Hashimoto sand digestive problems

[Cecilbenhard]

I am having digestive problems has any one else experienced these with Hashimoto

[SlowDragon Administrator]

Extremely common, especially if under medicated

Being under medicated frequently causes low stomach acid, acid reflux, bloating

What Levo or NDT are you currently taking

What are most recent thyroid results

What vitamin supplements are you currently taking

Are you on absolutely strictly gluten free diet and/or dairy free diet

[Cecilbenhard in reply to SlowDragon]

I’m taking levothyroxine 50 UGs but only just increased. December blood tests TSH 9.36, antibodies 83 Kiu fre T4 14. Iodine free multi vit min supplement from Solgar + additional Vit D and Magnesium. Gluten free but not dairy free diet and non meat eater.

[Cecilbenhard in reply to Cecilbenhard]

Levothyroxine 50 mcgs

[SlowDragon Administrator in reply to Cecilbenhard]

Standard starter dose of levothyroxine is 50mcg

You mean you were started on lower dose than this

Bloods should be retested 6-8 weeks after each dose increase

As a vegetarian you are likely to need separate B12 and vitamin B complex

Important to test vitamin D, folate, ferritin and B12

What were most recent vitamin results

[Cecilbenhard in reply to SlowDragon]

Started in 25 mcg at age 65 one year ago. Vits were all in range and B12 very high. I have cut on the multis recently to see if stomach problems were helped.

[Cecilbenhard in reply to Cecilbenhard]

How would I know if symptoms are due to thyroid or something like H- Pylori - without tests?

[SlowDragon Administrator in reply to Cecilbenhard]

So thyroid levels will need retesting in 6-8 weeks

Yes correct to start on 25mcg levothyroxine if over 65....but levels should have been tested 6-8 weeks later. (Not a year later)

Aim is to increase the dose slowly upwards in 25mcg steps until TSH is always under 2

When adequately treated, TSH will often be well under one.

Most important results are ALWAYS Ft3 followed by Ft4.

When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)

Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works

guidelines on dose levothyroxine by weight

Which brand of levothyroxine are you currently taking

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...

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...

[lisaj88 in reply to SlowDragon]

Absolutely. Because of each of us is unique and what may work for someone, won't work for another, it's a challenge. It's a hormone after all. Getting your TSH in the right range helps. I'm one of the people that natural thyroid did not work for. I take Synthroid, name brand, because generics are not the same. Cutting back on dairy has helped me, but honestly, gluten doesn't bother me. I can't get behind severe dietary restrictions just because some doctor with a book says so. I've done so much research over the years and there is a lot of quack advice out there. For me, the route I took is intuitive eating and really listening to my body about how foods made me feel. I also have gastritis - probably exacerbated by Hashimoto's - so I have absorption issues (my grandmother had pernicious anemia) so I take sublingual B12 and that has ensured my levels stay good. Good luck - stressing out over things really adds to digestive problems (no secret there!) so, honestly, therapy has helped me with this. Good luck - you're not alone.🙂

[CatsofCatford]

I have Hashimoto’s and digestive problems too. I found Isabella Wentz’s book ‘Hashimoto’s Protocol’ really helpful. It led me giving up gluten AND dairy ... as a real foodie, I was really resistant to this ... but my goodness, what a difference it made. Especially dairy, which was a big surprise. Eventually I went on to follow the Autoimmune Paleo diet (see Autoimmune Wellness/Paleo Mom or Phoenix Helix websites) which resulted in even more improvement. If you’re able to, consider seeing a functional medicine practitioner to help guide you through. I did this eventually and it was so helpful, as I’d read so much and was trying too many things. The woman I saw was excellent, she believed in a very light touch, and simplified my diet and the amount of supplements I was taking along with noticing another contributing issue. I would very much recommend it. All the best 😊

[Tayamil in reply to CatsofCatford]

It's a fabulous book

[Kandahar]

I had my oesophagus burnt by acid caused by high doses of ibuprofen for arthritis. So was on Omaprazole but because this stops acid production, I took advice from here and weaned myself off without getting indigestion by using gaviscon. Only needed it for a while, while thyroid was treated by Liothyronine. So it seems that low acid stomach(something I’ve had for years) can give impression of high acid as this site says!