Hi, there I am on 100mcg and 125mcg (alternate days). I also have silent reflux and was using omeprazole. It's a long story, but the omeprazole impacted on my thyroid because I was taking it first thing in the morning - when you normally are told to take levo. However I had to do this due to a severe gastric and gall bladder flare up in order to get it under control - have since had gall bladder removed. However i noticed my nails were so brittle, hair loss and extreme fatigue so I switched to taking the levo 1st thing and omeprazole later in day. Thyroid issues were resolved after about 2 months of my doing this and because I also stopped omeprazole as seemed to develop a bit of an allergy with it. But now silent reflux back and doctor said go back on omeprazole and when I raised the question of how this had impacted my thyroid she looked at me as if I was talking "double dutch", I found it so hard to explain to her that it had impacted and when I wasnt on it I was better - and although I now need to take something for my silent reflux I want to know how best to do this because these medicines act against each other. Anyone had similar issues? Help much appreciated as both conditions are so draining. Thanks so much.
Levo and Omeprazole: Hi, there I am on 100mcg and... - Thyroid UK
Levo and Omeprazole
hi
I have this particular T shirt, I got lucky with a well informed ENT.
Here is my post about it
healthunlocked.com/thyroidu...
My advice would be, eat main meal earlier, avoid fizzy drinks, optimise thyroid hormones (particularly FT3), raise head end of bed, take betaine with pepsin at mealtimes to raise acid.
I have older posts, including gross photo of my inflamed larynx 🤢
Hope this info helps, I agree the PPI is unlikely to help you 👍
Thank you for your very helpful advice its helpful to know its not just me... Just a question though how do you optimise thyroid hormones (FT3) - is there something I should be doing? Thanks
I would optimise by testing FT 4 and FT 3 regularly aim to be in top 25% of ranges for both. Adjusting Levo and Lio and or NDT very carefully one thing at a time and allowing 12 weeks between changes and testing again, monitoring symptoms. It’s a slow laborious process. But it really pays off.
You will need to seek advice from a functional health GP or a private endo if you want to try T3 or NDT as part of this process.
Also testing key vitamins B12, Folate, ferritin and D and posting results here asking for guidance to ensure you get to the optimal levels for everything and maintain those. Raising these can improve absorption of Levo too.
Diet - gluten, dairy, soy can affect absorption and leaky gut. Working in these (slowly remembering the one change at a time rule) can have quite remarkable results for some.
🌱
Thank you that's really useful. Just one other thing, what do you mean by a functional health GP?
As opposed to an allopathic NHS GP, the Functional Health ones are private doctors who work holistically for whole body health (not just 10 minutes 1 symptom) and can prescribe for you and you then get your prescription from a private pharmacy.
Acid reflux frequently result of low Ft3
Are your thyroid levels optimal
Ensure all vitamins are optimal for good conversion of Ft4 to Ft3
What vitamin supplements are you taking
if you absolutely have to take any PPi …..try
Taking Levo at bedtime
Thanks Slow Dragon - all useful comments. I dont take any vitamin supplements - I was tested for B12 deficiency but that was ok. Would a multi-vitamin be sufficient? Regarding my last thyroid tests June 2024 - T4 = 17.9 (10.5 to 21), the other test I assume is T3 but only says "TSH level" is 0.87 (0.35 to 5.5). Due to have another thyroid test 3/4 weeks and will be able to compare results as will have been on omeprazole for that period.
What was B12 result
You need to test vitamin D, folate and ferritin
no multivitamins never recommended on here
A) too low a dose to correct deficiency
B) cheap poorly absorbed ingredients
C) most contain iodine not recommended when on Levo as this contains all the iodine you need
D) usually contains iron not recommended unless had full iron panel test and deficient
Test vitamin levels at least annually
Many thyroid patients need to supplement vitamin D, vitamin B complex and separate magnesium continuously to maintain good levels
Thyroid
Free T4 (fT4) 17.9 pmol/L (10.5 - 21) 70.5%
was test done as recommended, early morning and last dose Levo 24 hours before test
Obviously need Ft3 tested
Rare for NHS to test Ft3 these days
Thousands of U.K. patients test privately
Yes test was done early morning and levo 24 hrs before. Is my test ok? Regarding the B12 it was 339 (211-911), Serum folate 7.49 (less than 42 considered deficient) and ferritin 87.1 (10-291).
So both B12 and folate are low
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
A week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Highly effective B12 drops
natureprovides.com/products...
Or
B12 sublingual lozenges
uk.iherb.com/pr/jarrow-form...
cytoplan.co.uk/shop-by-prod...
In-depth article on different forms of B12
perniciousanemia.org/b12/fo...
