Medication overload!: Dear Friends, Just... - Thyroid UK

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Medication overload!

LadyWard profile image
111 Replies

Dear Friends, Just concerned as i have gone from NEVER taking any medication to now having to take all this, please can you tell me if they are all okay to take and that i am not doing anything wrong!

I have taken your advice on the vitamins and have now been given Omeprazole 40mg twice a day for my voice issues as GP said its worth trying as i may have laryngopharyngeal reflux (LPR). This is what and when i take them x

7.30am - Levothyroxine 75mcg

7.30am - Vitamin D (spray)

12.30pm - Super B Complex (one) before lunch (only take one of these)

12.30pm - Apple cider Vinegar (1 TBS)

12.30pm - Omeprazole (40mg) before lunch

6.30pm - Selenium (200mcg) before dinner

10.00pm - Femoston 1/10

10.00pm - Omeprazole (40mg)

Am i doing it right, am i missing anything x

last tests before start on higher dose of Levo (this was at 50mcg0 now on 75

hs-CRP High 9.37 <5.0

Ferritin 40.0(13 - 150)

TSH

3.96 (0.27 - 4.20)

Free T4 16.1 (12.0 - 22.00

Free T3 4.43 (3.1-6.8)

Immunology

Anti-Thyroidperoxidase abs High >600 <34

Anti-Thyroglobulin Abs 29 <115

Vitamins

Vitamin B12 415

Serum Folate 10.60 (8.83-60.8)

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111 Replies
Nanaedake profile image
Nanaedake

Why are you taking omeprozole and what is femoston?

You should not be taking levo and any other vitamins at the same time. Vitamin c is the only exception as it can improve absorption of levothyroxine. All other vitamins may impair absorption of thyroid hormone.

You should leave at least a 2 hour gap between vitamins and thyroid hormone and 4 hours gap before taking iron tablets.

200mcg selenium daily may be too much long term. You may be better to reduce the dose once you've reached an optimal level.

Taking omeprozole and Apple Cider vinegar to improve gut function is counterintuitive as Omeprozole lowers stomach acid and Apple Cider Vinegar increases it.

LadyWard profile image
LadyWard in reply to Nanaedake

Thank you. I'm not taking anything with the Levo apart from the D Spray as i was told that should be ok as it is a spray? only started that yesterday so can change that if you think i should? I don't take anything else for at least 4 hours.

Femosten is Hormone replacement (Menopause)

Doctor prescribed the omeprozole, as for the last 14 weeks i have had a very hoarse voice and now i can virtually not speak, Camera showed damage to vocal cords, blood tests showed Hashimotos with antibodies over 600. Consultant said damage may have been caused my thyroid and once medicated should get better (Its got worse) GP now suggested trying these tablets as it may be silent reflux?

Lalatoot profile image
Lalatoot in reply to LadyWard

I have a sore throat and horse voice when I am undermedicated. It is one of my main symptoms.

I think there is a problem/clash with the apple cider vinegar and the omeprozole. Apple cider vinegar is taken when hypos have low stomach acid; omeprozole is a treatment for reflux caused by too much stomach acid.

LadyWard profile image
LadyWard in reply to Lalatoot

that makes sense, i shall stop the vinegar! thank you. I don't have a sore throat or heatburn, just a feeling of slight tighness and aching neck and NO voice :( x

greygoose profile image
greygoose in reply to LadyWard

If I were you, I'd stop the omeprazole! That's a dreadful thing to take and should only be taken short term. If you've been on it for 14 weeks, that's already too long, and your doctor's theory for your hoarse voice is illogical.

Hypos are far more likely to have low stomach acid than high, but the symptoms are the same. Silent reflux? Possibly. But due to low stomach acid, not high. Therefore omeprazole will make things worse, not better. However, by also taking the ACV, you've evened things out. lol

I unwittingly took omeprazole for a few months, not knowing anything about it. It completely mucked up my digestive system, which had worked perfectly before, even though I am hypo. And, caused constipation that I can't get rid of, and had never had before - even though I am hypo and have been for many years. Doctors don't understand quite how bad these things are, and hand them out like sweeties at the slightest excuse, without bothering to ascertain if the patient actually needs to reduce their stomach acid. I believe they get some financial incentive to do so.

So, if it were me, I'd stop the omeprazole - but wean off slowly - and continue with the ACV. :)

boxesandplanes profile image
boxesandplanes in reply to greygoose

Why is omeprazole dreadful? My 7 year old has been on 20mg per day for around a year!

Greybeard profile image
Greybeard in reply to boxesandplanes

Omoprazole is a proton pump inhibitor, used to lower stomach acid. The question is, was a test done to prove excess acid? Or was it just guessed at.

