Hi can anyone tell me how I am supposed to take Omeprazole when I take Thyroxine. The doctor who gave it to me said "I dont care when you take it",.. but to be honest I feel worse than I did before taking it, I was given it for nausea in the mornings, i have a Hiatus Hernia. So I am guessing that it isn't working as I am taking it before lunch four hours after Thyroxine and I think you are supposed to take it before breakfast which cant because of the Thyroxine. Any suggestions would be appreciated. Also does anyone else feel much worse on this or is it a side effect that will pass?

13 Replies

My first question is to ask why you have been told to take Omeprazole. It reduces your stomach acid. Many of us with thyroid problems already have low stomach acid, but most doctors assume that heartburn is only caused by high stomach acid. They are wrong and you need to check whether you have low stomach acid. If you haven't enough acid you don't digest food properly and you don't absorb vitamins and minerals from your food, so may become deficient.

There is a home test (burp test) which you may find helpful. See this interesting link to Dr Myhill's website

You can also search this site for low stomach acid.

I have a hiatus hernia too. The hospital specialist sent me a prescription for Omeprazole without testing my stomach acid. I looked up the patient information leaflet and decided not to take it (the hospital endochrinologist was horrified). I've recently had a test which confirmed my low stomach acid, so I take apple cyder vinegar with meals to boost the acidity, although I find it best not to have anything too acid in the evening so that I don't get heartburn when I go to bed.

Hope this is helpful.

Hi Anthea 55 thank you so much for your reply. I had a gastroscope about 4 years ago with same symptoms and this showed that I have hiatus hernia and also gastritis so i guess that the doctor thought as its the same sort of symptoms they would try this first. i am to go back if it doesn't improve in three weeks but I will go back before then if I feel as bad as I have over the past few days. I am a very anxious person so know that this is also not helping, the moment I worry I start to feel sick so this is probably part of the cause.

Did you have the sick feeling in the morning? I don't have any of the burning pain that I have read about though, I never have, this is why I find it hard to relate to the normal acid reflux symptoms, I do have a sour taste in my mouth when I wake up though accompanying the yeuchy sick feeling, but as soon as I have a cup of tea it goes away immediately and I don't feel sick for the rest of the day its really strange. However on the antacids I feel sick for the rest of the day so something is wrong somewhere.

I do know about the low stomach acid but have never investigated it but will have a look at the link so thank you.

When they found my hiatus hernia they also found inflammation and took biopsies, but didn't identify the inflammation or suggest an antibiotic. An infection would be consistent with low stomach acid as acid would have helped to kill it off. My inflammation eventually cleared up with my use of apple cider vinegar (but not too strong - must be diluted) and occasionally sucking Olbas throat pastilles.

My hiatus hernia is mostly under control, but I need to have something soft at the start of a meal which seems to get it ready for the rest of the meal. If I take supplements with a meal I space them out with food in between, otherwise I find that they can stick together and get stuck in my throat , especially the capsules with gelatine covers. That's the only time I'm sick.

Give up the antacids if they make you feel worse. Do try the 'burp' test to check your stomach acid.

What are the fillers in the Omeprazole? Are they contributing to your nausea?

I think Ive been quite lucky with mine as I don't really have any trouble with it unless the sickness is caused by it I suppose. I have read about people that have pain and all sorts of awful symptoms.

I am pretty sure that both the Thyroxine and the Omeprazole contain magnesium sterate (Im not sure if thats right) not sure if there are any other common ones but its either that or the colouring they use which is a yellow, I haven't checked all that yet but I think it could be that this is contributing to the nausea. I am going to check all the ingredients. I also cant take some vitamins for the same reason. But who knows it all gets so so complicated there are so many factors to consider, its hard enough to keep theThyroid on a steady level let alone without throwing in all these complications!

Thank you for your reply and yes I will get the stomach acid checked.

Depletes B12 and other VERY valuable nutrients too. They are big money spinners for Big Pharma and it is often prescribed without looking for the root cause.

