B12 deficiency and autoimmune gastritis

Thank you Rod for again furnishing me with your wisdom regarding B12 deficiency. I cant seem to reply direct for some reason as the comment section does not respond/is frozen. Anyhow you mention autoimmune gastritis which has alerted me somewhat, because for the last few months I have actually suffered with gastro/cramp-like pain in my upper sternum and sometimes around the back area which is associated with nausea, sometimes very severe. When I was unable to function nomally with this my GP prescribed me Omeprazole which helped, but since completing the course 3/4 weeks ago its gradually returning. My GP has stressed that these symptoms hve nothing to do with thyroidism, so I took her word for it and didnt research any further!! She says that I just have acid in my stomach. Its probably obvious but am I right to assume that this could be associated with AI Gastritis?

On another subject, does anyone know whether it is normal for me to feel SEVERELY ill with thyroid disease symptoms, WITH ONLY MILDLY ABNORMAL THYROID PROFILES?

Thanks in anticipation.

Shaz

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  • Shaz,

    No idea why you can't comment. You can try to use the Feedback 'tab' at the right of the screen to report problems like that.

    There is some evidence that some cases of acid reflux are caused not by excess acid (for which something like Omeprazole might be sensible) but by muscle issues which simply fail to close the lower oesophageal sphincter. Thus acid can flow upwards.

    An obscure Russian paper claims that hiatus hernia is a good predictor of hypothyroidism.

    Somewhere I found it suggested that *low* stomach acid actually contributes to the sphincter failing to close.

    I can't help thinking that having acid in your stomach is a) normal; b) desirable! And I bet your doctor didn't do anything to measure the acidity of your stomach - just asserted that it is acid (or excessively acid).

    May I suggest this link for starters on autoimmune gastritis:

    medscape.com/viewarticle/58...

    And this:

    emedicine.medscape.com/arti...

    On a slightly different tack, thyroid hormones are required by every cell of the body. So why ever should your stomach issues not be related to thyroid hormone levels? Or almost anything else?

    By the way, you mentioned before that you consume quite a bit of grapefruit juice. Just wanted to point out that there are very many interactions between grapefruit and various medicines - so do check for anything you are taking. You can do worse than look here:

    drugs.com/drug_interactions...

    Maybe someone else who has actually experienced feeling really bad with only slightly 'wrong' thyroid levels can actually post their views/experiences?

    Rod

  • Thank you all for your help again. Going to see my GP about the ?gastritis tomorrow and will keep you posted if thats okay.

    Re. Grapefruit juice - luckily im not on any meds ?yet? - still trying to convince Endo doc that I have a thyriod problem!!

    On another note 'again' would you mind casting an eye over my latest results and telling me what you think, baring in mind that I have most of the symptoms of thyroid disease and an x-ray confirmed goitre.

    April 2010 TPO 115 (0-40)> Treatment apparently not clinically indicated.

    June 2010:

    TT4 120 (58-154)

    TSH 0.595 (0.4-4.0)

    FTT4 17.5 (10-22)

    FT3 6.05 (2.8-6.5)

    FT4 ** 2.89 (3.0-5.0)

    Thyroglobulin ** 78.4 (0-40)

    Peroxidaes (microsmal) ** 291 (0-35).

    Sorry if im being too much of a pain, but there are so many conflicting issues surroundng the way ive been feeling, about which ive either been confused or made to feel crazy, and your support has given me an enormous amount of comfort and relief. Thank you.

    Shaz

  • Shaz,

    Your FT3 is towards the top end, your FT4 just below bottom end.

    One of the classic phases is exactly that - with a thyroid struggling to produce enough T4, the FT3 levels go up (seemingly to try to keep you going), which keeps the TSH down, and you feel bad.

    Further, the antibody levels seem to confirm that your thyroid is being attacked.

    So it looks to me as if you might have a problem. Below you will find three quotes (and links) taken from the very orthodox (and enormous) Thyroid Manager site.

    "Co-occurrence of Autoimmune Diseases

    The co-existence of AITD and other diseases possibly of autoimmune cause has often been reported, and suggests some intrinsic abnormality in immune regulation. An extensive review of these associations has recently been published (277). A striking association is with pernicious anemia. Perhaps 45% of patients with autoimmune thyroiditis have circulating antigastric antibodies (278), and the reverse association is almost as strong (279). Up to 14% of patients with pernicious anemia have primary myxedema, and pernicious anemia is increased in prevalence in patients with hypothyroidism (280). Another strong association is with celiac disease, which is found 3 times more commonly in patients with AITD. Intriguingly the autoantibodies which are the hallmark of celiac disease, directed against transglutaminase, can bind to thyroid cells and thus could be implicated directly in thyroid disease pathogenesis (280a). The association of Sjogren's syndrome and thyroiditis is not uncommon and both systemic lupus erythematosus (SLE) and rheumatoid arthritis are also significantly associated with AITD (281, 282). A high frequency of antibodies to nucleus, smooth muscle, and single-stranded DNA (26-36%) is found in AITD (283).

