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Taking synthroid along with calcium, vitamin and iron supplements. Unable to swallow and choking. Any drug interaction? Cure?

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Practicing since : 1998
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I am taking synthroid and was told that may interact with calcium vitamin and iron supplements. When / or can I take. Also what about primo optics? Also what tests are best for hashimotos dx. Vs differential dx ? throiditis. My t4 is low and tsh always normal and ultrasound w/ guided biopsy. Biopsy negative for 2 marginal cold spots. but lots of warm vascular areas. Synthroid not working and nodes getting larger symptoms such as fatigue weight gain getting worse. I f I eat anything I gain weight so may get worse without any vitamins sin ether interact with synthroid. Also can my chronic dx of mono with + egb Igm benefit from any tx even though viral and can this be somehow connected to thyroid. I injured my back in feb 2011 and received several large doses of cortisone in my lumbar between may and August of 2011. In sept 2011 I was deathly ill . Went to primary got cortisol level drawn which was .0001 last steroid one month prior. ACTH normal. eBV IGM 2.1. Tsh normal. I was unable to swallow and choking on food so got us which showed 9 nodules. Still choking 2 years later also.
Posted Thu, 19 Sep 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Minal Mohit 12 hours later
Brief Answer:
You may need pituitary work up

Detailed Answer:
Dear XXXX, thanks for putting up your queries at XXXXXXX I'll try to take them one by one.

1. Yes, multivitamins and calcium do interact with synthroid, if taken together. To avoid that you are supposed to take synthroid early morning on empty stomach. You will need to observe 30 minutes gap between synthroid medication and next meal. I recommend you to take your multivitamins and calcium at night or after lunch.
2. You need antibody studies, TMA/TGA to differentiate from/diagnose hashimoto's thyroiditis.
3. Differential diagnosis can be any other viral, bacterial infection causing thyroiditis.
4. Low t4 means you need to increase the dose, normal TSH does not always decide the dose.
5. You may need pituitary work up to understand cortisol functions.

Hope I have addressed all your concerns. Let me know if I have missed any - I shall address those in the follow up.

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