Stomach always bloated and hard..food..thyroid..?

Question

Hi all,
I am 35yo female, athletic and normal weight. I used to have a very flat stomach, but for years now, I feel like I am always bloated. Nowadays, it feels like my stomach is constantly bloated and swollen, regardless of what and how much I ate or drank. 
Sometimes there is a bit of pain, but I have no serious cramping or problems with bowel movements. It is mostly just that bloated tight feeling that annoys me and also affects my confidence (cloths, overall feeling "fatter" than I am).

I was diagnosed with Hashimoto's in 2008 but cannot see a connection to my thyroid levels. I have adjusted my Thyroxin doses over the years, but no matter how the levels are, the bloating is always there.
I do have some classic allergies (pollen, apples, nuts etc), so I know I am prone and sensitive to allergies, but I have never been tested for classic food intolerances like lactose, fructose etc.
Should maybe be a start, right? It is just hard for me to pinpoint if a type of food causes bigger problems. I mostly use lactose free milk at home and if I don't eat dairy for a few days, I don't notice any changes.

I have a new doctor who works with homeopathic remedies as well and she looks at the bigger scale and explained to me that having Hashitmoto always means that the gut isn't ok (since immune system is mostly in the gut and all that). A stool analysis showed I had some bacterial imbalance and I have been taking probiotics for 3 months now, but still no change. 
She also suspects my liver needs some "detoxing" (not sure if I believe in this kind of thing) and now I am taking some enzymes and milk thistle.

My other issues/annoyances, which I think might be connected to gut health, are:
being cold easily (cold hands, feet), especially when sitting in the office, and trouble getting up in the morning. I am a night owl, but even with 8 hours of sleep, I find it hard to roll out of bed, at 7:30.
I do have a notoriously low ferritin leves, and even when I substitute orally, it barely goes up.
So the tiredness and feeling cold might be a symptom of low iron levels, which might in turn come from gut issues? 

Other than that, I am healthy, checked through and resilient. I exercise and have a demanding job I like.
But I really really wish I could get to the bottom of these stomach problems and what comes along with it.

Does anyone have any suggestions or advice? I had high hopes for the probiotic as it was obvious my gut is in an imbalance, but am bit disappointed that so far it doesn't seem to help.

Thank you!

martav · Answer

Sounds like what I have IBS, I hate it,at times my life is miserable

VJWW · Answer

squatting toilets instead of commodes.

TheLightSeeker · Answer

Sure!
It all connects and I'm disappointed that whoever ordered your gut flora profile did not follow-up, once the results where in.
  Besides healthy gut bacteria which use proteins and aminoacids in the gut, opportunistic harmful bacteria in the gut also do this, however, more so when proteins consumed are insufficiently digested, mainly due to low gastric acid, but often also due to low protease.
Low gastric acid is usually a pretty strong sign when bloating  and cramping There's usually a release of excessive ammonia as a waste product and the liver  works hard to turn it into a less toxic chemical called urea, which is eventually filtered out by the kidneys.
A BUN test (Blood Urea Nitrogen) will verify this.
The triad , I go by is: Hypochlorydia + High BUN + symptoms= 
Gut Dysbiosis.

Oh, BTW wheat is one of the most genetically modified foods on the planet.
Other than gluten and gliadin, look into fructans as a potential offender.

Cheers,
Niko

Ariannis · Answer

Ah ok, got it. Thanks for explaining, Paxiled.

I have been reading up on the Hypochlorhydria, lack of stomach acid. And while I don't want to be grasping a straws now, just to finally find a reason and solution for my problem(s), there are some things that do make sense to consider if I might be affected.

Apparently it is common in Hashimoto patients. It would explain my low iron levels that are not very responsive to oral substitutes. And it might also explain why the probiotics aren't working yet.
And the bloating, of course. Would also explain why cutting out on carbs, or even gluten didn't make a difference. I eat quite a lot of meat (organic if possible), and well..this doesn't sit well if there is not enough stomach acid to properly digest.

