn't work for most people and TSH should be at least 2.5 or lower.

The positive ANA is not a big deal. That is just a general test for inflammation and it can be elevated by Celiac, Hashi's or any number of autoimmune conditions. It just means that yes, you have inflammation going on. The fact that it is speckled can pinpoint to a number of AI issues, though, and RA may be one of them. I have Sjogren's Syndrome and my ANA is speckled. Your titer is not terribly elevated so once you get this inflammation under control, that ratio can go down closer to normal. It may take following the gluten-free diet for quite a while before that happens so don't sweat it too much.

Do you have any symptoms of RA? That is very important because having multiple AI issues can elevate tests, even when you do not have the disease itself. I have an extremely elevated RF, which has come down a bit in the 6 years I have been gluten-free, but I have absolutely no symptoms of RA whatsoever and don't worry about it. Do you have joint pain? If you have no symptoms of RA, then you may not have it at all and your elevated numbers can be from Celiac alone. Doctors still do not get this, which boggles my mind. How long have you been gluten-free?

I would say you definitely need to be treated for thyroid disease, as you are highly symptomatic, and be proactive with the doctors if they refuse because your TSH is supposedly normal. Have other testing done but if you aren't symptomatic for RA, don't let them tell you that you have it. You may not, as I have said. Take a deep breath and don't freak out...most Celiacs have wonky blood work at first and many (like myself) continue to have wonky blood work. I feel good and have no symptoms of anything, besides the AI diseases I already have. We'll guide you through the AI testing because some doctors just don't get it right!

Thank you for responding, Gemini! My TSH has been:

4.450 in 2009

2.820 in 2010

3.500 in June 2011

So, if I go by the 2.5 being the upper limit, then Houston, we have a problem! I am going to see an endocrinologist as soon as I have my follow up with my rheumy, so I guess I will see what she says.

Yes, I do have symptoms of RA. I have for about 4 years now. I have stumped many docs....I even got a second opinion from the head of the University of Chicago rheumatology department and he diagnosed me with "just" fibromyalgia in 2009. I am on extended release morphine for the pain, mostly in my lower back/hips/SI joints. My hands and knees have been acting up in the last year or so, but they have never been obviously swollen or red, so docs just say it must be the fibro.

I have been gluten-free for almost a month. My GI symptoms have improved a lot, and my energy levels have seemed better. I had hoped that my CRP was just elevated from the Celiac, but now I am wondering what else is going on.

Thanks again for your advise! I will keep you posted...my gallium scan is next week. I bet my thyroid will light up like a Christmas tree.

[Gemini]

Thank you for responding, Gemini! My TSH has been:

4.450 in 2009

2.820 in 2010

3.500 in June 2011

So, if I go by the 2.5 being the upper limit, then Houston, we have a problem! I am going to see an endocrinologist as soon as I have my follow up with my rheumy, so I guess I will see what she says.

Ummmmm.....yes, Houston, you are hypo!!! Symptoms, high TSH and antibodies. Not to worry...once you supplement and stay gluten-free, things will right themsleves. My antibodies at diagnosis were 1200 (yes, that's right) and after 6 years, my last test was "no detectable antibodies". OK, 6 years is a long time but I was older and had active Celiac for most of my life. Lots of damage. You'll get this straightened out. Do not let the doctor tell you your TSH is OK....you have symptoms that need to be addressed.

Yes, I do have symptoms of RA. I have for about 4 years now. I have stumped many docs....I even got a second opinion from the head of the University of Chicago rheumatology department and he diagnosed me with "just" fibromyalgia in 2009. I am on extended release morphine for the pain, mostly in my lower back/hips/SI joints. My hands and knees have been acting up in the last year or so, but they have never been obviously swollen or red, so docs just say it must be the fibro.

I am sorry about the pain and it does sound like it may be RA. However, many people on this forum have reported a big improvement in pain once you are gluten-free for awhile and the inflammation goes down in your body. Fibromyalgia is a catch all term that they tell people when they cannot find the real culprit...like IBS. It's all from inflammation and this can be healed. Not everyone presents with classic symptoms on each AI disease. I never had lymph node swelling with my Sjogren's but had every other symptom so that didn't get diagnosed until lots of damage had been done. Geez, you have severe dry mouth and eyes but no swelling...can't be Sjogren's! What a bunch of dummies.

I have been gluten-free for almost a month. My GI symptoms have improved a lot, and my energy levels have seemed better. I had hoped that my CRP was just elevated from the Celiac, but now I am wondering what else is going on.

