Silent reflux or something else?

[Zoemarv1]

Back in June, my psychiatrist switched my antidepressant from Pristiq to Paxil because I felt that Pristiq was no longer working for me. When I started the Paxil I also started having this weird shortness of breath that I initially thought was some side effect of anxiety. I stopped this Paxil after a couple weeks because I couldn’t tolerate the shortness of breath that I thought was probably anxiety, even though I’ve never really had anxiety before. He put me on Prozac then and my symptoms never went away, so we stopped Prozac after about 2 months and symptoms didn’t go away. He put me on Trintellix then and I tried this one for a few months and still, shortness of breath continued, which eventually went into a sore throat, clearing my throat all day, and feeling like something was stuck in my throat. So my symptoms were getting worse and when it started to affect my throat, I didn’t think it was the antidepressant anymore, so that was when I went to get help from my regular doctor and he ordered tests and labs and thought maybe I was suffering from reflux, so started me on Protonix 40mg., he ordered a chest X-ray and also did a Strep throat swab, which was negative. My chest X-ray was normal. All my labs were normal, my TSH was 0.75, and my T4, free was 0.94. He did order a thyroid ultrasound just to check it out because thought it felt a little large. The ultrasound revealed that I have multiple nodules and said that a couple of them were moderately suspicious for malignancy. So I was referred to an endocrinologist, who did a biopsy of the nodules and they came back as non diagnostic. In the meantime I was still having a bad sore throat so I made an appointment with an ENT, she looked down my nose and throat with a camera and didn’t see anything suspicious, but did think that my tissues looked red, which she said was probably reflux, so she continued the Protonix 40mg and added Pepcid 20 mg at night. She ordered a swallow study that did show some mild reflux and a small hiatal hernia. Even though everyone agrees that I have reflux, the Protonix and Pepcid have not really helped. I’m wondering if any of them have ever heard of silent reflux? Nobody has said anything about it or even what the treatment might be. I have a follow-up appointment with the ENT end of January and a repeat thyroid biopsy the next day. I have been reading though that PPIs might not work for silent reflux and may make it worse. I want to stop the Protonix because what if I already had low acid levels and it was making it worse. Today I still have a sore throat that I have been treating with Tylenol pretty much around the clock and I still have the shortness of breath which seems to get better and then worse again, I clear my throat all the time and the lump is still there. I really don’t know how to heal myself because the doctors really don’t seem to know what it is and I feel like I need to just take care of it myself.

[greygoose]

Doctors never think about low stomach acid - I'm not sure they believe it possible - but the symptoms tend to be the same for both high and low stomach acid. Have a look at this article, and try the home test at the end:

healthygut.com/articles/3-t...

Just testing TSH and FT4 for thyroid problems is totally inadequate. And, I'm afraid, we cannot interpret results without ranges. Ranges vary from lab to lab, so if you could add them, that would help.

What you need is full thyroid testing:

TSH

FT4

FT3

TPO antibodies

Tg antibodies

vit D

vit B12

folate

ferritin

That will give us a much better idea of what's going on. But, what you are describing sounds very much like hypothyroidism. When you are hypo, you're prone to getting all sorts of problems with the throat: difficulties swallowing, the feeling of a lump in the throat, persistant coughing, sore throat, etc. etc. etc. And an ENT is very unlikely to pick up on the real problem - I speak from experience, here!

Depression is also a symptom of hypothyroidism, so it could be that you don't need that antidepressant at all, just some thyroid hormone replacement. But, more testing is obviously needed before you can know for sure.

[Chippysue]

I feel for you, it is absolutely frightening - terrifying the amount of drugs with horrendous side effects these doctors will happily prescribe!

Sadly they don’t look at root cause. They are just taught to prescribe drugs to treat symptoms.

Dr Isabella wentz - a pharmacist and now a thyroid expert had all of the symptoms, suffered for a while until she researched and acted - good gut health being key, getting rid of all toxins, clean diet, etc

She has been able to control hashimotos without any drugs.

Tge good news is that she made a documentary series called the thyroid secret which you can buy everything you need to know is in it.

She has also written several books.

You can get well !

[RockyPath]

Sorry for all that you’ve been through. Yes, you do need to take control of your diagnosis and treatment, because there are human limits to what doctors can understand and treat. They try.

You seem to be describing an unresolved inflammatory response. Something set off inflammation in your epigastric tract and you haven’t been able to shake it.

An interesting thing to consider is how you might boost your immune response. While vitamins are a common direction to pursue, you might consider the source of immunity that your body acquired at birth. The first product of the human breast during the late stages of pregnancy and immediately after giving birth is called colostrum. All mammals produce colostrum and there are sources of bovine and goat colostrum that strive to be ethically produced and free of harmful contamination. Studies suggest it can boost immune response and heal the digestive tract by boosting growth factors in the linings.

healthline.com/nutrition/bo...

[SlowDragon Administrator]

Are you diagnosed as hypothyroid and on Levothyroxine?

If yes, how much Levothyroxine are you currently taking?

When were levels last tested?

Extremely important to regularly retest vitamin levels too

Low stomach acid and acid reflux are extremely common hypothyroid symptoms

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 you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels and thyroid antibodies

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose 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)

Add results and ranges if you have them

Or Come back with new post once you get results

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...

For thyroid including antibodies and vitamins

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

[Batty1]

Acid reflux will cause coughing "silent" acid reflux isn't so silent in my opinion it feels like a nawling in your chest and throat which can be mild or severe ....post nasal drip can cause acid reflux And so can some medications (cymbalta) caused me to have reflux that caused a crazy cough for 5 months. PPIs work but not all varieties work for everyone, for me personally tablets don't work I don't think I digest them well I need capsules.

The nodules I believe are a separate issue that reared its head at same time.

[Miffie]

I have hiatus hernia and Barrett’s oesophagus. The pain was dreadful, no over the counter products did any good. Once diagnosed I was put on Omeprazole, I could not believe how well it worked, a few years later the symptoms returned and I had Ranitidine added and have been successfully taking both for a few years now. PPIs seem to cause a lot of people problems, however I am so glad to have them. I hope you get some relief soon.

[Zoemarv1]

Thank you everyone who has replied to my recent problems and concerns. I was diagnosed with hypothyroidism in 2013 and have been on different doses of Levothyroxine since then. I am currently taking 0.5 mcg. To Greygoose’s question about the thyroid values and ranges: TSH is 0.75 with the range being 0.49 to 4.67 and my T4, free is 0.94 with ranges of 0.61 to 1.60. I think maybe I do need to have a more comprehensive thyroid panel done, but my doctor never suggests it, so how do I go about getting it checked and would my insurance cover it? Does anyone think that my thyroid nodules have any thing to do with my symptoms or is it just something they found with all my testing? SlowDragon, thank you for suggesting getting my vitamin levels checked too, as they could be off as well. Maybe I should do private testing, thank you for the site. Also, Greygoose, thank you for the site to test my acid levels. I feel this is very important to know as well to start on something that will heal my problems. I do feel like PPIs are not helping and could be actually hurting my condition. I’m going to stop those. If anybody else has any other suggestions or sites for me, please let me know. I am open to any suggestions at this point. Thank you so much for your responses!!!