By Michael C Biamonte CCN, ND
Hashimoto’s disease is an autoimmune disorder affecting the thyroid gland. The thyroid is a butterfly-shaped gland located at the base of the neck just below the Adam’s apple. The thyroid produces hormones that help regulate many functions in the body.
An autoimmune disorder is an illness caused by the immune system attacking healthy tissues. In Hashimoto’s disease, immune-system cells lead to the death of the thyroid’s hormone-producing cells. The disease usually results in a decline in hormone production (hypothyroidism).
Although anyone can develop Hashimoto’s disease, it’s most common among middle-aged women. The primary treatment is thyroid hormone replacement.
Hashimoto’s disease is also known as Hashimoto’s thyroiditis, chronic lymphocytic thyroiditis and chronic autoimmune thyroiditis.
Auto-immune illinesses are often caused by infections such as EBV,CMV, Candida and many Bacteria and Protozoa.
The infections can either directly attack the thyroid gland or can Intestinal Permability which is also know as “leaky gut syndrome”.
The leaky gut allows substances that normally be barred from entering the blood stream from the intestinal tract to cross or pass through which creates an allergy like autoimmune response. Mercury has also be found to accumulate in the thyroid glans of Hashimoto’s patients and is involved in the decline of the thyroid gland and the autoimmune response.
Since 85-90 percent of hypothyroid cases are due to Hashimoto’s it is essential to support both, the thyroid itself that is being attacked and the immune system which got confused and started to attack the thyroid in the first place. It is very important to understand that it is not the thyroid’s fault it is being attacked, its the immune system that got confused and started to think that thyroid is not your friend. There are many things that create this immune confusion, I call them triggers. Every person can have various triggers and I like to group them into 4 categories. Foods, Infections, Stress and Toxins.
Candida, various bacteria such as H pylori, parasites and other dysbiotic organisms are big triggers for the immune system and can create more confusion. Dysbiosis and food sensitivities will then contribute to leaky gut which creates a lot of extra inflammation and it is important to support this while also supporting the thyroid itself.
Inna Toplier a noted extpert on Hashimoto’s says this about the relationship between Leaky Gut Syndrome and Hashimoto’s;
Thyroid is very important for gut function and plays a role in many many areas of digestion. It keeps stomach acid at a good level which is essential because when stomach acid is low we don’t have enough of this very important digestive “juice” to properly break down our foods, specifically our proteins and therefore would not absorb things as well making us deficient in essential vitamins, minerals and amino acids. You can be eating an amazing diet but how you process that food is what determines the benefit that you get from all those good foods that you eat.
Additionally, stomach acid acts as a natural antiseptic so that when you are eating foods, if there is any bacteria or other microbes, it prevents them from coming in. Many annoying digestive symptoms like gas, bloating, distention, pain and discomfort are often caused by what we call dysbiosis which is really just a fancy word that means not living in harmony together. In our guts we have what we call the microbiome which is a symphony of bugs. I know this may sound weird but these bugs are essential to life. Let me explain a bit about this because this is something we will be addressing and supporting as we go through this course and I want you to have an understanding of how this relates not only to your thyroid but to your whole body and is essential for your health.
When we have a good balance of both the good and bad bugs, things are in harmony, however if the bad guys overgrow, meaning there are too many bad bacteria, yeasts, parasites or other pathogens, they are going to create dysbiosis that can often lead to your digestive symptoms. The reason that so many people have this imbalance is because bad bugs thrive on sugar and higher carbohydrate foods and at some point in our lives, we have all typically eaten them. Also antibiotics which are given so freely these days are a big contributor. While they work on killing off the infection, they are typically very broad spectrum and strong and can kill off many of the good guys at the same time. Once the good guys are gone or are lowered to the point where they are weak, they can’t protect you as well and more bad bugs will over grow. Other medications such as NSAIDs and steroids can contribute to this overgrowth as well.
These bad bugs love living in your intestines if they are given a chance. Its warm, moist and there is food, who would not like it right? Your immune system knows they are there and tries to attack them but these bugs are quite smart and do everything they can to stay around and make a nice home for themselves. To do this, they burrow deeper and deeper into your intestinal lining to essentially hide from your immune system. As they do this, it helps them but unfortunately for you, this creates more of an imbalance and actual inflammation in your intestines because they are digging themselves further in. This inflammation and imbalance irritates the intestines and for good reason.
