I've been on 100mg levo for about 14mths now. I take Vit D and iron supplements (tummy friendly apparently) and feel well..... except for fact I now get almost daily attacks of GERD. I've done the baking powder test and feel quite convinced I have low acid issues. I take apple cider vinegar and Betaine HCI with pepsin before meals but neither seem to help.
I dont eat gluten, avoid dairy and caffeine and shy away from other potential trigger foods.
Any advice on how to stop or reduce the uncomfortable symptoms of GERD?
Thanks.
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Hel66
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Looking at your last post you were arguably slightly undermedicated on 100mcg levothyroxine. The thing that might make the most difference is an increase in dosage.
When are the GERD attacks happening? Are they linked to a particular meal/time of day?
It could be that you have a hiatus hernia. Have you done the whole “raising the head of your bed” thing?
Hi jazzw, it seems to happen in the day rather than at night time. Feels like I get it whatever I eat 😕. What does seem to have a positive effect is when I have a 'fast' day, as doing the 5:2 diet atm. But I can't survive on 500cals every day!
I have hiatal hernia and Hashimoto's Hypothyroidism. My GERD is positional, ie, if I bend over, it's really bad. Otherwise certain breads give me a problem though I can happily eat sourdough bread.
If your GERD isn't positional, I think it is less likely to be a hiatal hernia.
How long since you last had FULL Thyroid and vitamin testing
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.
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
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
Hi SlowDragon. Can you explain why you recommend waiting until after testing to take thyroid meds? I've seen that posted by other thyroid specialists and I've never been sure why. I've done it in the past and I'm having thyroid tests tomorrow. I was planning on waiting until after the test to take medication again, but would be thankful if you could explain why.
From when you swallow your thyroid hormone tablet, for around two hours, your Free T4 level will rise. Then it will fall, more slowly, over many hours.
You simply cannot time your blood draw to occur at the peak - no-one would know exactly when that would be, and the rate of change - going up, then going down - is rapid. A few minutes could make a significant difference.
From around twelve to twenty-four hours after your tablet, your Free T4 will be in a trough. You can relatively easily make sure your blood is drawn in that time. Hence make the conditions reasonably comparable one test to another.
Think about diabetes. No-one seems to think it would be a good idea to have a Mars bar then measure your blood glucose! (I know there is an Oral Glucose Tolerance Test but that is a specific test directed at insulin resistance.) The standard plasma glucose test is after a period of fasting.
I also suffer horribly with GERD but this is first year since having my thyroid removed 12 years ago. My issues started after I lost 45 lbs. Now having said that I’m in the midst of a 96 hour ph manometry test. My Bravo B was attached to my esophagus yesterday.
I also suffered terribly with GERD almost to the point where everything I ate resulted in acid reflux I tried the apple cider vinegar and had lots of gaviscon. Then I read on here one day that some one said TEVA brand medication gave them GERD so I asked my pharmacy to stop all TEVA brand meds. The GERD stopped. I take Levo and two blood pressure tablets and any or all of them could have been TEVA at any time. That was 18 month/ 2 years ago. Now I some times get heartburn but rarely. I’d say it’s worth a try if any of your medication is TEVA
If discontinuing Teva meds made your GERD symptoms almost disappear, it suggests that you could be sensitive to the mannitol used as a filler. Look out for this ingredient in foods that you eat; it also occurs naturally in some fruits and veggies such as sweet potato and cauliflower.
You mention you are trying to avoid possible trigger foods. Unfortunately we are all different in this respect, and we have to discover our own individual triggers. The FODMAP plan is a start, or you could format your own elimination diet. Just remember to introduce new foods one at a time, so you will know, hopefully, which ones are the problems. Things like lactose, fructose, fructans and wheat proteins (not just gluten) can be causes of irritation. It can sometimes take months or even years to find the answers. Many supplements cause issues, too; iron and Vit.D are both well-known for this. Good luck on your journey of discovery!
Just thought I should add that although low stomach acid is a common side effect of under-active thyroid I learned to my cost it doesn’t apply to all of us ... I found betaine with pepsin and even cider vinegar alone made me worse and I was better when I removed them ... I noticed you’re taking both, might be too much. For me, a gentle digestive enzyme like Enzymedica ‘digest complete’ works best. I’m also trying really hard to chew my food thoroughly !
Absolutely, not everyone is the same, and hypothyroidism is not necessarily linked with low stomach acid. No-one should assume what their levels are, as they can do more harm than good by treating themselves in the wrong way. My hypo partner was discovered to have acid levels that were almost too high to be recorded, and my level is high rather than low, too.
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(I know there is an Oral Glucose Tolerance Test but that is a specific test directed at insulin resistance.) The standard plasma glucose test is after a period of fasting.
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