Has anybody struggled with swallowing food and food not digesting especially on an evening/night. I have noticed over the last month that I'm struggling to eat food without it building up in my throat and the other day it made me nearly pass out. Also the food I manage to eat on an evening doesn't seem to digest and i wake up still with a full stomach. It maybe not a thyroid issue but I have found out since taking levothyroxine that most my past illnesses were thyroid related as nearly all went after taking the levothyroxine.?
Struggling to swallow and digest food. - Thyroid UK
Struggling to swallow and digest food.
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BlueKeith
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SlowDragonAdministrator
Looking at previous posts
Are you still only on 75mcg levothyroxine?
That’s only one step up from starter dose
As a bloke especially, likely under medicated
When were FULL thyroid and vitamins last tested
You have Hashimoto’s
Have you had coeliac blood test done BEFORE trialing strictly gluten free diet
Are you currently on strictly gluten free diet or dairy free diet
What vitamin supplements are you currently taking
I'm still on 75mcg of levothyroxine. I have been doing well on it until about a month ago. My last test results were August and the doctor said I didn't need anymore levothyroxine for the time being. I stopped eating gluten for a while but slowly reintroduced it about July time and not had any negative side effects, well not until now. I'm not celiac. I take magnesium before bed . Could be the gluten maybe . Don't like idea of giving up bread but needs must. I'm 86kg . Only other factor that's changed is I've been put on Metformin but all I've read is good things about that.
First step is to get hold of actual results and ranges for last test results
Was test done early morning and last dose levothyroxine 24 hours before test
Just testing TSH and Ft4 is completely inadequate
Make an appointment with/contact GP for new blood test results
When did you start on metaformin
Metaformin lowers TSH
cureus.com/articles/50564-e...
absolutely essential to test Ft4 and Ft3……
Starting back on gluten likely to have reduced absorption of levothyroxine
86kilo weight suggests you are perhaps not on high enough dose
The link on Metformin lowering tsh is very Interesting. I assume my GP will know about this maybe?? Probably not. I may have to jog his or her memory.
GP’s seem totally unaware of most things to do with thyroid
Strongly recommend getting full thyroid and vitamin testing done
Ask GP to include Ft4 and Ft3 test …..and point out that as on metaformin TSH is unreliable
Highly likely you are in desperate need of next dose increase in levothyroxine
Likely low vitamin levels as well
ALWAYS test thyroid levels early morning and last dose levothyroxine 24 hours before test
Come back with new post once you get results
Yeah will do. Thanks
SlowDragonAdministrator
pathlabs.rlbuht.nhs.uk/tft_...
Guiding Treatment with Thyroxine:
In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.
The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).
The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.
……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.
The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.
Approx how much do you weigh in kilo
all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
List of private testing options and money off codes
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins 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...
NHS easy postal kit vitamin D test £29 via
Only do private testing early Monday or Tuesday morning.
Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery
Thanks slowdragon. It may be a good idea to get private test. Thanks for the link. My doctor is very reluctant to increase dose or give out results. Thanks again.
You are legally entitled to printed copies of your blood test results and ranges……regardless of wether GP wants to deny you them
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
Link re access
healthunlocked.com/thyroidu...
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Thanks again. I need to get more blood test really . Give my doctor another chance to give a solution and to get them results so can get other opinions.
guidelines on dose levothyroxine by weight suggests EVENTUALLY likely to need some where around 137mcg levothyroxine per day
86 kilo x 1.6mcg levothyroxine = 137mcg
Obviously important to only increase dose SLOWLY upwards. Usually maximum increase is 25mcg at any one time
Wait at least 2 months before retesting after each dose change or brand change in levothyroxine
speak to receptionist to request printed copies of all recent existing test results
You don’t have to explain why you want them and they can’t refuse to give them too you
You may need to allow 2-3 days for them to get you access to online records or to print out test results
Frequently only TSH has been tested….which is useless
Have you checked for low stomach acid? It happens to many of us.
See this link to Dr Myhill's page about it. A quote from that page is that "acid is required for the stomach to empty correctly".
drmyhill.co.uk/wiki/Hypochl...
There's an easy test you can do - the Burp Test which will give you an indication.
Here's another link
healthline.com/health/hypoc...
I hope that helps.
was going to suggest exactly this, but less eloquently and without links! Totally endorse this answer! Apple cider vinegar and betaine with pepsin have been game changers for me (along with following all advice from slow dragon). 🦋💚🦋
Will try apple cider vinegar thanks
My friend has a similar digestive complaint. Acid Reflux had damaged her esophagus. So she was put on a Proton Pump Inhibitor to ensure her acid production is drastically reduced ! Unfortunately mainstream health NHS believe acid reflux is caused by too much acid when greater minds know that in 90+% of cases it is too little stomach acid production leading to fermenting of food in the stomach with not enough acid to break down the food. Fermentation causes gas which puts pressure on the epiglotis and it opens allowing stomach acid into the throat causing damage. So please be aware. Google Chris Kresser a Functional Medicine clinician he has written a free ebook for all interested. GERD is the US term for Acid Reflux. He has healed thousands of his patients
Use of Proton Inhibitors is not good for our health to put it mildly. My friend doing nothing got to the stage where she could not eat anything as vomited back up.
