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Hashi and gluten free diet

Christineblue profile image
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Hi everyone, I have posted before and posted my blood results for comment, I was advised that having tested positive with thyroid antibodies it was certainly Hashi but my GP has said my TSH levels have been 6.6, then 5.5, then 4.4 now 3.4. She has said that treatment isn't offered until the level reaches 10, also Levo can make you ill. Although she said my blood tests were normal I questioned this as I went to see an Endo who did new blood tests to find my ferritin level just in range but Vit d only 14. I have had 40,0000 units of Vit D for 8 weeks, now on 800 daily. I have iron at 600mg daily. Starting to feel less tired but still suffering acid reflux and am on Lansoprazole 60mg daily. Just trying to reduce this to 30mg daily with .75 Ranitidine. I was tested positive for H.Pylori and was treated, now negative. Normal Endoscopy. I am wondering about going onto a dairy and gluten free diet to see if that helps the acid reflux and reduce my antibodies but not sure if I should. Do you recommend a nutritionist or tests for food allergies/intolerances in case this is the issue or would this be due to the Hashi and possibly Hypothyroidism. Also have high blood pressure.

Thanks for any advice.

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Christineblue
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beaton profile image
beaton

I'm no expert but can give a personal view on this.

I'm gluten free although never tested by GP until I had already given up gluten. I find a lot of grains can give acid reflux. Try giving up gluten and see how you go. Taking drug to suppress stomach acid can have more detrimental effects as many people with thyroid issues have low stomach acid, and yes this can cause reflux. If you want to see a nutritionist ask for blood tests from your gp, they might say yes or no. Good luck.x

Christineblue profile image
Christineblue in reply to beaton

Thanks Beaton, I have an appointment with GP in June, I will ask her because I feel that I am being treated for individual symptoms without addressing the root cause.

What did the Endo say about your raised Thyroid Antibodies? If you have Hashimoto's Autoimmune Thyroiditis then he should have started you on Levothyroxine 50mcg or 25mcg dose and retested bloods in 6 to 8 weeks and increased dose. I had three appointments with Endo then under GP for monitoring for life. Did you have an Ultrasound scan of your Thyroid?

As you probably know, there is no cure for Hashimoto's it is the Hypothyroidism that it causes which is treated.

What were your Thyroid Antibodies and T4 , fT4 and fT3 results?

With Hashimoto's bloods can fluctuate.

Mine were Hypothyroid in 2008 and fell within 'normal' range (just) in 2010 so were reported as Euthyroid ie Normal.

I wasn't diagnosed till 2011 after I asked GP to send me for the Ultrasound scan of my Thyroid. I have Hashimoto's Autoimmune Thyroiditis & Hypothyroidism.

Don't understand what your GP means by 'Levothyroxine can make you ill'.

Being left undiagnosed and untreated Hashimoto's / Hypothyroidism can make you very ill.

What did your Endo say about your symptoms.?

Forgot to ask did you have the Short Synacthen Test to check your adrenals?

My Endo arranged for me to have that urgently first, then phoned to say OK to start my Levo as Adrenals OK.

Could your adrenals issue be the reason you are not on Levothyroxine? Can you ask your Endo about this.

🐥

Hi again Christine.

I just read your post from a month ago.

I have Laryngophayngeal Reflux also. This is when the stomach acid rises up above the oesophagus into the throat. You don't necessarily have regular symptoms of heartburn as the acid pools in the throat at night. I suffered acid damage to my throat. Was treated with 60mg Zoton Fastab lansoprazole initially and now on 30mg.

I also have post nasal drip (for many years) and chronic sinusitis and Vasomotor Rhinitis.

Do you have constipation and/or slow motility of food?