I now take my 'prazole in the morning and Levothyroxine at bedtime, seems to work OK as test results turn out fine.

I have to take a 'prazole as I have Barrett's Osoephogus.

I have LPR - Laryngopharyngeal Reflux . Suffered acid damage to Arytenoids and Cricopharyngeus. Damage to Arytenoids was resolved with twice the usual maximum dose of Zoton Fastab lansoprazole, short term. It recurred when dose was quartered ie half maximum dose. So now on 30mg daily.

At the time I was also Hypothyroid (untreated as yet undiagnosed as blood tests not acted upon - I wasn't informed).

My late Mother used to be on Omezprazole and had the side effect of headaches. This was changed to Lansoprazole by a hospital consultant she was under whilst staying with me. The headaches stopped.



You can take Levothyroxine at bedtime as long as it is 2 hours after food and drink. Research has shown that taking it at night may be more effective, perhaps because absorption is improved when there is no food/drink intake overnight.

Thank you Clutter,

I will look into doing this as it might just suit me better anyway.

Some links on the subject of low stomach acid that are short and very helpful :

As mentioned by others above, some people add acid to the gut using apple cider vinegar, rather than the betaine HCL mentioned in the above links. To be most effective it has to be vinegar that contains "the mother" (a phrase that I absolutely detest for some reason!) :

If you decide to try vinegar, use no more than half a teaspoon to begin with, and it must be diluted in a glass of water. Sip it throughout a meal. Depending on how you feel you can gradually increase the amount. Some people eventually take as much as a tablespoon or two in water. To improve the taste some people add some honey.

Thank you humanbean, I have had a look at the first article and so far i don't think I match the low stomach acid profile but will have a look at the rest.

I am wondering why,... if I have acid reflux why do I never have any heart burn because I can honestly say I have never had this burning described by most, just an acid taste and the nausea first thing,.. I don't really ever feel sick after eating or get any sort of acid after meals either this says to me it could be something complete;y different its just not right feeling sick every morning.

Going back four years when I first started feeling unwell was when I started Thyroxine,... and it took a long long time to get rid of the nausea that accompanied the introduction of this new medication into my body, I also developed a chronic cough which lasted a year. I insisted was an allergy to the fillers in the thyroxine tablet but when it was discovered i had a Hiatus hernia it was all blamed on that, however eventually they put me on a solution instead of the tablet and the cough stopped and for a long time I have been fine. Now this sickness again.

I am on 100mg of Thyroxine solution I am now wondering if it is anything to do with this again. I am just about to send off a test to Blue Horizon as I suspected it could be something to do with my levels, they don't test for anything except for TSH at the doctors and although I do see a private endo on occasions my insurance wont pay for the Thyroid unless it is a serious flare up, which I guess this could be, who knows?? and the blood tests they do at the private hospital are so so expensive on top of the consultation.

Thank you again for the info.

I don't know why you never get heartburn despite having a hiatus hernia.

I don't get heartburn either - or should I say it occurs very, very rarely. However I do get burning pain in the stomach and I've been diagnosed in the past (over many years, and on different occasions) with gastritis, a duodenal ulcer, and an inflamed oesophagus. So damage is occurring, even though I'm very rarely aware of having heartburn. Whether this is what applies to you, only you can say.

There is a condition called "silent reflux" that may be relevant to you.

Perhaps the sickness and nausea, the cough you had, the bad taste in the mouth, are just the way you perceive reflux.

One thing that may explain your sickness and nausea while on Thyroxine is that hypothyroidism cuts down stomach acid and so food is inadequately digested - instead it ferments and increases the risk of stuff going into the oesophagus. Once you start on thyroid meds your stomach acid may increase, and with a hiatus hernia perhaps your reflux is happening more as a result. I'm only hypothesizing, and I may have got it all wrong. :)

Hi Maggie. I never had heartburn either. But I have GERD and LPR.


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