Hi I’ve not posted here for a long time, my daughter has been diagnosed with the auto immune type of hypothyroidism for about 2 years and on slowly increasing doses of levothroxine, currently 62.5 mcgs. She was first diagnosed after having recurring stomach pains which they eventually put down to constipation and the thyroid problem was luckily picked up on routine bloods.
She has been fairly well until around last June when she started with random vomiting. This wasn’t too much of a problem until December when the number of times she is sick is increasing. Her latest blood results are Tsh 3.25 (range 0.27-4.20) FT4 20 ( not sure of range but think this is upper limit from memory. The endocrinologist was happy with this and to remain on current dose.
She has blood test booked for this week for coeliacs screen ( was negative 2 years ago) and various other routine bloods and an urgent paediatric referral has been done. She has lost nearly a stone in weight since December.
Does anybody know if chronic nausea and vomiting can be down to the thyroid tablets or the hypothyroidism? I know people can’t diagnose on line! But wondered if anyone has had similar problems? Thanks in advance.
Looking back in my posts here it was nearly 4 yrs ago she diagnosed! Time flies without realising!
in reply to
Hi mindful so sorry to read this she’s so young .
Can I suggest you ask for her to be tested for HPylori it’s a dredful thing to have and from what ive learnt on this forum can be a trigger for thyroid issues.ive suffered on and off with it for around 15 years most recent attack was last year and was a bugger to conquer this time,it’s worth asking to be tested given her symptoms,it’s a very common bacteria and in most cases it’s a very straightforward triple therapy treatment so 2 different antibiotics and a ppi for stomach acid ,sorry if I’m intruding but I’m hoping it’ll help good luck give her a big hug from me she’s a wee trooper x
Her TSH is much too high. I don't think her endo would be happy if they were his results. She's only on a tiny dose of levo, so she really needs her FT3 tested to see if she's converting the T4 to T3 - FT4 and FT3 tested at the same time.
Thanks for replying, her endocrinologist told me she wanted her Tsh below 3 (which it’s not quite)and the T4 in upper 1/3 of range but was happy to accept a higher or even out of range T4. Latest letter with these results is from 2nd jan and says blood tests acceptable. So I need to ask for further thyroid tests? Can this cause the vomiting?
I really don't know if low FT3 can cause vomiting, but a lot of hypos do suffer from nausea. And, it's low FT3 that makes you hypo and causes symptoms, not the TSH or the FT4. And, as I said, the only way to know if her FT3 is good and she's converting T4 to T3 as she should, is to get the FT3 tested.
Furthermore, a child of her age should not be given a dangerous drug like Omeprazole without much more thorough investigation. That is lazy doctoring. Omeprazole is a stomach acid lowering drug. As she is hypo, the odds are, her stomach acid is already too low, so of course that won't help.
When the stomach acid is too low, the food cannot be digested properly and spends too much time in the stomach, where it ferments and causes a volcanic effect, which can make people nauseous and possibly cause vomiting. So, what she would need is an increase in acid, not lowering it even more.
I suggest you read this article and have her try the home test at the end:
I'm really not impressed by the knowledge and know-how of your daughter's paediatrician/endo.
I’ll ask the paediatrician about the h pylori thanks. They gave her Omeprazole, not helping on its own.
No it wouldn’t help on its own mindfull she would need the triple therapy to kill it off ,my last treatment I needed it twice before it did it’s job and I then insisted on having the breath test to confirm it was dormant,I lost two stone myself it’s a horrible bacteria so I’m glad your open to having her checked for it good luck.
PPI’s lower stomach acid which provides H.pylori an environment to thrive. It’s very adept at hiding hence being difficult to treat. Raising stomach acid makes it harder for the bacteria to grow as well as being better for digestion & nutrient & hormone absorption.
Her a TSH is likely too high she needs FULL thyroid testing
EXTREMELY common to become gluten intolerant on levothyroxine
Low vitamin levels are also highly likely
For full Thyroid evaluation your daughter needs 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
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)
Is this how she does tests?
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone
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
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Thank you for all your very interesting information, very knowledgeable lot on here ☺️
I think I will stop the Omeprazole, she’s only been on it a week, it did cross my mind that she would need more stomach acid not less to help food go down.
Vit d level was 78 nmol/l in jan ( no range but think lower level is 50 ?)
She is having a blood test this week to include coeliacs screen and ferritin and b12 but I think she would seriously struggle with gluten free as her diet is rigid already (asd) but obviously if coeliacs I would have to address that.
I think I’ll order a blue horizon test and go armed with that. Thanks again.
Can you ask your gp to request a 9am cortisol? In my case 6 months of constant nausea, vomiting and various other symptoms was eventually diagnosed as adrenal insufficiency. Primary adrenal insufficiency(Addisons disease) is also an autoimmune condition.
I’m not saying it is that just saying that’s what caused my symptoms.
You must be worried sick yourself! Have you been referred to a nutritionist? Perhaps ensuring your daughter’s diet & nutrition levels are good might help stop the vomiting. Also increasing her stomach acid to help better digest & absorb both thyroid meds & food. If she likes yoghurt, try her on organic kefir which is the best known probiotic.
Chris Kresser has a lot of good info re exclusion diets such as FODMAPS. Something like this might be helpful.
I didn’t feel well when my TSH was above three and I experienced nausea the smell of food made me wanna barf as soon as I increased my thyroid hormone and my TSH dropped I felt better.
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