Thyroid UK
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Stomach acid and heartburn / indigestion

Can anyone help. My GP knows of underactive thyroid and the medication for it but hasn't carried out any of the blood tests I see mentioned on this site and nor does she seem to connect any of my symptoms I suffer with my thyroid problem. I've been having terrible acid / heartburn in my stomach, chest and throat. The doc treated me with omiprazol which is an antacid for acid reflux but from searching the internet the more likely cause is lack of stomach acid which is common with an underactive thyroid which also is what appears to be causing my recent food intolerances. The discomfort on a night from not being able to sleep lying down and the sleep deprevation is getting me down. Can anyone tell me what medication I should be asking her to prescribe me?

21 Replies

Have you had tests for thyroid function yet? Are you already on thyroid medication ?

If not then this would be the first thing to ask for. Whether the labs run all the tests (TSH, FT4, T3) is usually up to the labs whether the GP requests them or not, but the TSH is is the standard base test. Its not really a question of asking for meds its asking for the correct tests to be done first. Once they have been done, you can then move forward with treatment, or other tests which may be required (usually ferritins, foliates B12 and vit D)

Always get a copy of your test results if you can too, if you can post them (with ranges), others may be able to offer advice (non medical) as to what to try next.

A lot of fillers in modern medication can cause indigestion and stomach problems, and most food intolerances can be gotten round by finding out what upsets you and eliminating it from your diet. It can be a slow process working out what you can and cant eat, but worth it in the end.


The medication or low acid is betaine hcl. We use the lamberts one available on eBay, About £10 for a huge tub full, but I noticed that boots do one called digestion aid, in the alternative medicines section. It had 230 mcg of betaine hcl in it.

You are probably correct in assuming it is low rather than high acid which is the problem. The test is to ate a small glass of tepid water, with a teaspoon of bicarbonate of soda in it first thing in the morning, before anything else.

If you burp quickly you are ok, More than a few minutes or not at all then low acid.

Xx. G


Healthmonthly is the cheapest source I have found online, (Swanson brand)... Lamberts is only half the strength, so effectively MUCH more expensive! Delivery not the fastest delivery though :-(

My partner became severely malnourished after 3.5 years on Omeprazole and Ranitidine to the point of heart palpitations and severe weight loss! It wasn't HIGH stomach acid, it was LOW, as so many people find!

Lots of sites with info on how to start up with it... eg.


HI Galethea, really silly question, I tried your test this morning....sort of gurgled a bit but wouldn't call it a burp. It happened twice...but that's all. Does the betain take a while to kick in? do you need to build it up a bit. I took one last night with my dinner and still got indigestion. Thanks for your help

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Maybe one wasn't enough? Try two. I dont think it builds up.... Although my husband doesnt seem to need anywhere near as many as he used to. Obviously i have no idea of what strength you have bought, what does it say on the packet?

Xx. g


Thanks G! I am taking the below

Betaine Hydrochloride: 324mg Pepsin: 5mg

It says 3 tablets a day. I have low B12 and ferritin (bottom of range) etc and so it all ties in with low acid but I a sort of afraid of taking them in case I actually have high acid and I burn my stomach. :(

hard to know what to do for the best...




When my hubby too them for the first time, we had a pint of milk ready to netralise any acid if there was too much..... have never needed it though. 😀. There are accounts of people taking many more than three per day... Apparantly you get a warm glow at the most.....

I only really take a couple if i have had a hard to digestst greasy meal, say an english fry up breakfast.

Think it depends on what you eat and how bad your low acid is.... Three a day is fairly conservative....

X. G

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Acid reflux at night is a typical symptom of thyroid hormone imbalance. Too little, or too much thyroid hormone can cause weakness of the eosophagal sphincter, allowing the back flow of stomach contents. I suffered with this for many years on and off before being diagnosed with hypothyroidism, and it resolved when I eventually became sensibly medicated. If this is the cause for you, then it may be that your dose of thyroid medication needs adjusting, rather than needing to address the actual acidity level of your stomach.

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22/08/12 free T4 level 9.3 pmol/l (9-24 U) and TSH level 51 mu/L (0.2-0.5 U) ABNORMAL

18/09/12 free T4 level 17.5 pmol/l (9-24 U) and TSH level 9.6 mu/L (0.2-0.5 U) ABNORMAL

31/10/12 free T4 level 20.8 pmol/l (9-24 U) and TSH level 3.3 mu/L (0.2-0.5 U) NORMAL

I'm currently on the smallest dose (50mg?) of Thyroxine I got so low and depressed in October that I was in such discomfort I didn't bother with the doctors anymore after I started reading on here about all the things the doctor wasn't doing or suggesting I gave up so I've had no more bloods done. Think I got depressed on here too with the fact it's a slow process and people seem to have suffered for years and I'm just starting tired and so low, hoped there might be something I can organise myself to ease the symptoms :(


TSH at 3.3 is still too high for most people on thyroid medication. Your dose should be enough to bring TSH down to 2 or below. Some people need TSH to be right at the bottom of the range.

