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Thyroid UK
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Endoscopy - for gut issues? Any use?

I've been referred for an endoscopy as gp thinks I may have absorption issues due to low D3, low t3, failure to respond adequately to t4, problems with lactose. I know that low stomach acid may be an issue along with leaky gut. The question is will an endoscopy involving taking a sample from the gut show up these issues? Don't really want to put myself through it if it's not going to show anything. Gastro thinks it's "clutching at straws".

Any thoughts anybody please.

13 Replies

The biopsy taken during the endoscopy is usually tested for Celiac disease. This is useful if you normally eat gluten and have eaten it for approx. 6 weeks prior to the test. Celiac disease can cause malabsorption so it is definitely worth ruling out.

The lactose test is a breath test - would be separate presumably.

The endoscopy can show ulcers, inflammation, cancer etc. I think it might be helpful for ruling causes out rather than necessarily in. I think absorption can also be caused by issues lower down the digestive tract - so perhaps this is not the only test you'd need.

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Thanks for response Mabes. It doesn't sound as it it would be of particular use then and I gather it is not the pleasantest of experiences😕


Yeah it's not the nicest. I didn't have any sedation and just had the spray to anaesthetise. I opted for that as I am very unwell from sedation/anaesthetic. I did okay. It only took about 20 mins with 5 of that being the actual procedure.

I meditate, and so I focused on a point in the room and blocked everything out as much as possible. I unexpectedly actually felt very relaxed. I gagged a couple of times when they were passing it down my throat, but it wasn't as horrific as I had read of online. The worst bit was it going through my nose and the gagging which in reality took perhaps 30 seconds to 1 minute at the most.

It is probably no worse than a major trip to the dentist!


Many people 'fail to respond' to levothyroxine. It's not unusual for someones body not to like a 'synthetic hormone'.

If you are also on too low a dose - your body cannot possibly respond as we need an optimal dose. Optimal means the patient feels well - not to be kept on a low only upon the TSH result.

I think you may be very underdosed and if you can get a copy of your latest blood test results with the ranges and post on a new question for comments.

If you've not already had a Vitamin B12, Vit D, iron, ferritin and folate tested ask for these to be done. Your GP suggests low Vit D3 (has he supplemented with D) he suggests low T3 (not sufficient levothyroxine I think). Is he keeping your TSH somewhere in the range and not around 1 or below?


Thanks Shaws. Latest tsh was 2.5 (0.35-5.5), t4 11.8 (7-17), t3 3.7 (3.1-6.8) that was on 100mg t4 & 10 mcg t3. T3 dose now increased to 20mcg/day. I have previously been on much higher doses and also t3 alone and the free t3 never got higher than 5.9. 5.9 was when I was taking 60mcg/day.

Other results: b12 545 (150-900)

Ferritin 86 (15-300)

Folate 7.4 (>3.0)

HbA1c 33 (<48)

D3 65.1 >50

Also and complicating matters fsh has recently shot from 40-96.4.

Am prescribed d3 800 IU 3xday.

I'm thinking d3 and b12 need improvement and may also consider hrt . Would be grateful for any input.

Apologies for the late response half term makes life hectic.


Hi lolajone. You say your TSH has now risen despite being on a reasonable dose.

To get more responses copy and paste your above onto a new post.

Some people do have something called 'Thyroid Hormone Resistance' and I'll give you a link to read:-


Any links within may not work as the site is now archived.


Umm sorry typo that's what you get for rushing it's the fsh that has shot up to 96.4


I'm glad about that.


I've amended your response re tsh to fsh.

If you need to amend or change anything just press the down arrow and select edit then change and submit again.



I could've written what you wrote as same happened to me. my endo (clutching at straws I felt) blamed my symptoms on digestive issues. we spent around £3000 on endoscopy and entoscopy (not v pleasant ). from this in learnt that I am not Celiac, no cancer, a couple of diverticula from constipation and ...the gastroenterologist recommended Amitriptylene! ! so no better than endo who recommended Venlafaxine. what I needed was proper guidance with thyroid hormones! !


Hi Daffers, thanks for answering but oh dear I suppose it ruled some things out? I suppose I was wondering if low acid could be detected at all. Hmm don't know whether to go ahead with it or not.


Yes that's true. I was so hoping that one of the 'oscopies ' would throw up something curable ! anyway worst thing was the stuff you have to drink to clear you out beforehand. Procedure painless. I have looked into low stomach acid too but the only test I can find is one for about £300 so haven't taken it further yet. I do feel that low acid is a likely culprit though.

Do let me know how you get on



There are some advantages to having an endoscopy.

You can ask for tests to be done for Helicobacter Pylori. Other forms of testing for it may give false negatives. The biopsies during endoscopy are the most reliable way of testing.


If you've been eating gluten then coeliac testing is most reliably performed during endoscopy. If you've been cutting down on gluten then a negative result could be real or false, there won't be any way to tell. A positive test should be reliable though.

If you have oesophageal inflammation, hiatus hernia, gastric erosion, or peptic ulcers in the stomach they should be found :


And of course there are probably a couple of dozen other conditions that can be checked for that I know nothing about or haven't thought of.

I would go for it, in your shoes. It might all turn out to be fine, but why not get checked out while the offer is there?

The only advice I would give is to be prepared in advance with indigestion tablets and indigestion liquids. Where the biopsies are taken you have a raw spot in your gut that will need time to heal. Stomach acid might be a bit painful on that raw spot for a few days.

If there any gut problems beyond the reach of an endoscope then obviously you won't learn anything about them.

There is a way of looking at a large part of the gut, but it doesn't allow for biopsies and tests to be done. There is something called a capsule endoscopy that can be done, and some NHS hospitals do them. It involves swallowing a capsule that sends pictures wirelessly to a device you wear on your body. The pictures can then be looked at by a doctor. The capsule often runs out of battery power before it gets to the end of the bowel. It also might get stuck and need to be retrieved surgically, although this is not a very common complication. Usually it just gets ejected via the bowel with normal waste. It isn't retrieved, given a wash and used again for someone else. ;)


I don't know how often the NHS actually does these things though.


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