I’ve just had a gastroscopy. Diagnosis is oesophagitis and gastritis. The hospital recommends I’m prescribed a high dose PPI for 6 weeks which should then be reduced gradually dependant upon my symptoms.
I’m concerned that, combined with Hashimitos (I take 75mg Levothyroxine daily), this might cause me greater problems in time as I’ve read that PPIs adversely affect the absorption of Levothyroxine.
When I’ve queried this with my various GPs, they’re really not interested.
What should I do? Any advice would be greatly appreciated!
Written by
Murphea
To view profiles and participate in discussions please or .
If you need the PPI then you need it, it may only be for a short while. Take it at the opposite end of the day to your thyroid meds so there is the least chance of it affecting your Levo. Make sure that you have a full thyroid test (TSH, FT4 and FT3) regularly whilst on it to keep an eye on your levels so that your dose of Levo can be adjusted if necessary. If GP can't get the full test done then do it yourself with Monitor My Health (the NHS lab at Exeter hospital) it costs £26.10 with code here:
ank you. I understand that there’s a possibility my issues are caused by low stomach acid rather than high. Can this be tested by my GP? I’d hoped this might be established at tge gastroscopy appt but it wasn’t
thank you. I did the home test a while ago which I indicated low acid but, as you say, not very scientific to convince my disinterested GP! Not sure how to get a Heidelberg test done.
Can I self- refer to an endocrinologist? I think this might be the way to go….
many thanks for your guidance. Yes, I take my levo at 2am, and then 2 doses of 40mg Omreprazole at 8am and 6pm, 30 mins before eating. So far, so ok. I’ve also seen an endocrinologist who’s going to monitor my levels. Hopefully 6 weeks of PPI will heal my insides 🤞
I was offered it for my gastritis when I was first diagnosed but refused treatment. In hindsight, I wish I did a short stint to just allow my lining a break. I think prolonging it for 2 yrs did some damage. I came around after I could no longer bear the excruciating pain but stayed on it for a short period. I weaned myself off using pepcid ac (h2 blocker). Stayed on that for a bit and weaned myself by using slippery elm gruel . Did that for a bit and eventually stopped. In the meantime, I used dgl and zinc carnosine to help heal the lining. Both have a study behind it.
Also bone broth, gelatin and l glutamine are amazing for the lining but caused me to have palpitations. I took my 75mcg of t4 in the morning and took the ppi/h2 blocker an hour before bed to avoid absorption issues. My next lab work was wonky so it definitely affected my levels.
Hopefully they ruled out h plyori when they did your endoscopy since it's the main culprit for gastritis
Recently had a flare up so my heart goes out to you
Imaaan I suffer from gastritis too. I try to avoid using acid suppressing medication as I have osteoporosis and an underactive thyroid. I am having a flare up at present. Can I ask how you deal with flareups? Any recommendations would be most appreciated. Thank you
Honestly when it's bad I return to taking an h2 blocker but only at night. Pepcid ac 30 mg.
To help aid inflammation:
Vit d3 and k2 ( make sure u know your levels before supplementing)
Fish oil and canned sardines with bones. Omegas and turmeric are great for inflammation.
Bland foods of course. For lunch and supper, I live on white rice, protein cooked in water(chicken breast or beef) and some salt. Steamed veggies.Oats for breakfast cooked in water plus a glass of goat kefir.
30mg zinc carnosine by Doctors Best and 75mg of deglycyrrhizinated licorice by Nature's way
^^^ Both have a study that they help the lining. Also, L glutamine, bone broth and gelatin are tremendously helpful and have some research behind them but they give me palpitations.
Most importantly, slippery elm bark powder has made the most difference. I make a gruel by adding a tablespoon of the powder in a cup and then add hot boiled water. Let it cool down and then I drink it an hour and a half before bed. Slippery elm and marshmallow root both create a barrier on the lining and protect it from the acid.
To help take off the stress of digestion, my doc recommends probiotic and digestive enzymes. Note, digestive enzymes slightly increase acidity. I'm fine using them.
Two meds that I havent tried but help many ppl is Gaviscon Advanced, the UK version because it has a high amount of alginates. It creates a barrier as well. I've never tried it because it's very expensive to ship to Canada. Secondly there is carafate, I probably spelled it wrong. I've seen it reviewed by a girl that was hospitalized because of her gastritis. Both affect medicine absorption and need to be taken away from meds.
It usually takes me 3-4 weeks to truly settle a flare down
I did try slippery elm but I think it reduced absorption of thyroid meds so I stopped it. Do you notice any effect on your thyroid levels from using slippery elm?
I have some H2 blockers (famotidine) so I think I will try these for a month to allow healing of lining and see if I can wean off after that. With best wishes and thanks.
You're right that it affects absorption but I had no choice. Being on the h2 and later weaning it by using slippery elm did make my levels wonky but stopping the pain was more important to me at the time. You can think of slightly increasing your dosage to offset that. For the month of Ramadan, I used to increase my meds slightly to offset taking my meds right after breaking fast and eating.
I have gastritis, hiatus hernia and Barrett’s oesophagus with low stomach acid. I have been taking Omeprazole for many years. To avoid absorption issues I take levo and ndt at around 5 30 -6 :30 in the morning and go back to bed for a good hour before taking anything other than water.
You will feel fine if you plan well and stick to the schedule. All told I have 14 prescription items items to fit in, some twice a day. Thank goodness for spray and sublingual vits!
I hope the short course works for you. I was told immediately I’d need to take PPI for life. Take care
may I ask, did you sort out your regime with the guidance of a GP or an endocrinologist, or just by your own research/trial and error? This is all a steep learning curve! Best wishes
I have had hypothyroidism for sixty years and read a lot about it in the university library as a student. Also our GPS treated as as intelligent humans for a few decades. My mother’s family had a few medical professionals, her sisters were a doctor and a chiropodist. We had family friends who were GPs so had lots of informal input as well.
Originally ndt treated as we all were at time I discovered very quickly how fussy levo is when change was forced on me. So it was a no brainier to take it in isolation and obviously the PPI acts in such a way as to block absorption so needed to think carefully about what to take when.
You will find lots of advice on timings of meds, supplements etc on here by our fabulous admins and knowledgeable members. Good Luck going forward
thank you. I’ve now been prescribed 40mg Omreprazole twice daily for a min of 6 weeks. Not sure now how to balance taking this in conjunction with Levothyroxine….
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Levothyroxine and Menopause 
Levothyroxine concerns. 
Allergy to levothyroxine
Testosterone HRT with Levothyroxine 
Levothyroxine side effects 