Inside the intestines, there is a membrane that we just spoke about and this membrane, when intact, helps to regulate what can come in, like the essential nutrients from the food that you eat and what should stay out, like toxins, infections, undigested foods and other debris.
You can think of the body as a tube within a tube. The body is the outer tube and the intestines are the inner tube and only certain things are allowed to go through, otherwise the things that belong in the intestines should only stay in that tube so to speak.
This membrane is what creates that barrier and it consists of a thin layer of cells and these cells are very close to one another which keeps the membrane nice and tight. The spaces between the cells are called tight junctions and they stay closed unless something needs to get in or out. When the inflammation from the bugs irritates the intestines, this membrane can become breached. The inflammation can actually cause those tight junctions to open. So if you picture a gate that can open and close, that is what these tight junctions do. When the gate is wide open, things can come in and out freely and same goes for the tight junctions. While we do want things to be able to absorb through our intestines, the openings for absorption are meant to be teeny tiny so that large proteins that don’t belong and should not get out of the inner tube can’t get in. However when the tight junctions are open, the openings are much larger. This is what is called intestinal permeability or the more popular term leaky gut because the intestines have these holes and are essentially leaky.
Then when we eat foods, due to various reasons such as toxicity, stress and nutrient deficiency just to name a few, we may not produce enough digestive juices. That can look like not producing enough stomach acid in the stomach like we talked about which thyroid hormone helps to control and we need stomach acid to break down our proteins. It can also be not producing enough bile and bile is essential for emulsifying or breaking down fats properly, and, yes you guessed it is another thing the thyroid regulates. Without thyroid hormone, your bile can get thick and sludgy and won’t be released properly leaving fats just sitting there. This would affect not only how you digest your food but also how you absorb fat soluble vitamins. It is also possible that our pancreas may not produce enough enzymes which can be due to inflammation and the dysbiosis itself.
When we do not break down our food sufficiently which by the way is super common, not only can this give us all types of digestive symptoms like gas, bloating, constipation, diarrhea, heartburn and nausea BUT we can be much more prone to developing food sensitivities.
The reason for this is because food is supposed to be broken down into the smallest particles and long strings of proteins and other substances are supposed to break down into the simplest compounds and only those simple compounds are well received by the body when they absorb in. If you are not breaking down your foods well enough, they are not being digested into their most simple parts as they should and so the larger compounds and proteins are hanging out in your intestines. When the tight junctions are open due to inflammation, these larger chunks get into the bloodstream as they seep through the ‘Holes” of the leaky gut.
There, the body sees them but does not quite recognize them. Our bodies are really smart and know that food belongs in the intestines, the inner tube and not in the bloodstream the outer tube, so when the body sees this larger compound in the bloodstream, it does not realize that it is just food because it does not belong there in that undigested way and because of that it naturally thinks it’s a foreign invader and attacks it.
Once the attack occurs, the body creates a memory of this attack and it does this by creating an antibody to this compound. Remember that even though its just a food, since it was too large and didn’t belong in the bloodstream, the body thinks its something bad and does not recognize it as just a food. So the next time you eat that food, the body will see it and pull up the antibodies from its memory as something that it thinks is bad for you and therefore will attack it again and that is how food sensitivities can develop.
Since this attack can take a few hours to unravel, food sensitivities can affect you anywhere from 1 to 72 hours after eating the food and that is why it is sometimes more difficult to figure out which food is giving you issues as the response is delayed unlike a food allergy which tends to happen immediately. It is by the way a lot more common to have these delayed food sensitivities than actual food allergies.
Additionally, not enough thyroid hormone can lead to constipation. So many people rely on laxatives or other prescriptions or supplements like magnesium to help them go to the bathroom. While those things may help at the moment, dealing with underlying thyroid issue can often fix the problem and those supplements and medications may not be necessary. Plus constipation will fuel underlying gut issues and make dysbiosis and overgrowth like SIBO (small intestinal bacteria overgrowth ) and SIFO (small intestinal fungal overgrowth) worse so it becomes a vicious cycle and thyroid can be at the center of all of it.
