Understanding Your Thyroid and Autoimmunity

Your thyroid gland is a tiny butterfly-shaped organ located at the base of your neck near the Adam’s apple. Despite its tiny size, the thyroid has a big job controlling energy production for every cell in the body. The thyroid’s main role is regulating metabolism through two hormones, thyroxine (T4) and triiodothyronine (T3). T4 is an inactive form which gets converted into T3 in the liver, kidneys, gastrointestinal tract, brain and muscles. It is the active form of T3 that stimulates cells to produce energy. The thyroid works in concert with the hypothalamus and pituitary gland to regulate thyroid hormone production. But, the health of your thyroid is also intricately tied to the health of your gastrointestinal tract, gut microbiome, liver, kidneys, adrenal glands and even your immune system.

Problems with thyroid function arise when something throws off the delicate balance between any of these connections. Eventually thyroid hormone production gets out of whack, conversion of thyroid hormone into its active form falters, and/or thyroid tissue gets damaged. Compromised thyroid health may set the stage for a more debilitating autoimmune condition of the thyroid called Hashimoto’s.

What is Hashimoto’s
Hashimoto’s Thyroiditis, commonly known as just Hashimoto’s, is an autoimmune disease in which the body’s immune system attacks the thyroid. This attack gradually destroys the thyroid tissue and its ability to produce critical hormones. According to the American Autoimmune Related Diseases Association, Inc., approximately 20% of the U.S. population suffers from autoimmune diseases and Hashimoto’s is the most common. Even more shocking, thyroid diseases occur roughly five times more frequently in women than men. With such prevalence, it’s very important to understand its causes and effects as well as how you can effectively prevent or treat this common condition.

Causes and Risk Factors
As an autoimmune condition, Hashimoto’s arises from a dysfunctional immune system, not a dysfunctional thyroid. This means the condition is actually a symptom of a much deeper issue. Stress on the thyroid and/or immune system are at the root of Hashimoto’s and there are many stressors at play.

The first thing to consider is an overactive immune system. The primary cause for an overcharged immune system is inflammation. If the inflammatory process never gets a rest, it stays in overdrive. This can occur because of:

• Infections, both chronic and acute

• Injuries

• Overload of toxins

• Diet lacking in antioxidants

• Intestinal permeability or “leaky gut”

Additionally, there are other potential causes for Hashimoto’s:

• Exposure to radiation, through work or medical treatments.

• Excess exposure to environmental toxins, fluoride and perchlorate in water, mercury and other heavy metals, lithium, and estrogens from pesticides and hormone creams or pills.

• Overconsumption, or deficiency, of dietary iodine.

• Overconsumption of soy products and uncooked “goitrogenic” foods such as broccoli, Brussels sprouts, cabbage, cassava, cauliflower, kale, kohlrabi, millet, radishes, rutabaga and turnip.

• Leaky gut syndrome, food allergies, gut dysbiosis, nutrient deficiencies and poor digestive health.

• Chronic blood sugar imbalance, insulin resistance and diabetes.

• Chronic inflammation.

• Hormonal imbalances.

• Liver, pituitary, hypothalamus and/or adrenal dysfunction.

• Inappropriate use of thyroid medications.

• Presence of other autoimmune conditions such as Type 1 diabetes, celiac disease, lupus, rheumatoid arthritis, and/or multiple sclerosis.

• Chronic stress.

The major risk factors are chronic stress, gluten intolerance or celiac disease, insulin resistance, vitamin D deficiency, leaky gut and compromised detoxification. All of these risk factors create a vicious cycle of continually increasing stress on the body. Chronic and prolonged stress then increases damage to the adrenals, gut, liver and pituitary as well as compromises blood sugar, nutrient absorption and immunity. The cycle continues until the immune system spirals out of control creating chronic inflammation and an overactive immune system, the perfect storm leading to Hashimoto’s.

Gut Health
A leaky gut is not just a source of inflammation, it is a cog in a dangerous cycle that spirals out of control. The cycle starts with a disruption in the gut lining from food intolerances, alcohol, stress, anti-inflammatory drugs, antibiotics, candida overgrowth, or fatty acid deficiency. This leads to malabsorption of nutrients and undigested food particles directly entering the bloodstream which creates an immune response. The immune response creates immune complexes that settle in the gut lining and create inflammation. This inflammation continues to damage the gut lining which leads to food allergies/intolerances, more disruption in the lining, more malabsorption, more inflammation and more leaky gut.

Gut health is very important for immune and thyroid health. Over 70% of your immune system is in the gut, and 20% of circulating T4 is converted to T3 by an enzyme in your gastrointestinal tract. If the gut lining is compromised your immunity weakens and your production of active thyroid hormone decreases.

