Hi all, been feeling bad again for a while having bad reflux Dr told me not to take apple cider vinegar as it would make things worse so prescribed Omzoprazole twice a day with gaviscon when needed it did work ok for a while to clear up ulcers and then she told me only to take when needed, in the meantime have been suffering with prickly sensations all over body and joint pains in jaw neck hip knees and feet, which is very debilitating I am also very tired all the time and still get reflux. Last Thyroid test came back normal but my blood test has shown B12 and Vit D deficiency she is ringing me on Monday. All this is making me depressed, what should I do ask to see a specialist now?
Vit B 12 deficiency : Hi all, been feeling bad... - Thyroid UK
Vit B 12 deficiency
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Zizzy1591
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Ok will ask for them when she rings 😊
Another doctor that has never heard of low stomach acid. Low thyroid hormones and low vit B12 will both cause low stomach acid. But, the symptoms are the same as high stomach acid. Try the home Baking Soda Stomach Acid Test in this article:
scdlifestyle.com/2012/03/3-...
Thanks will try this 😊
This unscientifically validated test suggested I had low stomach acid but the cider vinegar and betaine made things worse.I believe my ulcers and reflux are caused by high acid .
It is a dilemma.
Hi I was wondering if you had looked at this report comparing omeprazole treatment to supplementation which took place over 40 days. Group A which used supplementation against Group B which were on 20mg omeprazole.
Group A reported a 100% relief of symptoms and Group B there was 65.7% relief. There were no significant side effects for Group A but there are for Group B.
What they did state was the lower oesophageal sphincter which is the muscle which separates the oesophagus from the highly acid stomach is controlled by the hormone melatonin. It is the same hormone that controls sleep.
The report can be found using the following address:
onlinelibrary.wiley.com/doi...
Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole
Have you noticed whether the symptoms of your acid reflux are associated with poor sleep and a lowered mood? If the answer is yes the study above would explain why.
When people have been under stress they lose sleep and this is associated with a corresponding drop in the melatonin level which results in the muscle which stops the acid moving back into the gullet becomes lax and this results in acid reflux.
This was one of the supplements that was given to Group A which had the 100% remission of symptoms.
Another supplement was L-Tryptophan this is the amino acid which is the building block for serotonin (so called feel hormone) and it is serotonin that is the building block for melatonin (sleep promoting regulatory hormone). There is therefore a corresponding low level of the feel good hormone serotonin.
The conclusion being that stress, results in low levels of serotonin and melatonin, which corresponds with low mood and poor sleep the latter hormone as it controls the lower oesophageal sphincter (LES) also resulted in acid reflux.
Three of the other supplements which was successful in treating the symptoms of acid reflux were the B vitamins B6, folic acid and B12. These are vitamins which were related to melatonin levels, as they are involved in the repair of DNA, RNA, and protein synthesis etc which are activities that occur to a great extent during sleep (melatonin levels are high).
The remaining supplements were methionine and betaine.
Methionine is an important sulphur containing amino acid which forms an important protein building block in the body, it can also be produced from homocysteine. Unless there is adequate B12 and folic acid (B9) then homocysteine is not converted to methionine. The presence of homocysteine is a risk factor for strokes and other diseases, and its presence indicates there is insufficient B12 or folic acid, though it is not possible to say whether it is the B12 or the folic acid which is deficient as both are required.
It is more sensitive than the serum blood test for vitamin B12 as the normal laboratory reference range is so wide often around 160 to 1000 ng/l using serum B12. Therefore if the serum B12 is in the lower part of the reference range people can still have high levels of homocysteine which would indicate a B12 deficiency that would put them at an increased risk of stroke, etc
The results were from a randomised study were 176 people were allocated to Group A and 175 to Group B, so is scientifically validated.