    Autoimmune Addison's disease and/or type I diabetes mellitus and AITD occasionally co-exist and this forms the autoimmune polyglandular syndrome (APS) type 2 (284). This is an autosomal dominant disorder with incomplete penetrance and is often associated with other disorders, such as vitiligo, celiac disease, myasthenia gravis, premature ovarian failure and chronic active hepatitis (285, 286). AITD is an infrequent feature of the much rarer APS type I (287) and there is no association between mutations in the AIRE gene, which causes APS type I, and sporadic AITD (288)."

    thyroidmanager.org/Chapter7...

    "Diagnosis is made by the finding of a diffuse, smooth, firm goiter in a young woman, with strongly positive titers of TG Ab and/or TPO Ab and a euthyroid or hypothyroid metabolic status."

    thyroidmanager.org/Chapter8...

    "GRADES OF HYPOTHYROIDISM

    Hypothyroidism is a graded phenomenon, ranging from very mild cases in which biochemical abnormalities are present but the individual hardly notices symptoms and signs of thyroid hormone deficiency, to very severe cases in which the danger exists to slide down into a life-threatening myxedema coma. In the development of primary hypothyroidism, the transition from the euthyroid to the hypothyroid state is first detected by a slightly elevated serum TSH, caused by a minor decrease in thyroidal secretion of T4 which doesn't give rise to subnormal serum T4 concentrations. The reason for maintaining T4 values within the reference range is the exquisite sensitivity of the pituitary thyrotroph for even very small decreases of serum T4, as exemplified by the log-linear relationship between serum TSH and serum FT4 1. A further decline in T4 secretion results in serum T4 values below the lower normal limit and even higher TSH values, but serum T3 concentrations remain within the reference range. It is only in the last stage that subnormal serum T3 concentrations are found, when serum T4 has fallen to really very low values associated with markedly elevated serum TSH concentrations (Figure 9-1). Hypothyroidism is thus a graded phenomenon, in which the first stage of subclinical hypothyroidism may progress via mild hypothyroidism towards overt hypothyroidism (Table 9-1)3."

    thyroidmanager.org/Chapter9...

    All the best

    Rod

  • Hi again. Thanks for your suggestions on my test results below. Unfortunately ive just heard back from my Endocrinologist, who has (surprise surprise) dismissed them as practically normal, though he does admit that I may be at risk of going into hypothyroidism!!!

    Fortunately my GP agrees with your comments :-) and has referred me on to another specialist. Fingers crossed.

    On overlooking the interpretation guidelines on my results though, they mention 'consideration of a heavy metal body burden in people with low TSH (that is unresponsive to treatment). Although I am not on medication this actually caught my eye because for a long while now Ive been wearing retainers. Would I be right to assume that this ?could? be a signficant factor in the recurrence of my symptoms?

    Thanks again,

    Sharon

  • SORRY TO HEAR YOUR PROBLEM ,I AM HYPO THYROID AND HAVE HAD GASTRITIS AND URTICARIA SINCE SEPT,READ THAT IT MAY BE CONNECTED TO THE HELICOBACTO PYLORI PROBLEM ,ASKED FOR TEST WHICH CAME BACK POSITVE,HAVE HAD MASSIVE DOSES OF ANTI BIOTICS AM NOW WAITING FOR RESULTS TO SEE IF THE HELICOBACTOR HAS BEEN ERRADICATED, PERHAPS ASK FOR B/TEST TO SEE IF THIS COULD BE YOUR PROBLEM, GOODLUCK . GEMINI.

  • "does anyone know whether it is normal for me to feel SEVERELY ill with thyroid disease symptoms, WITH ONLY MILDLY ABNORMAL THYROID PROFILES?"

    When it comes to thyroid issues, it seems there is no such thing as normal - something that most GPs just don't understand. Everyone is different. I have certainly heard many times that some people feel very ill indeed with supposedly 'normal' or mildly borderline test results, whereas others plod on for years without even realising they have a problem and it only gets picked up accidentally when testing for something else entirely.

    In a previous message you mention having high thyroid antibodies. That may be worth pursuing, because a positive antibody test together with borderline TSH etc. could warrant at least a trial of thyroid treatment 'to see if it helps'. If your present GP won't co-operate, maybe you could consider changing to a different one?

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