Thanks again for your advise! I will keep you posted...my gallium scan is next week. I bet my thyroid will light up like a Christmas tree.

I think that elevation is from all the stuff you have going on. Celiac, Hashi's and, possibly, RA. Same as me only different problems. It may take awhile but hang in there....things will get better. Patience will become your new best friend. Good luck!

[Skylark]

Thank you for responding, Gemini! My TSH has been:

4.450 in 2009

2.820 in 2010

3.500 in June 2011

Something is wrong with those numbers. What is the reference range and the exact name of the test you're reading? There's no way a doctor would ignore TSH at 450 on the even the old range of 0.5-5.0. If it was really ignored, find a lawyer because you can probably win a malpractice lawsuit.

My doctor diagnosed me with Hashi's on high TPO and did not do much other testing. I have had elevated TSH for many years so the TPO coming up wasn't a surprise. Good luck with the scan!

Arthritis can happen in celiac folks. I turned up this old study and some of the people in the study with SI arthritis were CRP positive/rheumatoid factor negative! The diet helped too, so I bet you start feeling a little better over the next few months. The article is free online. Maybe if you print it out and take it to the Dr. it can get your rheumy thinking and looking for newer info.

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[pain*in*my*gut]

Something is wrong with those numbers. What is the reference range and the exact name of the test you're reading? There's no way a doctor would ignore TSH at 450 on the even the old range of 0.5-5.0. If it was really ignored, find a lawyer because you can probably win a malpractice lawsuit.

My doctor diagnosed me with Hashi's on high TPO and did not do much other testing. I have had elevated TSH for many years so the TPO coming up wasn't a surprise. Good luck with the scan!

Arthritis can happen in celiac folks. I turned up this old study and some of the people in the study with SI arthritis were CRP positive/rheumatoid factor negative! The diet helped too, so I bet you start feeling a little better over the next few months. The article is free online. Maybe if you print it out and take it to the Dr. it can get your rheumy thinking and looking for newer info.

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Skylark...I know!! I was SHOCKED when I saw my TSH #'s from 2009! My medical clinic recently made all lab tests available to view online, so I can see all of my past test results. Here is that result copied directly from my chart :

Component Results

Component TSH

Your Value 4.45

Standard Range .450 - 4.50 uIU/ml

I was feeling like TOTAL CRAP when that doc ran the TSH! I had all of the symptoms then. I was told that "everything was normal". Why on earth would he not investigate that result any further?? He is no longer my doc, BTW!

I had the same issue back in 2009 with my first Celiac screen. It was the older AGA tests and my results were 3 (0-4 normal) for the IgA and 9 (0-9 normal) for IgG!! I was sooooo sick, most definately very symptomatic for the typical Celiac symptoms at that time.....why did the stupid GI doc not investigate? He told me I needed Xanax to calm my nerves! Right...I was bleeding from my rectum from pooping 20 X's a day because I was anxious. He is no longer my GI doc either, not that my current one is any better. He told me I didn't have to go gluten free because my biopsy was negative....REALLY?? With a DGP of 59, you think it's ok to eat gluten? THANK GOD my rheumatologist took one look at my blood results and gave me a DX of Celiac right then and there. Duh!!

Oh, and get this!!! My mom got a Celiac screen (DGP & Ttg) and genetic tests last week because of my positive dx. The nurse called her today with the results and said she tested positive for the Celiac gene and the doc wanted her to go gluten free (her Celiac screen was totally normal, she just has the genes). Obviously her doc is seriously confused about Celiac genetic testing and antibody screening! :unsure:

Sorry this turned into a rant...I have just had it with stupid doctors! I already have a good lawyer...he is sitting on the sofa next to me (hubby is a medical malpractice defense attorney...no joke)!

[Skylark]

I have to apologize. I have a cold and I'm apparently totally spacey. I totally misread your TSH as #4 was 450 rather than 4.450 and thought your readings were in the hundreds. I must be sicker than I realize.

Readings BELOW 4.5 or 5.0 are often marked as normal by labs that are using outdated reference ranges. It's still arguably poor medicine because by now most doctors are aware that the new recommended reference range is 0.5-2.5 but probably not malpractice.

