Acid blockers, digestion, and elimination. Episode 8.

Terrible heart burn !!What helps? Has anybody had any issues with Omeprazole or any acid reducer.

OMEPRAZOLE: aka Losec, Prilosec, Prilosec OTC and Zegerid

classified therapeutically as antiulcer agent and pharmacologically as a proton-pump inhibitor

Used for maintenance of healing in erosive esophagitis, duodenal ulcers with or without H.Pylori. Short term treatment of active benign gastric ulcer. The OTC or over the counter is for heart burn occurring more than or equal to 2x a week. 

What does it do?  it binds to an enzyme on gastric parietal cells in the presence of stomach acid. It diminishes the accumulation of acid in the gastric lumen with lessened gastroesophageal reflux and helps heal duodenal ulcers. 

Binds 95% of protein and is metabolized by the liver with a half life of 30 min to an hour. Half life means how long it takes for half of a medication to be eliminated from the blood stream.  

It says to use cautiously in liver disease, in geriatric patients due to increased risk of hip fractures in patients on high doses for longer than one year and in pregnancy, lactation or children. 

Acid blockers like the ones mentioned and also things like mylanta, maalox, tums alka-seltzer, tagamet, pepcid, zantac etc all will lessen the amount of stomach acid you have in your stomach. So how will you break down your food? That is what it is there for.  The acid blockers change the pH of your stomach which is supposed to be very acidic at around 3 I think. This low pH is how we break down our food, especially protein. Protein gets broken down in to amino acids which become neurotransmitter. Stomach acid breaks down our food so we can extract the nutrients we need from it. 

Low stomach acid, which happens naturally as we age and most of us with hypothyroidism don’t make enough of it can lead to anemia, candida, fatigue, constipation/diarrhea, tooth decay, hair loss, and a higher risk of developing food sensitivities. 

So you have less acid when you take an acid blocker but you also have a deficiency of good bacteria, calcium, coq10, folate, glutathione, iron, magnesium, melatonin, niacin, potassium, B vitamins, selenium, vitamin A, C, D and zinc. 

Hypothyroidism can lead to hypochlorhydria or too little stomach acid. This is what often causes acid reflux. When food is not digested well by the acid in your stomach it will putrefy, ferment and become rancid in the stomach. Our small intestine doesn’t like to let undigested or poorly digested food from the stomach enter there so it backs up in to the esophagus, irritating the tissue there and causing heart burn. 

Coffee and nicotine reduce the pressure on the esophageal sphincter so you end up with more reflux.

The food is not as acidic as it should be it doesn’t stimulate the gallbladder to secrete bile to emulsify fat and the pancreas doesn’t get signaled to release digestive enzymes to further digest the food. So you have this rotting food moving through the intestines which will eventually cause inflammation, maybe even an infection and likely leaky gut or intestinal permeability. 

The fat in the food isn’t being broken down by bile from the gallbladder so your cells are not getting any minerals. Zinc is a mineral which helps us produce enough stomach acid. Having hypothyroidism messes with our gallbladder function and it can cause it to become sluggish and it won’t release enough bile. Combine that with the SAD and you have the perfect storm for gallbladder attacks.  When the gallbladder isn’t working well, the liver also becomes sluggish and backed up so it can’t detoxify our hormones, toxins or other things. 

So as you can see, having less than good digestion is a real big problem for those of us with sluggish thyroids. Along with zinc, we end up depleted in tyrosine, selenium and vitamin A and D. When it is not working well it plays a role in autoimmune disease as well. Perfect. Look at all we have going for us!  We have a large amount of our immune system in our gut- around 60-80%. If our digestive tract is out of wack, inflamed, or if we are dealing with parasites then our adrenal glands will end up depleted. This will make your thyroid sluggish as well. 

It just keeps getting better for us. 

