I have been taking levothyroxine for over 30 years…just had my 70th birthday. In March 2023 after a severe covid cough I developed symptoms of acid reflux. The doctor prescribed Omeprazole followed by Lansoprazole & H2 blockers. I had bad side effects from both ppi’s, stomach pains, weight loss, brain fog and eventually excessive hair loss. In October 2023 after an endoscopy I was diagnosed with a very small hiatus hernia and told to continue with the medication but apart from the side effects neither Omeprazole or Lansoprazole stopped the acid reflux & I felt as if the acid reflux was made worse. I stopped taking the acid reflux medication in December 2023. I still take 100mg Levothyroxine daily. I have taken magnesium for many years and for several months have been trying various herbal remedies for acid reflux, including meadowsweet, ginger & marshmallow. I have also tried mild digestive bitters & apple cider vinegar. Also slippery elm. I have been cautious about all these things & at times feel they have helped far better then the prescribed meds, however, the acid reflux is relentless, I get it several time during the day & often during the night, I sleep with a wedge pillow to keep my upper body slightly elevated. A friend who also has hashimotos thinks it could be low stomach acid but the doctor does not think this is possible. Sorry this is rather long winded but I am now at a complete loss of what to do next. Has anyone had a similar experience to mime?
Hashimotos, Hiatus Hernia & acid reflux - Thyroid UK
Hashimotos, Hiatus Hernia & acid reflux
There is a simple way to check for low stomach acid and it is charmingly called the burp test!
loveleafco.com/baking-soda-...
Now I don't know anything about hiatus hernia and I'm sure someone will shout if this is a sensible test to try with one, for some reason Dr's don't seem to believe in low stomach acid and give everyone PPi's without testing🤷♀️
Seem to remember my MIL was on PPi's and when I read the leaflet it says they should absolutely not be used long term? She's still on them and copious gaviscon which suggests to me it isn't what she needs!
Oh and the other bit that might be relevant is that wedge cushions can actually make things worse as they can create a crease in your middle which can squeeze your stomach and actually makes acid more likely to enter the throat, much better to put blocks under the legs at the head end of the bed and sleep on a slope, 4-6 inches and sleep on your left side to keep the esophagus at the highest point of your stomach and acid as low as possible🤗
PPi's also lower T4 uptake 😕
Thank you, quite right about the bed wedge, the first I bought was too much of a wedge & very firm. I share bed with dh we have compromised with low blocks under head of bed & a lower pillow wedge for me, it is an improvement but not all the time. Sleeping on left side is sometimes ok sometimes not. The reflux is very random.
I have read so much online about symptoms of hiatus hernia (acid reflux is a symptom) & about hypothyroidism as a cause of low stomach acid that I admit I find it all quite confusing but I do believe there is a connection. I also forgot to mention that since I was a teenager I have had IBS, interestingly first diagnosed as Spastic Colon, not nice but in my case a good description of symptoms. The more I read the more I think the whole lot is connected.
Doctors know absolutely nothing about low stomach acid. It's not mentioned on the NHS list of conditions.
But acid and alkali can have similar symptoms. Then the doctors go and prescribe PPIs in order to reduce your stomach acid...... Oh dear!
Here's a couple of links which may be helpful. Low stomach acid is called 'hypochlorhydria'.
drmyhill.co.uk/wiki/Hypochl...
healthline.com/health/hypoc...
I have a hiatus hernia. When it was diagnosed the hospital sent me details and a prescription for Omeprazole. I looked up Omeprazole online and decided that it wasn't for me.
Occasionally my hernia gets a bit uncomfortable, so the first thing I do is to loosen my bra, but better to get a looser bra. I found this article about bras for hiatus hernia. It's headed 'These 6 Bras Help to Stop Hiatal Hernia & Acid Reflux Pain'
brabbly.com/best-bra-for-ac...
It's not easy trying to buy a loose bra, but worth it.
