Medication and supplement timings

[stevenotts]

Hello all,

I have Hashimoto's (and have also very recently been diagnosed with Barrett's oesophagus) and am taking a range of medications and supplements. I was just wondering whether I am following the right sort of timing schedule in order to prevent malabsorption issues and to get the most beneficial effects from the things I'm taking Here's what I'm currently doing:

MORNING

Vitamin C, Vitamin D, Vitamin K2 MK-7 Vitamin B Complex. fish oil (omega 3) capsules (all with my fattiest meal of the day - I tend to have eggs and a whole avocado for breakfast)

Prior to evening meal: Omeprazole (PPI)

EVENING: combined magnesium + calcium supplement

NIGHTTIME (usually 3 to 4am, when I get up to go the loo)

Levothyroxine

I'm trying to follow the various "rules" that have been suggested by members on this board, namely:

To take PPI, Vit D and calcium 4 hours away from levo

To take levo on an empty stomach, and at least 2 hours away from other meds and supplements

I would really appreciate any views and/or further suggestions.

Many thanks!

Steve

[bluebug]

There is nothing wrong with your supplement timings the main issue is that you are on PPI. This is going to screw up your stomach acid and help ensure you don't absorb your nutrients properly.

Hopefully someone else will post about the fact that most people actually have a problem with too little stomach acid, which is the cause of the problem not too much.

If no-one does then post a new thread asking about PPI and hypothyrodism e.g. how to control the stomach acid and get off the PPI as it is a common issue on the forum.

[stevenotts in reply to bluebug]

Thank you bluebug.

Yes, I am aware of the PPI issue, and the fact that stomach acid issues and hypothyroidism seem to be a common issue. The recent diagnosis of Barrett's oesophagus has now made me quite nervous about coming off the PPI (something I had previously intended to do), but I will most certainly post another thread about this at some point in the near future.

[shaws in reply to stevenotts]

Barrett's oesophagus - this diagosis will obviously worry you and I hope there is a solution for this.

This is a link I've just read:-

naturalendocrinesolutions.c...

I think I'd ask to have a second opinion - maybe you've already done so.

[stevenotts in reply to shaws]

Hello shaws,

Yes, the diagnosis was a complete shock, as the previous gastroscopy I had simply showed inflammation (oesophagitis). Obviously, having the Barrett's is rather a worry, but they are planning to keep the condition "under surveillance" via a gastroscopy procedure every couple of years. They mentioned a "minuscule" risk of this developing into cancer, and they did rather downplay things, so I'm not feeling overly panicked at this stage.

When you suggest asking for a second opinion, can I ask, about what in particular? The diagnosis?

[shaws in reply to stevenotts]

I suggested if you can have a second opinion as sometimes we've been diagnosed with something we didn't have (I have twice - along with prescriptions) and can someone confirm or not that you have Barrett's oesophagus or is it just inflammation in general which I should think some of us do have if we have low acid.

[stevenotts in reply to shaws]

Thank you for the clarification. I may investigate the idea of a second opinion with my GP, as the specialist who has done the two gastroscopies that I have now had doesn't fill me with confidence and doesn't really explain anything. I'm also quite bemused by how, following the first gastroscopy that I had only a few months ago (during which biopsies were taken), I was diagnosed simply with oesophagitis. Now, a few months later, Barrett's mucosa (albeit healthy looking) has now been found. It does seem like a major change!

[shaws in reply to stevenotts]

I was diagnosed with acid reflux which I didn't have. I had an undiagnosed hypo.

I had an op to remove a 'post cricoid web from my throat' and after op was told I didn't have it. What was it then on the barium swallow said I? No response.

After a few more months and on advice of a First Aider my TSH was 100. Not one of the professionals, GPs, Specialists etc.thought to test.

[stevenotts in reply to shaws]

That's absolutely terrible! Even from my own experiences with GPs (including the one I see most regularly now), I am increasingly becoming aware of their lack of knowledge on many conditions, reliance on whether test results are "in range", and their lack of joined up thinking and problem-solving. This has become particularly evident since I was diagnosed as hypothyroid and eventually (after pressing my GP to request the relevant test) as someone with Hashimoto's. Sites like this have been so incredibly useful, helpful and beneficial in terms of filling in the many gaps left by health professionals, and in providing a more in-depth and rounded approach to treatment options and strategies.

[shaws in reply to stevenotts]

Yes, the forum is successful and there are so many different experiences that someone would find the answer from at least one member.

[shaws]

PPIs are usually prescribed by GPs due to the fact that both high acid and low acid symptoms are so similar.

