Confused about Thyroid and IBS tablets?? - Thyroid UK

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Confused about Thyroid and IBS tablets??

Tallbird-Sammi profile image
15 Replies

Ok so not sure if this should be posted on Thyroid or IBS page but I'll start here and go from there as I know they can go hand in hand.

I have been taking Levothyroxine since 2001 ish and also been treating IBS flare ups on and off for nearly as many years!

At present I'm taking -100 Levothyroxin. Mebeverine 135mg 3x a day. And I have Omeprazole 20mg for if I have a flare up that gives me pain for days, I will take one a day for up to a week and then stop.

My confusion is from the fact that neither at the doctors nor people at the chemist have ever told me to keep these tablets away from each other but I keep reading different information online.

I always try to keep tablets a little apart but as they all have to be taken in the morning before I eat it does get a little difficult??

I've read that it should be 4 hours apart, 6 hours apart and also that it doesn't matter if taken at the same time??

At present I take thyroid table in the morning (I try to take it with water when I get up to go for a wee) sometime between 5 -7am.

If i'm in the middle of a flare up the Omeprazole is then taken between 8 and 9. And my first Mebeverine is taken 20 mins after that. Or if not needing to take Omprazole, Mebeverine is taken around 9am.

I'm lucky that I don't wake up hungry like my husband and can wait for food!!

So am I doing wrong??

Also slightly concerned that until quite recently I was taking to much Mebeverine as they prescribed double dose to calm my stomach down but no one ever told me to reduce it. So was taking to much for years. Should I be worried?

Thanks for any info.

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Tallbird-Sammi
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15 Replies
greygoose profile image
greygoose

You should never take anything with levo, no other pills of any sort. And you should leave a two hours gap.

But, two things worry me, here…

1) Has no-one ever suggested that your IBS may be due to your under-active thyroid? How much levo are you taking? Are you sure that you aren't under-medicated? Do you have any lab results to share with us?

2) Omeprazole is a PPI, it reduces stomach acid. Hypos usually have low stomach acid, anyway, so Omeprazole will make that worse, making digestion even harder, and probably impacting your IBS. Would you not, perhaps, be better off increasing your stomach acid, to make digestion easier?

Also, to avoid all possible problems of your medication affecting your absorption of levo, you could take your levo before bed, as long as it's two to three hours after your last meal. :)

Tallbird-Sammi profile image
Tallbird-Sammi in reply to greygoose

Thanks greygoose.

So 2 hours is enough space between Thyroxine and Mebeverine? That's good to know as it is always 2 hours between them but I was worried it had to be more!!

Ok so to answer your worries -

1) Yes my IBS is down to my Under active Thyroid.

I'm taking 100mg Levothyroxine.

I had a full blood count at the end of last year, I have the full results somewhere and will post when I find them (having a big clear out in my office at the mo and all my paperwork is boxed up in the spare room!!).

I do know Doctor and I were happy with my T4 which was in the high range where I like it.

But although I was happy with my low TSH the Doctor was worried it was to low but was happy for us to just keep an eye on how I'm feeling. Which by the way as far as my Thyroid symptoms go I feel good.

2) This is where it gets a little mixed up. I'm only taking Mebeverine for my IBS caused by my Thyroid.

I'm taking Omeprazole only when I get this horrid pain in the top of my abdomen, this is caused by me getting anxious and worried about "Stuff" and this then increases the stomach acid resulting in the pain and feeling sick and full.

I don't take Omeprazole all the time (last year was the worse year of my left, with hubby in hospital and needing my care for 5 months, losing far to many to cancer plus other things), so my anxiety levels were through the roof. It is slowly getting back to normal but it's a slow process.

So I tend to take it for around 5 to 7 mornings when I get this pain, it slowly helps to relax my abdomen and I then stop taking it.

I have thought about taking Levo at bedtime but I do tend to snack in the evening!! :)

greygoose profile image
greygoose in reply to Tallbird-Sammi

1) If you feel well, that's the main thing. But, you still have IBS, so you don't feel as well as all that, do you?

2) Have you actually had tests to prove you get high stomach acid at times of stress? The problem is that the symptoms of high and low are the same, but, when you say that you feel 'sick and full', that sounds to me as if your acid has gone lower, rather than higher, with the food not being digested and fermenting. But, it's good that you only take them for a short period at a time. :)

Tallbird-Sammi profile image
Tallbird-Sammi in reply to greygoose

As far as how my thyroid issues go I feel good. My only issues at the mo are my anxiety levels and my IBS that has no pattern if looking at my food diary??