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Thank you, lots of useful information here, as you can imagine I have trawled the internet for answers. I came across Dr. Myhill before & revisiting the website found lots more information that makes sense of the connection between Hashimotos & reflux from Hiatus Hernia. What she says about low stomach acid also makes sense.
I questioned my doctor several times about Omeprazole, she almost laughed when I mentioned low stomach acid. A bit sad.
Coincidentally I’ve also been looking for a comfy bra so that info has been useful too 🙂
Thank you, your post was very useful. I have both, a hiatus and reflux.
I had stopped wearing bras because they were tight even though they were the right size. Your video link was extremely useful so I have just treated my body to a set of Fruit of the Loom bras recommended on the video. x
I wish I could stop wearing bras, but my bust is too large! Not so long ago I went to a lingerie shop but couldn't persuade the lady in charge that there's no such thing as a correct size - especially for older ladies with large busts. The correct size is one that is comfortable!
Hi I did a food intolerance test and found I don't produce Pepsin, I too was on lamoperzole so stopped that & started using betaine HCL starting one with every meal, works a treat for me, although I need to be careful on brand as I found to my cost trying to stick with the one that works. Try a food dairy as mention gluten free has made a difference, dairy not but I don't eat a lot of it & plenty protein/veggies. Trail & error. All avenues are worth checking, good luck on your journey.
Thank you,
This is interesting. I have kept a food diary but nothing specific seems any better or worse for my acid reflux. I suspect I have low stomach acid rather than high. I am also trying Betaine HCL with protein meals. Would you mind if I ask where you had your intolerance tests done?
I have Hasimotos and also Barretts oesophagus which means the acid from stomach has changed the lining of the oesophagus which is potentially cancerous. I take Omeprazole to control acid but also have found a diet eliminating acidic foods such as coffee, animal fats etc has helped. Also when reflux is bad taking DGL liquorice root before meals helps enormously.
Hi. I don’t know if this helps, but I had a small hiatus hernia and Barrett’s Oesophagus and I very luckily got mine massaged down by an Osteopath. I’ve also had three gastroscopies since (with the last one on Tuesday last week) and it’s never come back. I’ve had to go back on a PPI called Rabeprazole for other reasons which for me is better than Omeprazole, Lansoprazole and Pantoprazole, but I also think the type 1&3 collagen and B vitamins may have also helped with the Barrett’s, along with diet choices. Hope this helps.
You might find this of some interest (I have posted it before, but not for months or years):
[Hiatus hernia and gastroesophageal reflux disease as a manifestation of a newly revealed hypothyroidism].
[Article in Russian]
Savina LV, Semenikhina TM, Korochanskaia NV, Klitinskaia IS, Iakovenko MS.
Abstract
The aim of the study was to reveal hypothyroidism (HT) in patients with hiatus hernia (HH), treated at Russian Centre of Functional Surgical Gastroenterology. The subjects were 64 women: 18--with HH and diffuse or diffuse nodular goiter, 36--with HH, and 10--without endocrine or somatic disease background. The examination included the evaluation of the thyroid and metabolic status, endoscopy, and 24-hour ph-metry. The results show that one of the early signs of HT is HH and gastroesophageal reflux disease. The latter in HT patients is associated with gastrointestinal motor-evacuatory disturbances rather than with acid exposition in the distal esophagus.
ncbi.nlm.nih.gov/pubmed/166...
Consequences of dysthyroidism on the digestive tract and viscera.
...