Stomach acid is needed to help us liberate and absorb nutients from our food , long term use can lead to deficiencies in vitamins and minerals. Lowering stomach acid can lead to problems with our gut flora,

The proton pump mechanism is also used by our mitochondria, which are the power houses of every cell in our bodies. So ppi's may be needed short term but they aren't a good idea long term especially when prescribed on a guess.

boxesandplanes profile image
boxesandplanes in reply to Greybeard

It was a guess, by me in fact after he was hospitalised for 2 weeks with asthma but basically a cough that was like whooping cough , but not it. He's had so much prednisolone for asthma in his life and I and his consultant agreed that maybe it was reflux causing the coughing. It turned out to be the most helpful medication he's ever used.

And having always been hospitalised around 10 times a year for asthma, hasn't been at all since the omeprazole!

So we're not giving it up in a hurry!!

However, he has developed side effects and has broken his arm, and so I'm worried about calcium depletion, but no, they haven't done any nutrient checks. He is terrified of needles

Treepie profile image
Treepie in reply to boxesandplanes

See my reply to Bantam12 below.

LadyWard profile image
LadyWard in reply to Greybeard

In case it is a complete guess by GP just trying to find an answer!

greygoose profile image
greygoose in reply to boxesandplanes

There have been many, many posts on the subject of PPIs on here, over the years. I suggest you do a search. The following are just a few high-lighting the problems PPIs can cause:

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

I hope your doctor is keeping a close eye on your child's nutrient levels, because they're likely to be depleted.

Ljg72 profile image
Ljg72 in reply to boxesandplanes

These things are always a balancing act.

My five year old was on omeprazole for four months because of severe stomach pains we couldn’t get to the bottom of. The gastroenterologist who put her on it said in her opinion that was about the right amount of time, because they didn’t yet know what the long term consequences of using omeprazole on children might be. When she stopped her reflux and severe stomach pains came back. We eventually managed to resolve her issues by putting her on a strict gluten dairy and soy free diet and going back to an 'old fashioned' diet of meat, fish, fruit and veg - all cooked from scratch, (paleo diet). We also had her nutritional levels done privately through a urine test.

It’s definitely worth reading up about possible side effects, but as I said before i guess it’s a balancing act when there are severe health issues the omprezole is helping to resolve.

in reply to boxesandplanes

I was put on Omeprazol along with prednisolone a year ago and was told by doctors at the time I'd need to take it as long as I was on prednisolone to protect my stomach. After six weeks on it, my B12 levels, always well in range, had dropped below range. After that, I read that Omeprazol and other PPIs can lower B12 so I'd advise you to keep an eye on B12 levels if on it long-term.

boxesandplanes profile image
boxesandplanes in reply to

Ok thanks, will mention it to his consultant

bantam12 profile image
bantam12 in reply to greygoose

GG Omeprazole isn't "a dreadful thing to take" if needed, my husband has been on a very high dose for a year and and he has to stay on it or risk serious problems.

greygoose profile image
greygoose in reply to bantam12

Well, seems to me the side-effects are pretty dreadful, but I suppose that's a matter of opinion. Whether or not you need it, it's still not a nice thing to take.

bantam12 profile image
bantam12 in reply to greygoose

My husband has had no side effects from it at all.

greygoose profile image
greygoose in reply to bantam12

Well, then, your husband is very lucky. But that's not the case for everyone. And, what about the long-term effects? Has anyone thought about those?

bantam12 profile image
bantam12 in reply to greygoose

His life is limited so long term is not something we can think about .

greygoose profile image
greygoose in reply to bantam12

I'm very sorry to hear that. But, you have to admit, he is a special case, and that doesn't mean that PPIs are good for everyone.

bantam12 profile image
bantam12 in reply to greygoose

I never said they were good for everyone 🙂

greygoose profile image
greygoose in reply to bantam12

No, that's true, you didn't. But, you were very quick to jump in and say that they weren't dreadful things to take, when for a lot of people, they obviously are. And, we have no proof - and neither does her doctor - that the OP actually needs to take them.

Treepie profile image
Treepie in reply to bantam12

I have been on Omeprazole then Esoprazole for over a year initially for high acid which turned out to be caused by lymphoma of the stomach. Also taken for Barratts oesophagus and reflux.

But I am increasingly concerned re the long term side effects.Doc says five years long term but......

