Can u tell me if acid reflux is part of having underactive thyroid and why do the doctors not tell you this and just prescribe more pills

[nationwid]

Doctors bad advice not taking ur concerns on board would rather just give u another prescription and send u on your way is this right

[bantam12]

Not something I've ever had.

[Honey1978]

I want to no that to

[Clarrisa]

I use to live near a retired surgeon while growing up. I could not help but notice that all family members had a paper cup set at their table place, each astonishingly full of assorted pills (their young son included). It left me with the impression that some healthcare providers live in a different stratosphere than us!

[greygoose]

Acid reflux can be a hypo symptom, yes. Hypos often have low stomach acid, so can't digest their food properly. The undigested food ferments at the bottom of the stomach, and starts erupting, like a volcano, causing what little acid there is to rise into the oesophagus.

Why don't doctors tell you that? Because they have no idea. They didn't learn there was such a thing as low stomach acid in med school. And, have little idea about hypo symptoms.

[nationwid in reply to greygoose]

How do I approach this with my doctor the last blood test I was told my thyroid was fine but this acid thing is not going away when I try and miss out the lansoprazole for a few days it just keeps coming back so surely this would tell you that I may need further tests

[greygoose in reply to nationwid]

I'm afraid I'm not very good at approaching doctors. My temper is on a very short lease, so I tend to avoid them as much as possible!

Can you post your latest blood test results and let's have a look? Have you had your vit d, vit B12, folate and ferritin tested?

[nationwid in reply to greygoose]

I live in Scotland not sure if we can ask for our blood results

[greygoose in reply to nationwid]

Well, for the time being, Scotland is still part of the UK, so it should be your legal right to have copies. This idea that patients shouldn't know their results is abhorrent to me, anyway, so I would always encourage people to do their best to get hold of them. But, don't ask the doctor. Ask the receptionist for a print-out.

The reason I asked about the nutrients is that if they're low, you have a good case for suspecting low stomach acid. Whether or not your doctor would buy that, and from there deduce that you need an increase in dose, is anybody's guess. Probably not. They are not noted for being able to join up the dots and put two and two together, without getting 5.

But, there is something you can do: read this article and try the home test at the end. You'd have to be off the lansoprazole for a while, though, because they lower stomach acid, anyway.

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

Oh, and if you're constipated, that's another sign that you have low stomach acid.

[nationwid in reply to greygoose]

Thanks I will try this I just can’t get my head around this where you are told you have an unde active thyroid here is a pill by by and you are sent on your way with no mention of all the things that you get with an under active thyroid

[greygoose in reply to nationwid]

Well, that's mainly because they don't know anything much about it. They just don't spend much time on it in med school. And, frankly, it doesn't inerest them because their is no cure, and it's maily a woman's disease, anyway - and we all know how women are attention seekers and exaggerate! ha ha ha (sarcasm). They really do believe it's no big deal because they have no idea of all the convolutions, details and possible damage. Rediculous, but there it is.

[nationwid in reply to greygoose]

Thank you for your response you have been very helpful will get some more bloods done and will ask for a print out of my results and will be back in touch

[greygoose in reply to nationwid]

You're welcome.

[nationwid in reply to greygoose]

I was given three months supply of 5mg of folic acid tablets was told my iron was low over the phone conversation with the doctor few months ago have been trying not to call them because of the COVID 19

[humanbean in reply to nationwid]

It tends to be one of those conditions that doctors have no cure for so it has to be self-help.

Doctors explain heartburn and indigestion that is food-related with references to high levels of stomach acid and offer prescriptions for pills and potions that neutralise acid or shut off stomach acid production. This ends up meaning that people with these issues and treatments can't digest their food properly. Stomach acid isn't an optional extra - it is vital for a healthy life, and the way doctors deal with it is the exact opposite of what they should be doing.

One point I should make... There are rare people who have a lot of stomach acid. And there are many people who take other medicines who have to cut down on their stomach acid to reduce stomach irritation caused by these other medicines. So, for example, anyone taking NSAIDs like aspirin, ibuprofen, naproxen have to cut down on their stomach acid. I took lots of ibuprofen in my 20s for pain problems, didn't take anything to counteract my stomach acid, and ended up with an ulcer.