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
healthunlocked.com/thyroidu...
perniciousanemia.org/b12/le...
And why aiming to keep B12 over 500 recommended
perniciousanemia.org/b12/le...
Low folate
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
healthline.com/nutrition/fo...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements
thyroidpharmacist.com/artic...
B vitamins best taken after breakfast
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week
Post discussing different B complex
healthunlocked.com/thyroidu...
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
Was just wondering how you get tested privately?
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
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...
Link about Hashimoto’s
thyroiduk.org/hypothyroid-b...
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
Monitor My Health (private NHS test service) 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...
Just TSH, Ft4 and Ft3 test - £32
monitormyhealth.org.uk/thyr...
10% off code here
thyroiduk.org/testing/priva...
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)
If you told her that omeprazole impacted your thyroid I'm not surprised she looked at you strangely because if you're taking thyroid hormone replacement, the thyroid itself is pretty much out of the loop. What it did was affect absorption of your levo. Which is to be expected because it lowers stomach acid so nothing much gets absorped - especially as hypos tend to have low stomach acid anyway. But doctors don't believe this and tend to think that any stomach problems are due to high stomach acid, hence the PPI. The symptoms are the same.
As Regenallotment says, what you need to try is raising your stomach acid so that your food gets digest and doesn't sit in the pit of your stomach festering and erupting like a volcano causing your reflux. 
Thanks for your response. I am totally confused as I've been told over and over by GP that the acid is causing gastro problems (recent colonscopy showed erosion), and that the acid needs to be kept under control so you can see why I am not keen to increase the acid. Feel like I am in a loop and just dont know what to do for the best. Meanwhile my tongue and mouth is swelling and burning and eating any type of food just makes it worse. Exasperated.
sorry meant to say endoscopy..
Yes, he would tell you that. Doctors refuse to admit that low stomach acid can be a thing. But the erosion is not caused by the quantity of acid, but by the way it behaves. When you don't have enough acid to digest your food, that food sits in the pit of your stomach and ferments. That causes volcanic-like eruptions that shoot what little acid there is up into the oesophagus causing the erosion.
I had the same problem. Omeprazole really didn’t suit me and made my hands and feet swell terribly. I stopped taking it and put up with the symptoms until I had an endoscopy and was told I had far too much stomach acid sloshing about. I started taking famotidine in the morning and levo at night and this seems to be working for me although it took a month to start working. Good luck, I feel your pain
Thank you - that sounds just like my issues as I had endoscopy too and was on 40mcg of omeprazole. Its a nightmare to get what you need and like you say you have to put up with the symptoms until you get there. Thanks for sharing your experience as at least I know that this is an issue.
I was told that I shouldn't take Omeprazole at all, but am prescribed Rabiprozole (spelling probably incorrect!). The only problem is that sometimes this is unavailable and the pharmacy has to find something else.
Trying to be helpful - not critical!
Rabeprazole
Brand name: Pariet.
Thank you - yes I will bear those alternatives in mind for next appointment. cheers.
I take my omeprazole later in the day too but what I did start to take was kefir every morning. I leave it an hour after taking my T4 and T3, it’s helped me reduce my omeprazole, I used to take 40mg and I’m now on 20mg. It may be worth a try .
Thank you - worth a try with kefir. Do you take different tablets as you refer to T4 and T3 but I only take one which I am told cover boths?
Yes I take levothyroxine (T4)and liothyronine (T3)
Just out of interest why the split of tablets.
I wasn’t converting well so my private endo put me on T3 to trial. Levothyroxine is not always a one size fits all unfortunately.
Hi have you looked into taking alternative 'remedies'? Several suggest taking a tsp of apple cider vinegar in water a little time before consuming each meal. (Is it OK admins to mention info/vids by Dr Berg? Also an Australian woman Dr Barbara...both are great for 'getting to the bottom' of conditions & offering more 'natural' solutions)
Dr. Eric Berg DC is not a medical doctor. He is a chiropractor. Dr. Berg and Dr. Berg Nutritionals do not diagnose or treat any medical illness or condition.
His website is, basically, an advert for subscriptions to premium memberships, an advert for their shop, a push to get your email address so they can email their sales information to you, etc.
[Barbara O'neill] is dedicated to assisting people find the optimum life, free from sickness, through natural means.
Our mantra is that the body was designed to heal itself and will do so given the right conditions.
We have a large focus on the 9 Laws of Health (Fresh Air, Sunshine, Pure Water, Exercise, Temperance, Good Diet, Rest, Trust in Divine Power, and Moderation) and it is our aim to equip people with all the tools they need to leave Misty and continue living a healthy life - free from sickness.
Again, a website largely dedicated to sales. With a strong religious aspect.
