Best way of dealing with acid reflux and digestion problems?

[kendrewaddams]

Hi,

My mum, who has acid reflux often, which I've only just found is linked to low stomach acid caused by Hashimoto's.

What is the best way to combat this? Taking an enzyme? What type?

Many thanks.

[Imaaan]

Optimizing her levels may improve the reflux. High/low acid and food intolerances can exacerbate the reflux. I've found help in a cocktail of supplements which include probiotics, digestive enzymes, zinc carnosine and dgl. Half a glass of goat kefir . Slippery elm/marshmallow root are great at soothing the lining from the acid and I reserve them for a flare up. I recently bought a mattress elevator as well.

[LynLyn]

Hi. My heart goes out to your poor Mum. That was (!) my worst symptom in some ways as you can’t hide it. It’s taken a long time but improving Vit d, ferritin, folate and b12 along with optimal T4 and T3 medication have virtually eliminated my acid reflux symptoms. I no longer cough and I constantly had a feeling as if something was stuck in my throat. I now only occasionally have this sensation. My ferritin and b12 still need a lot of improvement so there may be further improvements. It’s thanks to the members of this forum and their advice that I’m feeling so much better! It’s not been a quick fix though. It’s been 3 years to date! I hope your mum gets some relief soon.

[SlowDragon Administrator]

What are her most recent thyroid results and ranges And current dose levothyroxine and T3

Does she always get same brand levothyroxine at each prescription

Presumably on Thybon Henning T3?

Does she split the T3 dose

TSH, Ft4 and Ft3 and vitamin D, folate, ferritin and B12 results

Is she on absolutely strictly gluten free diet

[Hedgeree]

Hi kendrewaddams,

One of the things that can help is to drink something acidic like lemon or lime juice in water before and during your meal. I just use a fresh lime and squeeze some juice from it and mix with a small glass of water and sip it about 15/20 mins before I eat. You only need a small amount. Someone will know the amounts, I just tend to guess.

Some use apple cider vinegar (with the mother) though that is not to everyone's taste. Again you have to dilute it and be careful with your teeth. Yes as SlowDragon says use a straw so you don't damage your teeth!

I find this helps me a lot as I get heartburn quite a bit and it can be very uncomfortable almost painful. Also by chance I discovered a ginger shot drink (non alcoholic!) in my local supermarket (in tiny tins); it contains ginger, lemon and apple juice (not from concentrate). I really like that and it also seems to help with the heartburn. I also use it for nausea which I'm having most days and it's something I keep in stock as accidentally found it to be essential.

Best wishes.

[SlowDragon Administrator]

If drinking anything acidic use a straw to protect teeth

[Lizzo30]

An alkaline diet is good to counter acidity also bicarbonate of soda - half a teaspoon in water once or twice a day

Magnesium is also excellent for heartburn

[Lizzo30 in reply to Lizzo30]

I must add that bicarbonate of soda doesn't benefit those with diabetes but the alkaline diet is very good for diabetes

[fiftyone]

I have had acid reflux for a number of years. I find two 20mg (?)Omeprazole capsules, prescribed by my doctor, before I go to bed controls it well. Since I have followed this regime, I have had no pain at all. Before t hat, I took one capsule in the morning and one and night and that did not help so much. I had to supplement with supermarket antacid tablets.

[Mitch27 in reply to fiftyone]

I might try this option as like you split doses and honestly feel no different 🙄

[fiftyone in reply to Mitch27]

A consultant told me I could take two capsules together (though not more than two in a day) and it has worked wonders for me.

[Ellie-Louise in reply to fiftyone]

I was put on omeprazole a few years ago, but after researching and not wanting to continue with them I started taking a probiotic twice a day (capsule also included a prebiotic) and it did the trick. I came off the ppi’s altogether. It certainly helps with all my gut/acid issues.

[fiftyone in reply to Ellie-Louise]

interesting. thanks

[radd]

kendrewaddams,

Betaine HCL + Pepsin replaces missing stomach acid, digestive enzymes will help with food digestion and we often need to take a combination of the two.

Further supports are ox bile that gives bilary support as our own bile becomes thick & sluggish, probiotics will feed the good bacteria, and if your Mum has leaky gut then supplements such as glutamine, marshmellow root, slippery elm helps repair, and then collagen is great for ongoing gut support.

Gastric acid is one of the signals that closes the sphincter between the esophagus and stomach called the LES (lower esophageal sphincter). A common symptom of hypothyroidism is low gastric acid and the stress this causes on the body (together with possible food intolerances such as gluten) reduces stomach mucus so the small amount of acid left in the stomach injures the fragile lining causing inflammation at best and ulcers at worst, and always poor nutrient absorption.

[kendrewaddams in reply to radd]

Thanks very much!

Would you recommend a supplement like this?

hollandandbarrett.com/shop/...

[radd in reply to kendrewaddams]

kendrewaddams,

Yes, there are combos with higher betaine & enzyme content & improved fillers but these are great value as in the penny sale and maybe a good introduction for your Mum. I hope they help her.

