Absorption: Thyroxine: Low stomach acid, Hashimoto's - and Pernicious Anaemia

This I hope, may help anyone who has Hashimoto's, or both Hashimoto's and Pernicious Anaemia

I have discovered that taking my thyroxine tablets with a teaspoon or so of apple cider vinegar (acidic) or similar, crunching tablets with the cider vinegar in my mouth before swallowing, is working for me, and seems to be aiding absorption. If you want to try this and are avoiding gluten, don't use ordinary malt vinegar. I follow this with my morning black coffee (milk can also affect absorption). The result is that I am thinking much more clearly, and have more energy generally which lasts throughout the day. More recently, along with the foggy mind, my energy levels have dropped considerably in the afternoon.

I have two autoimmune illnesses, Hashimoto's and Pernicious Anaemia. I take 200mgs Levothyroxine daily, and have a B12 injections every 4 weeks. Some weeks ago I saw a post on this site which provided a link to a research paper which explained the results of tests of absorption of different types of thyroxine in relation to levels of stomach acid. (Many thanks to the poster of this post).

The paper was actually proving that a new type of thyroxine gel capsule could be absorbed more easily by people with low stomach acid, than Synthroid or Levothyroxine. My blood test results suggest that I am taking too much thyroxine, and when my doctor questions this I explain (and he agrees) that I'm not experiencing any of the symptoms which could suggest that I'm having too high a dose, (high blood pressure, rapid heart rate, palpitations, weight loss etc.)

More recently I have not been able to think clearly, low on energy, tired etc. symptoms which could be explained by low B12 or low thyroxine. However I have recently read that the Parietal Cells which are destroyed by anti intrinsic factor antibodies, hence preventing absorption of B12, also produce Hydrochloric acid, so it would be reasonable to infer that if you have Pernicious Anaemia, or you know that you have low stomach acid for any reason, you may not be able to absorb Leovothyroxine or Synthroid efficiently. Hence my experiment with the apple cider vinegar. I will update results just before my next B12 injection, when I usually experience return of a number of PA symptoms, to see if what I believe to be a greater absorption of thyroxine helps to improve my metabolism to an extent that the absorption of the B12 I am given by injection, is also improved. I hope this helps anyone who has absorption problems, and all best wishes to all who are living with either or both Hashimoto's or PA.

18 Replies

  • Hi Forest, thank you for the tip. But ACV isn't to everyone's taste - just the smell makes me want to vomit! lol

    Anyway, I hope you are leaving at least one hour before that black coffee. You don't have to have milk in it to affect absorption of levo. Just the coffee itself will do it.

  • Hi Greygoose, I didn't know about the coffee, thanks for the tip, already leaving at least an hour before breakfast. I have been leaving about 5 - 10 minutes before my coffee, but I will leave an hour from now on. I suppose anything acidic might help lemon juice, wine vinegar etc. but I don't know anything about their affects on absorption, only tried the apple cider vinegar. I'm taking it neat, but I know people (not PA/ Hashimoto's sufferers) who take a teaspoon of apple cider vinegar, or fresh lemon juice, in water in the morning, so diluted might also help. With both conditions I'm trying to second guess which is causing which problem, although my doctor is very helpful with allowing me to have B12 injections more often, I'm not sure he has an in-depth knowledge of either or the interaction of both conditions. Thanks again for the coffee tip, and all best wishes.

  • Well, instead of the revolting AVC, you could just take your levo with 1000 mg vit C. Much easier, and helps absorption, too.

    I'm wondering if your injections are enough for you? Once a month isn't very much. Have you had an active B12 test since you started the injections, to see where you are? Are you taking a B complex every day, to balance the Bs? Because they all work together, so no point in just taking one.

