Anti acid and Thyroxine

[dashi2208]

Hi, can anyone advise on the possible interactions between Omeprazole and Thyroxine (NDT) please? There seems to be varying opinions on the web.

Thanks

[Clutter]

Dashi2208,

You should take Levothyroxine and Omeprazole 4 hours apart to avoid Omeprazole reducing absorption of Levothyroxine.

[Scoobydoo666 in reply to Clutter]

My doctor told me to take Omeprazole at night time as i take Levothyroxine in the morning.

[Clutter in reply to Scoobydoo666]

Scoobydoo666,

That will reduce the likelihood of Omeprazole interfering with absorption of Levothyroxine.

[Marz]

...... and I am sure you have had your B12 checked .....

[Goodytwoshoes in reply to Marz]

Nobody told me about that. I take a hefty dose of omeprazole twice a day. And I just take all meds together. My B12 never gets checked and I hardly have any intestines left! Just recently started the levothyroxine so am grateful I noticed this, thank you

[Marz in reply to Goodytwoshoes]

It is more than likely you will need the following tested - B12 - Folate - Ferritin - VitD - as you will have absorption issues. I have Crohns so know a thing or two about guts and absorption.

Why are you taking PPI ?

[dashi2208 in reply to Marz]

thank you for replying. Simply because of Chronic heartburn. I take Bisodol regularly . . .trying to not coincide with NDT timings. Several people have recommended PPI as an alternative. My concern is that taking Bisodol several times a day is meaning that I'm not getting the full benefit of NDT which is therefore interfering with sleep patterns . . which in turn means I start to lean on Nitrazepam.

What a Mess!

[Clutter in reply to Goodytwoshoes]

Goodytwoshoes,

For maximum absorption Levothyroxine should be taken with water 1 hour before or 2 hours after food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements and oestrogen.

It takes 7-10 days for Levothyroxine to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

You should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after your blood draw.

thyroiduk.org.uk/tuk/about_...

__________________________________________________________________________

I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.

[dashi2208 in reply to Marz]

no I haven't . . .Iv'e tried supplements. There seems to be a never ending list of tests that people recommend. it's hard to know where to start and the order of priority? In particular when cost is taken into the equation.

[Marz in reply to dashi2208]

For your thyroid meds to work well and for you to feel well you will need GOOD levels of B12 - Ferritin - Folate - Iron - VitD. Docs do not always know about this fine detail - hence the value of forums like this. They should all be tested - obtain copies of the results and return here and post in a new post for people to comment.

It really can make a difference as you will know from reading the posts on this forum ......

[Goodytwoshoes]

I have ulcerative colitis and a failed j pouch. So no large intestine and only 2 metres of small intestine left (only 3 metres to begin with) gastro prescribed 40mg omeprazole twice a day. I have been taking for severaI years and tried to reduce but saw another gastro who has insisted on the higher dose. It has been interesting reading on this site as my GP has only done TSH levels and I have atleast 2 autoimmune diseases - the other being psoriasis. I have taken anti depressants on and off for the past 20 years. Goitre on and off over the years as well

[Marz in reply to Goodytwoshoes]

Are you gluten free ?

[dashi2208 in reply to Marz]

are yo asking me if I'm Gluten free? No, should I be?

[Marz in reply to dashi2208]

Sorry - no I meant Goodytwoshoes 😊

You could try it though 😊

[Goodytwoshoes]

No, I am following a low residue diet just now. Gastro/dietician suggestion since October - but I have been diagnosed with underactive thyroid since then. I have access to my blood test results. TSH was 4.6 then 6 the following month on repeat tests. The upper end of range was 4.3. My main symptoms weight gain and feeling very cold and always tired. Wearing thick jumpers the heating set to 25°C! And I'm still cold! Blood tests again mid January but I see gastro before then and that is where I can request the extra blood tests. However he probably did all them last time. He did loads! But this is a new gastro and I'm not getting results - unlike my last one who used to enclose results with summary letter that I got a copy of

[silverfox7]

Thyroid people tend to low in stomach acid, PPI's reduce stomach acid even further thus it can stop you benefitting for all the benefits in food but also in any medication you are taking. I saw an excellent article the other day but can't find the link. Ow but I'm sure if you ash the question in a search engine you will get a good response. I refused a PPI in hospital after several days of continual sickness following a hip operation. They didn't give me a choice and my next bout of sickness I produced a bowl ful of porridge and a few mouthfuls of omelette. It hadn't broken down at all after several hours and had actually come up whole so extremely painful

[silverfox7]

Found the article but is lengthy and I'm not clever enough to find and give you a link but it says long term use causes bone fractures and vitamins, minerals etc not to be absorbed and mentions B12, magnesium, calcium and D3 so things that helps conversion. Just put in PPI's and thyroid medication and after a few banks charging PPI's there are things medical. The arrival I found is dates 2016 though much of the info 2010.

I know many are given this for acid reflux but I've also seen the suggested that acid reflux can be down to an under treated thyroid causing slack sphincter muscles allowing the acid to flow back and cause pain etc.

[silverfox7]

Below is the conclusions. Sorry D3 wasn't picket out, it was iron. Go to:

V. Conclusions

The data reviewed here support the importance of long-term investigations of the possible effects of chronic PPI treatment on absorption of important nutrients including calcium, vitamin B12, iron and magnesium. In general, the studies in each of these areas have led to differing conclusions, but when examined systematically, a number of the studies are showing consistent results that support the conclusion that long-term adverse effects on these processes can have important clinical implications. What are badly needed for each of these nutrients, as well as studies of bone fractures, are more prospective studies. Furthermore, whereas the clinical implications in a number of cases are being much better defined, in almost all cases, the mechanisms of the observed clinical effects are unclear. Therefore detailed, careful studies of the long-term effects of PPIs on the absorption of these nutrients (vitamins, mineral) and studies of the PPI’s mechanism(s) at inducing clinical problems potentially related to these processes (fractures, anemia, VB12 deficiency manifestations, hypomagnesemia) are badly needed.