I have also taken a closer look again of the report of my gut flora analysis. It says for example that there is an increased protein breakdown...i didn't know what to do with that info at the time, but now I read that these bacteria can cause metabolites that aren't so good on the liver. as well as good old "decompostiton" gas. 

So for my non-medical view, it all kinda makes sense. But I really don't know if I am barking up the wrong tree now because it seems to be a fairly easy to manage thing > take Betaine HCL pills.

I also did the baking soda test this morning, which of course didn't work on me. Ha! But i know this is not bullet proof. 
Will do the Betain challenge as well though.

So maybe someone knows a bit more about these issues..?

Paxiled · Answer

The reason is that wheat isn't a natural food.  Like beef, it was completely invented by humans.  There are no wild cows, and no wild wheat.  It was hybridized from other grains way back when, and then continually hybridized over the years, but never for health reasons.  Most likely it's a cross between Egyptian kamut and Indian spelt, but who knows?  And most likely it was originally created because grains that were adapted from wild grains were very hard to get the husk off before modern technology came along.

Ariannis · Answer

Niko: 
Thank you for sharing this story, and I agree, a lot of doctors are good for a quick fix and know their textbook stuff, but complex individual problems..not so much. It is a lot to ask as well, with so many people and so many different conditions. And like in any field, there are good and bad ones. I always dream of finding my perfect personal doctor that knows my history and just knows me and can assist on physical and mental level- But who doesn't want that. Sounds great that you can use your knowledge  and skill in a non-pressure useful way!

Paxiled: 
Thank you for your insights. And thanks for the compliment :) I usually forget that i have Hashimoto's and I never dwelled on it. Only times when it sneaks up on me and I go "dammit, Thyroid, whyyyy" is when I notice little niggles that might be related to it, or when I have mood issues. But generally I know I am lucky because it doesn't interfere with my life at all and I am really fit and healthy. an outsider would have no idea that I have some mild health issues going on. My problems are very subjective and non-visible haha.

And I agree that most practitioners are of course businesspeople and while they want to help their patients, they also depend on pharma companies and other factors. The doctor I am talking about is for holistic/integrated medicine, and she was the first one to explain to me the connection gut health and autoimmune disease and how it is all connected ( I knew from reading up on it, but she considers all these factors that my endocrinologists and doctors before had not). She is taking a look at my basal temp curves, is trying to help my GI problems by testing probiotics and now doing something for the liver. She also suggested to do a blood test for food intolerances. Don't know if this is something legit or not. But she definitelty listens to me and is looking for solutions.

And I agree about these new diet trends and panic waves that have been arising over the last years. Gluten, paleo and whatnot. When you say that Wheat itself is more of a problem than gluten..do you now why that is, or which part of the wheat could cause problems?

Paxiled · Answer

And may I say, for someone with Hashimoto's, you seem incredibly healthy, disciplined and fit.  This little problem will pass.