Issues I have identified : higher odds of heart attacks, fractures, a recent German research paper suggested an association with dementia, there is a 16% reduction in effect of levo ( hope this means if taken close together) . A further issue probably related to the cause of heart problems is that it reduces nitric oxide.

bantam12 profile image
bantam12 in reply to Treepie

My husband had severe heart problems before going on to Omeprazole and came very close to dying 11 months ago from an acute heart problem and duodenal rupture, since being on them his heart function has improved as has his stomachs issues. Omeprazole may not be right for everyone, nothing is, but some people need it.

crazycatlady100 profile image
crazycatlady100 in reply to bantam12

Thats so true

LadyWard profile image
LadyWard in reply to greygoose

That's so interesting what you are saying about the low acid! Just to clarify, i only got given the Omeprazole yesterday. Only took one so far :) It's the Levo i've been taking for 12 weeks which i thought would have helped by now, and my voice started going before then, its just weird that its getting worse rather than better x

greygoose profile image
greygoose in reply to LadyWard

If you've only been taking levo for 12 weeks, you'll still be on a low dose, so not surprising if it hasn't helped much yet.

Things often get worse before they get better, it's not weird at all. Starting thyroid hormone replacement will have reduced your natural production of thyroid hormone - which is perfectly normal - so that's why things get worse. How much did you start on? When were you last tested? What were the results?

greygoose profile image
greygoose in reply to greygoose

Just seen your results above, and your TSH is still too high - should come down to 1 or under - and your Frees are still too low. So, early days. But, it's far more likely that it's the hypo causing your voice problems than lack of a PPI.

Things always move slowly with hormones, and we cannot hurry them. Any attempt at a short cut is likely to backfire and set us right back to square one. We need lots of patience, I'm afraid.

Gillybabe48 profile image
Gillybabe48 in reply to greygoose

Totally agree. My mother when underactive had a very deep voice sounded really hoarse. As did I. Constipation too.

LadyWard profile image
LadyWard in reply to Gillybabe48

Did your voice change back once you were medicated properly? X

Gillybabe48 profile image
Gillybabe48 in reply to LadyWard

Absolutely and my body. went back to normal but it took patience and time and adjustments to medication to 100 mg now.

san_ray70 profile image
san_ray70 in reply to Gillybabe48

I eat a lot of fruit and also eat liquorice and drink liquorice tea. Mostly I am ok, when I eat enough roughage.

LadyWard profile image
LadyWard in reply to san_ray70

Annoyingly I can’t have liquorice anymore, because it contains gluten! I love it too 😩

Gillybabe48 profile image
Gillybabe48 in reply to greygoose

Totally agree. I only feel well when my TSH is 0.07 as we are all different. It is not "one size fits all". The answer is an increase gradually until you feel better, with regular blood tests. My doctor got a bit concerned when my TSH was below range but I still felt ill on 75 mgs so in the end I had to buy the extra 25mgs at an online pharmacy.

LadyWard profile image
LadyWard in reply to Gillybabe48

I’m hoping they will just increase me! Voice is def starting to get better x

LadyWard profile image
LadyWard in reply to Gillybabe48

Hi Gilly sent you a PM X

LadyWard profile image
LadyWard in reply to greygoose

That is good to know abut the natural process slowing down, i didnt know that?!!

I think then, i'm going to NOT take this Omeprazole, as only started yesterday and preserver on with Levo and maybe try the cider vinegar as only had one dose of that so far, incase it is actually the low acid that causing it or indeed just my thyroid?

So first THS was 6.8 (so not too high) started straight on 50 Levo was on that for 10 weeks, been on 75 for 2 weeks.

Starting to understand it all, slowly!! its just yo hear people say they feel so much better and they have been on it 3 days!?? so i thought i should be noticing a difference by now, but understand what you are saying now , so makes sense that i dont x

greygoose profile image
greygoose in reply to LadyWard

6.8 is pretty high in my book. When you think that you're hypo with a TSH of 3, it's the ranges that are wrong. But, good that you were started on 50 mcg. Even so, you should have been retested after six to eight weeks. Ten weeks is just too long.

I think, actually, it's pretty rare for people to feel better in three days. That sounds more like the placebo effect, to me. Not that there's anything wrong with placebos, but it does give false hopes to others. It took me two years to feel better! And, then only after T3 had been added to my levo. But, I guess I was an extreme case in the other direction. :)

Nanaedake profile image
Nanaedake in reply to LadyWard

When I take apple cider vinegar, I take it in a glassful of water, I start with a teaspoon and then increase a little if needed. It works wonders for me.

Gillybabe48 profile image
Gillybabe48 in reply to LadyWard

Omeprazole lowers the effectiveness of the levothyroxine dose. I only feel well when my TSH is 0..07 so everyone is different. So 6.8 is high.

NWA6 profile image
NWA6 in reply to greygoose

What about Lansoprazole? Is it the same?

greygoose profile image
greygoose in reply to NWA6

Anything ending in -zole is a PPI, yes. It's the same.

NWA6 profile image
NWA6 in reply to greygoose

😞 thought so. My dad has been on it for years

greygoose profile image
greygoose in reply to NWA6

Doesn't surprise me. Has he already had a heart attack?

