Taking Omeprazole with Levo

[Foxie1234]

I had a total thyroidectomy in 2016 after having a thyroid storm……I have been on various doses of Levo over the following years both up & down doses (at one point only 50mcg per day!)…. I am now taking 75mcg per day & mostly don’t feel too bad….although medical professionals are trying to lower dose as my T4 is over ‘their’ higher level, at Serum free T4 level (XaERr) 22.4 pmol/L [10 - 22] - Above high reference limit. Serum TSH level (XaELV) 0.73 miu/L [0.3 - 4.2] No T3 tested…..I have persuaded the GP to leave me on 75mcg at the moment as I ‘feel’, most of the time, as good as it has been for a while…….however, saying that, I don’t do an awful lot. I tend to just do light housework, the cooking, occasionally go shopping……..I am quite happy just sitting & reading, knitting & watching tv…….. I also suffer from osteoarthritis, which I have had for many years, so I find walking a challenge & don’t go out without my ‘long suffering’ husband’s support.

Over the years I have also suffered with gastrointestinal issues. I had my gallbladder removed when I was 27 years old, I am now 72…..I took either Omeprazole or Lansoprazole 20mg for 20 years from approx 1995 to 2005 I then was given a reduced dose of 10mg which seemed to solve the problem of the GERD……the hospital stopped all my meds while an in patient in 2016 & I was not prescribed them again until I complained about experiencing stomach pain’s whenever I was anxious ie travelling on long journeys, going to the dentist, things that stressed me……my GP at the time suggested I took the PPIs three days before any such events to calm the acid my stomach down……I have done this & it usually works. I have been experiencing much more heartburn, stomach pain etc again & twice over the last 8 years it has been so bad my husband has called 111 and they have called paramedics, who have taken me to A&E to be checked out. Both times I have had tests to reassure me it is not my heart. Usually I can cope with the symptoms of GERD ( I eat boxes of Gaviscon tabs!)….but occasionally the pain is severe & lasts a long time so it frightens me as I think it may be my heart.

I now feel that I need to go back on my medication for this, ie PPIs, but am reluctant to ask my GP (if I can get an appointment even) about the contraindications of PPIs & Levo as I’m sure they would say it was ok to take them. I know I have read on here that you need stomach acid when taking Levo so as PPIs reduce stomach acid they act against each other. If anyone has a suggestion for something I can safely take for my GERD I would much appreciate the advice.

Thank you for reading my essay! Sorry it’s a bit long……..hoping someone out there can help me.

[Buddy195 Administrator]

Forum advice is to leave at least 4 hours between taking Omeprazole and Levothyroxine , as PPI’s can decrease the absorption of thyroid medication.

It's advisable to have a full thyroid function test 6-8 weeks after starting Omeprazole to see if it has any effect on your levels. It’s also very useful to check key vitamins (ferritin, folate, B12 and Vitamin D).

I hope other members can offer suggestions re alternatives to PPIs. Have you trialled a gluten free diet at all? This has a huge benefit for me and resolved my gastritis symptoms.

[Foxie1234 in reply to Buddy195]

Thanks for taking the time to reply. I take my Levo at night so wouldn’t interfere with the PPIs. I will certainly look into a full blood test.

[greygoose]

Are you sure you even have high stomach acid? Most hypos have low stomach acid, but the symptoms are the same - GERD is one of them.

I would suggest that, whilst you're off the PPIs, do a burp test to find out if you have high or low stomach acid before starting them again.

healthline.com/health/hypoc...

[Foxie1234 in reply to greygoose]

Thanks for replying….I have already started taking PPIs so burb test may not work…..I’m sure I was told I produce too much acid, I will check with my med notes.

[greygoose in reply to Foxie1234]

Doctors always tell you that! But they have no proof, they just assume because they refuse to believe that low stomach acid is a thing. But it most certainly is for most hypos. And PPIs - evil things! - will just make it worse. If it were me, I'd stop the PPIs (wouldn't tke them in the first place!) for a while and then try the burp test. You do need to know if your stomach acid is high or low because it affects just about everything.

[SlowDragon Administrator]

suggest you get FULL thyroid and vitamin testing

Essential to test vitamin D, folate, ferritin and B12

Lower vitamin levels more common as we get older

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we must maintain GOOD vitamin levels

What vitamin supplements are you taking

Also VERY important to test TSH, Ft4 and Ft3 together

Request GP test B12, folate, ferritin and vitamin D…..also magnesium

Or test privately

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

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...

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

Just TSH, Ft4 and Ft3 test - £32

monitormyhealth.org.uk/thyr...

10% off code here

thyroiduk.org/testing/priva...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

[Foxie1234 in reply to SlowDragon]

Thanks for replying. I will do a full blood test as soon as I can. I expect I will have to pay for this….but worth it to see what’s going on.