The Thyroid & the Gut:
How to Connect the Dots

Hello!

What follows is a presentation that I gave in Mississauga recently about thyroid conditions and the connection they have with the gut. It was really wonderful to share this information to so many interested folks!

Please feel free to contact me should you wish to discuss this topic further.

Yours in health!

Dr. Tiffany Wyse
Naturopathic Doctor|Medical Herbalist|Doula
Erin Mills Optimal Health in Mississauga

The Thyroid: What is it?

It is a butterfly shaped gland located at the base of the neck, below the adam’s apple and just above the collarbone.

The gland produces hormones that control the metabolic rate in the body. It acts like the thermostat of the body.

A sluggish thyroid slows down the metabolic rate leading to:

• weight gain
• feelings of lethargy
• mental fogginess
• dry skin & hair (and even hair loss)
• joint & muscle aches
• irregular periods
• fertility complications
• brain fog
• sugar & carb cravings
• and even high cholesterol.

Thyroid Hormone Production

A complex & dedicated set of interactions between the hypothalamus, pituitary gland and thyroid gland governs the function of the thyroid gland. This is known as the HPA Axis.

The pituitary gland, which is located at the base of the frontal of the brain, releases Thyroid Stimulating Hormone (TSH), which is required to produce thyroxine (T4). The production of TSH depends on the presence of Thyrotropin Releasing Hormone secreted from the Hypothalamus.

The main function of the thyroid gland is to produce the hormones, T4 and triiodothyronine (T3), that control the rate and intensity of most physiological functions, such as:

• Body’s temperature
• Heart rate
• Sweating
• Digestive action
• Calorie consumption
• Metabolism

T4 is converted to T3 by an enzyme (deiodinase) in multiple tissues and organs, but especially in the:

• Liver
• Gut
• Skeletal muscle
• Brain
• Thyroid gland itself

Thyroid Deficiency

• Thyroid deficiency is quite common, officially affecting about 1% of the population (especially women).
• It is much underdiagnosed, and physicians have now observed many cases of subclinical hypothyroidism, where patients have hypothyroid symptoms and respond well to thyroid support, although measure normal on thyroid panels.
• Hypothyroidism tends to run in families due to genetics

• The most common type of hypothyroidism, primary hypothyroidism, is usually a result of Hashimoto’s thyroiditis, where the thyroid becomes shrunken and fibrotic with markedly diminished function.

Hashimoto’s Thyroiditis (autoimmune disease):

• Women older than 40 years of age and elderly individuals of both sexes are affected most frequently, although it does occur in individuals of all ages.
• 90% of hypothyroid cases in North America
• Relates to the immune system attacking mechanics of thyroid function (e.g. thyroid peroxidase, thyroglobulin, TSH receptors), resulting in its gradual destruction

Other causes of hypothyroidism include:

• exposure to radioiodine
• dietary goitrogens  (brassica family, particularly)
• antithyroid drugs
• thyroidectomy
• DeQuervain’s thyroiditis
• suprathyroid disease; congenital absence
• hypoplasia or ectopia of the gland
• pituitary or hypothalamic failure/imbalance.

Signs & Symptoms of Hypothyroidism

Adult:

• Cold intolerance
• Dry skin and hair
• Constipation
• Heavy menses
• Facial puffiness and paleness
• Deep, monotonous voice
• Tingling hands (carpal tunnel syndrome)
• Decreased libido
• Decreased energy
• Mental slowness, confusion, lethargy, apathy
• Dull, expressionless look
• Possible goiter
• Decreased Achilles reflex return
• Decreased basal body temperature: 97°F or below on first a.m. reading

Typical Lab Findings

lab findings:

• Decreased serum T4: although it may be normal
• may see decreased T3U
• Decreased FT4I
• Increased TSH: though this is not specific for hypothyroidism, and may be normal
• Increased serum cholesterol
• T3 assay will often be normal (from increased TSH)
• TRH stimulation test for secondary hypothyroidism: if TSH rises, the patient has a hypothalamic disease; if TSH does not rise, then it is diagnostic for pituitary disease
• Hypothyroidism from sympathetic excess/adrenocortical compensation will show low T3 and borderline high T4; treatment with exogenous thyroid eventually stops being effective. (Easley)
• Liver enzymes may be mildly increased

Other labs will be examined in this lecture to address the autoimmune component of Hashimoto’s Thyroiditis.

The Thyroid & the Throat Chakra

It is important to remember that each of the endocrine glands also corresponds to a chakra in several Eastern medical systems.

The thyroid represents the fifth chakra, the one associated with communication. Sometimes people with various thyroid issues, realize that it may partially arise from “swallowing their words” in various relationships.

Of course the quality of communication in this case is the perception of the individual, not necessarily that of the wider community or particular culture they are in (though this can heavily influence it). We will see excessive communication in overactive thyroid often and under communication in underactive thyroids.

Hashimoto’s thyroiditis

•      Hashimoto’s thyroiditis is an autoimmune disease that is responsible for more than 90% of hypothyroid cases in North America.

