How Common Is Lactose Intolerance in Hashimoto’s?


Lactose intolerance rates in Caucasians have been reported to be between 7% to 20%, and much higher in people of Asian and African descent. Lactose intolerance can be genetic and permanent, or secondary to another condition and reversible. People with SIBO and Celiac disease are often lactose intolerant when first diagnosed, but once they address SIBO and Celiac disease, many times they find that their ability to tolerate lactose returns after 3-6 months. A 2006 paper in the journal “Thyroid” described one woman with lactose intolerance and Hashimoto’s, and determined that lactose intolerance was a rare occurrence in causing malabsorption of thyroid medications, however, a newer study, done in 2014 study by Asik and colleagues tested 83 Hashimoto’s patients for lactose intolerance and found lactose intolerance in 75.9% of the patients! 38 of those patients were instructed to start a lactose-free diet for 8 weeks, and the researchers found that over this time, the patients’ TSH dropped, meaning, they were absorbing their thyroid medication better.

So This Lactose Thing Gets Even More Interesting…
For some lactose intolerant people, even tiny amounts of lactose that are found in thyroid medications can be an issue, resulting in impaired absorption of thyroid medications. Yes, thyroid medications could be sabotaging their own absorption if they contain even teeny amounts of lactose. So if you are someone that can’t get his/her TSH into your sweet spot (TSH should be between 0.5-2 mU/L for most people to feel best) despite taking escalating doses of thyroid medications,consider lactose intolerance and the possibility that the lactose in your diet or even in your thyroid medication may be inhibiting its absorption.

Breaking Down Lactose
As my community is full of extremely smart and motivated people interested in finding solutions, someone is sure to ask… “What about taking Lactaid (a supplement that contains lactase, an enzyme that breaks down lactose) with your thyroid medications? Will that help with the absorption of the medication? This is a really interesting question… In theory, it should work, but I have not tested that theory yet. If any of you have had experience with taking Lactaid in conjunction with your lactose containing thyroid medications, I’d love for you to share your experience.As far as diet, I have personally seen tremendous improvements in my health and the health of clients and readers on a dairy free diet, so this is something that I recommend across the board for people
with Hashimoto’s.

Lactose Containing Thyroid Medications
• Synthroid
• Euthyrox
• WP Thyroid
• Nature-Throid
• Most generic brands of levothyroxine
• Some compounded medications- check with your pharmacist

Lactose Free Thyroid Medications
• Tirosint
• Armour Thyroid
• Cytomel***may be cross-contaminated with gluten***
• Levoxyl
• Some compounded medications- check with your pharmacist

Medication Tips
Of all of the T4 containing medications, Tirosint has the fewest fillers that may impair absorption, and this medication was specifically designed for this purpose. I’ve had many people on my Facebook page comment on how they felt much better on Tirosint compared to levothyroxine. Of course, many people do not feel good on T4 only medication and that is beyond the scope of this post (this post is getting a wee bit long), but you can read more about that at which thyroid medication is best, if you are interested. Of all of the T4/T3 combination medications, WP Thyroid has the fewest fillers that can impair absorption. Armour thyroid does not contain lactose but contains corn-derived ingredients that can be problematic in corn sensitive individuals.

September 20, 2018

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