Here's the thing. Don't start on thyroid just yet. You've not been gluten-free long enough to heal and a LOT of people with borderline thyroid function improve on the diet. If you start onto thyroid meds you may be stuck on them. Make sure you're getting enough selenium and avoid large amounts of soy and raw cruciferous veggies (broccoli, cabbage, cauliflower, brussels sprouts, etc.). They are anti-thyroid. See if your doc will watch and wait for a few more months and retest TSH. Also the thyroid books I've been reading recommend taking vitamin D.

I'd recommend a book called Living Well with Hypothyroidism, and possibly Kharazian's book although it's a rough read. The books will give you ideas to normalize your thyroid function. If your TSH is still above 2.5 after a few months gluten-free you may be stuck going onto thyroid meds.

And Xanax from a GI for celiac? Unreal. You've had luck as bad as I did.

[Gemini]

I have to apologize. I have a cold and I'm apparently totally spacey. I totally misread your TSH as #4 was 450 rather than 4.450 and thought your readings were in the hundreds. I must be sicker than I realize.

I am glad you wrote this reply, Skylark, because I was going to ask if you wore glasses! I would imagine anyone with a TSH of 450 would be lucky to have a pulse.

Readings BELOW 4.5 or 5.0 are often marked as normal by labs that are using outdated reference ranges. It's still arguably poor medicine because by now most doctors are aware that the new recommended reference range is 0.5-2.5 but probably not malpractice.

Agreed!

Here's the thing. Don't start on thyroid just yet. You've not been gluten-free long enough to heal and a LOT of people with borderline thyroid function improve on the diet. If you start onto thyroid meds you may be stuck on them. Make sure you're getting enough selenium and avoid large amounts of soy and raw cruciferous veggies (broccoli, cabbage, cauliflower, brussels sprouts, etc.). They are anti-thyroid. See if your doc will watch and wait for a few more months and retest TSH. Also the thyroid books I've been reading recommend taking vitamin D.

This is a slippery slope because thyroid numbers can get very bad, very fast if you do not supplement. It's a tough call. The numbers were high enough on testing that I would consider supplements, but that's just me. I know how bad I felt when my numbers where high but I also was hypothyroid 20 years before the Celiac diagnosis.

I also cringe somewhat when people are advised to stay away from cruciferous veggies. They have so many nutrients and I just won't give up veggies. It did not seem to have an impact on getting my thyroid under control. I still eat them everyday and I seem to be doing fine but I realize everyone is different. I don't consider thyroid supplement medication. It is really just hormone replacement therapy. I have no problems taking them for the rest of my life. No side effects if you get the dose right.

And Xanax from a GI for celiac? Unreal. You've had luck as bad as I did.

The GI I saw years ago suggested I see a psychiatrist because I obviously had problems in my life that were causing me so much stomach distress. It's sad to see this crap is still being pulled and now they want to drug you up to boot. Pathetic.

[pricklypear1971]

I agree thyroid supplementation, even with "slightly high tsh" can be hugely beneficial. I am a living, breathing example.

I saw drastic changes in my mood, energy, and brain fog in DAYS on very low-dose t3/t4.

It will be interesting to see if I can reduce my dosage now that I'm gluten-free.

[Skylark]

This is a slippery slope because thyroid numbers can get very bad, very fast if you do not supplement. It's a tough call. The numbers were high enough on testing that I would consider supplements, but that's just me. I know how bad I felt when my numbers where high but I also was hypothyroid 20 years before the Celiac diagnosis.

I also cringe somewhat when people are advised to stay away from cruciferous veggies. They have so many nutrients and I just won't give up veggies. It did not seem to have an impact on getting my thyroid under control. I still eat them everyday and I seem to be doing fine but I realize everyone is different. I don't consider thyroid supplement medication. It is really just hormone replacement therapy. I have no problems taking them for the rest of my life. No side effects if you get the dose right.

Agreed supplementing/not supplementing is a slippery slope. pain*in*my*gut is so new to the gluten-free diet it just seems a shame to change something right this moment. I totally KNOW how awful you can feel hypothyroid, as I have Hashi's myself. At TSH 5.5 last summer I had every symptom of hypothyroidism in the book. I don't agree that thyroid replacement is completely benign though. A functioning thyroid gland makes a little T1 and T2 as well as T3 and T4, and more importantly the level of hormone is better regulated than with pills. The thing that concerns me is that some people who start on thyroid hormone are unable to stop taking it because it changes the thyroid gland a little. Hashi's antibodies can come and go, and when pain*in*my*gut really gets going on the diet, the titer may come down and her TSH go down as well.