The supplements they used were melatonin, L-tryptophan, B12, folic acid, B6, methionine and betaine
The betaine also reduces homocysteine levels though you may be more aware of it concerning stomach acidity and absorption. The study because of the melatonin effect on the lower oesophageal sphincter keeps the acid in the stomach where it should be rather than in the oesophagus where it should not and where it has a damaging effect.
It was a scientifically validated study so it should be possible to replicate their findings if you wished to try.
Many thanks interesting reading. I am taking Citalopram as I had a bad stressful year in 2017 and wasn’t sleeping also Fenofibrate for high cholesterol and Thyroxine, I’m just wondering whether I have an allergy to one of these meds.
Hi your Citalopram is an SSRI a selective serotonin reuptake inhibitor so the reuptake is inhibited to prolong the action at the synapse, whereas the L-Tryptophan is the actual amino acid that goes into making the serotonin itself. The serotonin that goes into making the melatonin which is the hormone that regulates sleep.
Stress tends to push people towards a hypothyroid state apparently and that is associated with raised cholesterol.
Sleep is so important for mood, cell repair and digestion. Don't forget to include selenium as the conversion of T4 to T3 uses an enzyme which contains selenium (selenocysteine) so a deficiency will reduce the conversion. Also it is enhanced by the presence of vitamin C. Stress has an effect on the thyroid as 3 deiodinases involved in converting T4 witth different intermediates, some of the reactions are upregulated and some down regulated due to stress. There are some good articles which go into the details.
Stress has a horrendous effect on your sleep patterns and quality which is really damaging. There is another article you might find interesting:
wjgnet.com/2150-5349/full/v...
Which is the best choice for gastroesophageal disorders: Melatonin or proton pump inhibitors?
The latter is in the "World Journal of Gastrointestinal Pharmacology and Therapeutics"
You've got my sympathy I know how it feels (pretty horrendous) and I hope your sleep, health and happiness improves soon.
Wishing you a happy and healthy New Year
Thank you so much I just want to feel better, this forum is fantastic 🌸 a very Happy New Year to you too 😊
Many thanks for this link which I will study carefully.A quick response from just scanning your post is to say that I had no stress except caused by not knowing why I was feeling as I was and now knowing ( mostly) as cancer was suspected but not yet found.
I have no sleeping problems apart from waking every 2-3 hours to stroll for a pee. Woke up around 8.20 last few days! Even so the melatonin connection is worth exploring.
My B12 was over the max but folate was low in range when last tested. I have in the last few days added a Bcomplex to the mix although I had been taking a wide range of other vits ( including B vits ) previously.
Betaine HCL if anything made me worse.
Vitamin B12 Deficiency
aafp.org/afp/2003/0301/p979...
The study used betaine rather than Betaine HCl as it did not state any assumption whether the acid was high or low.
The above study shows a reaction in Figure 1 which involves the conversion of homocysteine to methionine (the latter is an essential amino acid which has to be supplied by the diet, the body can't make it).
It uses both folic acid and B12, so the lack of either would prevent the production of methionine.
Methionine can be converted to cysteine, the latter is not considered an essential amino acid because the latter can be produced in the body, but it is dependent on the availability of methionine. Therefore the lack of either folic acid or B12 would prevent the conversion of homocysteine to methionine and thus to cysteine.
ncbi.nlm.nih.gov/pubmed/182...
Type I iodothyronine deiodinase is a selenocysteine-containing enzyme.
The above is an old paper, but what it does highlight is that type 1 deiodinase is located in places like your liver or kidneys (actually all the deiodinases including DIO1, DIO2 and DIO3 all contain selenium and cysteine, that is they are selenocysteines membrane proteins).
A restriction in the supply of selenium or cysteine will lower your whole metabolism, as there will be a reduction in the supply of deiodinases (usually DIO1 and DIO2) available and it is these that convert the prohormone T4 into the active T3 (DIO2 in this example).