Paxiled · Answer

About the probiotics, I really have no idea if your colony is compromised or not, but the supplement given you is probably not a good one.  I know this isn't great to hear, but I managed health food stores for 18 years and worked very closely with holistic practitioners -- I was basically their pharmacist.  I met the people who wrote the books (signed, of course!), and was trained by them.  It's been a few years since I did this, but one thing that hasn't changed is that natural practitioners aren't a lot different than allopathic ones in this regard:  they have beliefs that aren't necessarily reflected in real humans, and they are just as acutely anxious to make as much money as possible.  Doesn't make them useless, just means you have to be aware of this as much as you need to be aware, as LightSeeker says, that endocrinologists are terrible at testing thyroids.  Holistic nutritionists tend to be much better.  So your probiotic is probably not refrigerated all the way down the line, so there could be significant die-off before it gets to you, and it lacks the main one we know of that affects digestion, which is bifido-bacteria.  It's multi-spectrum for immune system issues, but your issue is digestive right now.  As for gluten problem, this is, and this is only my opinion, a fad, has been a fad for awhile, and isn't a problem for the vast majority of people.  As LightSeeker said, the Greeks, who have a community being studied for living the longest in the world and where the famed Mediterranean Diet is studied the most, eat a lot of wheat.  I would tell anyone not to eat wheat, but then, I do.  The main problem is wheat, not gluten -- most people do not have problems if they eat spelt or kamut, or even heirloom varieties of wheat, all of which contain gluten.  Only the truly gluten sensitive will have the problem with those grains, so it's generally not a gluten problem.  Again, this is a huge fad right now, along with the so-called Paleo diet, a diet which never existed in "Paleo" times.  So it's just hard to practice any form of medicine.  The good thing about holistic medicine is if something doesn't work they don't blame you, they try something else.  Maybe, with your Hashimoto's, the best thing to do is try a practitioner of integrated medicine, someone with an MD who has also decided to study natural medicine because they're fed up with mainstream medicine.  Problem is, they don't take insurance.  But when it comes to supplements, go to your best local health food store -- not GNC, not Whole Foods, not any chain, so you might not have one left in your area -- and learn which brands are the best ones to trust.  And for symptomatic relief, try DGL or aloe vera juice -- might just be all you need.  Good luck.

TheLightSeeker · Answer

Sorry, I accidentally hit enter and it submitted.
Interesting as I never heard of this association!

It all started out of necessity, following some personal injuries and PTSD
related to a horrific car accident.
I realized that the medical system just did not cut it for me.
For some reason, I knew that I would be in limbo, if I stuck with 
their suggestions. It doesn't take a genius to realize when doctors
are mostly there for the acute trauma, injuries and illness, but when it comes to chronic and complex issues, their effectiveness drops dramatically.
So I immersed in studies to learn as much as possible about the human body, disease processes and health. 
Being a fast study and discovering that I also had a knack for this, I went along on this path,  as a vocation. I'm semi-retired at present , working as a Holistic Health Consultant, when and where I want and as I please, on a very selective basis!
Cheers!
Niko

TheLightSeeker · Answer

thyroid antibodies and fish consumption

Ariannis · Answer

Again, big thank you for taking the time to explain everything, Niko. I really appreciate it. 
Ha, medical terminoloy sounds like a very useful course in English! May I ask how you know so much about all of this? Are you working in this field or "just" researching a lot out of interest/necessity?

Anyway, back to me ;) 
Using the sublingual drops for the vitamins sounds good and easy to do. Thank you also for the suggestions for the pulse test. I hope I am not spoiling it by expectancy, as in "I am chewing bread now, maybe my heartrate will go up" and boom. (I am type 0 by the way.) But sounds very interesting. Love easy old school methods as well.
Regarding the Thybon: yes, it was in addition to the Thyroxine. I will mention a possible conversion disorder to my doctor. Although she is quite happy with my thyroid levels now as my antibodies have decreased significantly ever since she told me to cut out salt water fish. I used to eat tons of salmon and nibble on seaweed...poor thyroid.

I don't know why my my gut flora is compromised. I can count on one hand, literally, how many times I have taken antibiotics in my life. But I guess having an autoimmune disease is enough a reason, haha. 
I am also really curious about the Betaine HCL test, as I had never considered the problem starting right in the stomach. 
Many thanks!
Ari

TheLightSeeker · Answer

I understand about the gluten-free diet.
My background is from Greece, where every street corner has a bakery,
or pastry shop, lol! Greek people will DIE without any bread at the dinner table!
OK here's the option for the least resistance: Dr Coca's short version of the Pulse Test:
Just sit in a chair and come to rest for about 5 minutes. Take your pulse for a full 1 minute (not the 15 sec. multiply by 4 thing). Then put whatever you want to test in your mouth and chew it for 30 seconds. Then take your pulse again. If you find it is faster by 6 beats, you are allergic or have a sensitivity to it. If you have type “O” blood, use 4 beats as the criteria instead of 6. It’s that simple.
This test won't be as accurate as the full test which is available online as a free download, but it will give you an indication of what foods or substances you might be sensitive to.
Sublingual forms of B12 and D3 are preferred, as they bypass the digestion process, which will result in better absorption.
Try sublingual drops of D3 with K2 together,for better calcium allocation.