I take a much higher Betaine dose than these offers so if there is some improvement but not enough it may be worth looking at separate supplements at a later date.

[Jollypolly in reply to radd]

Hi raddCan you help a little more with any specifics…like amounts of these things..or even best brands? Also..how do you recommend taking the slippery elm to help heal?

I have no symptoms of low stomach acid ro speak of, however, I did the homespun test..bicarbonate in water…result..no burps at all…

The one thing I have which isn’t in the list of symptoms…is some weeks with a sore..inflames and slightly swollen throat..

It some years ago had a little heartburn and after a gastroscope he said I had too much acid…but e read dr Sarah Myhills take on that and believe her…

Can you help a little here ?

[radd in reply to Jollypolly]

Jollypolly,

I never did the burp test. I was under the care of a nutritionist and was told to just keep increasing betaine tabs each meal until I felt a warm feeling & then take one less tablet at the next meal. I worked up to five tabs with a protein heavy meal! Now I know which meals/foods need how many tabs, and doses have since reduced as own gastric acid has started working, although I still require betaine to digest meat.

I used to take Biotics Research Betaine Plus HP because they were high strength at 700mg + 10mg pepsin, but have since found Doctors Best Betaine HCl, Pepsin & Gentian Bitters (same strength) which is a huge tub at a much cheaper price. I ordered through bodykind.com, another member said she successfully uses dolphinfitness.co.uk. Some people with mild gastric acid deficiency find adding Apple Cider Vinegar to their food is enough.

Bile acid synthesis generates bile flow & biliary secretion of bile acids, cholesterol & lipids, and waste metabolites. It is essential for digestion of fats and helps the liver convert T4-T3. The ox bile was used with a complicated regime to shock the pancreas into secreting again, and involved a cycle of 1 pill at each meal on day 1, 2 pills at each meal on day 2, 3 pills with each meal on day three, and then repeating. I used Biotics Research Beta Plus which is a combo containing 100mg ox bile, and went through about three bottles. Many people just take 1 x 500mg tablet daily.

Slippery Elm calms inflamed mucus membranes & coats the digestive tract so great for leaky gut. I initially took it in a combo, can’t remember the name & have a feeling it’s been discontinued but it was similar to the Biocare Slippery Elm Intensive, except much higher strength, as I initially took around 2000-2500mg a day. biocare.co.uk/slippery-elm-...

Then I switched to a powder which can be used in anything, ie water, smoothie, porridge, and little balls of slippery elm-honey-coco powder left in fridge for snacks. theselightfootsteps.com/201... You can’t take high doses for longer than a few months but shouldn’t need to, and using small amounts in a smoothie, etc is a great way of tapering off. You can also get Slippery Elm T-bags.

I have tried all types of digestive enzymes: fruit sources (mainly pineapple/papaya/mango), plant sources (fungus), animal (pancreatin/pancreas glandular). If you buy digestive enzymes ensure they contain at least protease (breaks down proteins into amino acids), amylase (breaks down carbs), lipase (breaks down fats together with bile).

The better brands tend to contain more enzymes, Jarrows, Thorne, Nutri Advanced, Cytoplan, etc. At present I am taking Garden Of Life Dr. Formulated Enzymes which are fruits/veg. I practically snack on them as they are quite yummy 😁.

To eliminate the numbers of pills Now Super Enzymes or Thorne Bio-Gest are good combos of everything but obviously contain much lesser amounts. I found getting my gut sorted reduced the need for supplementing many other nutrients and reduced my need for thyroid hormone meds in spite of having no thyroid gland.

As you have Hashi a swollen throat could be down to taking insufficient thyroid meds. One of the biggest causes of T3/T4 intolerance I see on the forum is low iron, followed closely by low cortisol. Both are huge in the good workings of thyroid hormone meds just as a healthy gut is required for good conversion/absorption/immunity, especially with Hashi.

[Jollypolly in reply to radd]

Hi..thank you so much for your careful reply..I do so appreciate it. I printed it off..it makes perfect sense and is very applicable to me.I have ordered the relevant items you suggest..the betaine..and some digestive enzymes…and slippery elm caps.

I know my storage iron is showing low..

44…

So…my iron…do you perhaps understand..?

Serum iron =15.3………..6.60-26.0

And folate.=10.7 ….only says under 3 suggestive of folate deficiency..it’s a new ref range.

I don’t know what transferrin is…2.54…….2.0-3.60 g/L

And transferrin saturation index..27…….15.00-50.00%

I don’t want to ask too much of your time…but if you or anyone knows about these few results I’d be grateful..l

I take really good b complex daily ..Biocare…but no iron as such..and no b 12 though I always did till six months ago…

I want to thank you again..

I m so grateful.

Have added it all in radd…

One extra question…

I’m clearly short on stomach acid…I drink small amount red wine daily with evening meal…does this actually help du think ?