Now on the proton inhibitor (omeprazole) eats no acidic foods. Takes the medication before her meal and can eat only small meals not later than the afternoon. She brings back her food occasionally still. If eating out , has to be midday and chooses from the childrens menu but eats only about half of it. Because she will not be digesting food properly she will be lacking in a lot of nutrients inc most importantly B12 - worrying.
Re Gluten free diet. Coeliac is not the only issue . The tests for Coeliac are woefully inadequate and just give the patient a sense of false security. There are 60 gluten proteins and the NHS test for 2. And if have endoscopy of small intestine and for the camara to find the damage caused to just confirm Coeliac you would need to have serious damage. Most tests are false negatives, basically they are waiting for the damage to get a lot worse so that it can be identified in yards of intestine.
Gluten Sensitivity which sounds a much milder complaint is actually far worse. As any organ (inc brain ) in your body can be affected. The gluten protein is so similar to thyroid tissue that if the immune system is attacking gluten protein, it becomes confused and also targets and attacks the thyroid - see the gluten experts Dr Tom OBryan , Dr Peter Osborne , Dr Datis Kharrazian and many many more. (lots of video interviews info on you tube . Dr Kharrazian book : Why is my Thyroid still not working' I think thats the title. I have his book : Why is my brain not working. Same scenario different organ.
I have been GF and all grain free for many years (over 10) It is so easy to make bread cakes . takes 5 mins to make (50 mins in oven) 6 ingredients and no yeast. my recipe make 4 or 5 breadcakes and can last me 5 days . let me know if you want the recipe x
Hi Lynne, When you've a moment I would definitely like to try your bread recipe.
I'm not sensitive to gluten, but I am sensitive to wheat, oats and potatoes. So much of the GF stuff contains potato starch so I have to read labels carefully. There are very few breads available which I can eat.
Sorry didnt post last night. Awful firework trauma suffered by our rescue girl.
Breadcake Recipe
115g Almond Flour
12g Psyllium Husk
1/2 teaspoon Bicarb
Pinch Salt
Wet Ingredients
3 Egg Whites
Teasp Apple Cider Vinegar
160ml Boiling Water
Oven 150c - need to place immediately into hot oven
And kettle already boiled
Mix all dry ingredients
Beat egg whites and vinegar just simply with a fork until a little frothy
Pour beaten whites into the dry ingredients and mix briskly with a knife until all flour absorbed while quickly re boiling kettle
Pour water into the mixture and beat quickly with the knife
Mixture should look like sloppy porridge
Take a serving spoon and spoon 4 or 5 spoonfuls into an oven proof tray, I use my stainless steel roasting tin. Each spoonful is a breadcake.
Put in oven immediately - middle or lower shelf.
Set timer for 50mins. Do not open the oven door before cooked or may sink
Notes:
I use organic almond flour although more expensive (almond flour is just ground almonds). I also use organic psyllium husk (bought online or health food shops - often used to keep constpation at bay) I just pour the boiling water into the mixture straight from the kettle, not really measuring, just beating in with the knife briskly and then add more for consistency and beating. but I think around 160ml. I use free range duck eggs which obviously are bigger eggs so experiment , you may need to use 4 hens egg whites. I put the egg yokes in the fridge and fry in butter and have for lunch with a breadcake. Or make pouring custard with.
You will see the breadcakes rise quite quickly - the acidic vinegar with the alkali bicarb creates the rise when mixed with the boiling water which is why need to get in oven asap.
I dont bother greasing the tin as the breadcakes still stick. But just pour hot water in the bottom of the tin when finished with and almond flour soon disolves in the water.
I use a fish slice to remove the breadcakes.
I have experimented with cooking time and temperatures, occasionally I have ended up with hollow breadcakes, no loss as I just use as a desert with butter and honey or dipping in soup etc.
I store in a couple of greaseproof paper bags or air tight container.
Cheers
Wow. Thanks Lynne. Very interesting. I have been tested for celiac and got told that it wasn't bread and pasta that was making me ill ( that's what I'd told the doctor that I suspected bread and pasta). My family and work colleagues have all said to me that I'm acting (spaced out) lately and Ive been doing stupid things. I've been getting lost while driving in places I've been loads of times. I'm going to try going totally gluten free and see how it affects my brain.