While fixing the gut is essential, what many don’t realize is that if your thyroid is not in check and if you are lacking thyroid hormone it actually makes it much harder to balance and heal the gut even if you are doing all the right stuff for the gut itself. You may be avoiding your food sensitivities and doing things to kill off the bad bacteria and taking things to better digest your foods and while that is all good, it may not work nearly as well or at all if there is not enough thyroid hormone.
PAROTID GLAND
Many years ago I learned that I could improve Thyroid autoimmune conditions and get the antibodies to drop by administering “Parotid Protein” The parotid gland is the jaw region and is responsible for tagging items that enter our mouth as being good or harmful. It also helps regulate anibodies.
Thyroid expert Dr Westin Childs says;I hate to re-hash one of the most overused statements of all time, but I’m going to anyway:
As the saying goes… “all disease begins in the gut”.
Now, don’t take this literally because it’s not true that every disease begins in the gut.
But it’s definitely true that the gut plays a role in just about every major disease that you can think of including (and especially) Hashimoto’s thyroiditis.
If you have this condition, targeting and improving your gut health allows you to drastically improve the course of your disease and dramatically reduce your symptoms.
Does that sound like something that might interest you as a patient with this so-called progressive and uncurable (debatable) disease?
I would think so.
I don’t think I need to convince you that better gut health equals better thyroid health so I won’t spend much time there.
But what I do want to try to do is convince you that taking probiotics each and every day may be the single easiest and (perhaps) most effective way to improve your gut health.
Ok, maybe changing your diet is the MOST effective way to improve your gut health but taking probiotics is definitely easier and faster!
Why Gut Health Matters in Hashimoto’s
For starters, your gut is…
· A major site of T4 to T3 conversion: Roughly 20% of all T3 that circulates in your body (1) is created in your gut. If this area is compromised by chronic inflammation you better believe that your T3 production will be as well.
· The place where thyroid medication is absorbed: What good does thyroid medication do if you are only absorbing a fraction of the amount that you take by mouth? This is far more common than you might think which is why so many thyroid patients feel terrible even while taking thyroid medication daily.
· A major site of immune regulation and balance: Roughly 70% of your immune cells are found in the gut (2). If you are experiencing gut-related symptoms then those cells may not be doing their job adequately.
· A barrier to the outside world which, when compromised, may trigger autoimmune disease: If the intestinal lining of your gut gets damaged (so-called leaky gut), food and bacterial particles can get absorbed into your bloodstream where they can interact with your immune system (3) leading to autoimmune disease. Hashimoto’s may be triggered by this very mechanism!
· The site of nutrient absorption: The nutrients that your thyroid needs to function are all absorbed in the gut via supplements or food. If your gut is damaged, you may end up with multiple nutrient deficiencies that will negatively impact your thyroid.
It’s pretty easy to see why there is such a strong connection between your gut and the function of other tissues in your body, including your thyroid.
Developing Candida, constipation and leaky gut is often the precursor to developing Hasmimoto’s.
SELENIUM
Treating Thyroid Antibodies With Selenium
BY WESTIN CHILDS
So how effective is using selenium at reducing thyroid antibodies?
It depends on the study you look at:
One meta-analysis of 17 different randomized controlled trials and over 1,900 people total (2), suggested that selenium supplements were “effective in treating AITD patients, and greatly reduced levels of FT3, FT4, and TBOAb in AITD patients”.
This study of over 1,900 people highlights the fact that selenium supplements CAN and DO exert a powerful impact on both thyroid function and thyroid gland inflammation.
But the story gets a little more complicated.
Another systematic review, of over 400 people, concluded (3) that “the results of these four studies…show that evidence to support or refute the efficacy of selenium supplementation in people with Hashimoto’s thyroiditis is incomplete and not reliable to help inform clinical decision-making”.
In other words, they weren’t that impressed with what they found and their advice to doctors is basically to say “You don’t need to worry about selenium right now”.
So what should you as a thyroid patient make of all of this?
It’s honestly not that complicated, here’s why:
Of course, selenium supplementation is not going to work in every person because whether or not it works is likely dependent on whether or not the person taking it is selenium deficient.
In other words, the less selenium you have in your body, the more likely it is that selenium supplementation will help you.
It’s not rocket science.
And if you understand really basic thyroid physiology, it makes perfect sense why that it is.
