Patients who have Hashimotos Thyroid disease often suffer with a number of Gastrointestinal problems. One of the most common problems we routinely see in patients is acid reflux. If you are like most people who suffer with acid reflux, you are most likely under the assumption that this pain in the middle of the chest, the burning, the belching, and the regurgitation and even the stomach bloating is all caused by excess acid in the stomach.
And, if this is what you have been told and led to believe….. (thanks to the millions of dollars pharmaceutical companies spend on TV ads and articles in your favorite magazine), then you are probably using antacids to treat this problem. In today’s video, I want to share with you some information that you have probably never heard about and this information could be a game changer and ….potentialy live changing for you.
I’m Dr Hagmeyer and I am the clinic director here at DrHagmeyer.com where we help patients from all over the world find answers and natural solutions to chronic health problems using lifestyle medicine.
Today’s video is going to cover a lot of information on the connection between Hashimotos thyroid disease and acid reflux.
Some Of The Topics in Today’s Video Will Include;
- The causes of acid reflux in patients with Thyroid disease/Hashimotos (when its not caused by too much acid)
- Problem with taking antacids, Proton pump inhibitors, acid blockers when you have Thyroid disease (especially when used for more than 3 or 4 months)
- I’ll explain why stomach acid is so critical to your health an your immune system as Hashimotos Thyroid patient. Next I’ll explain
- Why taking certain probiotics and enzymes, like Betaine HCL and Pepsin can be an absolute life changer for acid reflux sufferers. Ill also talk about
- Who needs to avoid taking enzymes such as betaine HCL and pepsin and WHY and finally… if you stay with me to the end….
Let’s jump into this and start making sense of all this.
Let’s obviously start with some of the real reasons, some of the real Root causes why each month, 60 million Americans suffer with acid reflux.
Potential Causes of Acid Reflux You Need To be Aware Of.
#1 H.Pylori and Acid Reflux-
H. pylori is the most common chronic bacterial infection in the stomach and affects more than 50 percent of the world’s population. H.pylori is more common in patients with Hashimotos and Hypothyroidism.
One of the biggest problem with H.pylori infection, is that an H. pylori bacteria can promote acid reflux by decreasing stomach acid. This bacterium is so smart that by producing an enzyme called urease, it shuts down your stomachs production of hydrochloric acid.
Now, most people think that acid reflux is caused by too much acid, but the truth is too little stomach acid causes acid reflux. Actually, not only can too little stomach acid production cause acid reflux, but if the PH of your gut leans towards alkalinity (like when you take acid blockers, antacids, etc) you can also develop acid reflux
#2 Thyroid Disease, Hashimotos disease and Acid Reflux
- people who have Hashimotos disease often have more flare ups when infected with H.pylori and other intestinal bacterium.
- We also know that people who have Hashimotos also tend to be at higher risk for other autoimmune disease such as Atrophic Gastritis, Pernicious Anemia and Celiac disease.
But here’s why stomach acid enzymes are so vital when you have thyroid disease……and (you may want to write this down)
Three Reasons Why Stomach Acid Enzymes Are So Vital.
- #1 Digestion- you can’t break down the protein you eat without stomach acid enzymes.
- #2 Stomach acid enzymes allow you absorb vital nutrients such as minerals and vitamins
- #3 Stomach acid enzymes sterilize the contents of the digestive tract and protecting you from harmful bacteria like H.pylori and parasites.
If you don’t break down dietary proteins, (because of low stomach acid enzymes) these undigested or partial digested proteins can cause damage to your small intestines- They can be one of the causes of a leaky gut.
The damage to the small intestines, allows these proteins to enter your blood stream and this is where a chain reaction or domino effect of inflammation, immune system activation, food allergies develop. This becomes a vicious cycle.
The undigested or “partially digested” dietary proteins damage the gut lining causing leakiness in the gut, the leaky gut allows the proteins to “leak” into the blood stream, this sets off inflammation and now you develop sensitivities to all kinds of foods and environmental chemicals.
Keep in mind, while you can take antacids and they can bring temporarily relief, they will also worsen your acid reflux problem long term, because they make your stomach environment more alkaline.
The stomach was never designed to be alkaline and when it becomes more alkaline, people with thyroid disease end up with all kinds of vitamin and mineral deficiencies.
One specific mineral especially important for immune function and when tissues have become inflamed is zinc. Zinc is incredibly important to the healing of the gastrointestinal lining and all other mucosal tissues for that matter.
Zinc has been shown to have antioxidant protection, it’s been shown to strengthen the intestinal mucosal defenses, it buffer gastric acid, it maintains healthy inflammatory- immune release, it speeds up the healing of injured, ulcerated tissues. When you take antacids and proton pump inhibitors for several months, you will end up with zinc deficiency.