NWA6 profile image
NWA6 in reply to greygoose

Greygoose. No he’s physically so fit and healthy at 78yrs old, ex army but he was diagnosed with Alzheimer’s 12yrs a go but it’s not ‘taken hold’ like it ‘should’ and so now I’ve been looking at his drugs and got him a thyroid test which shows very low T3. I’m not exactly sure why he’s on it tbh I wasn’t concentrating on that particular drug because I thought it was innocent.

greygoose profile image
greygoose in reply to NWA6

No, it's not innocent at all. And, if he has been 'diagnosed' with Alzheimer's but doesn't seem to have it, and he has high cholesterol, then he's more than likely hypo. Very low T3 could cause both. What were his TSH and FT4?

NWA6 profile image
NWA6 in reply to greygoose

High TSH and low T4. The post is in my profile. It wasn’t until I began understanding my Hashi’s that I looked at my parents. My mum has under active thyriod, so I always thought Tg was from her. But I told her to get Dad tested too because his ‘Alzheimer’s’ isn’t behaving as it should. Although he does now have some bad confusion and dementia like symtoms but that could be from a host of things which have made him hypo. I think he’s been given the Lansoprazole to counter some effects of perhaps the Ebxia but I wonder if it was just routinely offered.

greygoose profile image
greygoose in reply to NWA6

Just had a look. His FT4 is even lower than his FT3! But his TSH isn't high enough for the average doctor to take any notice. I would think a little thyroid hormone would do him a world of good!

They're giving him Alzheimer's drugs without even being sure it's Alzheimer's? I don't know if Lansoprazole is usually given with that drug, but it seems to be handed out to just anyone, these days. But, the Lansoprazole itself can cause dementia. Oh, god, for an intelligent doctor that actually thinks about what he's putting in his patients and doesn't just act on autopilot!

greygoose profile image
greygoose in reply to greygoose

Are his nutritional deficiencies being supplemented? Because they won't help! Sounds like he has a jackass for a doctor who doesn't really care about the welfare of his patient!

NWA6 profile image
NWA6 in reply to greygoose

Greygoose it’s been a nightmare! I have to say that I’ve been in my own bubble in England with my own Hypo nightmare and raising 4 kids. I didn’t really have the capacity to voice an opinion on my Dads diagnosis but now that I am compos Mentis I am more involved. My sister is high up in NHS and stupidly I thought that meant that she knew what she was doing. As a physio they do more training than a GP. However you and I know that that’s bollox 😩

So now I’m involved. When he was diagnosed I believe he was severely lacking in Iron and B12. It was just after they refused him for blood, he’d been a donor all his life. They investigated if there was any internal blood loss as his test would have suggested but apparently he didn’t let them do some of the tests as they were rectal. He was given iron tablets for a period of time and has never had a follow up Iron test since that- so that’s over 10yrs!! So yeah, we all talk about incompetence but OMFG!

I have now just sent over all the Vits and minerals that I think he needs as again the GP’s are saying that nothing is really out of range so nothing to worry about. He will retest in 4wks time and we will go from there.

I am the one who’s doubting Alzheimer’s because I asked my mum about the last scan and had the lesions changed and she said there were no lesions???? WTF? I was sure that Alzheimer’s was such that lesions were always present? Anyway that’s what set me off down the rabbit hole and finding the link between low thyroxine and loosing your mind!!

greygoose profile image
greygoose in reply to NWA6

I thought there were always lesions, too. But, I have to confess, I don't know that much about it.

Can I ask where he lives? You said you were in England, so it sounds like he isn't.

I really have to ask myself just how many people have been diagnosed with Alzheimer's when they actually had hypo and/or B12 deficiency. But, doctors don't seem to ask themselves that question. They seem to jump at an Alzheimer's diagnosis as if it were the easy way out. And, hard as it is to lose a parent, I feel myself blessed that I never had to contend with the suggestion of Alzheimer's. I've seen it so many times with work collègues and friends. You have my deepest sympathy.

There is an Alzheimer's support group on here:

healthunlocked.com/alzheime...

I don't know what they're like, but maybe they'd be able to give you some advice?

NWA6 profile image
NWA6 in reply to greygoose

Thank you for the link. My parents are in my home country of N. Ireland so it’s doubly hard to be involved. My mum is on board with trying other things but obviously I feel out of my depth with giving advise. It’s ok for myself because I know how I feel and so can proceed but my Dads an army man who does not ‘show’ weakness so it’s always difficult to understand where he’s at.

greygoose profile image
greygoose in reply to NWA6

Yes, I can understand that. It must be very difficult. Hopefully, with your help and support, your mum will be able to convince him to take the right supplements. But, someone needs to have a stiff word with his doctor.