Esophagus and stomach
Severe hypothyroidism may lead to disturbances in esophageal peristalsis. When the proximal portion is involved, myxedema causes oropharyngeal dysphagia[53] while esophagitis and hiatal hernia occur when the distal esophagus is altered[22,54]. Esophageal motility disorders, reduced velocity and amplitude of esophageal peristalsis and a decrease in lower sphincter pressure all contribute to dysphagia[55]. Although it represents an extremely rare cause of dyspepsia, hypothyroidism should be investigated when all exploratory methods are negative[56]. A gastric myoelectrical study led by Gunsar et al[19] showed a positive correlation between dyspepsia and hypothyroid scores. Additionally, gastric dysmotility is significantly more frequent in hypothyroid patients and is a result of muscle edema and altered myoelectrical activity[57]. Despite a few contradictory results[58], the hypothyroid state seems to delay gastric emptying[19,59]. Phytobezoar due to hypothyroidism has also been reported[60]. Achlorhydria in hypothyroidism may be related to subnormal serum gastrin[61]. Finally, hypothyroidism is associated with a decrease in duodenal basal electrical rhythm[62].
...
europepmc.org/article/MED/1...
The above paper has been cited 33 times and some cites appear potentially relevant:
europepmc.org/search?query=...
Many thanks,
Just reading the articles above & they confirm my own thoughts. I said previously that as a teenager I was diagnosed with ‘spastic colon’ now referred to as IBS. Spastic colon described perfectly the feeling that peristalsis was not happening smoothly, difficult to describe it felt as if the bowel was clenched up. Apart from on/off gut pain constipation has been the main symptom with my IBS.
During my first pregnancy my gall bladder became inflamed, after I had my second child my gall bladder had to be removed. I think this also affected my digestion & IBS.
In my mid 30’s after a blood test I was told I’d be on Thyroxine replacement for life, at the time not much more than that was said! I now believe it to be Hashimotos. Over the years my thyroid blood tests have all read ok according to my GP practice. I have been also tested for gluten intolerance but it came back negative.
Because of all these issues I have always been careful of what foods I eat.
My questions now:
Would dessicated thyroid extract be a better alternative to Levothyroxine. Who would I see about this?
It appears that gut motility is reduced by both Hypothyroidism & possibly IBS. I have been trying to increase gut motility & improve digestion by taking bitters & occasionally Betaine HCL. However I am concerned about making the acid reflux worse. I have kept a food diary but it hasn’t pointed to anything specific. Who would I see about improving digestion & gut motility?
I ask this because the symptoms overlap & I do not know whether I should see an endocrinologist or a gastroenterologist. Both are expensive but right now I feel I need some help. The most helpful person so far has been a herbalist.
PS. I have had an online appointment with a gastroenterologist who in some ways was helpful but ultimately I felt he wanted to sell me an operation. Fundoplication does not appear to have a good long term outcome, as my hiatus hernia is apparently very small I would not think it beneficial.
Some people take to desiccated thyroid as duck to water - while others do not get on with it. Ideally, you would see a GP, then an endocrinologist. But, in truth, few ever get desiccated thyroid prescribe on the NHS. And I doubt anyone else in the entire NHS would ever prescribe desiccated thyroid.
I'm pretty unimpressed by what I know of gastroenterologists.
Maybe start by have a look round people like Tim Spector and Zoe? No-one is perfect but they get quite a lot of positive comments.
Have you seen your results? I wonder if you are optimised. My free t3 was always very low on Levothyroxine. I eventually switched to NDT (self sourced) and felt a lot better all round. My digestion isn’t perfect but is a lot better than it was on Levothyroxine.
It might be worth a go, but be warned, your GP will probably blame every last ailment you seek advice about on NDT which I find very annoying, especially after what I went through even getting a diagnosis from those stuffed dummies. All the suffering, then to feel utterly lousy on Levothyroxine and not even be offered combination therapy, when it was cheap and more available than it is now, despite saying I still felt dire. It was desperation that led me to NDT, thankfully it gave me my life back. I’m afraid I’m pretty jaundiced with the white coats’ attitude towards it. Had they diagnosed me in a timely manner my problems could have been greatly reduced. I’m lucky to have made a reasonable recovery on NDT after the state I degenerated into. As for their gold standard Levothyroxine - they can keep it!
Acid Reflux
acid reflux for years
Gastritis/severe acid reflux
Acid Reflux 
Low Stomach Acid