Christineblue profile image
Christineblue in reply to Mary-intussuception

Hi Mary, thank you for your reply. I was under Gastro doc first who did bloods, endoscopy and ultrasound of gall bladder as I get pain in top centre of stomach, I have a gallstone but not yet an inflamed gall bladder. He referred me to Endo for further blood test as my thyroid levels were 5.5. The Endo checked and found thyroid antibodies and out of range adrenals, had to have further blood test to spin the blood to check adrenals they came back ok. He did not suggest a Thyroid Scan. I don't know what the short sync test is, have not had anything else. The Endo discharged me back to GP with diagnosis of Hashis, Hypertension, Acid Reflux Disease (Gerd) and vitamin d difficient. GP is meant to be monitoring my thyroid every six months but said they don't treat with Levo until the levels are 8-10 mine are 3-5. I have the same issues with throat acid and post nasal drip, this is where I first presented with symptoms over a year ago and fluid in the throat, I sometimes get hourse throat and loss of voice intermittently. I am on HRT patches as we'll and am beginning to wonder if Eastrogen is playing a part here with high blood pressure, high cholesterol, gall bladder and now thyroid. It's all very confusing and feel like stopping all meds cos they seem to be treating symptoms in isolation but not getting to the root cause. I am taking 30mg Lansoprazole daily but they don't prevent the acid in the throat, I am adding in Ranitidine, they seem safer as over the counter med, not sure if this will be better yet or nay still need 60mg Lansoprazole.

I posted my blood test results on here or Thyroid Uk but not sure how to find them again on my posts.

What do you make of this, I think GP is relying on Endo, if he said prescribe Levo I think she would but he didn't.

Mary-intussuception profile image
Mary-intussuception in reply to Christineblue

I just replied after looking up your post about blood tests.

About your throat - I asked for a Nasendoscope and was referred to ENT. That's who diagnosed me and started Lansoprazole. I have had to fight to keep Zoton Fastab as capsules not helpful for me nor lower 15mg dose.

I think you should speak to Endo . See my other reply.

Also do you have any constipation, slow food motility?

When my bowels are full then this puts pressure on upper abdomen. This can prevent or slow down stomach emptying properly. This can make acid Reflux symptoms worse.

Iron tablets can cause constipation. As you know it is also a symptom of Underactive Thyroid.

Have you been prescribed Gaviscon by Gastroenterologist or GP? I had it from ENT Consultant. I found it too thick because of swallowing problems from the acid damage. There is another you could try - Peptac peppermint or aniseed flavour. I found it easier to swallow when I needed it. If it doesn't interfere with any other medicine and you can take it last thing at night it should help prevent the acid Reflux.

Christineblue profile image
Christineblue in reply to Mary-intussuception

GP initially put me on Omeprazole to deal with the acid issue and gave spray for post nasal. It was Gastro who advised remaining on Omeprazole but they don't make my stomach feel good and didn't stop throat acid so mentioned to Gp she changed them to Lansoprazole which are better on the stomach. I don't suffer with constipation, whether food leaves my stomach as it should I don't know. I am not sure why we should be on a acid reducing meds anyway cos Hashi causes low stomach acid to start with, not sure about nutrient absorption either if I am difficient in iron and Vit d, unless that is caused by Hashi too.

Does Levo solve all these symptoms.

Sorry to ask all these questions but I don't get any answers from GP, not great from Endo either.

I think there is a fine line between Gastro docs and ENT docs when it concerns acid in the throat.

It's very frustrating though isn't it.

Mary-intussuception profile image
Mary-intussuception in reply to Christineblue

Hashi's hasn't caused low stomach acid with me that I am aware of.

I didn't know my Cholesterol was high.

I had started to eat porridge every morning with added fine oat bran. After about 10 months my Cholesterol had come right down !!!

Do you like porridge?

Christineblue profile image
Christineblue in reply to Mary-intussuception

Hi, yes I like porridge, I have it with fresh berries or dried fruit. I mainly follow the Slimming World way of healthy eating, only problem I think I have now though is most high fibre cereals like weetabix, bran, shredded wheat etc all have wheats and gluten not sure if they are right for thyroid antibodies. Looked at going Gluten free but it's a minefield to manage it on your own there seems to be gluten in everything.

I have just removed my HRT Patch as I have been on it for 5 years and am now 60, this increases blood pressure therefore may help to reduce it and cease the meds which have unpleasant side effects. In turn this may assist with high cholesterol as well. With the iron and Vit d supplements I hope those will assist with nutrient absorption. Blood pressure meds are also linked to causing acid reflux so hopefully this may help. I feel that we have to take some control ourselves but I am not sure where that leaves me with treatment for Thyroid, I am going to email my Endo for some answers as I saw him privately which means your consultation remains open whereas if it was on the NHS I would need my GP to agree to a further new referral.