NWA6 profile image
NWA6 in reply to greygoose

Doctors and consultants! I can forgive Gp’s more easily because they really are fur basic ailments and referrals but consultants are supposed to be specialists in their field!

greygoose profile image
greygoose in reply to NWA6

Yes, that's true. But, even GPs jump to conclusions too fast without any justification.

Gillybabe48 profile image
Gillybabe48 in reply to greygoose

Not wishing to scaremonger but a district Nurse told me that the Doctor were being paid so much per patient to diagnose Alzheimers. No wonder it is on the increase. Every other avenue should be evaluated before they make a rash opinion because the mind is very powerful and once someone is told they have something it CAN take hold.

greygoose profile image
greygoose in reply to Gillybabe48

That doesn't surprise me at all! It's tragic that they are so ready to betray their calling for cash - if it ever was their calling.

Gillybabe48 profile image
Gillybabe48 in reply to greygoose

Absolutely. We use to have a lovely doctor who retired, his was a calling. But a company took over the practice and many others in the Southeast of England, a sort of syndicate. Five doctors own about five practices and have filled them with trainees and locums who seem to rotate between surgeries so there is no personal continuity of care.

greygoose profile image
greygoose in reply to Gillybabe48

Yes, medicine is a business, these days, I'm afraid.

LadyWard profile image
LadyWard in reply to greygoose

One more question.. sorry, if the apple cider vinegar gives me a burning feeling and slight indigestion, would that suggest I don’t have low acid? Took it yesterday in a tiny bit of water abs it was fine, today I mixed it with lots of warm water in a mug and drank it and got indigestion heart burn feeling?

greygoose profile image
greygoose in reply to LadyWard

To be honest, I've never tried it - just the smell of it makes me heave. So, I don't know what's normal and what isn't. Maybe you just added too much water, I don't know. Try taking 1000 mg vit C before a meal, instead.

NWA6 profile image
NWA6 in reply to LadyWard

I used Turmeric to help with low stomach acid. I don’t know how much it helped because I was quite quickly properly medicated and the low stomach acid subsided.

SeasideSusie profile image
SeasideSusieRemembering in reply to LadyWard

I'm not taking anything with the Levo apart from the D Spray as i was told that should be ok as it is a spray?

Yes, that's OK. The spray is absorbed through the mucous membranes in the oral cavity and bypasses the stomach. With the Levothyroxine, a little is absorbed through the stomach but mostly in the small intestine > duodenum, jejunum and ileum.

If you were swallowing a D3 softgel, tablet or capsule then it would have to be 4 hours away from Levo.

Sorry to add to your growing pile of medication/supplements, but when taking D3 we need it's important cofactors Vit K2-MK7 and magnesium so you should plan to introduce these.

LadyWard profile image
LadyWard in reply to SeasideSusie

Susie, i'm happy to take whatever is needed to feel better, it just all alien to me and i don't know where to start and my ongoing issue with my voice that you know of is really annoying as no one seems to know exactly whats causing it? x :(

SeasideSusie profile image
SeasideSusieRemembering in reply to LadyWard

Of course, there may be a particular reason for your hoarse voice but for me I used to get a very hoarse voice, to it practically disappearing altogether, if I had a visitor and I nattered for a good while. Eventually I discovered that this happened when I was undermedicated. Now I am optimally medicated it doesn't happen.

If I were you I think I would wait until my test results were where they should be for a treated hypo patient (generally TSH below 1 and FT4/FT3 in the upper part of their ranges) and my symptoms alleviated. If I was still experiencing a hoarse voice at that time I might be looking at other causes. I wouldn't be considering taking a PPI at this stage.

As well as optimal thyroid results, optimal nutrient levels are important.

LadyWard profile image
LadyWard in reply to SeasideSusie

perfect thats what i shall do - and yes mine is exactly the same, its like i only a few hours of voice time, so i start off fine and then it runs out lol x

Treepie profile image
Treepie in reply to LadyWard

My hoarse voice went when I was on sufficient levothyroxine.

LadyWard profile image
LadyWard in reply to Treepie

fingers crossed then that what it is x

posthinking01 profile image
posthinking01 in reply to LadyWard

Hi there is the D Spray from a company called Better You - as it contains zylitol and this can affect the gut.

Gillybabe48 profile image
Gillybabe48

I would definitely wait until levothyroxine levels are right because a hoarse voice is a side effect of hypothyroid. My mother completely lost her voice which was hoarse at the start. It has an effect of lowering your vocal register. I know this as I sing and my register changed from high to low with hoarse voice too. Omeprazole also decreases the effectiveness of the levo dose. Are you suffering from gastric reflux? Or just doctors diagnosis? If you do take it, take it as far away from levothyroxine dose. Take all medications at least two to four hours after levo. The vitamins and supplements you are taking have you been tested to see if you are deficient. As I took vitamin D and ended up with a skipped heartbeat as I did not need it. If you have a good vitamin D based diet you should not need extra. Stop taking spray and see if voice improves. Just my own experience. Hope this helps.