The reduced supply of cysteine can be traced back to the inadequate supply of either B12 or folic acid (both required) during the conversion of homocysteine to methionine. The raised homocysteine level would reflect the deficiency in either B12 or folic acid and as can be seen in Figure 1 of the original diagram is more sensitive than a serum B12 to indicate deficiency. (There are more recent additions but liked the original diagram)
The deiodinases are enzymes responsible for deiodination (activation and deactivation of thyroid hormones) such as conversion of T4 to T3 by Type 2 Deiodinase or Type 1 deiodinase which can produce T3 or rT3. These can be broken down further to T2 (both T3 and rT3 to T2). It removes the iodine from either the inner or outer phenolic ring (if outer ring then get T3 if inner ring then rT3).
The basal metabolism is governed by your thyroid (before that by hormones of hypothalamus and pituitary etc. If the folic acid is restricted then there will be restrictions placed on your metabolism as the supply of protein enzymes (deiodinases they are selonocysteines) will be restricted (as reduced supply of cysteine) and it is this which converts the inactive T4 to the active T3. (DIO2)
Similarly for T4 to T3 or T4 to rT3 in the case of DIO1 (rT3 (metabolically inactive in comparison to T3) more rT3 if restrictions apply seemingly). Essential tissues such as the heart express DIO2 (always T4 to T3) the heart is a priority. Other tissues may express DIO1 which can produce T4 to T3 (no supply restrictions) or T4 to rT3 (restrictions apply). Most conversion is actually in the liver and kidneys.
The preferred substrate of DIO1 in the liver is apparently rT3 which can be converted to T2.
In cases of hypothermia preserve core temperature (heart etc) rather than the extremities.
The study did not use from the extract I read Betaine Cl, it was betaine. The article below should hopefully explain, it is based on homocysteine levels (due to insufficient B12 or folic acid) rather than stomach acidity
academic.oup.com/jn/article...
Low Dose Betaine Supplementation Leads to Immediate and Long Term Lowering of Plasma Homocysteine in Healthy Men and Women
The GERD symptom relief in the original study making the comparison with omeprazole was achieved not using betaine Cl but instead all of the following melatonin, L-Tryptophan, B12, B6, folic acid, methionine and betaine.
It was not betaine Cl but a combination of all the above and could well have been dose dependent.
Rather than low B12, melatonin (circadian rhythm) or L-Tryptophan (mood) yours could simply be low folic acid which you've identified and hopefully you've corrected.
Everyone is different and what suits one person might not suit another
Best Wishes
Many thanks for the additional considerable detail.Interesting to read that main sources of betaine are spinach,beets and wheat.
I am avoiding wheat because of gluten and rarely eat spinach or beets.
Did resemble War and Peace!
Reflux is usually due to low stomach acid, not high. Therefore as much as Omzoprazole and gaviscon will give temporary relief, they will also make the actual low acid problem even worse long term. Betaine hydrochloride and digestive enzymes and the diet are the best way to get rid of this issue for good.
The prickly sensation could be due to B12 deficiency, but it could also be muscles that are pressing nerves or muscles that have inflammation in them. (There are other causes too, but these probably are some of the most common ones with thyroid issues.) If you have sore muscles, try massage. If massage makes the issue worse, it's inflammation. You can massage also the jaw both inside and outside of the mouth. I'm guessing it's inflammation.
Joint pain also tells about issues in the digestive tract. So it would be a good idea to drop out foods that cause inflammation like gluten and dairy. If the issue continues and there are other symptoms, a food intolerance test might be needed.
I'm not sure what your cortisol levels are so I cannot say much about this, but it's also a good idea to check.
Is your doctor a functional medical doctor? This type of a doctor together with a functional nutritionist/naturopath is the best way to recover from these issues. I'm saying it because I've had all these issues (CFS, hypothyroidism, Hashimoto's, fibromyalgia, gut issues and the list is still longer) and I'm mostly recovered (still have histamine intolerance, but no other issues - however, histamine intolerance is not a small issue). I'm not in the UK or US so I can't recommend a doctor, but I can recommend finding a good functional medical doctor. They are all private. I was bed-ridden for 1.5 years, but am now working part-time and living close to a normal life. And when the histamine issue goes away, my life will return back to normal.
