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Thyroid UK
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Omeprazole and digestive enzymes

I have suffered from GERD for a few years now but had great success phasing myself away from omeprazole onto digestive enzymes, containing betaine hcl which completely resolved the issue. I suspect I have low stomach acid due to Hashimoto’s.

Fast forward a year and I’m now expecting my first child (13 weeks) and the heartburn has been atrocious. Hardly keeping food down with the nausea caused by acid reflux. I have been taking omeprazole ( not ideal, I know) which has allowed me to keep food down and stop suffering as the digestive enzymes (with added acid) I was taking no longer work in keeping the heartburn at bay.

Is it possible to take digestive enzymes that do not contain added acid to support digestion whilst on omeprazole? Or would this be adding fuel to the fire somewhat? I want to make sure I’m getting as much nutrition as possible if I have to be on acid blockers.

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Have you tried cutting out black tea & coffee, altogether. It took a few days to work, but this stopped my pregnancy indigestion. I'm fond of hot milky drinks, so swapped to substitutes of which there are several varieties available in healthfood shops, & fruit/plant based teas. Ginger helps most people's digestion, though it doesn't agree with me.

I now take a little ACV or eat a grapefruit prior to meals I think may cause indigestion, usually if I'm not in control of what I eat out. Obviously, avoiding trigger food & drink altogether is best

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Hey badhare, thanks for your advice. Unfortunately through my heartburn doesn’t seem to change regardless of what I eat :(. Completely went off tea when I became pregnant for some reason too, wish there was a trigger food I could avoid! It’s really confusing why one thing worked before and not now, suspect it has to do with hormones relaxing the valve in my stomach even more than it was before I was pregnant! Definitely have to have more investigations after baby is born.

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Have you had thyroid levels retested as soon as pregnancy confirmed.

How much was Levothyroxine dose increased by?

Obviously essential to test vitamin D and ferritin, but folate and B12 especially

Acid reflux increase may be because you need dose increase in Levothyroxine

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Hey slow dragon my most recent blood results (3.10.18) were TSH 2.18 (0.27-4.2) and T4 18 (12-22). These were taken in an antenatal clinic and the endocrinologist has since increased my dosage by 25mcg. However admittedly this was mid day non fasting. So I repeated my bloods very soon after with medichecks fasting from levothyroxine and from food first thing in the morning, results were TSH 3.18 and T4 was 17.3. Same range. I’ve been taking the extra 25mcg hoping this is enough to resolve the high TSH.

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Suggest you ask GP to retest TSH, FT3 and FT4 after 6 weeks

What about vitamin levels, when were they last tested?

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Oh gosh asking my GP to test FT3, they’ll likely ask me what that is ha. I last tested my vitamins in July. Folate was 7.96 (2.91-50). I had been taking folic acid for a long time, stopped and then when I saw these results I started supplementing again but with methylfolate instead. Vitamin D was 65.6 (50-200), B12 was 277 (25.10-165), Ferritin 67.7 (13-150). I also had fasting medichecks blood results done at the end of August I should say ( I was about 6 weeks pregnant then) TSH 1.34, T4 21.6 and T3 4.31. My T3 always seems to sit around 4. I have T3 but wasn’t sure whether to take it as I fell pregnant soon after getting the tablets. I didn’t want my GP decreasing my levothyroxine and wasn’t confident in getting the right balance.

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I would agree that not taking T3 is probably best. Otherwise TSH will be suppressed and GP likely to reduce dose

Very few endocrinologist will allow T3 during pregnancy

Yes keep on improving vitamins

Vitamin D might be better a bit higher

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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Interesting just looked at my prenatal vitamins and they contain high amounts of biotin. Perhaps I should leave off these for a few days before tests. Do you think supplementing with digestive enzymes might be helpful?

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I have never suffered much acid reflux

Suggest you put au a post asking advice, more tricky as pregnant

Have you tried Apple cider vinegar with mother?

Lots of posts on here about low stomach acid

Yes just stop any biotin supplements 2-3 days before any blood test

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Seems that you're getting advice re thyroid and effects with GERD. Also you understandably are concerned about short term effects during pregnancy. I presume you are also aware of longer term consequences and more natural treatments? If not, I can send links.

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Hi userotc, I’m normally very pro natural treatments for health. I managed to come off omeprazole years ago with a lot of research, the help of a routine of licorice root, slippery elm powder and digestive enzymes. Took probiotics also and number of other gut healing supplements eventually just needing the digestive enzymes (which also contained betaine hcl). I found though that if I missed the enzymes with food though heartburn definitely returned. Unfortunately about six weeks into my pregnancy the heartburn didn’t respond to natural methods any more and I was gutted. I’m still looking for options though, taking probiotics, tried ACV with unfortunate results 🤢 I have tried reducing omeprazole the last few days and have begun being sick again sadly and losing my appetite also 😔.

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Oh forgot to say I am quite concerned about the long term consequences of omeprazole too, I’ve read so much about it. I’m really hoping that if I do absolutely need to take them for the rest of the pregnancy, that I can try to come off them afterwards as I did before without negative effects to me or my baby. GERD is just a pain in the bum, thought I had it solved too.

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