I definitely recommend watching Dr Tom O' Bryan you tube videos - his website drtom.com - videos on there the last time I looked. lots of info, I would suggest that you need to learn as much as you can
Also reading Dr Datis Kharrazian's book Why is my brain not working
Learn how a leaky gut, affects different parts of the brain. Made leaky by gluten, antibiotics other meds, also unbalanced microbiome (too many bad bacteria) will mean any too large food protein can get through (not digested long enough to be small enough before passing through a healthy gut wall into the blood stream)
Dr Kharrazian has in the past in podcasts shown a chart of which food proteins - dairy , tomatoes (anything you eat ) affect different parts of the brain . Frightening. You can test privately to see what antibodies you have which trigger your immune system to attack your organs because they are attacking the food proteins that have got through - Expensive.
You can contact British clinician Micki Rose for advice, she is lovely with excellent gluten free support group. Her website is purehealthclinic.co.uk. Join the support group where you can ask advice from hundreds of people (if they have had tests. What they eat etc )
The best thing I feel you could do, as with me is to heal your Leaky gut . Leaky gut means Leaky Brain as par for the course. firstly Gluten /Grain free which doesn't mean gluten free commercial products (full of other gluten containing grains eg corn and full of starchy stuff that will feed your bad bacteria - need to try going really low sugar and organic)
Not organic means you are consuming herbicides, insecticides which are designed obviously to kill . They kill your positive for your health bacteria , bad bacteria are a little more resilient which leads to an unhealthy gut microbiome balance. Also LPS from these negative bacteria also will make holes in your gut lining. Avoid anything to do with glyphosate (Round Up weed killer) proved to be disasterous for our health . 90% of Soy crops are sprayed with If you eat soy it has to be organic. Many crops sprayed with. The makers of glyphosate Monsanto/Bayer were taken to the European court of justice for crimes against humanity. Was banned in Europe. use freely in US and other parts of the world. Of course we couldnt wait to leave Europe so our farmers can use. They cannot spray organic crops
So dont eat harmful stuff, take excellent Probiotics (see microbz.co.uk) Collagen powder (known to heal the gut lining) for a good start. x
Hi Lynne, I'd love your recipe too if you wouldn't mind please, thanks for the informative post 
Will post asap today x
Sorry didnt post last night. Awful firework trauma suffered by our rescue girl.
Breadcake Recipe
115g Almond Flour
12g Psyllium Husk
1/2 teaspoon Bicarb
Pinch Salt
Wet Ingredients
3 Egg Whites
Teasp Apple Cider Vinegar
160ml Boiling Water
Oven 150c - need to place immediately into hot oven
And kettle already boiled
Mix all dry ingredients
Beat egg whites and vinegar just simply with a fork until a little frothy
Pour beaten whites into the dry ingredients and mix briskly with a knife until all flour absorbed while quickly re boiling kettle
Pour water into the mixture and beat quickly with the knife
Mixture should look like sloppy porridge
Take a serving spoon and spoon 4 or 5 spoonfuls into an oven proof tray, I use my stainless steel roasting tin. Each spoonful is a breadcake.
Put in oven immediately - middle or lower shelf.
Set timer for 50mins. Do not open the oven door before cooked or may sink
Notes:
I use organic almond flour although more expensive (almond flour is just ground almonds). I also use organic psyllium husk (bought online or health food shops - often used to keep constpation at bay) I just pour the boiling water into the mixture straight from the kettle, not really measuring, just beating in with the knife briskly and then add more for consistency and beating. but I think around 160ml. I use free range duck eggs which obviously are bigger eggs so experiment , you may need to use 4 hens egg whites. I put the egg yokes in the fridge and fry in butter and have for lunch with a breadcake. Or make pouring custard with.
You will see the breadcakes rise quite quickly - the acidic vinegar with the alkali bicarb creates the rise when mixed with the boiling water which is why need to get in oven asap.
I dont bother greasing the tin as the breadcakes still stick. But just pour hot water in the bottom of the tin when finished with and almond flour soon disolves in the water.
I use a fish slice to remove the breadcakes.
I have experimented with cooking time and temperatures, occasionally I have ended up with hollow breadcakes, no loss as I just use as a desert with butter and honey or dipping in soup etc.
I store in a couple of greaseproof paper bags or air tight container.
Cheers
I’ve had the same problem with digestive issues so now I take digestive enzymes with a meal which helps a lot. So times I have difficulty with swallowing but have a hospital appointment to look into this
The slow gut motility due to hypothyroidism (called gastoparesis) doesn't just start in the stomach. The esophagus is part of the digestive system and the gastoparesis also results in the constipation, which is a common symtpm. A year before I was finally diagnosed, I had experienced the difficulty after swallowing (ie even getting food to enter my stomach) and thought it may have been a hiatus hernia. In retrospect, it was hypothyroidism. Proper dosage of meds (for me T4 and T3) eliminated (pardon the pun) the constipation and gastro paresis.
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