Here’s what I mean:
Thyroid Physiology & Why Your Thyroid Needs Protection
Selenium acts to protect your thyroid gland from oxidative stress (4).
The act of creating thyroid hormone in the thyroid gland results in the production of hydrogen peroxide which can be damaging to thyroid gland cells.
Selenium helps your body produce glutathione which acts to neutralize hydrogen peroxide (5).
You can see why this becomes a problem if you are selenium deficient:
No matter what, your body is going to produce thyroid hormone because it’s required for life.
Your body doesn’t know if glutathione is present or not to protect your thyroid gland, it just keeps producing thyroid hormone because it needs it.
When you are selenium deficient, glutathione levels fall, and the very creation of thyroid hormone results in thyroid gland damage.
When this happens, proteins and enzymes (thyroid peroxidase and thyroglobulin) from the thyroid gland spill into the bloodstream.
These proteins then interact with your immune system and you end up with the thyroid antibodies characteristic of Hashimoto’s and Graves’ disease.
This is how it works in a nutshell.
By the way, this physiology is also why taking iodine has the potential to cause autoimmune thyroid disease.
Taking iodine triggers the creation of thyroid hormone, and if you trigger the production of thyroid hormone without the protective effects of selenium, you increase your risk of thyroid gland damage and thyroid autoimmunity.
If you are taking iodine, always make sure that you are either taking it with selenium or make sure you are not selenium-deficient BEFORE you take it.
How To Determine If You Should Use Selenium
After talking about all of this, what should you do as a thyroid patient?
Should you take selenium supplements or not?
Well, it depends on your situation but, based on my experience and research, I think that all patients with Hashimoto’s (and Graves’, by the way) should give selenium supplements a try.
Here’s why:
#1. Just looking at the numbers, there’s a very high chance that you are selenium deficient if you are listening to this.
With roughly a 1 in 8 chance of being selenium deficient, there’s a good chance taking this trace mineral will benefit you.
And as I mentioned previously, the reason we see variability in the positive benefit from various studies is because there’s variability in selenium status among different groups of people.
The more deficient you are (as a thyroid patient or otherwise), the more benefit you will obtain when supplementing with it.
#2. It has the potential to not only improve your immune system but also to improve thyroid function.
Yes, selenium is important for protecting your thyroid gland, but it also is important for thyroid hormone conversion.
Taking selenium is another way for you to boost your thyroid levels, specifically T3, which may help you better manage your hypothyroid symptoms.
This is true for regular hypothyroidism as well as hypothyroidism from Hashimoto’s which means this supplement is beneficial for ALL low thyroid states.
#3. It’s cheap and safe.
We’re not talking about treatments that cost thousands of dollars here, we’re talking about a treatment that you can get for under $20 dollars a month.
Not only is it relatively cheap, but it’s also safe, as long as you use it correctly.
It is definitely possible to take too much selenium, though, which is why we need to have a discussion about dosing…
Selenium Dosing: How To Avoid Taking Too Much
If you are going to supplement with selenium here’s what you need to know:
The RDA for selenium is set at around 55 mcg per day but if you are taking selenium to try and treat Hashimoto’s then you’ll want a little bit more than that.
My experience suggests that dosing in the range of 75 mcg to 150 mcg is the ideal range for thyroid patients.
And even temporary doses as high as 200 mcg for a short period of time can be helpful in some patients.
This can be confusing because people without thyroid disease shouldn’t go above 100 mcg per day.
The reason for this is that there is some potential that higher doses of selenium may increase the risk of developing diabetes (6).
I don’t think this is a concern for thyroid patients, though, because the benefits of using selenium are so high that a small risk of diabetes would be washed out in terms of the pros vs cons.
But if that is a major concern for you, just be sure to keep your total selenium intake under 100 mcg per day.
If you are going to use supplements then look for organic forms of selenium such as selenomethionine, selenocysteine, or a selenium glycinate complex.
Avoid inorganic forms like selenite and selenate.
If you prefer to get your selenium from a food source then aim to get 1/4 to 1/2 of a Brazil nut each day.
I’m not a huge fan of using Brazil nuts as a sole source of selenium, though, and if you want to learn more about why then I would recommend checking out this article right now.
While Brazil nuts may be a super source of selenium, it’s easy to accidentally take too much which can cause more harm than good in the long run.