Thank you.
I was told by GP to take Omeprazole 4 hours away from Levothyroxine. If Omeprazole doesn’t suit you there are other PPI’s they can prescribe, the ones listed below are taken from the NHS website as similar to Omeprazole, maybe one of these may suit you.
Maybe a good idea to discuss these with your doctor. I hope you find one that is right for you and you feel better soon.
There are 4 other medicines that are similar to omeprazole. They are:
lansoprazole
esomeprazole
pantoprazole
rabeprazole
Thank you will mention these alternatives at next appointment. I do try and space the levo and omeprazole out, but GP says no point as omeprazole is in the system for 24hrs etc etc, so whenever you take the levo it may conflict. I like you, feel its better to space them out - as everybody's bodies work differently surely!! Thanks you.
I think the issue is to allow the absorption in the stomach of the levothyroxine before the initial Omeprazole hit. Omeprazole is said to last for 24 hours but then again some people have to take them twice a day so go figure.
So true its complex
If it’s in the system for 24hrs, why take twice a day, which is what I used to do, one in the morning and one in the evening?
I had reflux long before I was diagnosed with thyroid issues. My doctor kept giving me a higher dose of Omeprazole but my symptoms just got worse. I stopped taking it altogether and just watched my diet. Like someone else said - cut out fizzy drinks - my downfall was fizzy water - I thought I was doing a good thing by drinking more!! I also found that oranges, tomatoes, chocolate were also big culprits. I lived on rennies and gaviscon for quite some time but gradually it healed itself and now I only have a problem if I eat something that I shouldn't. As others have stated when you have problems with your thyroid you are more likely to have low stomach acid not too much and the Omeprazole is making things worse. I am not advising anything but just telling you my story. Hope it helps in some small way.
Thank you - its very interesting what you say. Shame they cant actually test for the acid! THey seem to make assumptions. My diet is good, but always room for improvement - but more recently I have had to cut out tomatoes, and citrus fruit, coffee is an absolute no no and looks like tea is not great either. I think when you get a flare up everything is an issue tbf. Interestingly I dont have an issue with cheese although it can be a bit fatty. What is so confusing is that I had stopped taking the omeprazole for a few months and then had this flare up out of the blue - so I'm guessing its food related that has triggered this. Nightmare. Thank you for sharing.
They CAN test for stomach acid:
Medical tests to diagnose stomach acid include:
The Heidelberg pH test. For this test, you’ll swallow a small capsule with a radio transmitter that measures the pH levels in your stomach. After taking a baseline measurement, you’ll drink a baking soda solution to neutralize your stomach acid. Then the test measures how long it takes your stomach to return to baseline acid levels. This tells healthcare providers how well your stomach produces and secretes acid.
The SmartPill test. The SmartPill is another wireless transmitter that you swallow. Unlike the Heidelberg test, which measures pH levels, the SmartPill measures gastric acid levels.
The gastric string test. This test involves swallowing a capsule attached to a string, then pulling it out by the string after 10 minutes. The string is tested with pH paper. Normal stomach acid has a pH level of one to two, which is highly acidic, with zero being the most acidic level on the scale. If you have hypochlorhydria, your stomach acid might be more in the range of three to five. Above five is a severe condition called achlorhydria, which means you have virtually no hydrochloric acid.
my.clevelandclinic.org/heal...
It is a matter of a) realising it is something that should be done; b) knowing how to do it; c) having the resources - staff and necessary devices. Followed by appreciating what is to be done!
Thanks Helvella, thats good to know - I'll mention to GP but I'm guessing its something you do privately - but if you know what your stomach acid is makes sense in terms of how best to diagnose issues.
I'm not sure what options there are in the UK - and via NHS.
Just wanted to make it clear that there are technical possibilities. Hence, not doing so is not actually due to the technology not existing.
Got it. thanks.
Hi there!
Just wanted to pop in here and say that there are ways to work to improve reflux over time involving diet (as people have mentioned above) and also herbs...
So for example, things like marshmallow root (in combo with other herbs) can be really helpful and for many, working with bitters (starting very very slowly) can help enormously too - however, I would always recommend talking to a medical herbalist as every single person is different and may need different treatment and different herb protocols. If you google 'medical herbalist' in your area you'll find one. Bear in mind that just like doctors some herbalists are better than others, or some may have a biomedical leaning whilst others may be a bit more...lets say 'woo'. They can be extremely helpful in supporting all kinds of health concerns alongside conventional treatment. The disclaimer here is that I am biased as I'm in the middle of my 5yr medical herbalist training!
Thank you for the info. Good to know.
Omeprazole
HASHIMOTIOS and SULENT REFLUX
Stomach and back pain n nausea
