Hashimoto’s and autoimmune atrophic gastritis

[Knittingcat123]

Hi , Recently diagnosed with AAG with high Gastrin level and pernicious anaemia. I have Hashimoto’s and diabetes 2.

Question : should I be taking something for low hydrochloric stomach acid?

I am concerned I am not absorbing thyroxine as feeling very tired. Anyone using liquid or gel capsule form of thyroxine. Thanks

[Marz]

I would suggest asking on the PAS Forum where they may be some good suggestions for you.

[Knittingcat123]

Thanks. I will try that, I thought I would ask here as AAG is associated with Hashimoto’s .

[helvella Administrator]

Are you in the UK?

Gel levothyroxine is, effectively, unobtainable in the UK. (Yes, it just might be possible, but difficult to find a source and expensive to pay for.)

There are several oral solutions and some patients like them. However, the large amount of glycerol causes some to suffer gut issues.

For a start, I would consider dispersing your dose in ordinary water, e.g. with a teaspoon and a glass. Then swallowing that. Make sure you don't leave any in the glass.

This would ensure that it has the best chance of being absorbed.

Others have personal experience of taking acidifying agents - I do not. So I shall let others answer.

You are, of course, welcome here but I concur with Marz that the Pernicious Anaemia Society forum has a lot of experience on the B12 front and is likely to be helpful. One of the problems is that few seem to have received useful treatment for AAG or other stomach issues.

healthunlocked.com/pasoc

[SlowDragon Administrator]

How much levothyroxine are you currently taking?

Do you always get same brand at each prescription

As you have Hashimoto’s are you on strictly gluten free diet

Absolutely essential to regularly retest vitamin D, folate and ferritin

What vitamin supplements are you currently taking (apart from B12 injections...how often are these?)

[Knittingcat123]

Thank you for your replies

I am British female 60 but currently residing in Australia

I am taking 150mcg levothyroxine, recently increased from 125mcg

I have full blood tests every 6 months which shows I do not store ferritin . I have had iron infusions in past and thought I needed another but my folate was 120 so Told didn’t need it

I am taking B12 injections every 3 months but been told to increase 2 months

I also take vit d 1000 units daily

Magnesium

Coq10

Hair supplement as hair loss. This made me feel better which is interesting as brand contains biotin but also zinc and selenium

Also have high cholesterol but statins make me depressed and brain fog

I have asked about gluten free diet but told not necessary

Have been told recently to cut out nuts and legumes. I am low carb for diabetes.

All very frustrating as thought I was doing right by following a low carb Mediterranean diet.

Now just confused but main issue is fatigue

Thanks for reading my post

[SlowDragon Administrator in reply to Knittingcat123]

High cholesterol is linked to being under medicated and still hypothyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

Absolutely essential to ALWAYS get TSH, Ft4 and ft3 tested

Likely you have low ft3

Folate, ferritin and Vitamin D need to be frequently retested

Are you supplementing a daily good quality vitamin B complex?

This is recommended when on B12 injections. It helps keep all B vitamins in balance and may help maintain B12 levels between injections

Vitamin D at 1000iu is unlikely enough. Important to test twice yearly. Aiming for level at least around 80nmol and around 100nmol may be better (that’s equal to 40ng/ml)

Ferritin needs to be half way through range

[Knittingcat123 in reply to SlowDragon]

Brilliant, thanks very helpful. Especially vitamin b complex and ranges

[SlowDragon Administrator in reply to Knittingcat123]

Presumably you know to always stop taking any supplements that contain biotin a week before ALL blood tests

Biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[Knittingcat123 in reply to SlowDragon]

Yes I have learned that the hard way but thanks for mentioning 🙏