Ideal elimination from the time you eat a meal to the time it leaves you in the form of a bowel movement is between 16-24 hours. This is slower with hypothyroidism.  Constipation is anything longer than what your normal elimination would be. You can end up with malabsorption issues and toxins  and hormones get recycled which add fuel to the fire. There is a good chance you will be growing more of the harmful bacteria putting your good guys at risk for being taken over by the bad guys. Remember that we convert some T4 to T3 in the gut but we won’t do that as well when there is an imbalance of bad to good bacteria. 20% of thyroid function relies on the right balance of bacteria. 

Another biggie mentioned briefly earlier is the elimination of hormones, particularly estrogen. I am not a hormone expert but I do know that poor digestion means you can end up with higher amounts of estrogen that can lead to hypothyroidism that doesn’t show up on a blood test. This information came from Why Do I Still Have Thyroid Symptoms from Datis Kharrazian. He says that “excess estrogen binds the thyroid transport proteins so that thyroid hormones cannot get to the cells to do their jobs, causing hypothyroidism symptoms”

There are a lot of things you can do to eliminate acid reflux and keep things moving along smoothly. 

Food sensitivities or allergies can cause reflux or silent reflux which often has a cough with it. 

Look at your diet. As per usual, gluten free, dairy free and an elimination diet are the first place to start.  Remove also, eggs, corn, soy and yeast. This will give your immune system a break. A chance to calm down and your gut can repair itself.  These foods should be eliminated for 3-4 weeks. The longer the better.  Typical food reactions can look like skin rashes, eczema, acne, fatigue, joint pain, bloating, gas, heartburn, constipation, diarrhea and even nasal congestion. You can have anxiety, irritability, headaches and more. 

Manage your blood sugar. 

Stress. Don’t eat when you are stressed, take a minute to calm down, sit at the table without a phone, book or anything else. Take a few deep breaths, say grace if you like or whatever. Then take a bite of your food and chew it really well. Like 20-30 times per bite. 

Don’t drink a lot of water and avoid anything bubbly with dinner. The phosphorus in pop can put you in to sympathetic or fight or flight which will automatically turn off stomach acid production. 

You can take digestive bitters about 20 minutes before dinner and if that is not enough you may need to supplement with stomach acid. Something called Betaine HCl. I like a product called Hydrozyme from Biotics Research. I recommend buying it from a practitioner, not off of Amazon. 

To find out how much you need you take a bite of food, chew it well, swallow it and then take an HCl supplement with a small amount of water. Take another bite of food, chew it well and take another pill. Keep doing this until you feel a little burn, kind of like heartburn or like you just took a shot of alcohol. If you felt the burn at 3 pills then you know you only need 2 at each meal. Eventually you can get enough healing of your body done that you will start to make more stomach acid and you won’t need to take as much of the supplement. 

You can check in on your digestion by keeping a food journal. Write down everything you eat and drink and how you feel afterward. Keep track of your bowel movements. Look at them. Do you see undigested food in your stools?  What shape are they?  You can google the Bristol Stool Chart and see where you are at and where you need to be. Your eliminations should be solid, about the length of your forearm from your elbow to your wrist. It should come out with no straining, you should not feel like your elimination wasn’t complete and you should not have much on the toilet paper after you wipe. 

If you want to test your transit time you can take some activated charcoal pills, like 5 of them or you can eat about a cup of beets, or take 2 tablespoons of sesame seeds. Take them first thing in the morning, don’t chew the seeds if you use them, just swallow them. You want to be able to see them when they come out.  Write down what time you take them and what day you take them. Then keep track of your bowel movements. Write down the first time you see the seeds, beets or charcoal (your stool will be black with charcoal and reddish with beets) and write down the last time you saw them in your stool. The difference between the time you swallowed them and the last time you saw them is your transit time. Remember we are looking for anywhere from 16-24 hours.  Also, ideally you might go two times a day. 

That is it for me today. If you have any questions about this episode or you would like to submit a question for the podcast, please feel free to leave a comment on my website, www.outofthewoodsnutrition.com or www.helpforhashimotos.com or email me at helpforhashimotos@gmail.com

You can find me on facebook at www.facebook.com/outofthewoodsnutrition or on instagram at stephanieewalsntp. 

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