Will Being Glutened Affect A Medication From Assimilating?

[saaa-wheat<3]

I have hashimoto's hypothyroidism, and have noticed that sometimes my numbers can be all over the place when I have my blood tested. For example, the last time my numbers were almost the same as right when my hypothyroid was discovered a couple of years ago, whearas the time before that my numbers were almost too low. I was really sick last month and I decided to see an endocrinologist for the first time (I had only seen my GP so far) and have come to the conclusion that one of the reasons why I was feeling so crappy was that I had been majorly glutened. I was wondering, does anyone know whether having a gluten episode can affect how much medication is assimilated into the body? I was thinking that since it looked like I wasn't getting enough thyroid hormone last blood test, that perhaps my meds weren't being assimilated properlyand that was contributing to my feeling so ill. My endocrinologist doesn't seem to know much about Celiac Disease, and since I am self-diagnosed through DH rash and process of elimination and haven't been to a GI doc, I don't have that resource. It would make sense to me that since it effects how nutrients can be assimilated that it also could affect how medication is as well. If anyone has any resources to substantiate my inquiry, I would be most appreciative!

[Nancym]

I think it is par for the course with Hashi's. Your thyroid is dying and sometimes producing, other times not.

Also, if you're having food run right through you fast because of dairrhea, you might not be absorbing your thyroid meds. You could let it dissolve slowly in your cheek (sub-lingual) and then you'd be assured that it is getting absorbed.

[Suzie-GFfamily]

There is a research group here in London, Ontario [London Health Sciences Centre/University of Western Ontario] that are asking that kind of question. They are studying how celiac disease affects drug disposition, comparing newly diagnosed celiacs (with intestinal damage) to treated celiacs (where the gut has healed).

An interesting thing is that many drugs are metabolized by enzymes located at the tip of the villi (similar in some ways to digestion of lactose). So this group is wondering if drug metabolism, absorption, etc. will be different in celiacs.

They are still enrolling subjects in the study, so the results will probably be published in a couple of years.

Suzie

[saaa-wheat<3]

I think it is par for the course with Hashi's. Your thyroid is dying and sometimes producing, other times not.

Also, if you're having food run right through you fast because of dairrhea, you might not be absorbing your thyroid meds. You could let it dissolve slowly in your cheek (sub-lingual) and then you'd be assured that it is getting absorbed.

I do remember asking my endocrinologist something to the effect of why one time even though my dosage was increased that my numbers appeared to be the same as when I was diagnosed and within the "normal range" even though it was clear that I was having thyroid (very ill and goiter) and even though she wants it to be lower, and she said the same thing about it being erratic and taking the meds helps to ensure that I am getting what I need, so that makes sense.

What's interesting is that now that I have been gluten-free, now when I get glutened, not only do I get a rash and bloating, hemorrhoids, mood changes and dizziness, I also now get the diarrhea, so that's why I was wondering. The only thing I know about the meds being assimilated is that I cannot take it with any sort of mineral or soy (nothing soy based gluten free for breakfast!) or it will bind itself to it and not be absorbed.

There is a research group here in London, Ontario [London Health Sciences Centre/University of Western Ontario] that are asking that kind of question. They are studying how celiac disease affects drug disposition, comparing newly diagnosed celiacs (with intestinal damage) to treated celiacs (where the gut has healed).

An interesting thing is that many drugs are metabolized by enzymes located at the tip of the villi (similar in some ways to digestion of lactose). So this group is wondering if drug metabolism, absorption, etc. will be different in celiacs.

They are still enrolling subjects in the study, so the results will probably be published in a couple of years.

Suzie

There wouldn't be some sort of mailing list I could sign on for updates on this, would there? I wonder if perhaps the pharmacist would know how it is assimilated in the manner that you have mentioned. hmmmm...

[Nancym]

Yeah, that's another advantage of taking it sublingually, you don't have to worry about taking it with your supplements or foods, since it goes from your mouth directly to your blood stream. The T4 tablets don't really dissolve in the mouth all that well though, I'd crunch it gently and then shove it into the cheek, ifyou want to be really SURE you're getting your dose. But if you're not having diarrhea, no need to worry about it.

