I now have Silent Acid Reflux (LPR) ie. Acid reflux with the main symptom being a very bad sore throat, particularly at night. I have had it for months and it's not getting any better. It stops me from sleeping and I'm exhausted.
I saw a gastroenterologist who prescribed Omeprazole which did not work for me (it did not stop the symptoms). Recently, he prescribed Famotidine 20mg twice a day (which is a H2, so I think it's another way to reduce the production of acid).
I read that Hypothyroidism patients produce less gastric acid. So I am worried that taking Famotidine will make things worse.
I know I need to avoid acidic food, stop drinking caffeine, fried or spicy food and not drink while I eat. Leave 3h before going to bed after dinner, manage/reduce stress etc... which I am doing.
Wondering if anyone has advice or could share their own way to deal with this because I'm struggling at the moment. Or what other sort of doctor (Functional/integrated medicine?) I should see.
Many thanks
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Oddly, if you can rest your voice that helps as you take in gas you breathe. Also, use Gaviscon Advance before bed, as well as double action throughout the day and especially after meals (Advised by ENT). Smaller albeit more frequent meals will help too.
I did all this, as well as stopped having meat, only eating freshly cocked meals without tomotos around 6 months. I was prepared to do all that that as the pain was terrible and impacted asthma, and I had little choice left when my voice became hoarse!
Do you mean H2? Or H2 blocker? H2 is hydrogen. And H2 blocker is like a PPI and stops production of stomach acid.
You're right, hypos do usually have low stomach acid, rather than high, and the symptoms are the same. Doctors refuse to believe that low stomach acid is a thing and always treat the symptoms as if they are due to high stomach acid. Which is not very perspicacious of them! But, like old dogs, you can't teach them new tricks! What your probably need is something to raise stomach acid, so avoiding acidic food is rather counter-productive. Did you suggest to this 'specialist' that it might be low stomach acid, not high?
I told the gastroenterologist that i may have low acid and he replied that it was a myth!!! But looking at reliable sources, I do think I am likely to have low acid due to my hypothyroidism.
Well, there you are then! And all these people are suffering from a myth. Who'da thought it! Sigh. Funny how they get better when they increase their stomach acid levels, isn't it.
And then there are the tests to detect low stomach acid. I wonder why they bother if it's a myth. What a silly man! It even has a name: Hypochlorhydria. This is quite a good article about it:
Thank you GG for that link from Cleveland clinic. I just read it to its entirety, very accurate and informative. Those doctors that are jumping the gun and pushing the PPI’s should be reading that article. My heart goes out to all the sufferers of high/low stomach acid. It’s really life altering. This forum is priceless🙏🏻
There's a good article here about LPR, which gives lots of tips to help manage this. It also suggests non-prescription antacids/alginate preparations (e.g. Gaviscon Advance) may help. britishvoiceassociation.org...
Hi all, Sorry I have not replied sooner, I was waiting for a thyroid scan & to be given blood test results.
To recap: I am hypo since I'm 17, so 29 years. I had few symptoms until last summer when my TSH increased to about 5 (my usual is circa 1.2). Following this abnormal blood test, my Levothyrox was increased to 100 and again to 112.5 (because I was tired and had silent acid reflux). I currently take Levo: 100mg of Aristo and 12.5 of Mercury Pharma.
In Dec 2023: I had a Thyroid ultra sound scan that showed a 6 millimetre benign cyst (I used to have a much larger one which almost vanished - in the 30 years I had Hypothyrodism - and now it seems to grow again)
Ultra sound report: " The left lobe measures 1 x 1.4 x 3.8 cm and the right lobe measures 1.0 x 1.4 x 4.7cm The thyroid is normal in echogenicity and shows a 6mm U2 nodule in the right lobe. No pathological nodes. The salivary glands are normal. Opinion: The thyroid is normal in size and shows no features of autoimmune thyroiditis. Small benign U2 nodule in the inferior right lobe."
Symptoms: I now seem to have less silent acid reflux (ie no or little sore throat which was the symptom) but a very dry mouth, all day and even worse at night. One morning, my toast did not go down until I drank a glass of water. I use Xylimelts to sleep (otherwise I wake up due to my dry mouth: they are lozenges that melt slowly), drink more water, and use Salivix lozenges and spray. My eyes and nose feel dry too. I have headaches. Some nights (not every night, once or twice a week) I wake up at 4-5 am and can't find sleep again. I also have a scalloped tongue (started last summer). I had vertigo once (I think it was Sept 2023) and I sometimes feel dizzy when I get up. I feel tired easily.
