ENT diagnoses laryngopharyngeal reflux caused by hypothyroidism

[Regenallotment]

Had a scope up my nose 🤢 at my ENT appointment today. I was there because I have a persistent sore throat and swelling in my clavicle pits, ultrasound showed extensive thyroiditis and cysts. MRI results not back yet.

I have a photo of my inflamed larynx! Wanna see?

Hopefully sharing this will help someone else.

The ENT specialist is convinced the laryngopharyngeal reflux has caused the inflammation, despite me not being overweight, not drinking, not smoking. and me having low stomach acid. I didn’t agree.

He wants me to take Gaviscon at night, raise the bed a cm at the head end.

I wholeheartedly disagreed with him on that too, took hubby in for backup so that he could mediate if he got gaslighty and resolved to get a second opinion.

One thing he did say was that the laryngopharyngeal reflux is caused by hypothyroidism. I softened a bit to hear this.

I did some more research this evening and realised he’s probably right, I do wake up choking, I do wheeze in the night, I do have post nasal drip, I do cough after meals. I do burp a lot and apparently those gases do some damage over time. So even though I’ve made huge improvements in my digestion there is some way to go.

I looked up alternative approaches as I’m wary of taking gaviscon which might resolve the symptom but not the root cause, and would reduce my terrible absorption of nutrients in my leaky gut even further.

I discovered root causes could include low cellular T3 (I’m low in range on recent bloods). H. Pylori, SIBO too.

thyroidproblemsdoctor.com/h... explains it well.

ncbi.nlm.nih.gov/pmc/articl... also a good read and covers both hypo and hyper thyroid conditions.

So back on the trail of optimal thyroid hormone replacement. I’ll ask GP for a trial to raise T4 once more, latest bloods show room for that, wait 6 weeks and then look at T3 via endo or privately next. Meanwhile some digestive testing and improvements are needed.

[Imaaan]

Thanks for sharing your ent visit. Was waiting to see a photo. Maybe the question was rhetorical.

Hypo can cause low acid and by improving your levels hopefully it will stop the reflux. Besides the acid, there is pepsin that can irritate the lining. I think that's what causes my nasal congestion. I was hoping as my thyroid levels improved my reflux would improve but it hasnt. Could be due to the fact that I have a small hernia. I have elevated the head of my bed to ease the reflux.

I've been on a journey to cure my sibo with herbal antimicrobials that have a study backing them. I've done one and half rounds. It's difficult to get rid of so I'm gearing myself up for another round and God willingly it will eradicate it.

I wanted to share with you that dgl and mastic gum are good for the lining and reflux.

Keep us posted on your journey

[Alanna012 in reply to Imaaan]

If you don't mind, I'd be interested in knowing what herbs you're taking for Sibo. I don't want to go down the antibiotic route...

[Imaaan in reply to Alanna012]

ncbi.nlm.nih.gov/pmc/articl...

^^^^I did Biotics Research dysbiocide and fc cidal. Also read another case study with sibo and hypothyroidism and she was prescribed Biotics Research A.D.P.(emulsified oregano)so I added it in my regimen along with blackseed oil and mastic gum. I felt a difference upon completion so I knew I was on the right track. I would have taken garlic and neem since they help with methane sibo but they reduce blood pressure and that would give me palpitations.

Its recommended to do the kill phase first and then reintroduce probiotic to replenish but my doc told me to continue with probiotics and digestive enzymes. Took S boulardii, sauerkraut and goat kefir.

One thing I'll say about dysbiocide is that it contains wormwood and the recommended dose gave me palpitations and insomnia so I just took 3 pills rather than 4. 2 at 12pm and 1 at 3pm. No biggie it just took me longer to complete it. If I took it after 3pm it kept me up.

sibosense.blog/2018/06/17/a...

^^^ this might interest you. Another thing to look into is L reuteri yogurt by Dr William Davis for sibo.

Edited to add: Its great to add a bio film disrupter to the regimen to make your herbal antimicrobials or antibiotics more effective. Also after antibiotics its important to use a motility agent to keep things moving since that's an issue that causes sibo and Dr Mark pimmental talks about it. Hes the leading authority on sibo. One other thing is to space out meals and to cut out snacking to give the MMC time to do its thing which helps to keep sibo at bay.

[Regenallotment Ambassador in reply to Imaaan]

thanks for this info, I’ve been round the 90 day black seed oil, refrigerated sauerkraut and S Boulardii loop once already hmmm I think I need to GI map test first so I don’t take any more expensive snake oils without the need. I hope it’s working for you 💚

[Imaaan in reply to Regenallotment]

Hopefully the gi map will be of help but the the sibo trio test designed by Dr Mark Pimmental (probably butchered his last name) is the most helpful in figuring out which sibo you have. Knowing that info will help with which treatment route to go. Hes the leading figure when it comes to sibo.

Sibo is notoriously difficult to get rid of and most ppl require multiple rounds even with the heavy duty antibiotics that come with a black box warning. Its recommended to do rotate the antimicrobials with each round.