An underlying gluten intolerance may be the most damaging risk factor. Thyroid tissue and the gluten molecule have a similar protein structure. If the body mounts an attack on gluten, it may also inadvertently attack thyroid tissue. It is a trifecta of autoimmune risk, a compromised gut, an overactive immune system, and a diet high in gluten. Your body attacks gluten while also mistakenly attacking healthy thyroid tissue. This is the very definition of Hashimoto’s Thyroiditis. In fact, Hashimoto’s is always associated with gluten sensitivity. If you suspect Hashimoto’s, already have an autoimmune condition, or suffer from a compromised immune system you should completely avoid gluten to protect your thyroid.

The Varied Symptoms
Many things can increase your risk of Hashimoto’s. It is also common to have many symptoms, including:

• Fatigue

• Excessive sleep

• Depression

• Poor concentration and memory

• Weight gain

• Dry and brittle hair and nails

• Thinning eyebrows

• Muscle and joint pain

• Morning headaches

• Tendonitis

• Puffy eyes and face

• Cold hands and feet

• Full sensation in neck

• Raspy, hoarse voice

• Heart palpitations

• Insomnia

• Shortness of breath

• Low sex drive

• Infertility, heavy periods and PMS

• High cholesterol

• High blood pressure

• Insulin resistance

• Worsening allergies

• Chronic infections, including yeast and sinus infections

• Slow wound healing

• Heartburn and difficulty swallowing

• Indigestion, nausea, gas and bloating

• Constipation and other digestive issues

Diagnosing Hashimoto’s
The most common diagnostic test for thyroid dysfunction is testing levels of thyroid stimulating hormone (TSH). However, to confirm Hashimoto’s it is important to test for thyroid peroxidase antibodies (TPO Ab) and thyroglobulin antibodies (TGB Ab). A full Thyroid Panel which includes Total T4, Free T4 Index, Free T4, Free T3, T3 Uptake, Reverse T3 and Thyroid Antibodies will be beneficial to determine the source of dysfunction and the degree of damage. If you are diagnosed with Hashimoto’s, you have both conventional and alternative treatments to consider.

Treatment Options
Conventional treatment for Hashimoto’s is to monitor thyroid hormone levels, adjust medications accordingly, and prescribe more medications to suppress any symptoms. This could include thyroid hormone as well as Prozac for depression, or medications to slow heart rate or adrenal function. Treatment may even lead to partial or complete removal of the thyroid and a lifetime of hormone replacement therapy. The concern with conventional treatment, however, is that it does not address the underlying issue, an overactive immune system and the root causes of its hyperactivity.

Alternative and holistic minded treatments address the root cause of an overactive immune system. Alternative medicine practitioners will determine the health of your gastrointestinal tract, liver and adrenal glands; your level of exposure to toxins and excess estrogen; as well as the quality of your current diet and how it may contribute to nutrient deficiencies, toxin exposure, blood sugar imbalance and stress on the body. Also, through blood tests they can determine not only current thyroid function, but what may be at the root cause. Through this, they can determine the course of treatment. In any scenario, regulating the immune response with targeted nutrition and supplementation will be critical.

Lifestyle Changes for Hashimoto’s
If you have been diagnosed with Hashimoto’s, hypo- or hyperthyroidism, or any other autoimmune disease, the most important dietary change is to completely remove gluten from your diet. Consuming gluten when the immune system is already overactive will actually increase damage and destruction of the thyroid.

Here are lifestyle changes that can reduce your risk, or improve your symptoms, of Hashimoto’s:

• Test for other food allergies.

• Consume a diet high in healthy fats, fiber, clean protein and organic produce, and low in carbohydrates to help balance blood sugar, increase immunity and support the thyroid.

• Eat every 2-4 hours.

• Avoid soy, dairy and sugar as well as gluten.

• Choose organic to reduce pesticide and toxin exposure.

• Cook goitrogenic foods such as kale, cabbage, turnips, sweet potatoes, kelp, broccoli and Brussel sprouts. Goitrogen is a compound that inhibits iodine uptake by the thyroid. Lightly cooking these veggies will prevent this negative effect.

• Consider a safe liver detox protocol.

• Practice stress management techniques daily.

• Incorporate a mix of short cardio sessions and strength training for exercise.

• Avoid iodine supplementation if you are diagnosed with Hashimoto’s, it can further damage the thyroid.

Supplements for Hashimoto’s
Certain supplements may also help support the thyroid:

• Selenium may reduce inflammation, assist with conversion to T3 and protect thyroid function.

• Magnesium may help balance blood sugar and support the pituitary-thyroid connection.

• Vitamin C may enhance immunity, repair the gut lining, and reduce inflammation.

• Vitamin D is key for regulating the immune system.

• B Vitamins may support proper digestion, immunity and thyroid function.

• Zinc may promote thyroid hormone production and enhance immunity.

• Maca Root may enhance thyroid function.

• Milk Thistle may support detoxification and reduce inflammation.

Remember, your body systems and organs are all intimately connected. Focusing on thyroid health will naturally enhance your overall health. The more you support your thyroid with quality nutrition and targeted supplementation, the more you can calm your immune system, heal your gut and optimize your health.

Stephanie Walsh, MNT, CEPC, CPT, CPI