I'm kind of old school and try hard to see the logic and reasoning (besides profits) for newer methods of testing and thyroid testing is a bit of a challenge.
One thing I know for sure is that nothing beats the Basal temperature Test
as I mentioned in my earlier post.

But to be absolutely certain when using lab tests, you must consider the RT3 and the FT3/RT3 ratio, besides the FT3 and FT$ levels.

Was the Thybon ( syntheticT3) intake in addition to the thyroxine you were already on?
If this was the case, then likely  the desired result could not be achieved.
You see the idea of this trial is to cut out the precursor of RT3 which is T4
(thyroxine), so if the RT3 is plugging the  cell receptors, yet when let's say your cortisol levels were normal , your T3 was perhaps excessive (converted from T4  plus the T3 from Thybon.
It may sound complex, but if you read it a couple times it will be easier to understand.

Probiotics help  a lot when your healthy gut flora is compromised by factors like antibiotics, yeast imbalance, high carb diet, stress, poor nutritional habits etc.
Personally, I try to consume homemade sauerkraut and kefir, unless I'm travelling to Mexico, where I always bring probiotics with me.

Your English is very good and BTW English isn't my first language either,
but one of my courses was in medical terminology (in English).

Cheers,
Niko

Ariannis · Answer

Thank you Niko. Wow, a lot of things to consider.
re 1: B12: When you say "opt for a trial" you mean I can just test the drops and see if I notice anything?

re 2. My ft3 and ft4 are usually both mid range. My TSH easily gets decreased and doctors scream "overdosed", which does make sense to me since the times when I feel especially moody, agressive, sad have been times when my TSH was below norm. 
The trial with Thybon was to test if I'd feel great when ft3 and ft4 are in the infamous "higher third" range. I started out low and increased...don't remember the doses anymore though. But it really didn't work at all for me.
Just to make sure I understood correctly (English isn't my first language so some med terms are new to me): you think I might have a conversation problem, from t4 to t3?
But as mentioned, my ft3 is usually within the same range as my ft4 (percentage wise). So the only way to really confirm a conversion problem would be to test reverse T3?

3. Last VitD result was: 33 ng/ml (20-50ng/ml)...which would mean the lab has lower lab range than what you'd recommend. I did start taking a supplement again though and with summer coming up, my level should rise as well.

4. Just read up on the Betaine HCL Challenge. Might be worth a try!

5. That is the very difficult part for me...To keep to a strictly (!) gluten free diet, without knowing if it really is the culprit/will help. If I knew, I am severly gluten intolerant (I know I am not celiac)  it would be ok for me to accept and stick to that diet. But without "proof", I don't know how I can do this. I like to eat out, I am invited by friends, I travel a lot. There are so many stories out there about gluten. Some say it is bad for you, others say it is only bad for you if you're celiac, others say it is bad for all with Hashimoto, others say it isn't...

What I don't understand is that the probiotics do not seem to significantly help yet. I have a tested imbalance so I really set high hopes in them and all my little issues and niggles made sense to me. 
Thanks so much again for taking the time to explaining all of this and for all these suggestions of where to look for further testing.