I am concerned about the acid though, like you I am going to have throat damage long term.

Did you feel so much better once treatment started with your Levo?

Mary-intussuception profile image
Mary-intussuception in reply to Christineblue

Why don't you ask GP to refer you to ENT for Nasendoscope for your throat problems?

I had acid damage to the Arytenoids (these hold down the Larynx) Larynx wasn't damaged itself. This was treated and cleared up with the double max dose of Zoton Fastab lansoprazole (60mg ). This was 2 or 3 years before Levothyroxine was started. I was having sharp pain in my throat especially when singing.

When GP reduced to 15mg and capsules it came back. So on 30mg orodispersible tablets. I think that if you get that from ENT it would help you. What I don't understand is why you are on Ranitidine. Have you looked up both?

I contacted Consultant's secretary and was seen again by ENT and sent for Barium Swallow xray. This immediately showed posterior Prominence of the Cricopharyngeus. This is permanent acid damage.

I too have numerous Gallstones.

I just sent you a ps and it has vanished. Will be in touch again soon.

Christineblue profile image
Christineblue in reply to Mary-intussuception

Hi, oh gosh, what's involved in nasendoscopy, I had an endoscopy but couldn't cope with tubes going down my throat, I had to have it done under a general. Do you take the Zotonfast tabs as well as Lansoprazole or are they something similar. I don't feel that the Lansoprazole at 60mg is doing any better than 30mg and don't want to take meds unnecessarily so spoke to Pharmicist in Boots who advised trying Ranitidine to replace one dose of Lansoprazole and see if it makes a difference, it isn't doing really. I read an article about Hydrocloride Acid tablets, they increase stomach acid over a programme dose to educate your stomach to get back to a normal acid secretion which stops excessive acid therefore repairs acid reflux, not sure about this theory though. I think I will request a referral to ENT, I thought my Gastro Dr would have suggested a Barium Swallow but he hasn't, unless that comes under the remit of ENT. It may be due to having random tests and the issue with Thyroid that they haven't persued other areas.

Christineblue profile image
Christineblue in reply to Christineblue

Thank you x

Mary-intussuception profile image
Mary-intussuception in reply to Christineblue

Hi again Christine.

Just a few points as my bedtime now.

Zoton Fastab is the Brand name of my lansoprazole. It dissolves in the mouth and is faster acting than the generic lansoprazole. Our local health board say it's not different and make doctor prescribe generic so cheapest given. I have had to fight to keep it and Boots pharmacist said they have put it in their computer so I will get it all the time now. It IS better in my opinion and the ENT opinion. They prescribed it.

Don't worry about the Nasendoscope as it is very thin. Much thinner than Gastroscope. Actually I couldn't cope with the Gastroscope as too wide because of the narrowing in my throat so they had to stop. You could try asking the Gastro for a Barium Swallow see what they say. If you get referal from GP for ENT ask for it to be urgent. You are so right when you say it is frustrating. It is very frustrating. You need to get things sorted , full diagnosis and correct treatment. And we know this isn't going to happen quickly. But persevere.

The Short Synacthen Test was to check my adrenals. OK. It seems Endo checked yours in some way. Cannot understand your Endo diagnosing you, finding adrenals ok - then NOT treating you and discharging back to GP???

It is for the Endo to treat you and get your TSH down to 2.

Would you consider phoning Endo's secretary and asking to speak to Endo?

Perhaps the email would be better if you went private as phone call might mean more costs. I am also thinking now of the possibility that there has been a misunderstanding between Endo and GP. If Endo was private then surely he would have to charge you for prescribing Levothyroxine. Maybe his intention was that GP should now take over and prescribe on NHS. Maybe GP has not understood this.

I got better after 2008 Hypo bloods. Was much improved in 2010. But was at the point in 2011 where I was extremely tired all the time. Just getting up and coming down in the morning exhausted me and I had to lie down on settee! As you know with Hashi 's every time you get a cold or other infection then your Thyroid comes under more attack -rendering it underactive. Been on Levo since late 2011.

I am 63 now and have claimed my life back.