  • I could well try the Vit. C., just happened to have the ACV in the house. With the B12, no I haven't had an active B12 test, I will ask my doctor but I'm not sure if it's available on the NHS. After the loading doses, I received an injection once a month for 3 months, and then told that I would then have an injection every 12 weeks. I did say that although I felt much better generally, some symptoms were returning before the monthly injection, but was told that according to guidelines, it would have to be every 12 weeks. Anyway, over the course of a year or so, the gap between injections has been reduced from 12 to 9, to 6 and now to 4 weeks. I'll be seeing my doctor on Monday to explain that symptoms are returning increasingly from about 10 -12 days before the injection, and please will he consider reducing the gap further. I'm not sure if he will agree, though he has said that he's willing to work with on this, which is a great change of heart since the ridged 12 week schedule.

  • You still need the B complex. :)

  • Thanks, I'm taking a multi vitamin which includes B1,2,3,6 and 12 (though I can't absorb the B12), every other day because I can't tolerate the iron content every day, and also vitamin D and calcium on the alternate days. You mentioned the active B12 test. Please let me know if you know if is it available via the NHS and if not, any ideas about how expensive is it to take the test privately, and is my doctor likely to recognise the findings from a private source?

  • I'm sorry, I can't tell you anything about the active B12 test and the NHS, I don't live in England.

    Why are you taking a multi-vit? You know, surely, that they're a waste of money. And if there's things like calcium, magnesium, zinc, iron in them, they will cancel each other out. You won't get anything out of them. You'd be better off getting yourself a decent B complex.

    And have you tried taking a gentle iron, like Solgar? Plus at least 1000 mg of vit C to help absorption and avoid tummy upsets. Have you had your ferritin tested? Do you know that you need iron?

    Why are you taking calcium? Have you had that tested? If you're taking vit D3, it will increase absorption of calcium from food. If you take a calcium supplement as well, you risk over-dosing on calcium. Especially if you aren't taking vit K2 with it. Why not just take the vit D3 every day?

  • That's lots to think about, thank you. I'm not in England, I'm in Wales, where are you?

  • I'm in France. :)

  • J'ai adore Paris 😊

  • Me too. But, unfortunately, I don't live there. lol

  • Hi Forest1000

    B complex is best, as greygoose says, to keep all B vits balanced. Preferably one containing methyfolate rather than folic acid. I use Jarrows B Right. I also supplement 4x 5000mcg Solgar Methylcobalimin sublinguals every day between my 2 monthly injections as symptoms never really disappear. Adding T3 to levo has helped a great deal with the brain fog.

    Active B12 test is only available at one of the hospitals in London (sorry can't remember which one of top of my head) but it's not free. Not particularly reliable either apparently and no guarantee that Dr will understand.

    To be honest you're very lucky to be getting 4 weekly injections. Despite symptoms mine will not increase frequency at all.

    Head over to the pernicious anaemia society forum here on Health unlocked and do a search for active b12 and you will find lots of info.

  • Hi Singoutloud, thanks for the info. re. Jarrows B vitamins and the Solgar subliguals, I'll look out for them. Sorry to hear that your doctor isn't listening, that's atrocious. I repeatedly went to my doctor with a record of symptoms, dates of occurrence and frequency etc. worked for me eventually, and if anyone witnesses what is happening, that too may help. If your doc. can't say what he/she is going to do to help you to get better ask to be referred to a specialist, a neurologist might be best, depending on your symptoms. You deserve to get the treatment you need. 😊

  • Forest1000,

    Research has shown that taking coffee within an hour of taking Levothyroxine reduces absorption by up to 40%.

  • Thanks for the figures. Will definitely leave the coffee, or anything, for over an hour in future.

  • You also may like to check out Garden of Life Vitamin Code raw b complex. It is all natural, no nasty fillers. I found it in the USA but it is available on Amazon. Works a treat for me. I stopped taking it for a week and felt like death was imminent 😣 They also make a raw D3.

  • Thanks Daisy77, I'll check Garden of life vitamin code B, and raw D3. 😊

  • It says on the bottle to take two a day, but I have only ever taken one. They are the best I have found... vegetable fillers...novel concept!

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