Low Magnesium when taking Proton Pump Inhibitors AND Diuretics
And you may be interested in this Russian paper - which I have quoted before here:
Klin Med (Mosk). 2006;84(2):71-4.
[Hiatus hernia and gastroesophageal reflux disease as a manifestation of a newly revealed hypothyroidism].
[Article in Russian]
Savina LV, Semenikhina TM, Korochanskaia NV, Klitinskaia IS, Iakovenko MS.
The aim of the study was to reveal hypothyroidism (HT) in patients with hiatus hernia (HH), treated at Russian Centre of Functional Surgical Gastroenterology. The subjects were 64 women: 18--with HH and diffuse or diffuse nodular goiter, 36--with HH, and 10--without endocrine or somatic disease background. The examination included the evaluation of the thyroid and metabolic status, endoscopy, and 24-hour ph-metry. The results show that one of the early signs of HT is HH and gastroesophageal reflux disease. The latter in HT patients is associated with gastrointestinal motor-evacuatory disturbances rather than with acid exposition in the distal esophagus.
PMID: 16613012 [PubMed - indexed for MEDLINE]
Wish the whole paper were available in a decent English translation!
Hiatus hernia and related issues around the effectiveness of the lower oesophageal sphincter seem to be behind many acid reflux issues in hypothyroidism.
All too often the issue is NOT the production of excessive amounts of acids - for which PPIs and other medicines may have their places. Indeed, insufficient acidity seems to be implicated.