The cruciferous veggies are only a problem raw. Apparently cooking them removes the goitrogen. The only things I avoid that I would have eaten before are cole slaw and raw cauliflower. It's just a small thing you can do to help. I didn't avoid them for years but I learned a lot more recently and I'm trying to do everything I can for my poor thyroid. I like to pass on what I learn.

[Gemini]

I agree thyroid supplementation, even with "slightly high tsh" can be hugely beneficial. I am a living, breathing example.

I saw drastic changes in my mood, energy, and brain fog in DAYS on very low-dose t3/t4.

It will be interesting to see if I can reduce my dosage now that I'm gluten-free.

My dosage has only gone down 20mcg from pre to post diagnosis and healing. It swung super hyper when I healed and my original dose was too high. You have to watch that because you never know when the shift will come because you cannot guess at what point you start to really absorb again. Not a pleasant experience.

I think it really depends on how long you have been an undiagnosed Celiac and how old you are. I hate to say it but age is a factor. I was in my mid 40's when the Celiac was figured out and I had symptoms since childhood.

I recently had to up my dose a bit and the only different factor was I had started an exercise and weight training regimen last year. I wonder if that plays a factor? It is a very hard work-out with a trainer and they push you a bit. As I cannot make much of my own hormone, I think maybe when you exercise your body calls for more hormone...sort of like insulin. This is a totally un-medical theory but I am doing fine on the higher dose. Or it could be that aging thing. With each decade of life , your metabolism naturally slows down a bit anyway so maybe dosage will have to be tweaked from to time. I hate that.

[Gemini]

Agreed supplementing/not supplementing is a slippery slope. pain*in*my*gut is so new to the gluten-free diet it just seems a shame to change something right this moment. I totally KNOW how awful you can feel hypothyroid, as I have Hashi's myself. At TSH 5.5 last summer I had every symptom of hypothyroidism in the book. I don't agree that thyroid replacement is completely benign though. A functioning thyroid gland makes a little T1 and T2 as well as T3 and T4, and more importantly the level of hormone is better regulated than with pills. The thing that concerns me is that some people who start on thyroid hormone are unable to stop taking it because it changes the thyroid gland a little. Hashi's antibodies can come and go, and when pain*in*my*gut really gets going on the diet, the titer may come down and her TSH go down as well.

Your argument is a good one. My fear is that I did swing hypo a couple of years ago when trying to re-tweak my dose and I ended up anemic again and then I got nailed with shingles because I was run down. I am a tad paranoid about it now. You do have a good point and it very well may happen that pain*in*my*gut will recover well without supplements. I hope so.

I did not know that cooking these veggies made them safer to eat! I usually eat them steamed but do have a salad everyday for lunch, with broccoli and sometimes, cauliflower. The amounts are small and the other veggies are all non-cruciferous. Maybe that's why, overall, I have been able to control my thyroid without too much grief. I just would hate to give up my veggies...I really like veggies.

[Skylark]

I recently had to up my dose a bit and the only different factor was I had started an exercise and weight training regimen last year. I wonder if that plays a factor? It is a very hard work-out with a trainer and they push you a bit. As I cannot make much of my own hormone, I think maybe when you exercise your body calls for more hormone...sort of like insulin. This is a totally un-medical theory but I am doing fine on the higher dose. Or it could be that aging thing. With each decade of life , your metabolism naturally slows down a bit anyway so maybe dosage will have to be tweaked from to time. I hate that.

My dosage keeps going up. My body is systematically destroying my thyroid gland. I don't think it has to do with age for me. My TPO titer has doubled in three years to over 400.

I've noticed what you are talking about with exercise. If I'm slightly hypo I don't recover right and instead of the exercise feeling good I'll be tired the next couple days. They thyroid gland is dynamic and in a feedback loop with the pituitary and adrenals as well. We lose the "hormone on demand" aspect with the pills.

[pricklypear1971]

My TPO is down from 240 at dx to 60 after 2 months gluten-free. I have no idea what it was pre gluten-free, on meds.

I haven't felt hyper or hypo, then again I don't know the difference since gluten-free is a new ballgame. I just know gluten-free life is much much better.

I am getting to the point I can start working out - and need to do it. I have lots of personal training sessions left to use. We'll see. I'll need new labs in a few months for thyroid and we'll take it from there.

Right now it's day to day, just trying to add back everything but gluten, and get iron and vit d in the normal range.

I do feel better on iron and vitD .

