Acid Reflux, Stomach Acid and Hypothyroidism

Doctors put most thyroid patients with these problems on PPI medications such as Omeprazole, which are acid suppressors. If you have too much stomach acid, then this may help, but if you actually have low levels, it could make it worse or mask the problem.

Whether you have high or low stomach acid issues, you will likely benefit from exploring why exactly, before immediately going to acid suppressing medication.

Optimal Thyroid Levels 

Low thyroid hormone levels can be behind stomach acid complaints.

The first step you can take is to make sure your thyroid condition is optimally medicated. Whether you’re on T4-only meds like Levothyroxine or Synthroid, a T3 and T4 combo or NDT, you want to aim for optimal levels.

You may find that getting your thyroid levels optimised could well correct or improve not only your stomach issues, but a whole host of other health conditions and symptoms you have, too.

Diet

Eating too much sugar, fatty meals, tomatoes, spicy food, drinking alcohol or caffeine can worsen acid reflux or trigger it directly. So keep these in mind and trial whether any are contributing to yours.

Also, any disordered eating behaviours (such as skipping meals, ignoring hunger, eating a really low-calorie diet etc.) can also contribute to stomach issues. Some experience more reflux when they are not eating enough, or often enough (smaller snacks may work better than fewer, large meals). 

We can trial less sugar, removing gluten, dairy, reducing caffeine and alcohol, and figuring out if any food sensitivities are causing reflux with an elimination diet.

Learning how to balance your blood sugar and introducing gut-loving, helpful foods such as chia seeds, coconut oil, turmeric, cinnamon, flaxseed, hemp oil, oregano and garlic, all to support your gut health may also help.

Apple Cider Vinegar 

Apple cider vinegar is said to help raise low stomach acid also, and can help with digestion. However, you want to ensure you don’t actually have high stomach acid levels before taking it, as it can make things worse.

Adding a little to a morning drink is reported to be effective. My functional medicine practitioner had me take two tablespoons of apple cider vinegar in warm water with each meal (though using a straw as it can be damaging to teeth), until symptoms resolved, and it did help me digest food and have less issues with acid reflux and heartburn.

Iodine 

Checking for iodine deficiency and restoring any low levels may also improve stomach acid production as well. It’s not wise to guess if you have low iodine levels, as supplementing it when you don’t need it, can make your hypothyroid situation worse and it can be dangerous, especially for those with Hashimoto’s.

Gut Health

Some people also find that adding a probiotic to their health regimen helps, as it can help to balance out the good and bad bacteria. Anything that improves or aids gut health and function can certainly help with stomach complaints. More information on this is here.

Along the same kind of lines, a digestive enzyme or Betaine HCl and Pepsin can also help, as they aid the digestion process. However, you want to ensure you don’t actually have high stomach acid levels before taking it, as it can make things worse.

Going gluten-free can also be a good step for many thyroid patients’ gut health.

But it’s very important to address your gut completely if you have digestion issues or complaints. This includes your diet, Candida, any increased gut permeability, food sensitivities and infections (such as H-Pylori and SIBO). More information can be read in this article.

A UK test for Candida can be found here and a US test here.

Autoimmune Atrophic Gastritis

This condition occurs when your immune system attacks the cells of your stomach lining cells. It may also be referred to as autoimmune gastritis (AIG) or autoimmune metaplastic atrophic gastritis (AMAG).

When you already have one autoimmune disease (such as Hashimoto’s, which most people with hypothyroidism have), you are a lot more likely to develop another, including Autoimmune Atrophic Gastritis.

Tests used to check for this condition can include an Anti Parietal Cell Antibodies Test, Serum Gastrin Test, as well as tests for B12 and iron stores which can be very low with this condition.

This condition is quite rare, but people who those with thyroid disease are more likely to have it. You are also more at risk if you’re African-American or of northern European descent. AIG can increase your risk of stomach cancer.

Conclusion: Hope For No Reflux 

Many thyroid patients complain of stomach acid issues, and while some will experience too much and others too little stomach acid, symptoms can be very similar, so it’s important to confirm which you are experiencing.

Once you know, you can start implementing some changes to improve this, such as those mentioned in this article.

As you correct your stomach acid issues, the ability to absorb nutrients and minerals should also improve, as well as relief of acid reflux and heartburn. However, when coming off acid suppressing medications for example, make sure to do it with a doctor’s guidance, and wean off of them slowly to avoid nasty side effects.

Other causes for stomach acid and reflux problems may be a hiatal hernia, Zollinger–Ellison syndrome, stomach cancer and pregnancy. Not all cases of reflux disappear after pregnancy, and are thought to be due to the pressure of a larger uterus on the stomach during pregnancy weakening the lower oesophageal sphincter, which can continue past pregnancy. As always, please have your doctor rule all possible causes out.

Have you experienced reflux or other indigestion with your thyroid condition?

You can click on the hyperlinks in the above post to learn more and see references to information given.