If you put your lab results here, that would help us help you more.
Sounds like you’ve had a tough time satu55555.
I’m interested to learn what your functional practitioner is advising for histamine issues as I have them too.
Thank you
Polly.
Zizzy1591:
I am in the US and can confirm satu55555 experience . Everything written in this reply is almost exactly the same for me - including the functional Dr, the removal of gluten and dairy, the addition of betaine hydrochloride and digestive enzymes, and the return to a very active employment / volunteer activities / travel / highly involved grandmother! Life with Hashimotos / recovering is beautiful! Possible! Within almost everyone’s reach! (I would be most interested to hear more about the histamine battle!)
My journey also included being advised by mainstream medical Drs (1 particularly ignorant endo and many others) that my thyroid problem was “borderline” hypo. (In the 1980s Hashimotos was “emerging” as they say) suffering for 10 years of my younger days until finally finding a very intelligent young Dr who just listened to me - and then actually brought out a medical reference book in my presence and said “You just described a text-book definition of Thyroid Storm.” That was the beginning of the road back to health. That’s what functional Drs do. They listen. Yes they do tests, yes they do some trial and error. They also heal. What a concept! A whole medical group practicing the art of healing - not just treating. They are maligned and kicked out of insurance groups for “prescribing treatments not recognized....” (for instance Vitamin D testing).
Wherever you are - find a Dr practicing Functional Medicine, if at all possible. If it is not possible stay tuned here. Add the Betaine Hydrochloridr (with pepsin) / digestive enzymes. (I use both - but do not take at the same time). From time to time also add proteolytic enzymes. I learned about most of these right here. (I was actually tested for low stomach acid and been advised to start the betaine hydrocloride by a Dr - but at that time did not believe it - I didn’t really have that much of an acid reflux). It so makes all the difference.
Wishing you a speedy return to health. Unfortunately, with Hashimotos (fibromyalgia, chronic fatigue, and many other new diseases) the patient can and does have to “heal thyself” with nutrition, knowledge, and a whole lot of others who have been there / Drs who will LISTEN!
I'm very happy to hear that other have had similar experiences with recovery. So here's about histamine issues. Histamine issues take a long time to go away. My functional medical doctor says that she hasn't seen anyone not recover from it though.
You can take antihistamines for the worst things, but it's not recommended longterm as it will longterm reduce the amount of DAO enzyme production and make the problem worse. This actually happened to me.
Gut healing is the number 1 thing to do to get rid of histamine issues. So digestion, gut lining, yeast, leaky gut, bacterial problems like dysbiosis and SIBO and also parasites. I had SIBO and dysbiosis and leaky gut. SIBO has been long gone over a year and no sign of it anymore. It was treated with antibiotics twice have a year apart together with FODMAP diet and taking serrapeptase to break the biofilms.
Also any food sensitivities need to be tested and treated.
I take quercetin as my antihistamine and CoQ10 to reduce histamine production by the mass cells. I use nettle tea and consume only very small amounts of high histamine foods. The worst ones (these are individual) I avoid altogether. I also use CBD oil to lessen the fibromyalgia pain caused by histamine. It will still be seen how this turns out. I am in contact with my functional medical doctor and functional nutritionist every 2-3 months to update the treatment and diet.
Generally when the gut is healed, histamine issues go away. But this means properly healed.
And a small addition to the thing about betaine hydrochloride (=HCl). This should not be used longterm and it lessens the production of your own acids if taken too long. Enzymes don't do this so they are fine. A few months of HCl is fine. There's lots of text about how to use this on the internet. If the gut is in a really bad condition and has ulcers etc, it might not tolerate HCl. If HCl causes issues, it should not be used at that point.
