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Avatar universal

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

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!







18 Responses
1530171 tn?1448133193
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
Avatar universal
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.
1 Comments
Thank you, Paxiled. You are right, it is also a body image issue on top of genuinely feeling the bloat. I guess they go hand in hand since always feeling tight around the stomach and bloated does affect how comfortable you feel in your body. I have never had weight issues, despite the Hashimoto's, so I know I am quite lucky in that respect. My doctor has also touched my stomach and confirmed it feels swollen. The meds she described me now are no classic homeopathic I guess, but she has described homeopathy for my Thyroid before, so she is definitely working with it.
The probiotic I am taking right now contains the following:
Lactobacillus acidophilus W57
Lactobacillus casei W56
Enterococcus faecium W54
Lactobacillus acidophilus W22
Lactobacillus rhamnosus W71
Lactococcus lactis W58
Lactobacillus plantarum W62
Should do the trick, right?
1530171 tn?1448133193
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

1 Comments
Thank you for this detailed reply, Niko! Interesting information.
My ft3 and ft4 are within the range, could this still mean I am not converting in enough T3? I did try Thybon for a while to experiment if I felt better (not stomach wise though, mentally mostly) but my levels shot up the roof and I was overdosed. That was back in 2010 and a lot has changed sicne then so I generally feel a lot more balanced.
Anyway, as for Vit B 12 and Vit D: not deficient. Have them tested from time to time and they are both really not low.
As for basal temp: my doctor makes me do this as well. To monitor my mentrual cycle and check for lack of progesteron. My basal temp ranges from 97,34 in the first half to 98,24 in the second half. (Had to use a converter as I am using Celsius!).
I have also read up on the gluten issues with Hashimoto's, and it does make sense to me. So I started to omit it for some time, but didn't notice any difference. Not sure if I should have or if it takes a long time but I have heard that improvement is following soon if it really was a gluten problem.
So this is why I am a bit frustrated as it feels like nothing I do changes anything. It really is not that big a deal since I am completely "functional" and a lot of these issues might be very subjective, but I would love to have a "breakthrough" to know which direction is the right one.
According to alternative medicine it totally makes sense that my liver is out of balance since I get angry very easily etc. But this is where I ask myself if I really do believe in this or not...
Avatar universal
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.  
1530171 tn?1448133193
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


Avatar universal
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.
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