I suspect you need to have your thyroxine increased to at least 75mcg, if not 100mcg. 50mcg is regarded as a 'starting dose'. Most people end up on at least 100mcg before they feel well.

I think you need to go back to your GP and request a dose increase to 75mcg, with a follow-up blood test after 4-6 weeks.

Do you have the BMA book 'Understanding Thyroid Disorders' by Anthony Toft? If not, you can get it from local pharmacies, and online. Here's a direct amazon link:

Take the book to your GP appointment and if the doctor is reluctant to increase your dose, show him/her this bit (on page 94 in my copy, but page number may have changed since):


I feel better when I am taking a higher dose of thyroxine than recommended by my doctor. Is this safe?

There is considerable debate about the correct dose of thyroxine. The consensus is that enough should be given to ensure that levels of T4 in the blood are at the upper limit of normal or slightly elevated and those of TSH at the lower limit of normal, or in some patients undetectable.



You could also print this PubMed abstract from a Russian paper, and take it to show your GP, to back up your argument that the acid reflux may be caused by the thyroid problem.

Hiatus hernia and gastroesophageal reflux disease as a manifestation of a newly revealed hypothyroidism


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.


I forgot to mention that whilst I was working up to the correct thyroid medication dose, I found that apple cider vinegar in water before bed helped tremendously. I took a teaspoonful of the vinegar diluted in a small amount of water each night. It seems to trigger the closing of the eosophagal sphincter.


I was also going to suggest you try Apple Cider Vinegar.

However, I would not personally use the stuff from a supermarket. BRAGGS Raw, Organic un pasteurized is the best.

Ebay is the cheapest, it last for Ages. I use 1 tbsp in a mug of hot water, flavoured with honey is the ACV is too sharp for you. (It is excellent to use for the absorption of iron taken along with Vit C if you are taking an iron supp?)

Yes eve time would be a good time to take it.




Whilst I agree that a significant number of people do find various improvements by using ACV, there is the possibility of the reverse. Some who try it find the acidity very unpleasant - and for anyone who is unsure, I'd suggest taking it very slowly. Maybe have some sodium bicarbonate available so you can neutralise the acid if needed? If nothing else, it helps in to have the reassurance that you can do something about it, if needed.

Also, try to make sure you rinse the ACV off your teeth to avoid any impact on the dental enamel.

Also wondering what is better about Braggs' than, say, Aspall's? Aside from anything else, you can go and get some right now. And is a lot less expensive. I often wonder about foods and supplements from ebay - I don't exactly trust that many ebay sellers, though some are good.


It's organic, secondly it's unpasterurised and unfiltered. You can google yourself why that is important.

It is available via some health food shops but is far less expensive via the supplier on Ebay which is why I but it there.

Like most things we take to help ourselves it makes a difference as to what is the source of the product and how it is processsed that makes the difference.



Let me try again:

Also wondering what is better in your opinion about Braggs' than, say, Aspall's (that is, Aspall's Organic Cyder Vinegar)?

Obviously both are organic. I appreciate that, for those to whom it matters, Bragg's claims kosher certification. I also understand that Aspall's is filtered whereas Bragg's is not.


I used Aspall's organic cyder vinegar. It worked just fine for me, is reasonably priced and easily available. I find the flavour good without any sweetener, but I don't have a sweet tooth. I'm still alive to tell the tale :D


I can't say I've tried the Aspalls, but I did try the Braggs but I didn't find that I got on particularly well with it. I have used the Gert Naturals Organic Apple Cider Vinegar with the 'Mother', Raw & Unfiltered (available from Amazon at £7.29 for 500ml) and that worked very well for me.


Interesting. It was a few years ago that I needed to use ACV, and I just grabbed what I found on the shelf of my local shop. I'm not sure I'd have been able to obtain anything else at the time, even if I'd known about the existence of a mother, raw & unfiltered version.

There is so much more info and availability of products on the net now than there was then. The Aspall's worked from day one for me and was a little life-saver at the time. When you're that ill, anything that helps with even just one horrid thyroid symptom is so very welcome, as I'm sure you know! I often wondered if I could actually have used ordinary malt vinegar and it would have done the job... but I'd never have been able to get it down my throat of course!


A very simple trick that really does help is to raise the head of your bed. You can use books, bricks or wood, anything that will keep your head and chest higher than your stomach by about 6" or so. Pillows under your head do not count. By raising your bed this way it stops much of the acid getting into your throat and makes for a more comfortable nights sleep. Hope you feel better soon, it is a miserable feeling.


I didn't realise this was so common. I have had a scan showing gallstones but declined surgery in Nov 2011. Diet seems to keep it at bay mostly but when I have a glitch Nutrigest from nutri seems to help - especially if I remember to take it half an hour before last meal of the day. Dr BDP recommended this a couple of years ago. I have also found lying with the pillow lengthways seems to give some relief. Have also tried Apple cider vinegar. Raising the bed head sounds a good idea.

Thanks all for the info here ! Good Luck Little Sam.


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