So yes, I am much better on my Levo.

I also have Diverticular (shown in Barium Enema xray in 1988 and 2008). I read recently that Diverticular as well as Hypothyroidism can cause absorption issues. Yet I had to learn to ask for tests on this forum and now know I need Vitamin D and Folic Acid supploments.

Don't worry about missing fibre from your weetabix etc. You will get plenty from fruit and veg as well as porridge. You could take a Fybogel sachets every evening.

If your lansop & ranit aren't enough then I think the Peptac medicine will help. Ask GP for some?

Also, occassionally I have sipped a little Bicarbonate of soda in warm water. If you'd like to try that.

Also Rennies help.

Let's hope Endo and GP will communicate and clear things up and get you started on Levo.

If not THEN you must ask Endo WHY NOT.

You still have throat/acid issues to resolve. So keep going back to GP and contact Gastro till you get sorted.

X

🐥

ps

If GP still not happy to prescribe and private Endo doesn't give explanation then would you consider asking GP for urgent referal to NHS Endo?

X

🐥

Christineblue profile image
Christineblue in reply to Mary-intussuception

Hi Mary,

My Endo sent me a copy of his discharge letter and it tells GP to monitor Thyroid every six months so he did not advise to treat. I asked GP why I am not being treated with Levo and she said it can make you ill and the NHS don't treat unless TSH levels are still 10 or symptoms and levels are at 8. That was it.

I went private for Gastoscope as the NHS would not do it under general, then he referred me to Endo also private. It was the Endo that advised on Thyroid, iron, Vit d and antibodies, no other blood tests I had with GP advised on any of that and I have had several in the last 12 months.

I am getting sporadic pain as well in upper abdomen where the LES Spincter sits, not sure if this is acid, Spincter muscle going into spasm or gallbladder pain therefore going back to original Gastro doc this week to see what he makes of that I will ask him about Zoton Tabs as well. I am hoping coming off HRT patches may help weight and blood pressure as blood pressure meds can cause acid reflux as well, weight loss may help acid as well. My theory anyway.

Like you I was exhausted all the time and am 60 and still working full time in a stressful finance role, this doesn't help.

So glad you have made some sense of your health issues to finally get your life back, there's nothing worse than feeling constantly unwell is there.

I will let you have an update after appointment.

Thanks for your help, everyone on here are so lovely and helpful, without the help I would be nowhere and I have a thousand questions to ask docs now.

Be in touch xx

Mary-intussuception profile image
Mary-intussuception in reply to Christineblue

X

JennSp profile image
JennSp

I Coeliac on lots of Meds and Lansoprazole, being on GF foods does not stop Acid Reflux...being a good healthy weight would help...pardon me if you already are, eating regularly, the correct food, not eating too much butter or fats in foods and meat and not drinking fizzy pops and wines....I'm not a drinker, but every at a function and I have a mouthful of Prosecco I get acid reflux that night....I don't really do fizzy pops either but also Orange juice does the same gives me acid....I have also been H.Pylori and took the medication to eradicate it, but my doctor would not test me afterwards as said Meds always work. Also I take thyroxine and on High Blood pressure Meds...My blood pressure started to go up about 15 years ago or more even, about the time when I was being tested for Coeliac....I was put on beater blockers then...Oh and I was early Menopause as well at that time....not sure if any of this is of help, but just letting you know you're not the only one out there.

Christineblue profile image
Christineblue in reply to JennSp

Thank you Jennsp, yes this is helpful info, I don't drink fizzy or any alcholol. I drink water, tea, herbal teas and an occasional cup of coffee. I thought maybe gf food may help if I had a food intolerance to wheat etc, that may be causing Thyroid Antibodies to be worse. I am guilty of being 2 stone overweight brought on at the menopause, despite healthy eating and a Slimming World way of life I can't budge the weight, great at maintaining though now for some reason. I have just stopped my fourth different types of blood pressure meds Ramipril as I can't deal with the side effects. I have just looked at my HRT Patches Evoril and they say should not be used if blood pressure is high or gallstones both of which effect me so just come off that as well, see what happens next... I am sure it's the onset of Menopause that's starts all these health issues not been right since.

Hope you keep well x

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