Can I take a lactase supplement with my Levothyroxine medication?

[Bookworm63]

Like a lot of people on here I have an intolerance to lactose and to mannitol so I have been wondering if it would be ok to take a lactase tablet with the meds containing lactose? Have tried the lactose free brand but don’t seem to be tolerating the mannitol on those. Any thoughts greatly appreciated 😊

[Hashi-hacker]

That's a really interesting thought. I am guessing that as the lactase in an enzyme that should break down the lactose in the Teva levo before it does any harm, then it should work. But I honestly don't know. Maybe worth a trial?

[Bookworm63 in reply to Hashi-hacker]

Thank you Hashi-hacker. Teva don’t have the lactose but I still seem to get tummy bloat so I’m guessing that’s the mannitol. I’m going to start taking them at night and see if that helps. My theory is that because we are advised to take these meds on an empty stomach we have more trouble digesting the fillers. People seem to tolerate them better when taking at bedtime. Maybe that’s because there is still some food in their digestive track and it helps to move it all along. It’s just a theory and worth a try. If that fails I’ll try the lactose ones again with a lactase pill and see if that works! Thanks for replying and have a good day 😊.

[Hashi-hacker in reply to Bookworm63]

Sorry yes of course Teva doesn't, that's the point. Doh! I take Teva and definitely have problems with dairy, but probably the protein and not the sugar, so I was interested in your post, despite my confused reply. As an aside, I did a lot of work on getting rid of SIBO (small intestine bacterial overgrowth) which really helped with the daily bloat that I had. There are lots of online resources about this x

[Bookworm63 in reply to Hashi-hacker]

Have read about SIBO and often wondered if this was one of my problems too. Will do some research on that too 👍.

[Hashi-hacker in reply to Bookworm63]

I worked with the lady that wrote this article, to treat the SIBO, I did a round of anti-microbials which helped but didn't totally fix it then a round of Rifaximin on a private prescription (pricey at nearly £600). I very rarely get bloating these days - and eat all the high fodmaps foods with no issues.

chriskresser.com/why-diet-a...

Good luck x

[Bookworm63 in reply to Hashi-hacker]

Thanks for this very interesting reading. Will look into it x

[Heloise in reply to Bookworm63]

Hi Bookworm, I watched the SIBO summit and now see there is one for SIFO which is fungal rather than bacterial. With hypo you are often constipated and that's what may instigate either one. Rifaximen is usually very effective for the bacterial infection because it stays in the intestine. I don't know where Hashi-hacker obtained her rifaximen but the functional doctors were able to get it for a much cheaper price from Canada. They use a breath test for hydrogen or methane as a dignostic tool.

[Bookworm63 in reply to Heloise]

Thanks Heloise, seems I’ve opened a whole can of worms here! It does seem to make sense though. Seriously going to get it looked into. Thanks for sharing your knowledge on this. When I’ve read about SIBO before it’s always seemed so complicated to resolve, but maybe it’s easier than I thought 😊.

[Heloise in reply to Bookworm63]

Ha, ha, not sure it's that easy. If you don't have a lot of digestive problems it might be a mild case. The idea to eat things you can digest quickly so as not to feed the bacteria and some go so far as to eat the stuff they use in stomach feeding....all predigested or a fodmap diet. It's so opposite the fermented food we all felt was so healthy.

I've taken some herbals like berberine, allicin, oregano oil, Neem, etc. Berberine seems to have a lot of health benefits if you just want to try one. I think it's a tough call in our case.

[Bookworm63 in reply to Heloise]

Thanks Heloise, I think or at least I’m hoping it is only a mild case. Was looking into herbal solutions online so will definitely give them a go. I understand about what your saying about fermentable foods and I always had difficulty with probiotic pills. They would give me awful tummy bloat so I would have to stop. I’ve started taking my Teva med at bedtime in the hope that it will easier on my digestive system. 🤞 Thank you for your help and suggestions and have a good day 😊 x

[Hashi-hacker in reply to Heloise]

I had to get my GP to write a private prescription and got the Rifaximin through my local pharmacy in the UK. I did the breath tests too.

[Heloise in reply to Hashi-hacker]

I had looked into it more than a year ago and it was close to $1000 in the U.S. which is notorious for "stealing" from insurance companies especially medicare and not affordable for those with no insurance. They are being brutal about epi-pens cancer drugs and insulin. I used to order Erfa from Canada so I checked out rifaximen and they were selling it for $150 at that time. I'm glad it worked for you.

[asidist in reply to Hashi-hacker]

Hi Hashi-hacker, so great to hear a success story! I hear so much about SIBO returning after some time for most that I’ve been hesitant to get treated (also waiting to get a second opinion since i’m not sure my results, which have a single rather than double peak of hydrogen, are indicative of SIBO as my gastro says, or just rapid transit time to the large instestine). Can I ask how you’re doing these days and if there’s anything you did or took beyond Rifaximin to which you would credit your success? Thanks in advance for any input

[Hashi-hacker in reply to asidist]

Mostly all good in the tummy department, I think the Rifaximin nailed the SIBO. I follow a gf, df and soya free diet. I take LDN and an assortment of the usual suspects of supplements. I haven't had to 'do' anything for my guts for a long time :o) I am about to start T3 due to having the DI02 and some lingering symptoms and feel like I am blessed to have got the prescription on the NHS. The only other thing I recently started is red light therapy which is meant to help with T4 to T3 conversion but haven't noticed any major changes in symptoms other than about 7lbs disappearing which is a happy by product (although I am not overweight, there had been some creeping weight gain which I was happy to lose)!

[asidist in reply to Hashi-hacker]

thanks so much for responding! sorry for the delayed reply - had written a reply last week but got pulled away before i could send it and it was lost. yours is one of the first longer term success stories i’ve heard, gives a lot of hope. did you take probiotics afterwards? probiotics seem to make things worst for me in recent years but my gastro recommends a course after the rifaximin. i know there are types that won’t colonize the small intestine, but i am still hesitant and unsure why they would be necessary considering the rifax supposedly does not affect the bacteria in the large intestine (perhaps it does to a small degree?).

interesting to hear about the red light therapy, thanks for sharing - have read a bit and long wondered about that. i too recently got an rx for and am about to start T3 - hopeful but nervous! actually that is one of the reasons i haven’t tried treatment for SIBO yet - thought might be better to get my thyroid health in order and improve my baseline functioning before treating the SIBO in order to potentially address underlying factors first and have a better chance of keeping it away.

best of luck to you with the T3 - hopefully a large part of the puzzle for both of us

[Hashi-hacker in reply to asidist]

Happy to share, especially when it gives hope! As to pre and probiotics post Rifaximin, I can't remember exactly what I did apart from taking some acacia fibre (pre) and maybe a round of Symprove probiotics. I am a bit lax about eating saukraut and kefir but know I should do so!

I dug out my notes from before I did the Rifaximin, as I was seeing an RD over Skype, and this is the anti microbial protocol that I did which mostly worked but didn't nail everything; Candibactin, GI MicrobX, Interfase plus, Probiotic 50B, Atrantil, FOS, Lauricidin, SBoulardi. I can send you her details if you are interested (she is associated with Chris Kresser).

The RD was of the opinion that getting your gut in shape was important as this is where a % of T4 conversion takes place plus for general good health. Equally she said that if your thyroid performance is better then your gut performs betters as e.g. your transit time for food is better (I had slow transit time and tended to constipation).

I am 3 days into my T3, nothing to report which I'm happy about as one of my concerns was feeling really rough with it or going hyper. Onwards and upwards hopefully! Good luck with your T3 x