carbimazole and GERd

[Dumame]

I have been on carbimazole for a while, suddenly I’m developing GERD, highly uncomfortable and unproductive. Any advice?

[Zahrazori]

what is GERD

[PurpleNails Administrator in reply to Zahrazori]

Gastroesophageal reflux disease (GERD)

[Zahrazori in reply to PurpleNails]

Bless u, I hope someone can help you I’m sure they will.

[pennyannie in reply to Zahrazori]

Gastroesophageal reflux disease -

In a nutshell - it is stomach acid that repeatedly returns from your stomach back up through the esophagus and into your mouth.

[Zahrazori in reply to pennyannie]

I am very confident someone will help you on here. That’s sounds awful bless u.

[pennyannie in reply to Zahrazori]

I think you meant this reply to the person who started this question - Dumame ?

No worries he will see this -

just make sure that when you start replying you reply within their post and their name pops up as you write your reply - however we can all read everything that's being written so we can follow and learn as more information is shared.

If you have your own health issues and needing some help please complete your own Profile page and start your own set of questions for forum members to read, help and support you with.

[pennyannie]

Hello Dumame and welcome to the forum :

Do you have Graves Disease and why you are taking this Anti Thyroid drug ?

Please share time line and readings and ranges at diagnosis and which antibody has been found positive and over range in your blood ?

There is an alternative AT drug - Propylthiouracil - PTU - for short - maybe ask to be switched.

I'm not aware GERD a known side effect of Graves or Carbimazole - but we need more information.

Most recent research maybe useful for you to have :-

pubmed.ncbi.nlm.nih.gov/338...

ncbi.nlm.nih.gov/pubmed/306...

[Dumame in reply to pennyannie]

I was diagnosed last year match but been living with Graves disease undiagnosed as my GP said. I am currently on 18 months oral Carbimazole treatment plan. I had problem getting stable hormones, if the dosage is increased, I will develop hypo and if reduced I go hyper. recently, I stabilised on 10mg per day Carbimazole. however, I have been experiencing fatigue, indigestion and reflux for the couple of days now. I dont know if there is any home remedy before my consultation?

[pennyannie in reply to Dumame]

Ok - so that' s the usual issue -

trouble is blood tests tend to run behind symptoms by a few weeks and if your Graves antibodies are still raging, and taking off, it's like playing catch up - and it takes great skill and much time for an endocrinologist to get the dose of the AT drug exactly right - so you are neither hypo nor hyper.

All the AT drug does is semi-block your new own daily thyroid hormone production - and ' buys you time ' - while we wait for your immune system response to calm back down and hopefully your thyroid revert to normal function.

It's a bit like a plane being put into a holding position in the air - while waiting for a landing slot - slowly circulating and loosing excess fuel - so you stay on the AT drug and slowly your T3 an T4 levels fall back into range and hopefully have a smooth transition down into normal thyroid function territory and ideally don't land with a thump or be allowed to fall too far through the T3 and T4 ranges.

Acid reflux is very common in hypothyroidism so do wonder where your T3 is currently sitting - too high and you will feel hyper type symptoms - too low and you feel those equally disabling hypo symptoms.

Please confirm your antibody reading and the diagnosis you have been given and share your blood test results at diagnosis- if you have them - a TSH, Free T3 and Free T4 reading and range along with any other readings as you have gone through this treatment.

The NHS generally allocate a treatment window with AT drugs of around 15-18 months and then reassess your progress and may suggest definitive treatment - please do read the links I sent earlier - we are looking at an Auto immune disease for which there is no cure - and simply flipping you to permanently hypo - is not necessarily the best solution for many patients - and staying on the AT medication a safer longer term solution.

When metabolism is running too fast as in hyper or too slow as in hypo the body struggles to extract key nutrients through food - no matter how well and clean you eat - so please get your ferritin, folate, B12 and vitamin D run as these need to be maintained at optimal levels which we can advise on - as if just in the range somewhere these can compound your ill health further the necessary.

Have you discussed this acid issue with your doctor ?

[PurpleNails Administrator]

It may be that your thyroid levels are have become too low & you need to adjust down your carbimazole.

Lots a people report reflux when thyroid levels are low.

How long is a while? & what dose.

How frequently are you monitoring. Do you have results to share?

[Dumame in reply to PurpleNails]

I suspected too low as well, I booked appointment for blood test today, unfortunately I only get appointment by 24th May, I had blood test last 2 weeks, and my GP didnt told me to continue with the 10mg Carbimazole

[PurpleNails Administrator in reply to Dumame]

10mg a rather low starting dose. Getting a hold of your results & seeing what they are & what impact the medication is having on your levels is best way to ensure you getting the right treatment.

You don’t need to ask doctor, go directly to reception and ask for printed copy with lab range of your tests. Also see if you can set up online access to view results for future tests. This can take time to process by practice & you may need to fill in form / show ID.

[SlowDragon Administrator]

Gerd is common HYPOTHYROID symptom

Your Carbimazole may need reducing

When were thyroid and vitamin levels last tested

Bloods should be retested 6-8 weeks after each dose change in Carbimazole

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

have you had TSI or Trab antibodies tested to confirm Graves’ disease?

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common with autoimmune thyroid disease - Graves’ disease or Hashimoto’s

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

TSH often remains low or suppressed long after Ft4 and Ft3 start to reduce

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[SlowDragon Administrator]

if it’s impossible to maintain stable levels on Carbimazole an endocrinologist can prescribe “block and replace “

This is where you take higher level Carbimazole to block and REPLACE by taking levothyroxine

Important to get vitamin levels tested and optimal FIRST

[Singwell]

When you say unproductive, what do you mean? Very helpful guidance on acid reflux at the British Voice Association website. Look for Free Resources. There's a downloable pdf

[Singwell]

OK, I read down the thread. Get the BVA leaflets ASAP as these help. SELF HELP

1. Raise the head of your bed with 2 house bricks.

2. Finish evening meal 3 hours before bed

3. Treat your stomach like a hot water bottle without a stopper after eating - don't slump or slosh it around.

4. Sleep on your left side if you can so that the lobe of the liver on the rights doesn't press against your stomach when you're lying down

5. Gaviscon Advance is recommended by laryngologists for acid reflux. Its main component is seaweed, which forms a raft over the stomach contents while you're digesting. Be careful to take your thyroid meds away from the Gaviscon therefore, as the alginate could interfere with absorption

6. Once you've had your Gaviscon (use the liquid form for best effects at night) don't drink any liquid, not even after brushing your teeth. Or the protective 'raft' will be breached.

OTHER INFO THAT MIGHT HELP With both forms of acid reflux the problem ironically is not the acid itself (most hypos have too little) but the digestive enzyme pepsin, which attacks the soft tissue of the oesophagus or larynx, if it gets up there. We need that pepsin for food absorption, and IT needs acid to work properly. So unless for a short time I wouldn't suggest PPIs because if you have a poor digestion it'll only make it worse long term. That's why I personally won't use PPIs but use the strategies above. Due to a digestive fault my own stomach doesn't make acid anyway but I will say that most of the time, having worked out a dietary regime that suits me, I enjoy my food and don't suffer much from reflux anymore. I did have an attack of Gerd recently and it's jolly painful I know!

Hope this helps.

[JuSa44]

This is interesting to me. I am currently in the midst of a hyperthyroidism/Graves relapse and had bad GERD for a few weeks just before my hyper symptoms became obvious. It is much better now. I had GERD before I went on carbimazole. My theory is that it was related to my hyperactive thyroid. I’m not sure if the thyroid triggered the GERD or the GERD triggered the thyroid issues. I definitely feel they are related.