acid reflex heartburn

42 yrs old female with hypothyroid  been on 150mg synthroid now for 3 years never had hearburn but for the past few months i have been getting heartburn but not from eating I get like a acid burn when I dont eat the only way to make it better is to eat something it seems to be getting worse for the past week i wake up in the middle of the night with it burning and have to make a half of sandwich to calm it down. Is this heartburn or is it something else. I just never heard any one getting heartburn from an empty stomach?

[Ratnakar Kini, MD]

Hi,
I would suggest you have an upper GI endoscopy to rule out ulcer disease.
Hypothryoidism can cause decreased motility of stomach which may predispose to reflux disease.
For confirmation of reflux  24 hours pH monitoring test may be done.