[Alanna012 in reply to Imaaan]

Thank you so much!!🤗

[Imaaan in reply to Alanna012]

No prob. I edited and added a little more info that I forgot. There are a few videos that I found helpful and I can share if you like . Let me know.

[Regenallotment Ambassador in reply to Imaaan]

Here you go! The bobbly round bits towards the front should be peachy coloured and not red, this is what he thinks is caused by laryngopharyngeal reflux and giving me persistent sore throat symptoms.

Photo of larynx

[Imaaan in reply to Regenallotment]

It is raw red, poor thing. Hope it heals.

[Alanna012]

Taking T3 hasn't actually stopped reflux altogether for me although it got a bit better and I've had times when it seems to have retreated, but it always comes back. Going gluten free helps some. I do have a very compromised gut and hashimotos causes gut problems in its own right due to autoimmune activity. But gaviscon reduces further your acid meaning you need more gaviscon, which reduces your acid, which means you need more.....

[Regenallotment Ambassador in reply to Alanna012]

Similar story here, yes I went gluten and dairy free early summer as well as avoiding soy and being allergic to sulphites. Sorry to hear T3 hasn’t resolved this for you. I tried some betaine earlier and now have indigestion 🙈 so that wasn’t the answer today and yet it resolved lots for me a few months back. Seems like the goalposts are moving… argh 😣

[Delgor in reply to Regenallotment]

Thank you for sharing everything Regenallotment as you are indeed helping others by doing so but I'm very sorry that you are going through it in an attempt to get yourself right again. I paid a visit to the acupuncturist who has been helping me of late and was told that I wasn't absorbing nutrients despite my going gluten, dairy, soy, caffeine free over a year ago and taking probiotics.

In reading Dr Westin Childs he thinks that thyroid dysfunction leads to gut dysfunction and when stomach acid levels drop you start to develop nutrient deficiencies which changes bacterial concentrations in the gut and hence problems with malabsorption. He believes that prolonged use of acid blockers is known to cause issues with thyroid function in many different ways and that you should fix the thyroid and get off acid blockers as quickly as possible. Decreased stomach acid also increases your risk of developing deficiencies in calcium, B12, Vit D and magnesium - I now wonder if that has something to do with my having such a bad bone scan which nobody was expecting. If only there were some clued up endo's out there life would be a lot simpler. My hospital endo wants me to come off all thyroid meds to see what is happening - he has to be joking and I told him so!

[Regenallotment Ambassador in reply to Delgor]

goodness coming off all 😳

They wouldn’t suggest this to a diabetic would they!

Yeah we are a complex and interconnected system, standard medicine has split into so many specialist areas that don’t interlink this.

Good luck with it 💚

[Imaaan in reply to Alanna012]

Gaviscon doesnt reduce acid. It contains alginates and its main purpose is to create a barrier to prevent the acid from irritating it. That said, it affects absorption of meds and supplements

[Alanna012 in reply to Imaaan]

Ahh interesting! That's good to know. But I always found once I start taking gaviscon there is a rebound effect after a few hours where the symptoms of acid reflux feel worse, necessitating me taking more & more gaviscon and finding very difficult to wean off. I really don't know what the answer is because PPI's are worse. I wonder where the vicious cycle starts. I get tired of it all sometimes. I ought to have got help in the early stages of this disease, it's very difficult to deal with now.

[Imaaan in reply to Alanna012]

Sorry to hear that it increases your reflux. Something in it must be triggering it. For me salty or fatty foods cause me to have more reflux especially eaten at supper. Hope all of us get cured someday soon.

[Regenallotment Ambassador in reply to Alanna012]

yeah that’s familiar, I used it 20 years ago in late pregnancy, ended up sleeping almost sitting. Sadly I think my chocolate eating days are numbered. It’s definitely one of the major contributors and I only have 85% plus 🙈

[jimh111]

Hypothyroidism can cause reduced lower oesophageal sphincter pressure leading to reflux. The suggestion to elevate the head of the bed is a good one. Whilst you want to solve the underlying problem raising the bed will give considerable relief. I had bile acid reflux due to hypothyroidism and putting the head of the bed on two bricks gave great relief until I worked out I was hypothyroid. I found levothyroxine has more effect on the gut than liothyronine does. So, I'd be inclined to raise your levothyroxine dose if your fT4 is low.

[Regenallotment Ambassador in reply to jimh111]

thanks! We’ll give it a go

[humanbean]

raise the bed a cm at the head end.

I raised the head of my bed with a very large breeze block under each leg of the head of the bed many years ago (about 25 - 30 years ago). I won't deny it takes a while to get used to it, but now I never think about it at all unless someone else mentions it, and I really think it helps.

Personally I wouldn't want to take Gaviscon or any other antacid every night if I could deal with the problem some other way.

I would recommend to anyone with reflux taking the time to learn what triggers the valves at the top and bottom of the stomach to open and close. I learned this from the free e-book by Chris Kresser which can be requested from this page (it is rather a long read) :

chriskresser.com/what-every...

