Thyroid disease does not solely affect the thyroid gland. Other organs that can be affected by thyroid disease include the heart, liver, and stomach. Your digestion and thyroid function are closely connected, so if one isn't functioning properly, the other may not either.
In the case of those with hypothyroidism or Hashimoto's, acid reflux or gastroparesis is often overlooked and not often associated with one another. However, studies have shown that the connection between the two is not unusual.
What is acid reflux?
Acid reflux, also known as heartburn, is a common condition, occurring in 20% of people in the US. Primarily felt in the lower chest area, those with heartburn experience a burning sensation, caused by stomach acid flowing back up into the esophagus (food pipe).
Gastroparesis is a related, albeit more severe, condition that affects the normal muscle functioning of the stomach. This usually causes symptoms like heartburn, nausea, vomiting, and feeling full very soon after eating. The term gastroparesis means "stomach paralysis" because the stomach is unable to contract normally and, therefore, cannot break down food properly to be sent to the small intestine. Weight loss is also common in those experiencing gastroparesis since nutrients and calories from food are not being ingested.
It's understood that hypothyroidism decreases gastroesophageal motility, causing symptoms of acid reflux. What's very interesting is research that suggests Hashimoto's patients who have autoimmune gastritis may require a higher dosage of Levothyroxine (a common thyroid hormone replacement medication) to balance thyroid-stimulating hormone (TSH).
Eighty percent of Levothyroxine itself is absorbed in the small intestine, in a part called the jejunum. Therefore if someone with hypothyroidism has digestive issues like acid reflux, their medication dosage should be addressed with their doctor.
If you experience symptoms of acid reflux or gastroparesis, it is important to communicate these symptoms with a trustworthy doctor or practitioner so that the root cause can be better understood.
How to decrease the effects of acid reflux
Avoid drinking liquids with meals
Our stomachs contain a strong acid that breaks down food into its proper nutrients for our body to then use for appropriate functioning. When we drink liquids (usually water) while we are eating, it dilutes the acid in our stomachs, making it more difficult for the stomach to do its job. The rule of thumb is to keep liquids at bay 20 minutes before and 20 minutes after eating, to allow the stomach to begin the digestion and churning process properly.
Eat slowly and chew your food thoroughly
Eat slowly by chewing your food thoroughly. Chewing your food helps it break down into smaller pieces which are easier to digest. Chewing stimulates saliva production, which is alkaline and may help neutralize acid that refluxes from the stomach.
Add acid to acid
Take 1-2 teaspoons of apple cider vinegar or lemon juice to a glass of water and drink it 20 minutes before eating. The acid found in the vinegar and lemon will help stimulate the stomach's production of hydrochloric acid.
Remove foods that trigger symptoms
Caffeine, alcohol, sugar, refined carbohydrates, and spicy foods are the most common foods asked to avoid when experiencing symptoms of acid reflux.
Avoid eating 2-3 hours before bed
Give yourself and your stomach enough time between your last meal of the day and bedtime. This break will give your stomach a chance to empty and help decrease the likelihood of acid reflux when you lay down. It also helps to elevate your head when sleeping.
A note from Paloma Health
We want you to feel at your absolute best. Our doctors will explore all possible treatments based on your hypothyroidism symptoms and history. They'll work with you closely to find the optimal medication and dosage for optimal thyroid function.