LadyWard profile image
LadyWard in reply to Gillybabe48

Hi Gilly, i've added in my last blood tests. I just dont know what is best to do? i dont know if i have relux, all i know is i cant speak, it is like you say, 'if' i sing in a high pitched voice (on my own not in front of anyone) i sound fine! I just thought after 12 weeks of being on Levo it surely would have helped?

As for vitamins, again, i don't know if i need them, people have recommended taking B12 and Vit D, but i dont know if i need them?

I feel tired alot, constipated and cant loose weight, but thats it apart from my voice. Im not cold, i dont have hair loss, i dont have dry skin??

xx

SeasideSusie profile image
SeasideSusieRemembering in reply to LadyWard

As for vitamins, again, i don't know if i need them, people have recommended taking B12 and Vit D, but i dont know if i need them?

Who has recommended what?

What are your results, with reference ranges and units of measurement for Vit D and B12 for:

Vit D

B12

Folate

Ferritin

and exactly what are you taking supplement-wise?

LadyWard profile image
LadyWard in reply to SeasideSusie

didnt get checked for Vit D i don't think others are:

Ferritin 40.0 - range 13-150

Vit B12 415 - Deficient <145, Insufficient 145-300

Serum Folate 10.60 - range 8.83 -60.08

Not sure whether i should just wait until next text in a couple of weeks x

SeasideSusie profile image
SeasideSusieRemembering in reply to LadyWard

Vit B12 415 - Deficient <145, Insufficient 145-300

Serum Folate 10.60 - range 8.83 -60.08

Those results suggest you should take a B Complex.

There is no unit of measurement for the B12 but if it's pg/ml or ng/L then the following applies:

According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Folate is recommended to be at least half way through it's range.

A good B Complex will contain bioavailable active ingredients so look for methylcobalamin and methylfolate. Often recommended here are Thorne Basic B or Igennus Super B.

Ferritin 40.0 - range 13-150

Ferritin is recommended to be half way through range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

apjcn.nhri.org.tw/server/in...

Do not consider iron tablets unless you have a full blood count and iron panel carried out to see what those tests show.

didnt get checked for Vit D i don't think

It's important to test for Vit D level before supplementing. Vit D is fat soluble and gets stored in the body, too much and you could be headed towards toxicity level. Dose of Vit D supplement is based on current level and what is suggested to reach the level recommended by the Vit D Council/Vit D Society which is 100-150nmol/L.

LadyWard profile image
LadyWard in reply to SeasideSusie

Black pudding!! YES :) every cloud! thank you i got the B Complex you recommened the Igennus ones. will stay off the Vit D until next tests, am i ok to take Selenium? x

SeasideSusie profile image
SeasideSusieRemembering in reply to LadyWard

am i ok to take Selenium

Some people prefer to test selenium first. I have taken it without testing but only take 100mcg. 200mcg is often suggested when Hashi's is present. If you do decide to take it, make sure it is either selenium l-selenomethionine or a yeast-bound selenium (Cytoplan do a good one). Avoid selenite and selenate forms of selenium, they are poorly absorbed. And if someone tells you that you can get selenium from brazil nuts then the pack has to say "Grown in selenium rich soil" and also say which area it is grown as the amount of selenium varies greatly. If it doesn't say that it's grown in selenium rich soil, with the actual area, then there's probably little to no selenium content in the nut.

LadyWard profile image
LadyWard in reply to SeasideSusie

Thank you, i have eating loads of brazil nuts as well, but not grown in the soil! I do have hashimotos so was thinking the selenium 'might help'

thank you as always

Lora7again profile image
Lora7again in reply to LadyWard

Try eating pate to raise your ferritin.

humanbean profile image
humanbean

40mg omeprazole twice a day is a heck of a dose. I don't know anything about laryngopharyngeal reflux, so your dose may be appropriate for all I know. But it would be worth your while to do some research on the dose.

See the British National Formulary reference here :

bnf.nice.org.uk/drug/omepra...

And drugs.com is also worth reading :

drugs.com/dosage/omeprazole...

Cooper27 profile image
Cooper27

Omeprazole is to neutralise stomach acid, so taking at the same time as ACV (to increase stomach acid) makes no sense.

I've just stopped taking omeprazole for an irritated stomach lining, and I only needed to take it for 4 weeks. If you get to the end of 4 weeks with no change, come off it. 2 doses a day is quite a lot - my stomach is still getting over the discomfort of it, and my B12 ferritin and folate levels all nose-dived over that short period, so you really don't want to take it for longer if you don't have cause.