I think it helps to understand how those valves work, otherwise you'll be trying to fix your problem with too little information.

Kresser doesn't tie gut problems to hypothyroidism in that e-book, but he does mention a connection in this link, which you might also find of interest :

chriskresser.com/the-thyroi...

[Regenallotment Ambassador in reply to humanbean]

thanks for this info, I have bookmarked to read up.

[SlowDragon Administrator]

Looking at your most recent thyroid results …..yes Ft3 has a way to go to get to adequate level

[Regenallotment Ambassador in reply to SlowDragon]

thanks for this. I’ll approach the GP for a dose increase and endo referral and go to Roseway labs if not. 💚

[Crwbin1]

I am in the same position as you. Caught between ENT and gastro and Endo . Had a terrible feeling of a lump inside of throat, coughing with eating , swelling around larynx. Also had episodes terrible chest pain (put in hospital with suspected heart attack). Subsequently heart consultant thinks pain is from oesophageal spasm. Had endoscope with gastro team -found Barrett’s oesophagus and and a hiatus hernia -so treatment was to review in a years time and take Gaviscon And omeprazole , didn’t work so now on Gaviscon and nizatidine and pantoprazole.Still having issues. Ent did nasal scope said swelling on larynx due to gastric reflux but said no baddies so sent me back to gastro team for another referral. Meanwhile Endo team gave me ultrasound said I had nodule but not on the side the lump feeling is so doesn’t think that is what causing problem. No one seems to want to talk to each other….meantime still suffering. Have under active thyroid and on Armour (NDT) 1.5 grains. Recent tests show I am in good range for thyroid meds. 🤷🏻‍♀️

[Regenallotment Ambassador in reply to Crwbin1]

I feel for you! Isn’t it annoying. Gotta keep trying, our future selves will thank us 😊

[Batty1]

I personally would take the heartburn medication even if its just for a short time because leaving (acid) reflux go could cause problems and all you would need to do is take it 3 hours away from thyroid meds and is this a perfect solution (no) but neither is dealing with inflamed esophagus that over time could be bad. My husband was on PPI for a couple of years and he actually did wean himself off so it can be done. Im one of those people who can not stop PPI because without them my life will be hell and not enough diet changing in the world can fix my issue which Im almost certain came from a severe seafood food poisoning incident.

[waveylines]

Your best way forward is to be optimally treated for your hypothyroidism. Anything else you do eill simply be shoring you up until the chore issue of optimal treatment t is addressed. This isn't to say you shouldn't fo it just to be sure you're aware that it's a sticking plaster not a resolution Hypothyroidism is well known as the great mimicked. Itcan affect people in multiple ways and it can be very diverse. Most doctors ignore this and treat each symptom as if its do etching separate. Seems your ENT consultant is better I formed than many.

[Regenallotment Ambassador in reply to waveylines]

yes on reflection I think you are right! I wasn’t in the best frame of mind having no MRI results back yet to discuss and feeling fobbed off. I get into that mindset where I think they must think I’m a time wasting hypochondriac fraud who likes procedures 😣

[Sparklyjenson]

Hi - it’s been a couple of years since you made this post. Out of interest, how did you get on?

[Regenallotment Ambassador in reply to Sparklyjenson]

Hi Sparklyjenson,

Thanks for your interest, the symptoms are pretty much gone. Following all the tips raising FT4 and FT3 with a small dose of T3 plus all the dietary/timing and stomach acid boosting tips worked.

I occasionally get an attack but I know it’s fizzy drinks, eating too late, garlic or over eating that does it.

Are you a fellow sufferer?

[Sparklyjenson]

It’s great news to hear you have it under control. This is a fantastic forum!

I have Hashimotos and LPR which is flaring up at the moment. I also have gastric parietal cell antibodies so don’t absorb vitamins and nutrients very well. The gp always tries to get me to take omeprazole but since I probably have low stomach acid, it would make it even more difficult to absorb b12 and vit D which I need for my thyroid medication to work. It’s all such a vicious cycle. I was searching the forum for advice and found your post. I think it’s time to get my full thyroid bloods done again.

[Regenallotment Ambassador in reply to Sparklyjenson]

Good for you taking on the battle, are you also on the PA (Pernicious Anaemia) forum on Health unlocked. Another useful resource for B12 and absorption conditions. From their advice I’ve tried B12 injections and my goodness they have helped no end with the tingly fingers, numbness, anxiety etc.

yes knowing all your levels regularly really is key to maintaining health. 🌱

[Sparklyjenson]

Yes I’m on the PA forum thanks - my gp wouldn’t give me injections, but my pins and needles went away when I got my thyroid and vitamins under control so I didn’t push it. They are coming back again now though, so I might revisit that. It’s so helpful to hear what helped you - it makes me feel better to know I’m not the only one and motivates me to sort myself out! Thank you

[Regenallotment Ambassador in reply to Sparklyjenson]

Good stuff, it’s amazing what you can pick up here. I found out about B12 from someone here too, she was addressing my moans and groans and it turned out a cheap self injection from Germany really helps!