Coeliac Disease and Levothyroxine for Hypothyroidism

[Littleshopofhorrors]

Coeliac Disease and Levothyroxine.

I have coeliacs and follow a gluten free diet. This is not helping my symptims of chronic constipation, fatigue and depression. I take 150mg Levothyroxine, which is gluten free, but not lactose free. I need to trial a lactose free diet (as well as continuing to be gluten free) for 2 weeks. Should I continue with my tablets, or stop them for 2 weeks? I can't get a gp appointment for 3 weeks.

[Cooper27]

Don't stop your thyroxine, whatever you do! You'll feel awful within a week, and won't be able to tell whether your lactose free diet is making any difference because you'll feel so rough.

The amount of lactose in a tablet is pretty small, so I think you would notice an improvement from stopping all other lactose and only taking the tablets. If you are still having issues, then you could get a Lactase Enzyme, which you could take with your thyroxine. I take lactase Enzymes sometimes, if I'm struggling for dairy free options, and they really do help. I would only take 1/4 of a tablet before the thyroxine though, as you can cause digestive issues by taking more than you need.

Lactose free thyroxine is available, but many report that the brand doesn't agree with them, so I would think you need to change over for a few weeks before you try lactose free, just so you know which symptoms are due to the change of diet and which are due to change of medication.

How long ago were you diagnosed coeliac?

[Littleshopofhorrors in reply to Cooper27]

Diagnosed 4 months ago. I need to make a difference soon, as I am also anaemic and can't tolerate oral iron in any form and my gastro won't prescribe an iron infusion.

[Cooper27 in reply to Littleshopofhorrors]

4 months is really not that long - it can take 9 months for your antibodies to fall back into range, and it can take years for the damage to your gut to heal. I know people can hope their symptoms will disappear overnight, but it's a long road.

Consider whether there's anywhere you're potentially getting cross-contamination (did you buy a new toaster, replace cooking utensils/chopping boards/baking trays?)

For the Iron, I'd recommend taking apple cider vinegar before an iron containing meal (1tbsp diluted in 50ml of water), which will help your stomach to break down the food so you will absorb more. I'd also suggest taking a high dose of vitamin C, as this helps you to absorb iron. I took a 400% GDA Vit C supplement last year, and ended up causing my iron levels to go too high, so it does work!

You're probably worth trying a lactose free diet, as about 50% of coeliacs are also lactose intolerant. I'm inclined not to worry about the little bit in your tablets though.

[Littleshopofhorrors]

Brilliant. Thank you.

[Cooper27]

I've used this too, but wouldn't know how much to take before thyroxine. I took one at the weekend unnecessarily, and my stomach just ended up hurting anyway...

[Cooper27]

It's that I took 1 at the weekend, before eating a bit of cake, but I later realised the cake only had butter in it (which is considered lactose free anyway), so I ended up quite uncomfortable from too much enzyme. For the amount of lactose in a tablet, I wonder if a quarter of a lactojoy would be preferable?

[Cooper27]

There were no ingredients I struggle with, so the lactase is the only thing I can think of that upset me.

[Pharmaguapa]

Have you checked whether you actually have Hashimoto's btw? It's also closely linked to gluten intolerance. Also have you tried the Autoimmune Protocol diet? I've found it really life changing. But yes don't stop taking the thyroid meds!

[Littlebee]

Hi there I'm coeliac and hypothyroid. I was still feeling tired on T4 only and Iwasn't converting the Levothyroxine (T4) into its active form Liothyronine (T3) I discovered I had a gene called DIO2 which proves I am physically challenged in this conversion. So you could look into that and here is some info

thyroiduk.org.uk/tuk/testin...

Good luck getting sorted it's not easy.

[Hidden]

Hi

Re: the constipation

Hope this helps

I too struggled with this when I first started GF, just about managing a tiny output per day

Previously, before GF, I was fine with added wheat bran with cereals

Now, I'm fine again, with the following:

-After eating my daily 1/2 mango, I then eat the skin!

- Cauliflower - I now eat the tough kernel below, plus the leaves, that previously I would have thrown away - microwaved at high power for 6 mins to make it easier to chew

I am now absolutely fine again!

Good luck

ALps Holiday

[Lynilou]

Hi hope it is going well. I also have coeliac disease and had my thyroid removed so I take thyroxine. When I was first diagnosed with coeliac I also was lactose intolerant.. it often links when the gut is really compromised and damaged.

I also have reflux.

I continued with my regular thyroxine and reduced my lactose intake drastically, changing to soya milk first but then finding almond milk, and goats cheese, I love cheese! It took a couple of years to heal my gut enough to tolerate a little ordinary cheese. I agree I found the AP diet useful and often return to my version of it if I feel I’ve overdone the dairy. I can’t eat fresh cream still but following an issue when I needed another endoscopy I was advised by the consultant to try to bring some dairy back into my diet. I now compromise eating low fat cheese, low fat cream substitute and Bob milk I still have times when I feel the dairy has been too much, but mostly I’m good, it has taken me 12 years to get to this point. But if you are lucky enough to have a dietician who understands coeliac disease make sure you also work with the lactose intolerance. This does usually improve after a couple of years of a gluten free diet the gut heals enough to tolerate some dairy again. Best wishes

[Littleshopofhorrors in reply to Lynilou]

Thank you! I am having to remove all dairy, as it appears to be milk protein which is causing the issues, rather than lactose. I've switched to coconut or almond 'milk' and soy based yoghurt. I'm getting used to the taste, slowly! It is making some difference, even after only 4 days, so I'll continue and see what happens!

[Lozzer1991]

The lactose free brand of thyroxine (Teva) is awful. Stay away from it. Have a search of the symptoms it's caused on the Thyroid community on here. I was lactose intolerant/sensitive for a while (also have hashis) but that's gone now and I seem to be having issues with gluten. Have you tried the better you iron spray? If you are autoimmune your gut will often struggle to absorb anything. The sprays are fab to get you going - iron and B12 and Vit D.

Don't stop taking your thyroxine - perhaps look at the other options available to you (T3). It can take years to sort hashis out and you will have ups and downs.