Treepie profile image
Treepie in reply to Cooper27

If only it brought my ferritin down at over 900 when last tested.

LadyWard profile image
LadyWard in reply to Treepie

I didn’t even know it could go High? Does that mean you have too much iron? X

Treepie profile image
Treepie in reply to LadyWard

Not necessarily ,ferritin is a protein that stores iron being high can indicate liver disease ,inflammation and other conditions.

Cooper27 profile image
Cooper27 in reply to Cooper27

Mine dropped from 160 to about 90, so it nearly halved. It's scary that it dropped so much in a month!

Have you been tested for haemochromatosis (the autoimmune disease)?

Lora7again profile image
Lora7again

Blooming heck! I thought I was taking a lot of medication at one time .... I was taking PTU, Vitamin D Tablets, Tranexemic acid, Iron Tablets, selenium and some expensive tablets for hair loss. I think I was desperate to feel better quickly ... now I just take selenium and vitamin D spray.

LadyWard profile image
LadyWard in reply to Lora7again

i know lol - i never took anything before not even paracetamol lol x

Lora7again profile image
Lora7again in reply to LadyWard

Neither did I and I actually worked in a hospital pharmacy for several years. You need to take your levo and the vitamins that you are lacking in.

SlowDragon profile image
SlowDragonAdministrator

Couple of points

Can see in the photo your 25mcg Levothyroxine is by Teva

Many people find Levothyroxine brands are not interchangeable.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Levothyroxine should always be taken on empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and more effective taken at bedtime

All medication at least two hours away from Levo. Some like HRT, PPI's, magnesium, iron at least four hours away

verywellhealth.com/best-tim...

Although vitamin D mouth spray is not absorbed in gut, I would delay using it until after breakfast

Also B vitamins are best taken with/after food in the morning. So I would take your vitamin B complex after breakfast

Suggest you test vitamin D now via NHS postal kit

vitamindtest.org.uk

There are literally thousands of posts on here about low stomach acid. It's even more misdiagnosed than hypothyroidism

healthunlocked.com/search/p...

Articles about low stomach acid and hypothyroidism

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

scdlifestyle.com/2012/03/3-...

naturalendocrinesolutions.c...

Ppi can lower vitamin levels

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

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

As you have Hashimoto's are you on strictly gluten free diet?

LadyWard profile image
LadyWard in reply to SlowDragon

Thank you so much fir that. I don’t know what I would do without you all.

Gluten free, I will be honest, no I haven’t, I keep putting it off, but maybe now I should give it a go!

Xx

SlowDragon profile image
SlowDragonAdministrator in reply to LadyWard

Get the Teva brand changed ......always stick to same brand at each prescription

LadyWard profile image
LadyWard in reply to SlowDragon

I haven’t noticed anything different since I’ve had Teva as well!? So I maybe ok with it ?

SlowDragon profile image
SlowDragonAdministrator in reply to LadyWard

Teva upsets gut function for many. It contains mannitol rather than lactose.

mannitol can change gut flora. Lead to acid reflux etc...which you seem to be suffering....

bmj.com/content/360/bmj.k71...

LadyWard profile image
LadyWard in reply to SlowDragon

Yeah but I had these symptoms way before I was even diagnosed with a thyroid problem, so before Levo?

Buddy195 profile image
Buddy195Administrator

Hi LadyWard, my thyroid symptoms worsened with PPIs and If I were you I would only take them if it’s absolutely necessary. Also be careful with Brazil nuts. The max daily dose of selenium is 400mcg (as excess doses can be harmful). Brazil nuts vary widely in their selenium content, so it’s hard to judge how much you are taking. Don’t have more than 3 a day or instead take one if the Selenium supplements recommended by Seaside Susie.

LadyWard profile image
LadyWard in reply to Buddy195

Thank you will do x

Even the leaflet that comes with the medications must say you should be careful taking omeprazole as well!!!! I stopped it as soon as realising it was not a good idea..

I was on it for reflux, that apparently caused hoarseness and a cough for several years before discovering I was hypothyroid.

Taking thyroxine has improved my reflux symptoms so I only need occasional Gaviscon Extra (half a tablet is usually plenty to deal with the discomfort, but what can you do with a half chewed Gavison? :-D

When my thyroid symptoms are at their least tro8ublesome I can even sing again, which has become increasingly difficult to do for several years.

Hypothyroidism can cause both reflux and throat problems, as well as almost any odd symptom that isn't caused by something else!