This is also why when people use antacids and Proton pump inhibitors they have weaker bones and develop osteoporosis, they are at increased risk of food poisoning, they develop that leaky gut which I just mentioned, They develop Small Intestinal Bacterial Overgrowth, that I just talked about.
This is why Zinc is so important.
#3. Gluten Sensitivity And Acid Reflux
Another potential cause of your acid reflux when you have Hashimotos Thyroid disease is the protein found in wheat, rye, and barley better known as Gluten. Studies show a strong connection between gluten intolerance and Hashimoto’s hypothyroidism. If you have Hashimoto’s hypothyroidism, a strict gluten-free diet can help you manage the underlying immune component of the disease and this in turn can have far reaching effects on your acid reflux.
If you have thyroid disease and you still eat any of these gluten containing grains and you suffer with acid reflux, at some point I want you to read the article I wrote titled, “7 things you never knew about acid reflux, GERD and Gluten.” I will leave a link for this article in the YouTube description box. But let me just say this for the purpose of today’s video, gluten is a highly inflammatory protein.
Gluten has been shown to cause leaky gut, it has been shown to inflame the mucosal tissues, it flares up the immune system, it increases damage to your thyroid. All reasons why you should consider a gluten free anti-inflammatory diet.
You might remember earlier, where I said that people who have Hashimotos often have other autoimmune diseases- Celiac disease is very common among those who have Hashimotos.
But how does this relate to acid reflux? Let’s look at
This study here that found chronic acid reflux affected 30 percent of patients with celiac disease compared to less than 5 percent of those NOT diagnosed with celiac disease and
this study study found almost 40 percent of children with celiac disease suffer from esophagitis, inflammation of the esophagus that causes acid reflux and heartburn.
#4 Pernicious Anemia and Acid Reflux-
Now another cause of acid reflux, I want you to be aware of and this is #3 is Pernicious Anemia- and this is really important if you are that person who has acid reflux, bloating, and frequently have low B12 levels, you are always getting B12 shots to feel more energized… Now
I bring this up because just a few weeks ago, I ran some testing on a patient who has a long history of B12 deficiency, zinc deficiency, was always sick, always coming down with a cold- it turns out that she has pernicious anemia.
If you have never heard of Pernicious anemia, pernicious anemia occurs when the immune system attacks the cells in your gut called parietal cells. (This is an autoimmune disease seen in people with hashimotos)
Now. Parietal cells produce stomach acid (Hydrochloric acid) and if you immune system is destroying them, like we see in pernicious anemia, then those parietal cells are not producing hydrochloric acid. It also means
your gut is not acidic, food is not being digested and absorbed, your not absorbing vitamins and minerals and food and now because you are not propely digesting your food, some of the acid that is in your gut backwashes into the esophagus, and irritates delicate esophageal tissue.
So, if any of what I just told you sounds familiar- you have symptoms of acid reflux, you have Hashimotos disease, You have frequent low levels of B12, this is something you should discuss with your doctor.
Hopefully, your doctors won’t miss this like they did in the patient I just started working with. Being a good doctor requires being a good investigator and putting the pieces of persons health puzzle together!
Problem with Taking Antacids, Proton pump inhibitors, Acid blockers, When you have Thyroid and Hashimotos disease
There is another problem I want you to know about if you take proton pump inhibitors and antacids as it related to Thyroid disease.
Unfortunately, chronic use of proton pump inhibitors (PPIs) also disrupt a person’s microbiome. The gut microbiome plays a critical role in helping your body fight off intestinal infections, but it also a major area of importance when It comes to autoimmune diseases. 80% of our immune system is in your gut. Which means we can have a substantial impact on your autoimmune disease by improving gut health.
But if you are someone who is using PPI and other acid blocking medications the job of improving your immune system, stabilizing your immune system down just became more challenging.
Take a look at this study on the affects of Proton pump inhibitors on the Microbiome.
In this study that you see here, they took 211 people who were currently using Proton pump inhibitors, these people had stool samples done. Within your stool sample, there are all kinds of good bacteria- (Hopefully!) but a stool test essentially looks at the terrain and the health. In this group of people using PPI, what they found is that they had significantly higher counts of bacteria associated with disease, compared to people who did not take Proton pump inhibitors.
On stool sampling they found higher amount of bacteria such as Enterococcus, Streptococcus, Staphylococcus and E.coli as well as C.diff. As a Hashimotos thyroid patient, you do not want an over abundance of these bacteria. This is not helping your acid reflux and it is not helping your Hashimotos.
If we look at the conclusion of the study….
The differences between PPI users and non-users observed in this study are consistently associated with changes towards a less healthy gut microbiome. These differences are in line with known changes that predispose to C. difficile infections and can potentially explain the increased risk of enteric infections in PPI users. On a population level, the effects of PPI are more prominent than the effects of antibiotics or other commonly used drugs.