[radd in reply to Jollypolly]

Jollypolly,

We need the ranges (numbers in brackets next to each test resulst).

[Jollypolly in reply to radd]

I’ve edited my post radd…THANKYOU.

[radd in reply to Jollypolly]

Jollypolly

Alcohol is said to reduce gastric acid but I think that is referring to large quantities. I would say enjoy your daily small glass of red 🍷😊. It will also help with iron absorption if drank alongside iron rich meals.

Serum iron 15.3 (6.60 - 26.0) 44.85%

transferrin is 2.54 (2.0 - 3.60) 33.75%

transferrin saturation index 27 (15.00 - 50.00%)

The body cannot produce iron and must absorb it from the foods we eat or from supplements. Storage iron is in a protein called ferritin, and you haven’t supplied the reference range but I agree 44 is looking low. Serum iron is just under half way through range and this could easily fall further without good ferritin levels should adequate iron consumption/absorption not to be maintained.

Transferrin is the protein carrier that transports bound iron mostly to make haemoglobin within RBC's. It also ensures iron remains un-free (bound). Usually transferrin labs increase with low levels of iron to encourage further iron but may decrease in the presence of inflammation because transferrin is also a negative acute phase reactant. This may indicate you have inflammation within the body.

Transferrin saturation is the percentage that your body is saturated with iron. Anything between 25 - 45% is acceptable by GP's but may not indicate good working iron but just levels scraping within range.

Remember gut infections must be addressed in addition to above mentioned supports as they won’t alone tackle issues such as candida, SIBO or H.Pylori. They are simply supports to help a good tummy work better and mainly help digestion/absorption.

You have room to supplement iron in an effort to raise ferritin and retest in a couple of months, or just keep eating iron rich meals. In the absence of gut infection, you should find the betaine improves all iron and nutrient absorption anyway.

Folate is over 3 which your ref ranges indicates as adequate. Folate isn’t part of an iron panel but the B family (B9) and works together with VitB12 for good RBC formation/function, and levels should ideally balance. Therefore, you also need VitB12 testing, especially as you have stopped supplementing.

Have you had Vit D tested?

As these subjects are deviating away from the O/Ps original topic matter, I think you should now ask any new queries in a new post 😊 .

[Jollypolly in reply to radd]

D3 is 113.3…over 75 is optimal it says….Am taking 4000 iu daily at the moment…usually 2000..

Perhaps I should restart my B12 …

It all gets SO expensive doesn’t it..plus taking all those pills..it I feel it does my head in..

Feels like everything is too much !

[serenfach]

Antacids lower the acid content of the stomach - just what you dont need! Most GPs are used to heartburn caused by high acid and do not consider low acid.

I find a teaspoon of cider vinegar, mixed with a teaspoon of honey and a tablespoon of warm water does the trick. It also means you dont breath fire as it goes down!

[humanbean]

You might find these links helpful :

healthygut.com/how-to-suppl...

healthygut.com/4-common-bet...

[PrincessAnnie]

These can also be a symptom off a hital hernia so she’s maybe best pushing for an endoscopy.

[Charlie-Farley]

Hi kendrewaddams

Many (accepted not all) with an under active thyroid suffer with low stomach acid. In terms of symptoms low and high stomach acid present the same and docs often don’t know this and just tear off a prescription for PPI’s proton pump inhibitors like omeprazole.

If you have low stomach acid, it impairs absorption of nutrients, leading to vitamin deficiencies. Also, because the acid in the stomach is weak it does not activate the valve at the top of stomach /bottom of oesophagus to close properly. This is when stomach acids escape causing heartburn, coughing etc.

I worked out I had low stomach acid because when I took omeprazole prescribed by my doc it made things even worse. I was already at the stage if not being able to lie down to go to sleep. It was reading answers to another person’s post that alerted me to the possibility of having low stomach acid. Reading other peoples experiences has deepened my understanding on many things.

As an aside, I believe PPI’s can interfere with absorption of thyroid hormones as well.

Getting to full therapeutic dose on Levothyroxine, going gluten-free (strictly), optimising my vitamins and noting foods that cause me problems and importantly avoiding them 😂, I am able to remain symptom free and comfortable.

Combinations of food high sugar, high carb, high fat do it for me 😱. So even a gluten-free fruit crumble is a no no.

Likewise I will pay for pigging out on chocolate 🍫

We are all different- many scenarios here that have worked for different people, but making a note of what you eat , when and any negative results help to understand one’s body.

[radd in reply to Charlie-Farley]

C-F,

'I believe PPI’s can interfere with absorption of thyroid hormones as well'.

Yes most definately but it's more about healthy good/bad bacteria balance thats required for the 20% of thyroid hormone conversion to happen within the gut. Gastric acid keeps healthy/unhealthy flora in check. .

drknews.com/good-thyroid-he...

[Charlie-Farley in reply to radd]

Thanks rad I’ll have a read. I’m on a mission to REALLY understand my condition. All info is so gratefully received 😊👍