To determine if you have low stomach acid try the last suggestion in this link - it isn't a very scientific test, but it is virtually free, other than buying the bicarbonate of soda, and won't do any harm that I know of.:

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

Assuming that the only problem is low stomach acid, there are ways and means of dealing with it and they involve taking stomach acid replacements immediately before and/or during meals.

I know of three replacements for low stomach acid :

1) Betaine Hydrochloride (preferably + Pepsin). For info on this - please read both these links - getting it wrong could be painful :

healthygut.com/articles/how...

healthygut.com/articles/4-c...

2) Apple Cider Vinegar "with the mother". (In the UK this is usually referred to as just "Cider Vinegar", and usually the mother is filtered out, but if the mother is left in the bacteria involved is alleged to be good for us.

"Mother of vinegar" is described here :

en.wikipedia.org/wiki/Mothe...

3) Some people use lemon juice instead of vinegar.

Both (2) and (3) above must be used with care - being liquid acids they can damage teeth.

Always use vinegar or lemon juice diluted with water. Start with 1 teaspoon in a small glass of water and sip it throughout a meal. Always use a straw to reduce contact with your teeth. After a meal rinse your mouth out very thoroughly with plain water and spit it out. Don't clean your teeth for an hour after you've used lemon juice or vinegar.

Starting with the suggested 1 teaspoon in a glass of water, you can raise the amount of lemon juice or vinegar by, say half or one teaspoon in water gradually up to a maximum of 1 - 2 tablespoons depending on how well you cope with it. The idea is to find the right amount of acid for you to not have heartburn, indigestion, burning pain.

[MY04zzz]

Acid reflux was just one of my symptoms when under medicated? Once T4 T3 were optimal ( in top third of ranges) my other Vit levels rose too.

Is it possible you need a T4 dosage increase?

[Alanna012]

Long before I was diagnosed with hashis, I was in my mid twenties I was constantly in and out of Gastroenterology. When I turned up, losing weight from chronic gastric reflux and digestive issues, I kept being told 'you're too young to be here' in the end after several failed protocols for suspected Helicobacter Pylori they said 'you have two children under 5 and you're stressed' take PPIs. Forever.

I'm strongly convinced that Hashimotos plays a part in acid reflux, because I have had many symptoms of hypothyroidism and this looking back was one of them and came from no where.

However there are other causes and the direction of the relationship isn't clear either ie is it something to do with digestion that becomes compromised first, leading to development of Hashis or is it the other way around? Low gut motility, weaker stomach acid, low uptake of b vitamins and decrease in enzyme efficiency all occur with untreated hashis.

The problem with something like hypothyroidism is that it causes so many issues that GPs need to be capable of putting it all together into a whole picture. At the moment, the vast majority are inclined to treat each physical manifestation as an end in itself and not connect the dots. Add to that the fact that they see many people with no thyroid problems with similar illnesses and you can see why there are issues and they fail to see any connection between the two.

[SlowDragon Administrator]

Are you still only taking 75mcg levothyroxine??

This is only one step up from starter dose

Which brand of levothyroxine are you currently taking

Do you always get same brand

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 if not been tested yet)

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

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Or alternative Vitamin D NHS postal kit

vitamindtest.org.uk

[SlowDragon Administrator]

Do you have most recent thyroid test results and ranges

Please add actual results

guidelines on dose levothyroxine by weight

Even if we don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months.

RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

[jrbarnes]

Yes I've had this due to under medicated thyroid. My ENT doctor sent me to have a barium test where I stood against a flat table as I drank barium and they took xrays. He pushed a camera down my nose to inspect. Then my endo said I could just go ahead and have the rest of my thyroid removed if the reflux and hoarse voice was a problem. I looked at him in bewilderment. How many doctors does it take to screw in a light bulb?

[Miffie]

I had heartburn when pregnant but no real issues until I was diagnosed with Hiatus hernia and Barrett’s oesophagus at 60. I have been hypothyroid since childhood so wasn’t sure any link in my case. However I take Omeprazole twice a day , have done for about 10 years and ever have any problems as long as I take it. We often have different experiences on our thyroid journey.