[2kids4me]

Even in a normal functioning thyroid - if the patient (animal or human) has generalized illness. There is something called the euthyroid sick syndrome. The thyroid is affected by the systemic illness and the illness creates extra demand for thyroid hormone... which can be hard for the thyroid to do if it is beig affected as well.

In the thyroid being destroyed by an autoimmune attck - it becomes even more whacky because it cannot respond to the extra need.

Thyroid tests should always be done at the same time of day and pills should be taken at the same time too. My daughter gets her blood taken late morning any time they are checking her levels.

[Suzie-GFfamily]

There wouldn't be some sort of mailing list I could sign on for updates on this, would there? I wonder if perhaps the pharmacist would know how it is assimilated in the manner that you have mentioned. hmmmm...

I've looked for on-line info about the research study before, but didn't find anything. There is often a blurb about the study in the newsletter published by the local celiac support group- a brief description of the study because they are looking for more subjects.

You could ask your pharmacist how your thyroid drug is metabolized- I believe that celiac disease might cause damage to the cytochrome P450 enzyme system in the intestine. This system is involved with metabolism of some drugs (first-pass metabolism)- but it would depend on the properties of the medication. I don't know whether your thyroid medication would be metabolized &/or absorbed in the intestine? Your pharmacist should know.

[saaa-wheat<3]

You could ask your pharmacist how your thyroid drug is metabolized- I believe that celiac disease might cause damage to the cytochrome P450 enzyme system in the intestine. This system is involved with metabolism of some drugs (first-pass metabolism)- but it would depend on the properties of the medication. I don't know whether your thyroid medication would be metabolized &/or absorbed in the intestine? Your pharmacist should know.

I actually work for a dentist and he looked up the Synthroid in the PDR for me here to see how it is metabolized, which is through the jejunum and upper ileum, as well as through the liver, so it totally makes sense to me (and to the pharmacist with whom I also spoke with) that having a gluten reaction would affect assimilation. Whether I have diarrhea or not, as from what I understand, would not matter, for even if one does not feel the gastro effects of an incident, it is still present none the less.

Also, because it is absorbed via the digestive tract, taking it sublingually means it gets absorbed more quickly and through the blood to the heart, rather than through the digestive tract, and though the pharmacist wasn't able to find anything on taking the thyroid meds sublingually, she seemed to agree that since it isn't being metabolized as it should through the digestive tract, that taking it sublingually would not be any better.

[wacky~jackie]

My sister and I both have celiac and we have discovered that before going gluten-free we had to take a larger dose of otc pain meds. If we took 2 advil it did absolutely nothing for our pain. I have always had to take at least 4 at the same time to have any relief. Since going gluten-free I have been taking only 2 at a time. I'm also on Synthroid at a large dose. My gyn has even commented that it is a very high dose and I told her that my levels are all within normal range. I'm waiting until I've been gluten-free for 4-6 months and then I'm going to have my thyroid labs checked to see if the dose can be lowered.

Basically what I'm getting at is I personally believe that celiac does affect the absorption of medicines into the body. No scientific basis - just my own observations.

[saaa-wheat<3]

My sister and I both have celiac and we have discovered that before going gluten-free we had to take a larger dose of otc pain meds. If we took 2 advil it did absolutely nothing for our pain. I have always had to take at least 4 at the same time to have any relief. Since going gluten-free I have been taking only 2 at a time. I'm also on Synthroid at a large dose. My gyn has even commented that it is a very high dose and I told her that my levels are all within normal range. I'm waiting until I've been gluten-free for 4-6 months and then I'm going to have my thyroid labs checked to see if the dose can be lowered.

Basically what I'm getting at is I personally believe that celiac does affect the absorption of medicines into the body. No scientific basis - just my own observations.

Thanks, Jackie, for sharing your experience. I've learned that lots of us celiacs have to rely on personal experiences because so little is known. I had suspected that the one time that my numbers were almost too low compared to my other blood tests was due to the fact that at that particular time I was being most anal about eating gluten free and not taking any chances with anything. Unfortunately, it's easy to slowly work your way out of that mode, trying different things and getting caught in the snowball effect...guess it's back to just meat and rice and veggies for a bit!