During the Christmas holidays, the dry mouth improved, although it did not disappear completely. I think work and stress make things worse... as in many conditions.
I got tested for Sjorgren's syndrome (and rheumatoid arthritis and lupus) in September 2023 and did not have any of that, but I read that one can have symptoms for 3 years before being diagnosed with Sjorgren.
Sept tests (all negative in Sept 2023): Antinuclear Antibodies (titre & pattern), DNA (Double Stranded) Antibodies, Extractable Nuclear Antibodies (nRNP, Sm, Ro, La, Jo1, Scl70) CENP-B, ANCA (Anti-Neutrophil Cytoplasmic Abs), Anti CCP Antibodies, Rheumatoid Factor Turbidimetry, Thyroid Peroxidase Antibodies 11.6 (normal: 0-34). Anti TG not tested in Sept 2023).
In July 2023, my anti TPO was <4 (range: <25) but anti TG 118 (normal is <40): this led to the diagnosis of Hashimoto (July 23).
Last blood tests in November which I did on an empty stomach, at 9am, before taking Thyroxin:
Serum Iron level: 18.4 umol/L (range: 6.6 to 26)
Se Unsat iron binding capacity: 40 (range 20-66)
Serum TIBC: 58umol/L (range 41-77)
Saturation iron capac: 32% (range 15-50)
Serum ferritin: 40 ug/L (range: 13-150)
B12x: 957 pg/mL (range: 197-771) - I was taking a vit B supplement but stopped 5 days before the blood test
Serum folate: 19.3 ng/mL (2.9-26.8)
Serum total 25-OH vit D: 57 nmol/L (range: 25-120) - I was taking a vit D supplement (1000 dose, recommended by endocrinologist in July) but stopped 5 days before the blood test
Serum TSH: 1.36 mlU/L (range: 0.27-4.2)
Serum Free T4: 18.6 (11.9-21.6)
FT3 sadly not tested but the two times it was tested (in 2023) it was always 4.2 (range: 3.1-6.8)
I am seeing an oral health specialist at a hospital this Monday (in a week) and ENT in February (because I had a sore throat)
Last week, I saw my GP and told him about my dry mouth and headaches. I asked if I could be prescribed T3 (I believe it's liothyronine sodium) as my T3 is low (although within range). He said he preferred to refer me to an endocrinologist... but I know it will take a good 6 months.
I worry about this dry mouth because it's been constant since last summer and is getting worse. It used to be during the day only, now it's at night and it wakes me up.
I wonder if I do have adrenal fatigue or adrenal insufficiency although I do not have all the symptoms of this.
My questions:
- Any idea why I have a growing dry mouth?
- How can I avoid developing Sjorjen Syndrome (I guess few people will be able to answer that, but still asking!)
- Should I change the Levothyroxine brand (I'm on Aristo 100 and Mercury 12.5, for a total of 112.5) ? ie. I used to be on Teva or Mercury (either one or other) and had no/little symptoms back then.
- My vitamin D and Ferritin are relatively low. Should I take Iron or something else to increase my ferritin?
- Do you think an endocrinologist would help with this ? (or another practitioner)?
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
BEFORE booking consultation with endocrinologist to consider T3
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
Thank you for responding again Slow Dragon. ... I have the doctors' list. I did not think about this which sounds good: "Ideally, choose an endocrinologist to see privately initially and who also does NHS consultations".
I was tested for it and I'm negative to Coeliac. I stopped gluten when I had acid reflux and then re-introduced it (organic pasta, organic flour but sometimes non-organic as well) but now I have this symptom, I should stop gluten, to see if it helps.
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
I note (from one of the links provided by Slow Dragon -thank you) that someone had replied to another person who also had OK Iron and low ferritin: advice was not to supplement with iron but to eat more iron-rich food.
and another tip was to have more Vitamin C. I avoid acidic food due to my dry mouth (although I have occasional orange and do have lemon juice on food) but do take vit C supplements and will certainly continue
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