TheLightSeeker · Answer

A few important details to be aware of, as they could make a difference:

1. B12  testing.
Two possible issues with this.
a. Lab ranges could be too low for proper function.
In Japan the lab ranges are  range to 500 – 1300 Pmol, as levels below 500 are associated with B12-deficiency issues!
b. You have adequate B12 serum Cobalamin levels, but still have a
methylocobalamin B12 ( bioactive form of B12) deficiency due to conversion issues. 
You may need a UMMA and/or a CSF (invasive!)test.
I would opt for a trial of sublingual methylocobalamin drops instead!

2. If you have low normal range FT4 and a mid-range or slightly higher FT3, it usually means the T4 is converting  aggressively in order to supply you the T3 , and you do have low thyroid function.
Reverse T3 is made by the body to trim excess T4 -so in a way we can say it's made from T4- but under some conditions like low or high cortisol , it plugs cell receptors and therefore T3 uptake is impaired, causing low thyroid function.
Free T3 should be at least 20 x Reverse T3 levels ( FT3/RT3 ratio should ideally be over 20)  and the RT3 test should be a taken at the SAME time as FT3, for accuracy.
Hmm, your Thybon prescribing doctor should have started you with the minimal starting dose, monitor you very closely and gradually up your dose till the optimal dose is reached!
Do you recall the dosing instructions?

3. Vitamin D :    Optimal maintenance level 50 ng/ml - 70 ng/ml
                          Therapeutic level  70ng/ml - 100ng/ml   
Should you have the VDR gene mutation, you probably need to be in the
70ng/mg - 100ng/ml level.
 
4. If you have digestive, G/I  issues and/or your gastric levels are low, your ability to absorb nutrients will be diminished. This also pertains to iron
(from food sources or supplements), vitamin D, B12,, other minerals etc.  Also check with your doctor or pharmacist about your medications (formulations vary widely), but please consider the Betaine HCL challenge! 

5. Gluten sensitivity may result in longer-lasting effects, so a few months
on a gf program is recommended.
Beware of the fact that gluten is found in products you don't expect and often not necessarily listed as an ingredient. Cosmetics, shampoos, playdough, envelopes, ointments, condiments, sauces...

I hope this helps.
Cheers,
Niko

Paxiled · Answer

Don't know about the above, hard to see why a GMO grain would be any different than any other grain in that respect, the main problem with them is their effect on the environment.  And in my understanding, when you have Hashimoto's your thyroid doesn't work anymore, so while it's very likely your med isn't being well prescribed or your levels accurately determined, as this is something doctors don't do well, you do need to take medication that supplies the hormones the thyroid can't make anymore.  Also, the longer you're on these meds, the thyroid basically dies even if you're on them for a different purpose.  As  for iron supplements, Floradix works quite well.  While it's true the ones your doc gives you are constipating and not absorbed well, plant sourced iron supplements do work.  They are very low dosage, but we don't need huge amounts of iron -- too much can cause heart problems -- we just need enough.  Good food sources are eating a wide and plentiful selection of organically grown greens -- organic because the soil is likely to be better and therefore supply better mineral content -- such as dandelion greens, parsley, watercress, and kale, collards, and the like.  Beets with tops are great.  People often assume only organ meats supply iron, but that isn't true -- lots of plant sources.  Floradix is from plant sources.

TheLightSeeker · Answer

Hey Ariannis.
You should look at your thyroid function again!
You might be converting thyroxine to Reverse T3
 thus lowering T3 further. Your thyroxine (synthetic)
needs conversion to T3 before it can be used.
I would ask your new dr. to prescribe natural desiccated thyroid which contains mainly T3 (which is what the body uses) T4 and lesser amounts of T1 and T2 as everything works better in synergy
If after a while this is still a problem, your thyroid function could be tweaked with a trial of T3 only (cytomel).
If your new doctor is not familiar with all this, let me know.
Your low ferritin is indicative of likely iron deficiency, which could also impact B12 levels, thyroid function and digestion.
Most people do not do well with oral iron supplements and the absorption rate is low.
I would have all of the above investigated thoroughly, before looking into other areas, with the exception of checking vitamin D levels and if low to rule out vitamin D resistance (beware of LOW FAT diets, which may contribute to hormonal deficiencies-Vitamin D is a hormone, fat soluble and synthesized from cholesterol)
and finally low gastric acid levels, which would explain the
bacterial overgrowth.
For the latter, you can do a Betaine HCL challenge-just follow the instructions and if you consistently feel better,
then you probably have hypochloridia.
BTW how to you monitor your thyroid function ?
Is it a shot in the dark, when your thyroxine dose is increased?
As far as serum thyroid testing goes, the most indicative & accurate for cellular thyroid function are: Free T3 (fT3), Free T4 (fT4) AND Reverse T3 (rT3) 
All 3 are needed! 
  fT3/rT3 ratio is probably the most reliable marker for low cellular thyroid function. 