[Gemini]

My dosage keeps going up. My body is systematically destroying my thyroid gland. I don't think it has to do with age for me. My TPO titer has doubled in three years to over 400.

I've noticed what you are talking about with exercise. If I'm slightly hypo I don't recover right and instead of the exercise feeling good I'll be tired the next couple days. They thyroid gland is dynamic and in a feedback loop with the pituitary and adrenals as well. We lose the "hormone on demand" aspect with the pills.

Yes, I think that is the problem with needing more with heavy exercise....there is no way for my body to pump out more hormone on demand. I am hammered after a work-out but do recover pretty quickly by the next morning so at least that's a positive. Before I upped my dose, I would be really dragging after exercise for at least a day or 2.

I wonder sometimes if once the damage has started, some do not recover well. It took me 6 years to normalize my TPO after going gluten-free but I still need supplementation. The damage that was done is permanent. I wonder why the hell yours keeps increasing? That is so frustrating when you work so hard to make it better. All I know is, it can change dramatically overnight so maybe there is hope for you. Mine has done some pretty wacky things over the past 6 years but I have managed to keep it fairly stable...for now! It is hard to control Hashi's at times...so many things contribute to it being unstable.

[pain*in*my*gut]

Thank you all for the helpful advise! I have a question, though. If my body is attacking my thyroid, and I am fluctuating between normal, hyper, and hypo (which I believe I am according to symptoms), how on earth do you supplement? One day the dose might be fine, but the next it would be too much, or too little, no?

Can't the docs just zap my thyroid so it doesn't make any hormone at all and I could supplement with a steady dose of synthroid (or equivalent). This seems more straight forward to me for with somebody with Hashi's because of the fluctuations in the function of the thyroid on a daily basis.

Also, according to my scope, there was no damage to my gut (biopsy showed no damage), so is it still possible that I was not absorbing vitamins/minerals correctly? I had assumed based on normal Ttg and biopsy that I have latent Celiac and it hadn't gotten my villi yet. Could I still have an absorbtion issue, even with normal villi?

One more....do any of you notice that your neck aches in the thyroid area when it acts up?? My neck/jaw/upper shoulders have been aching on and off for weeks now. I don't think I have a goiter, but it feels funny when I swallow (tightness). Is this common? Am I imagining things?

Thank you guys so much!!

[pricklypear1971]

My neck doesn't ache around my thyroid. Never has.

Did your blood work show any vitamin malabsorption? As far as not absorbing thyroid meds, it is true from what I've read, that you only absorb a portion of it (differs pet person). Also, some people absorb some specific brands of thyroid meds better/worse than others.

Thyroid can be difficult up treat. I found supplements -vitamins, minerals, efa just as important at relieving symptoms as the thyroid med itself. Probably because of gluten problems.... Getting off gluten has made my "thyroid" symptoms literally disappear.

In that murky place you may be at - between hypo/hyper/perhaps Graves you will probably find your relief comes more from one approach (treat the hypo v. Hyper) than the other. I suggest reading on About.com's thyroid section - lots of good, cumulative info there.

Also, yes, you could zap or make your thyroid nonfunctional; however, that is a desperate last resort if it cant be controlled otherwise. Your thyroid does more than can be supplemented. Rather like removing your ovaries and trying to supplement with hormones. Sometimes it is necessary, but only as a last resort.

[Skylark]

I get that "lump in the throat" feeling when I'm hypothyroid. It's not an ache, just an odd feeling when I swallow.

You don't want your thyroid burned out for all the reasons we're discussing. It will settle down on its own, and you will still be able to make some thyroid hormone "on demand". Be patient and let the diet have a chance to work.

[Gemini]

Did your blood work show any vitamin malabsorption? As far as not absorbing thyroid meds, it is true from what I've read, that you only absorb a portion of it (differs pet person). Also, some people absorb some specific brands of thyroid meds better/worse than others.

If you chew your thyroid tablets to break them up in your mouth before swallowing, that will make absorption better. It works like a sub-lingual tablet...some of it gets absorbed right into your blood stream. That way, you don't have to wait an hour before eating, either.

[Skylark]

If you chew your thyroid tablets to break them up in your mouth before swallowing, that will make absorption better. It works like a sub-lingual tablet...some of it gets absorbed right into your blood stream. That way, you don't have to wait an hour before eating, either.

Definitely chew thyroid pills but you still want to wait an hour before eating even if you chew them. Sublingual absorption is not that fast or efficient and you will still absorb a fair portion of the dose at the intestine.