Hello v interested in your post but can I ask about betaine HCL and digestive enzymes? you say you take both but NOT AT SAME TIME. I have been taking both - together!! Would be so grateful if you could let me know how best to take them separately please ? They're too expensive to 'waste
Many thanks
Andrea
HCL and enzymes are fine to take together at the same time. They work fine like that. Half way through the meal taking both so you need to have eaten some meat before taking HCL. I take/took mine a lot of the time right after eating so either half way through or right after.
I understand that taking Omeprazole can cause a magnesium deficiency. This could be responsible for the symptoms you are having. Magnesium can be taken by spraying an oil on to your skin, or what I do is to put a lot of epsom salts into my bath to top me up.
please note this forum in relation to B12 deficiency
healthunlocked.com/pasoc/posts
PA is the most common cause of non-dietary B12 deficiency. It is an autoimmune disorder that affects the gut and attacks the mechanism that allows most B12 to be absorbed from food. It can also result in low stomach acidity, the symptoms of which are pretty much the same as high stomach acidity. a particular type of anaemia in which red blood cells are larger and rounder than normal is another symptom but isn't present in 25% of people when they present with deficiency.
reflux can be due to food intolerances. Have a look at izabella wentz article about acid reflux. Removing food that caused it cured mine instantly x
Zizzy1591 in reply to
Thanks will have a look at that 😊
A friend was prescribed for over 6 years the PPI Esomeprazole (originally on Omeprazole) and had the same symptoms that you describe. It was prescribed for GERD / acid reflux the friend having congenital hypothyroidism.
The result was that he had low B12 and low vitamin D. The former is very important and in my friend resulted in neuropathic changes and the latter resulted in low calcium levels. Activated vitamin D3 is required for the absorption of calcium in the intestines and this is dependent on the pH and which therefore resulted in malabsorption. The hypocalcaemia resulted in muscle weakness, muscle cramps which included tetany (muscles lock) and fasciculation (muscle twitches). Depression is also a symptom of vitamin B12 deficiency and one that I can vouch for from personal experience.
The PPI did not cure the problem of acid reflux and instead replaced with a large number of others due to the malabsorption of nutrients.
Have you ever been tested for Helicobacter pylori? I think if I was in your shoes I would ask for a referral to a Gastoenterologist and try and find what the root cause of the acid reflux is (including the pH)? I would also have a read about a healthy microbiome and see what research there is concerning what this comprises and about any dietary changes that could bring this about.
Have you ever been tested for TPO antibodies as some research has shown a relationship with low vitamin D (though much of the population is actually low unfortunately according to some). Often the thyroid test does come back normal (it is a statistical measure) that does not always result in normal functioning (asymptomatic).
One of the symptoms of hypothyroidism (myxoedema) can result is water moving into the tissues, these can become swollen and can compress the local nerves resulting in pins and needles outside of the low B12 (required for nerve functioning). Hypothyrodism can cause neuropathy in addition to B12 deficiency. There is an association between carpal tunnel syndrome which results in pins and needles in the hands due to compression of the median nerve in the wrist.
Below is the address of the long term consequences of chronic PPI use from Gastroenterology which details the problems from malabsorption of calcium, magnesium, etc and the increased risk of infection.
uspharmacist.com/article/lo...
Good luck and I do hope you feel better soon
Thanks so much this is a brilliant forum 😊
SlowDragonAdministrator
How much Levothyroxine are you currently taking?
Being under medicated for thyroid is very common reason for acid reflux and low vitamins
Do you have recent results for TSH, FT3 and FT4?
Have you ever had thyroid antibodies tested? If not request that GP tests these
On Levothyroxine TSH should be under 1.5 and FT4 in top third of range
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
All thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies
thyroiduk.org.uk/tuk/testin...