Jazzw profile image
Jazzw

Whether or not omeprazole is required or not—80mg seems excessive. I’m currently prescribed it because I’ve needed to take naproxen recently which can be hard on the stomach. But only 20mg per day and only on the days I take naproxen. 80mg seems rather heavy-handed!

crazycatlady100 profile image
crazycatlady100

Keep taking meds, its hard at first, but the doctor will not give them if you do not need them. A routine on a dalily basis what ever suits your life style. :)

helvella profile image
helvellaAdministratorThyroid UK in reply to crazycatlady100

At one time, I might have believed that. No longer.

I was at one point prescribed statins and omeprazole and beta-blocker. I am quite sure I didn't need them then, and still don't. At the time, my cholesterol was at borderline hypocholesterolaemia levels. One omeprazole made me violently sick for hours.

crazycatlady100 profile image
crazycatlady100 in reply to helvella

Hi, i was worried about cholestrol levels too, I have been using flora spread instead of full fat spreads and eating more fruit instead of sweets it was so very hard but i have toned up a bit with running on the spot , walking and sit ups.

helvella profile image
helvellaAdministratorThyroid UK in reply to crazycatlady100

I was more worried about being too LOW in cholesterol!

My previous cholesterol test, my GP had exclaimed it was like a super-fit athlete rather than a fifty-something year old. The number was at or below BOTTOM of range.

crazycatlady100 profile image
crazycatlady100 in reply to helvella

Im glad for you , im going to do the same :)

Ljg72 profile image
Ljg72

Ladyward,

Have they checked for nodules on your thyroid? I developed a very hoarse voice which it turned out was a symptom of a serious thyroid problem. Not for a moment suggesting your issue will be the same but in the interest of thoroughness presume if they sent a camera down to check the vocal chords they have also done an ultra sound of your thyroid to make sure there's nothing there's pressing on anything important?? If not wonder if is worth asking your doc about this? Again as I said it’s probably not nodules or anything similar, but it’s just about being thorough.

Also I agree with the comments about trying apple cider vinegar ahead of

Omeprozole.

I take a teaspoon full before each meal (if I remember!) as my nutritional levels plummeted once I was put on thyroid medication.

liaratsoni profile image
liaratsoni

I have only just started on levo too and I'm only on 25mcg (have been for little over a week and got 3 weeks until I go up to 50mcg.) One of my late stage symptoms that started in may is silent reflux/lpr - I don't have as much of a hoarse/loss of voice and no heartburn but instead I hiccup and burp and get a bad taste and burnt/raw feeling in my throat which causes a thick coaty post nasal drip/throat mucus that is very frightening at times. My endo has also said digestion issues should resolve with medication but that it will take time for the medication to work and of course then it's even more time to find your perfect dose! Silent reflux is usually low acid - I have done the baking soda test and never burped which is indicative of VERY low stomach acid and my reflux is the worst when I eat protein (hardst for stomach acid to digest) and my digestion improves when I eat acidic foods like lemons but they burn my throat from the leftover reflux and worsen the mucus so I can't win right now! I am currently eating small plain meals just to keep symptoms at bay and had gotten them to a bareavle level but my reflux (and also my other symptoms like constipation and coldness) has actually gotten worse since starting the levo (mine is also the teva so whether its to do with the mannitol I don't know) but I assume that the fact both of ours have got worse/not improved is just a sign we are under medicated (I cannot wait to get up to the 50mcg!) The reflux is probably the worst symptom for me because of how frightening it can be and how it impacts my eating. Just wanted to let you know you aren't alone in this and hopefully we both can get properly medicated soon so that this horrible symptom resolves! x

Lora7again profile image
Lora7again in reply to liaratsoni

I had reflux after the birth of my son over 20 years ago. I had investigations and I was suffering from oesophagitis .. I am ok now btw

patient.info/digestive-heal...

LadyWard profile image
LadyWard in reply to Lora7again

What symptoms did you have Lora? I don’t have anything apart from a croaky voice and sometimes feels like a lump in my throat x

Lora7again profile image
Lora7again in reply to LadyWard

I had a gruff voice and burning in my throat

crazycatlady100 profile image
crazycatlady100 in reply to liaratsoni

The constipation is such a hard one to try to get rid of i do prefer diet change to more laxatives.This helped me go a few times a week . Fruit and fibre cereal and oranges also seeded bread and drinking lots more tea and coffee i felt alot better as laxatives on top of thyroxine is not a good mix for me i wanted to sleep alot more .

Gillybabe48 profile image
Gillybabe48

It is only my opinion but your Thyroid results indicate you may be under medicated.

LadyWard profile image
LadyWard in reply to Gillybabe48

Yeah that’s what I think, they have increased me to 75mcg 3 weeks ago, so hopefully that will help. Nit sure when I will notice the difference? X

LadyWard profile image
LadyWard

Lol they don’t seem to know she just says take them all together x

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