Unfortunately for us, being hypo means everything slows down and it is most likely to be due to 'low acid' that we have unpleasant clinical symptoms and doctors prescribe to lower stomach acid, when in fact we need stomach acid to dissolve food, particularly protein in our stomachs.

Most on the forum take Betaine with pepsin or good Apple Cider Vinegar mixed in Juice or water or digestive enzymes with meals.

scdlifestyle.com/2012/06/hy...

[stevenotts in reply to shaws]

This is what I was planning to do, but I'm not sure whether to now. Please see my reply to your other posting.

[shaws in reply to stevenotts]

Don't rush into any decisions. You must always consider what is best for you. not what others find especially if your condition could be serious. It is a worry.

I will look at your other post now.

[MrsDG in reply to shaws]

I have had acid reflux for a lot longer than I've been hypothyroid. I have taken nsaids for years so need ppi to counteract. I've tried various other treatments for reflux but only ppis help. I take my levothyroxine around five o'clock in the morning,( then go back to sleep) then lansoprazole around nine o'clock. Breakfast between 09.30 - 10.00. So far everything seems to work ok. I've only been on levo for four months so hoping everything continues to be fine. (Good job I can wake up to order)How do others on arthritis medication get on with excess stomach acid?

[shaws in reply to MrsDG]

Very few people who are hypothyroid have excess stomach acid. Many are prescribed Antacids as symptoms are more or less identical and doctors don't know any clinical symptoms at all.

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

wiserootsnutrition.com/the-...

[Marz in reply to MrsDG]

How did you know it was high stomach acid you had ? PPI'S can affect the uptake of B12 as you need good acid levels to break down protein and release B12 molecules.

Low B12 is a serious neurological condition if left untreated - even implicated in brain shrinkage. Do you know your level - Folate too as they work together in the body.

PPI'S are intended as a short course.

[stevenotts]

Thanks shaws. No, I won't rush into anything.

[SlowDragon Administrator]

So if you have Hashimoto's are you gluten free?

If not then you might find this helps toward healing gut and lower antibodies

Also daily bone broth

thyroidpharmacist.com/artic...

Thyroid Pharmacist website is very indepth on everything to do with Hashimoto's

[stevenotts]

Yes, I have been gluten free for the last couple of months or so, as a result of advice from members on here and reading information on various other sites. I can't honestly say that it's not made any difference to any symptoms that I've been experiencing, but I guess the real point is whether it's preventing any further damage to my thyroid. I have only had antibodies tested once (my GP doesn't feel that there is any need to re-test), but I am planning to pay for one of the comprehensive thyroid tests offered by Medichecks in a few weeks, to see how the numbers are looking on a range of things, and, specifically, to see what (if anything) has changed as a result of the various actions I have taken in the last few months - and then take things from there.

[Tiggerdumbo]

I am also in the same boat as you. I have been taking omerprazole for 25 years now. 6.15am I take my levothyroxine. 11am I take omerprazole, citralopram and ceteizine (hayfever). At 10pm I take vit d, vit b, iron occasionally when extremely tired as stomach cannot handle iron supplements, 5htp, a natural herbal remedy. I have been taking this regime for a while now, have had hashis for 3 to 4 years now, have stomach condition on top too, miserable juggling drugs and timings etc

[SlowDragon Administrator in reply to Tiggerdumbo]

The stomach condition is due to Hashimoto's

Low stomach acid and high stomach acid have very similar symptoms but very different treatment

Lots of posts on here about LOW stomach acid which is common with hypo

thyroidpharmacist.com/artic...

If you have not had full Thyroid and vitamin tests then suggest you consider it

Omeprazole lowers magnesium and B12

gov.uk/drug-safety-update/p...

pulsetoday.co.uk/clinical/m...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice

DIY finger prick test or option to pay extra for private blood draw

All thyroid tests should be done as early as possible in morning and fasting, and don't take Levo in the 24 hours prior to test, delay and take straight after

No point testing magnesium, it is easy to supplement (check first if have known kidney issues )

[stevenotts in reply to SlowDragon]

Slowdragon,

Thanks for the recommendation! I have had a whole range of things tested over the last 12 months by my GP, but am waiting a while to give recent additions to my supplementation regime a chance to properly settle down before taking further tests - and then see what the overall situation is and what tweaks or other interventions need to be made.

[SlowDragon Administrator in reply to Tiggerdumbo]

Also .....As you have Hashimoto's have you tried strictly gluten free diet

Very many find it helps

amymyersmd.com/2017/02/3-im...

Also as well as bone broth, probiotics and fermented foods like kefir can help

[stevenotts in reply to Tiggerdumbo]

Yes, it's a real pain, isn't it?!!!