To my opinion though we cannot find a better method to test than Dr. Barnes Basal Temperature Test. (there are several versions now) 
I have devoted countless of hours, scanning through the studies and groundbreaking work of Dr. Barnes, The Father of Hypothyroidism, lol! 
  Simply brilliant and way ahead of his time! 

Instructions For Taking Basal Body Temperature: 
Use an ordinary oral or rectal glass (not digital) thermometer. 
Shake down the thermometer the night before, and place it on your nightstand. 
The first thing in the morning BEFORE you get out of bed, place the thermometer under your arm for ten(10) minutes. 
Record the temperature reading and date right away! 
Repeat for 10 days. 
Normal Range: 97.6 to 98.2 
Averages below indicate hypothyroidism. 

Note that in the presence of any infectious conditions, (I remember you had  a question in the past regarding infections & fever when someone's temp. is normally lower than 97.6)  these results may be inaccurate and this could be a problem with chronic low grade infections accompanied by low grade fevers, for the purposes of the temperature testing. 

Or you may want to do Dr. Barnes Test. Very similar. 
Just check it out online. 

Most Hashimoto's sufferers have gluten intolerance and don't even know it! 
The gluten molecules-mainly from gmo grains- resemble the TPO(Thyroid Peroxidase - an enzyme necessary for the signalling Thyroid hormone production) molecules and thus the immune system in its response against gluten, attacks the TPO in the Thyroid also! 
FYI, look into Gliadin test (urine), by Cyrex labs. They test 12 forms-not just the alpha ordered by most doctors- of gliadins regarding gluten intolerance (not necessarily digestive). 
Now they can also test which part of the body is affected!


Hope this helps. You can contact me anytime, 
so please do not hesitate to do so, when the need arises.

Blessings! 
Niko

Paxiled · Answer

I'd only comment that you say you "feel" bloated, but obviously have some body shape issues that might be clouding this whole thing.  Having a flat stomach is easy when you're young, but harder when you get older -- you need extra room for bearing children.  Not to say you don't have some digestive issue, and when you have Hashimoto's (my wife has it) it becomes very hard to keep weight stable no matter what the idiot endocrinologists say and it's very hard to properly adjust the medication.  Do you know which probiotics you were put on?  Was Bifidus the primary one?  Have you been on antibiotics lately?  And you should know, lactose isn't the only problem with dairy -- it's just one factor.  You also say you're seeing a homeopathic doctor, but none of the remedies you've mentioned are homeopathic, so are you sure you aren't seeing another kind of practitioner?  I do think with all the autoimmune problems you've got going, probiotics seems a likely culprit, but there's more than one way to skin that cat -- while taking probiotics is one way, taking foods that promote probiotic health is even better, such as eating fermented foods such as kim chi or miso.  Good luck.

TheLightSeeker · Answer

Hi Ariannis.
Beware of the I don't believe syndrome, where misinformation or lack of knowledge drives us away
from what could be the truth.
Make sure you deepen your knowledge, so you can
make better judgments and still be able to avoid biased
and distorted information.
I'll continue later my post as something just came up.
Cheers!
Niko

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