Stress and anxiety can activate the flight or flight response in our central nervous system which can cause spasms in the oesophagus, increase stomach acid and make you feel nauseous. The longer it goes on you can get a decrease in blood flow and oxygen to the stomach which leads to cramping, inflammation and possible diarrhoea because the gut is then imbalanced making IBS worse. I believe I'm trapped in this cycle??

I have had tests in the past but plan on going back to the doctor and having another conversation about everything, My last appointment was cancelled so I'm waiting again!!

:)

greygoose profile image
greygoose in reply to Tallbird-Sammi

But, given that IBS and anxiety can both be due to under-medication of hypothyroidism, I would still say that you are under-medicated, at a guess. :)

Tallbird-Sammi profile image
Tallbird-Sammi in reply to greygoose

Ooh sorry been a very busy few weeks!!

I have suffered with anxiety since primary school so it's not a thyroid issue.

I know IBS is related to under active Thyroid but it's also very much an anxiety thing and my flare ups are mostly down to my anxiety levels, although of course some other things can make it worse.

I don't believe I am under-medicating, I have taken more in the past and have weird?!?

Thanks again for your time. :)

greygoose profile image
greygoose in reply to Tallbird-Sammi

How do you know you haven't been hypo since primary school?

Tallbird-Sammi profile image
Tallbird-Sammi in reply to greygoose

Because I was tested in Secondary School and all was good.

greygoose profile image
greygoose in reply to Tallbird-Sammi

Well, you know as well as I do that that means nothing. Did you even see the results? Or was that just your doctor's opinion?

Tallbird-Sammi profile image
Tallbird-Sammi in reply to greygoose

No at that time the doctors were actually telling the whole factual truth!! I had a perfectly happy and healthy working thyroid when I had those tests taken.

My thyroid issues didn't start until much later.

SlowDragon profile image
SlowDragonAdministrator

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

Recommended on here that 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)

IBS is often due to gluten intolerance which is common with Hashimoto's (raised antibodies)

Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

chriskresser.com/the-gluten...

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

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

Tallbird-Sammi profile image
Tallbird-Sammi in reply to SlowDragon

Thanks SlowDragon I shall take a look at the links over then next few days.

I had a full blood work up done at the end of last year. Everything was looked at for example - Liver/kidney function, Anemia, vitamins and minerals deficiencies, hormone levels etc

My husband has a wheat/gluten intolerance and is a keen runner (slowly getting himself back to it after last year). We don't take short cuts in the kitchen and everything is made from scratch so everything we eat is gluten/wheat free with no processed stuff in at all.

There seems to be no pattern to my IBS flare ups, I can have something for ages and then one time it can cause tummy to bloat up and crap!!

The tablets help but are definitely not a cure, I was just worried I wasn't leaving enough time between Levo and Mebe. :)

SlowDragon profile image
SlowDragonAdministrator in reply to Tallbird-Sammi

Good you are gluten free already

Have you tried dairy free, or lactose free diet too

You need FT3 and FT4 tested together with TSH

Often we are poor converters, especially if vitamins are low

High FT4 and low TSH, doesn't mean FT3 is necessarily high enough

Low vitamins are extremely common. Have these been tested

Vitamin D, folate, ferritin and B12

Thyroid hormones need optimal vitamin levels

Omeprazole lowers vitamins, especially B12 and magnesium

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

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

Gluten free diet is often low in magnesium

Hypo patients also often low in magnesium.

Recommended on here that 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 or all vitamins

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

Come back with new post once you have results and ranges on Thyroid and vitamins

Tallbird-Sammi profile image
Tallbird-Sammi in reply to SlowDragon

Yes for the last 18 years I have never taken my Thyroid medication before a blood test, so early morning and no food or drink.

I had a full blood work up so they checked for everything, I always get a print out (much to the annoyance of the ladies at reception) and all is good.

I do take an array of supplements including Bs and Zinc.

:)

SlowDragon profile image
SlowDragonAdministrator in reply to Tallbird-Sammi

You know to stop any supplements containing biotin 5-7 days before any blood tests?

Vitamin D around 100nmol

Folate and B12 towards top of range

Ferritin at least half way in range

Many of us still need small dose of T3. Seems to often improve gut function

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