Had gallbladder removed in September nit felt well since. Since December not sleeping have a sore burning tongue and at night dry mouth and eyes. Not been able to get to a gp no appointments. Take 100mcg levothyroxine, 29mg omeprazole, pre diabetic, raised cholesterol, no thyroid due to cancer. Anyone else experienced similar since a gallbladder removal.
Sore tounge dry mouth and eyes: Had gallbladder... - Thyroid UK
Sore tounge dry mouth and eyes
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punkabean
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Hey there again :
I'm not sure you read the last 2 replies from your previous post -
One question from someone else was -
Did you have RAI after the thyroidectomy for cancer - and I ask this again because I experienced similar symptoms years after RAI thyroid ablation for Graves back in 2005.
Otherwise the other reply was from me - so guess you can read that rather than me retyping everything I wrote.
You wrote last time you were having follow up blood tests at around 8 weeks for the endo you see and that s/he was talking of a trial of T3 - so can you please share with forum members these blood test results and ranges - and what happened and what are you now taking ?
It is essential that we see some blood test results showing a TSH + Free T3 and Free T4 reading and range - so to try and understand your situation better -
Some people can't tolerate some brands of Levothyroxine - could this be a problem for you ?
Some people simply can't tolerate T4 tablets at all - but are ok if taken T4 in liquid form :
Others can't tolerate T4 at all and need to take T3 only.
Whilst others feel improved taking Natural Desiccated Thyroid and which is the original treatment option for hypothyroidism and derived from pig thyroids, dried and ground into a powder, medically graded and then made up into tablets referred to as grains and the original treatment for hypothyroidism used successfully for over 100 years by thousands of patients.
Whatever eye drops, ointments and lotions you use to ease this discomfort please ensure all are preservative free - even those prescribed.
There are heavier duty small tubes of a vaseline type grease that is best used last thing at night for overnight protection as your vision will be blurred.
The raised cholesterol and pre-diabetic symptoms may well sort themselves out once you are optimally medicated for hypothyroidism.
nhs.uk/conditions/underacti...
Omeprazole can cause many symptoms some of which are a sore red tongue, mouth ulcers, low B12 level and so it goes on - is there an alternative that is less damaging to the body and do you take this well away from your T4 medication ?
Not had results of bloods still waiting for hospital appointment.
You are legally entitled to copies of test results and ranges.
Was testing early morning, ideally before 9am, only drinking water between waking and test and last dose Levo 24 hours before test
Exactly what vitamin supplements are you taking
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 if last test result serum B12 was below 500 or active B12 (private test) under 70
Not taking any supplements only levothyroxine and omeprazole
are you taking omeprazole as far away from Levo as possible
Have you tried weening slowly off omeprazole. Can be extremely difficult
So extremely likely to have
Low magnesium
Low B12
Possibly low iron
as result of omeprazole
U.K. government recommends everyone supplement vitamin D at least October to end of April and “at risk” groups supplement continuously
all thyroid patients tend to need higher vitamin D than average person and need vitamin D all year
Test folate, B12 and ferritin at least annually
Test vitamin D twice year when supplementing
vitamin D
NHS Guidelines on dose vitamin D required
panmerseyapc.nhs.uk/media/2...
GP will often only prescribe to bring vitamin D levels to 50nmol.
Some areas will prescribe to bring levels to 75nmol or even 80nmol
leedsformulary.nhs.uk/docs/...
GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)
mm.wirral.nhs.uk/document_u...
But improving to around 80nmol or 100nmol by self supplementing may be better
pubmed.ncbi.nlm.nih.gov/218...
vitamindsociety.org/pdf/Vit...
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Test twice yearly when supplementing
Can test via NHS private testing service
Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.
There’s a version made that also contains vitamin K2 Mk7.
One spray = 1000iu
amazon.co.uk/BetterYou-Dlux...
It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average
Web links about taking important cofactors - magnesium and Vit K2-MK7
Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine
betterbones.com/bone-nutrit...
medicalnewstoday.com/articl...
livescience.com/61866-magne...
sciencedaily.com/releases/2...
Recipe ideas
bbc.co.uk/food/articles/mag...
Interesting article by Dr Malcolm Kendrick on magnesium
drmalcolmkendrick.org/categ...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
B12 and folate
Sore tongue is typical low B12 symptom
Test BEFORE starting any B vitamins
Low B12 symptoms
b12deficiency.info/signs-an...
methyl-life.com/blogs/defic...
NICE guidelines on B12 and testing
healthunlocked.com/redirect...
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...
Great reply by @humanbean on B12 here
healthunlocked.com/thyroidu...
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 if last test result serum B12 was below 500 or active B12 (private test) under 70
Post discussing how biotin can affect test results
SlowDragonAmbassador
how long have you been taking Omeprazole (PPI)
Any PPI will lower vitamin levels often significantly
gov.uk/drug-safety-update/p...
pmc.ncbi.nlm.nih.gov/articl...
pharmacytimes.com/publicati...
PPI and increased risk T2 diabetes
gut.bmj.com/content/early/2...
Iron Deficiency and PPI
medpagetoday.com/resource-c...
futurity.org/anemia-proton-...
ESSENTIAL to test and maintain GOOD B12, folate, ferritin and vitamin D
What vitamin supplements are you taking
When were vitamin levels last tested
Please add most recent results
Which brand of levothyroxine are you taking
Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime
verywellhealth.com/best-tim...
markvanderpump.co.uk/blog/p...
markvanderpump.co.uk/blog/p...
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Post about Timings
healthunlocked.com/thyroidu...
Get FULL thyroid and vitamin testing
Ideally via GP ……but privately if they are unhelpful
Only do private testing early Monday or Tuesday morning.
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
Monitor My Health (NHS private 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...
Randox FULL thyroid test including both thyroid antibodies just £31
Test at home or in clinic
Also available via Amazon
randoxhealth.com/en-GB/at-h...
Taking Omeprazole for 6 years this all started after gallbladder removal. Also feel like I have a constant cold. Will try surgery again tomorrow
Print out articles re low vitamins levels as result of long term PPI use
Request GP test B12, folate, full iron panel including ferritin and Vitamin D
Thank you will ask. I am wondering if its how the omeprazole is now working due to lack gallbladder or I have become diabetic.
On levothyroxine it’s absolutely essential to maintain GOOD vitamin levels for good conversion of Ft4 (levothyroxine) to Ft3 (active hormone)
With low vitamin levels conversion will be poor
This results in lower Ft3
Low Ft3 results in low stomach acid and low vitamin levels
PPI lowers stomach acid further
Absolutely essential to test TSH, Ft4 and Ft3 together
Low Ft3 =hypo
Being hypo raises cholesterol and HBA1C
Come back with FULL thyroid and vitamin test results
Will do
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