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. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
As others have said, low stomach acid is more common reason for acid reflux when hypothyroid. H Pylori is more common as result too
Acid reflux is common too when gluten intolerant. If you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies gluten intolerance is frequently a hidden issue and can cause low vitamins too
I’m on 50mcg at present and had blood thyroid test done about a month ago which was normal. Prior to that test I had a full private test with Medicheck and that report came back normal, this was a year ago. It was about 9 months ago the prickling sensation came when I was taking the PPIs, I shall know better tomorrow the results of the vitamins I am deficient in, I feel at the end of my tether at the moment and depressed, its like being on a merry go round! Thanks for your comments.
This is an old study comparing dietary supplementation with the vitamins below and omeprazole all patients of group A in the study experienced a total relief of their symptoms during the 40 day randomised trial whilst only 65% experienced symptom relief.
Hence this would result in 35% in the omeprazole group suffering symptoms and taking a drug which causes malabsorption of nutrients amongst their significant side effects.
Group Group A however had 100% remission of symptoms by providing the body with the nutrients that it requires.
It is an old study but I think that is probably unsurprising as it is unlikely that pharmaceutical manufacturers would want such findings and as such funding would be a somewhat harder to find as there is not the financial inducement to fund the research (no profit for them).
onlinelibrary.wiley.com/doi...
Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole
Many thanks interesting reading 😊
Alot of those symptoms are of vitamin B12 deficiency. So start taking high dose vitamin B12 and vitamin D.
For vitamin D, my GP said you can either have 1000iu's for 30 days, or 10000 iu's for 3 days. I did the 3 day version.
For B12 the methyl version is best in case you have the MTHFR gene mutation that means you can't absorb vitamin B12 very well.
So did doctor actually test your stomach acid? If not, how does she know it is too high? Far more likely to be too low and now you have vitamin deficiencies because of taking antacids (as you don't good enough digestion to absorb them). If you have ulcers, you usually need something to kill off the H pylori and then digestive enzymes to stop them recolonising
Yes, if your doctor does not suggest it then ask to see a gastroenterologist. It's possible you have a coexisting autoimmune condition such as pernicious anaemia or coeliac disease.
If you have only been taking the omeprozole for a short time and had stomach problems before hand then it's unlikely the low B12 and low vitamin D have been caused by the omeprozole although it won't have helped. It's more likely you have an underlying condition that needs treating.
Do not self-treat with vitamin B12 if you are going to have further investigations as it will complicate things. Ask your doctor to look into all options and rule out all possible conditions that might cause these deficiencies and refer you immediately for full investigation.
proton pump inhibitors are terrible. The mitochondria use the proton pump to make energy through the respiratory chain. Inhibiting that in any way is not healthy. While I am no doctor my reading indicates that acid reflux can actually be "not enough acid" in the stomach to digest the food and then the stomach churns. My brother had severe acid reflux for 15-20 years. The looked at him two years ago and told him that his esophagus was getting eaten up and he would get cancer. I told him about Fire Water - an old remedy of fermented herbs, peppers and cider vinegar. He started taking it every day and has not had a problem since. You can find a recipe on the internet - many of them in fact. It takes about 6 weeks to do it properly. I age mine in the sun outside which may not be practical in winter. Proton pump inhibitors increase the risk of many diseases. I would not take them - ever. But that's me. I tell everyone I know who has Parkinson's not to take them. Many of them were on PPIs for a decade before being diagnosed with Parkinson's.
I intend to stop as there is so much bad press about them. It is hard to stop though as my reflux is horrendous and stops me sleeping and the worry is all this acid and inflammation could cause oesophageal cancer! Will be talking to my GP tomorrow. Thanks for your comments
I have same dilemma ,whilst I think my ulcers etc must be caused by too much acid not too little ppi treatment has major long term drawbacks .
For sleeping you need to raise your head and chest .I purchased a wedge pillow and have two ordinary pillows on top .Have to keep pushing myself back up .A friend has put his bed on bricks at the top end.
Super info ! So appreciated!!
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