•      Unlike the iodine deficiency-induced hypothyroidism seen in places such as rural Africa and India, Hashimoto’s relates to the immune system attacking the mechanics of thyroid function (e.g. thyroid peroxidase, thyroglobulin, TSH receptors), resulting in its gradual destruction.

How do we know if we have Hashimoto’s Thyroiditis?

Thyroid testing:

•      TSH (Thyrotropin)

•      Thyroid Antibodies

TPO-Ab (Thyroperoxidase Antibodies)

Tg-Ab (Thyroglobulin Antibodies)

•      Urinary Iodine

•      Reverse T3

•      Celiac Profile

1. TSH (Thyrotropin)

•      The TSH test is frequently the first strategy for diagnosing a thyroid dysfunction.

•      The upper level though of TSH measurement is routinely criticized and a general recommendation by specialists is that people with TSH readings greater than 2.0mLU/L be referred for antibody screening.

2. Thyroid Antibodies testing

Thyroid antibodies are proteins that are manufactured by the immune system that are directed against proteins in the thyroid.

There are two tests that can be done to test for Thyroid Antibodies:

•               TPO-Ab

•               Tg-Ab

A. TPO-Ab (Thyroid Peroxidase Antibodies)is a test measuring autoantibodies against thyroid peroxidase. Thyroid peroxidase is an important enzyme responsible for the production of thyroid hormones.

Certain factors leading to increased TPO levels include:

•      Excess estrogen conditions such including pregnancy and oral estrogen supplementation regimens from the oral contraceptive pill & hormone replacement therapy

•      Tamoxifen therapy for breast cancer

•      Liver disease

B. Tg-Ab (Thyroglobulin Autoantibodies) is a test measuring autoantibodies. The antibodies in this case attack thyroglobulin which is the key protein in the thyroid gland, essential in the production of thyroid hormones T4 & T3.

3. Urinary Iodine

•      Testing urinary iodine provides an approximate measure of dietary iodine intake.

•      Iodine’s main action in the body is in thyroid function. The implications for a deficiency of iodine are vast. Thyroxine (T4) the major hormone synthesized by the thyroid is dependent on iodine.

4. Reverse T3 (rT3)

•      Triiodothyronine (T3) is the most active of the thyroid hormones. Around 85% of the circulating T3 is produced by the alteration of T4 in tissues such as the liver, muscles & kidney.

•      Reverse T3 (rT3) is the inactive form of T3. Increased rT3 is often seen in people with disorders such as fibromyalgia, chronic fatigue syndrome, Wilson’s temperature syndrome & high stress levels.

5. Celiac Profile

ENDOSCOPY & a small bowel biopsy offers a definitive diagnosis of celiac disease.

One of the best tests for gluten intolerance is simply to remove it from your diet for a few weeks and follow by a challenge.

The Thyroid & Gluten Intolerance

There have been a number of studies demonstrating a strong link between Autoimmune Thyroid disorders and gluten intolerance.

• Mistaken identity: gliadin, the protein portion of gluten, closely resembles that of the thyroid gland
• Gliadin breaches protective barrier of the gut, and enters the bloodstream, the immune system tags it for destruction
• Antibodies to gliadin also cause the body to attack thyroid tissue
• If you have an Autoimmune Thyroid Disease and you eat foods containing gluten, your immune system will attack your thyroid

My Ancestors Grew Up Eating Bread & Grains with Gluten…
what happened?

• Increased rates of celiac disease and intolerance to gluten grains
• Traditionally, grains used to prepare bread would go through a fermentation process using a sourdough, taking a few days
• Modern day baking & industrial production opt for mass production and speed rather than health, rendering the gluten grains not only indigestible in our bodies, but also harmful
• Industrial baked goods often contain bromine
• Ingested bromine competes for the same receptors used in the thyroid gland to capture iodine, thus is detrimental to the gland

Autoimmune Disease & Intestinal Permeability

How is increased Intestinal Permeability connected to autoimmune disorders?

• Intestines are a hollow tube and through a complex system, are able to discern what substances to absorb and what to allow to pass through
• With a more permeable intestinal wall, the body loses its ability to recognize benign substances like our own cells and foods we eat
• Instead, it treats them as foreign invaders such as bacteria and viruses

Testing for Intestinal Permeability 

1. Zonulin

• Zonulin is a human protein that modulates the permeability of the tight junctions between the cell walls in the intestinal tract
• It can change the size of the openings in the gut lining
• If the openings increased in size, the lining becomes more permeable
• Zonulin is found in excessive amounts in those with intestinal permeability & autoimmune disease

2. Lactulose & Mannitol test

• Test involves drinking two types of non-metabolized sugar, one lactulose, with large molecules and the other, mannitol, with small molecules
• The urine is then analyzed to see which sugars passed through the system
• If lactulose is found, intestinal permeability may be considered

Healing Autoimmune Conditions

Address Intestinal Permeability through:

• Diet & Lifestyle: Elimination diet, Broth, Hydrolized collagen powder
• Herbal Medicine: Calendula, Matricaria, Filipendula, Plantago
• Anti-inflammatories: Curcuma, Zingiber
• Antioxidants
• Probiotics
• Zinc
• Quercitin
• Medium chain fatty acids
• Lauric acid
• Butyrate

Underlying Triggers of Hypothyroidism

• Leaky Gut – food allergies/sensitivities
• Microflora imbalance in the Gastrointestinal Tract
• Poor digestion & elimination
• Chemical Overload
• Food Additives, agricultural chemical run-off (organochloride exposure especially), environmental pollutants, chemical exposure, household cleaners and sprays, herbicides & pesticides, hair dyes
• Stress, depression, inadequate rest & relaxation
• Low grade chronic infections

Hypothyroidism does not respond to any particular herbs that I know of, in either a hopeful or remedial manner. Seaweed therapy with a strong fresh green vegetable diet, particularly chickweed, dandelion, parsley, spinach, and beet greens, seems to be the best. Brassicas are probably best kept to a minimum because of their known goitrogenic activity. -RYAN DRUM

Further dietary comments: I usually recommend eating very little or no flour products in an effort to reduce erratic iodine intake and to reduce bromine intake as well as reduce the hyperglycemia that often accompanies the eating of flour products and simple sugars (I also recommend totally eliminating all simple sugars except fresh fruit). All non-organic meat and meat products are contraindicated since xenoestrogens can disrupt thyroid function (just like intrinsic estrogens generated by the patient’s body). I usually suggest elimination of all dairy products except unsalted organic butter to further reduce exposure to growth hormones and iodine and unwanted tetracycline residues. I usually recommend eating avocados, organic eggs, and sardines to provide quality fats to keep that bile flowing and wasted thyroid hormones moving out of the liver.  -RYAN DRUM

Other tests for Thyroid disease

• Salivary cortisol
• Mercury & Nickel

RECOMMENDATIONS FOR DEALING WITH LOW THYROID FUNCTION

DIETARY CHANGES:

•      Eating principles: low sugar, low fat, high fiber, low cholesterol

•      Calorie percentages: 60% complex carbohydrates, 20% protein, 20% good fats

•      Therapeutic foods: oats, kelp, seaweed, dulse, artichokes, onion, garlic, Swiss chard, turnip greens, egg yolks, wheat germ, lecithin, sesame seed butter

•      Fresh juices: carrot, celery, and/or Swiss chard with powdered kelpor dulse (seaweed)

•      Avoid goitrogens (which can reduce thyroid function) unless cooked: broccoli, cabbage, kale, rutabaga, soybean, peanuts, yams, radishes, millet, green peppers, beets, pears, lettuce, cauliflower, Brussel sprouts, kohlrabi, strawberries, cherries, grapefruit, oranges

•      Avoid known food sensitivities

HYDROTHERAPY:

•      Short cold water spray to thyroid after warm bath/shower OR

•      Cold mitten friction to thyroid after bath/shower

•      Alternating hot and cold compresses to thyroid daily

•      Hot compresses molded to neck for 3 minutes FOLLOWED BY

•      Cold compresses for 30 seconds to 1 minute

•      Repeat 3-5 times

•      Cold shower to middle and lower back to stimulate adrenals

•      Constitutional hydrotherapy treatments

OTHER CONSIDERATIONS:

•      Do not use electric blankets to warm up: body’s metabolism will be slightly raised if it must generate its own heat to keep warm

•      Exercise daily to stimulate your glands and elevate body’s metabolic rate

•      Improve overall digestion and assimilation of food

Disclaimer

•         All health and health-related information contained within this presentation is intended to be general in nature and should not be used as a substitute for a visit with a health care professional.

•         The advice is intended to offer only a general basis for individuals to discuss their medical condition with their health care provider. Your health care provider should be consulted regarding matters concerning the medical condition, treatment and needs of you and your family.

10 things to do to improve your thyroid function

1. Take a high quality multivitamin that contains Iron, Iodine, Zinc, Selenium, Vitamin D and B vitamins.

2. Take a tyrosine and iodine supplement – it will help you with the FT4 to FT3 conversion.

3. Try going gluten-free! And if you have Hashimoto’s thyroiditis, try going completely grain and legume free.

4. Deal with your stress and support your adrenal glands. The adrenal glands and thyroid work hand in hand. You can start practicing restorative yoga and try adaptogenic herbs, which support the adrenal glands in coping with stress.

5. Get 8 to 10 hours of sleep a night.

6. Consult with a biological dentist to safely remove any amalgam fillings you may have.

7. Limit your intake of cruciferous vegetables (although, there’s still some debate surrounding this topic).

8. Remove fluoride, bromide and chlorine out of your diet and environment.

9. Heal your gut. A healthy digestive system (gut) is critical to good health.

10. It is important to find a medical doctor in your area and have them run the laboratory test described above and work with you to find the root cause of the thyroid imbalance.

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