If you have a lot of GI problems, at some point in time, I recommend that you watch a video I did on the 10 most common intestinal and gut issues seen in patients with hashimotos and thyroid disease. Why taking certain enzymes, like betain HCL and Pepsin can be an absolute life changer for acid reflux sufferers.
So back to acid reflux what can you do, to improve this acid reflux when your acid reflux is caused by low stomach acid. One of the things you can start supplementing with is Betaine HCL and Pepsin.
What is Betaine HCl and Pepsin?
Betaine HCl and pepsin are naturally occurring components of gastric juice that help you break down large proteins into smaller amino acids. Essentially these enzymes Betaine HCL and Pepsin are like scissors- they take those big proteins and snip them into smaller proteins that are more easily digested. By the way this also helps if you have a leaky gut. Remember I said earlier that it is the large undigested proteins cause leaky gut, inflammation, food sensitivities, food allergies which progress to autoimmune disease. Betaine HCL and Pepsin is also important for proper absorption of calcium, B12, and iron and many other vitamin and minerals often deficient in people with Hypothyroidism
Let me share with you 5 ways Supplementing with Betaine HCL and Pepsin may help you.
- Better digestion and more stomach Acid– As you begin to digest your proteins better, those proteins are more efficiently broken down into amino acids. If you are a patient of mine, you know that I love looking at amino acid levels. Amino acids are your building blocks for hormones, for neurotransmitters, for the immune system for rebuilding and repairing DNA.
- Better digestion and more stomach Acid leads to more energy. means your body is not expending as much energy on the labor intensive process of digestion. Digestion requires lots of energy and if your body becomes more efficient at digestion- you have energy that can be better utilized in other areas.
- Better Digestion and more stomach Acid of proteins leads to healthier immune response to foods. If foods are not properly broken down they can be more immune reactive in a body that is already hypervigilant. People with Autoimmine diseases have immune systems that are often reacting to foods, reacting to tissues and reacting to environmental triggers.
- Better Digestion and more stomach acid means less bloating and less bloating reduces the chance of developing food cravings and SIBO or small intestinal bacterial overgrowth. SIBO is a big problem for people with Hypothyroidism and Hashimotos. One of the causes behind Small Intestinal Bacterial Overgrowth is the ileocecal valve. When you are bloated, your ileocecal valve stays open, this allows the bacteria in the large intestines to migrate up into the small intestines where bacteria don’t below.
- Better Digestion and more stomach acid can help with inflammation. Less systemic inflammation = Less pain ! Fibromyalgia and chronic pain is again very common in patients with Hashimotos and Hypothyroidism.
A common thread or one of the common puzzle pieces that we see in patients with chronic pain and Hashimotos autoimmune thyroid disease is systemic inflammation caused by a mutation in the MTHFR gene.
If we can reduce systemic inflammation, not only can we calm the immune system down we can reduce the damage to tissues. That’s what pain is, pain is the result of tissue damage.
You may remember earlier in the video, I spoke about the importance of why the gut needs to be acidic as it relates to absorption of B12 and zinc. I said that if we don’t have proper production of stomach acid we end up with B12, Zinc, Calcium, Magnesium deficiencies.
B12 and magnesium are very important when you are systemically inflamed.
One of the markers I often run in patients with Hashimotos and hypothyroidism, (because they are at an increased risk of coronary artery disease and strokes) is an inflammatory marker known as Homocysteine.
High levels of homocysteine or hyperhomocysteinemia is an independent risk factor for coronary artery disease, stroke, DVT, and for arterial and venous thromboembolism.
What does this have to do with stomach acid? It all comes back to what you are absorbing.
Stomach acid production is increased with supplemental Betaine HCL and Pepsin. This allows for better absorption of B12 which we know helps reduce homocysteine levels.
If you want more information on Understanding the Connection Between MTHFR Thyroid Disease and Heart Disease you can watch this video below.
Who Should Avoid Betaine HCL with Pepsin?
While there are some great benefits of supplementing with digestive enzymes such as Betaine HCL and Pepsin, what is good for one person is not good for everybody.
You should not take Betaine HCL and Pepsin if you have bleeding ulcers, peptic ulcers, if you have been diagnosed with gastritis, if you are currently using steroids, NSAIDS or proton pump inhibitors.
If you have any of these conditions I just mentioned, You should first talk to your treating doctor about using Betaine HCL and pepsin.
Now I realize that this video is getting just too long and rather than making another video, what I’m going to do is put a link in the description box in this video, on my “5 favorite strategies for improving acid reflux naturally.”
It will be a free download PDF file. You can print it up and implement some of those strategies.
So there you go! I hope you liked todays video, If you did be sure to comment below, I do try to respond to questions, make sure you subscribe to my Youtube channel
Also, If you have questions about working with me, or one of my nutritionists in my practice, whether you need help with implementing a certain diet or you are looking to dig deeper into the Root cause of your health problems with testing, visit my website and look for the start here button.
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Till Next time! I’m Dr Hagmeyer take care!