How to Give Yourself Hashimoto's Thyroiditis: 101

I borrowed this from the enormously clever Dr. BG at The Animal Pharm Blog.


How to Give Yourself Hashimoto's Thyroiditis: 101

--lack of sunlight/vitamin D/indoor habitation
--mental stress
--more mental stress
--sleep deprivation... (excessive mochas/lattes at Berkeley cafes)
--excessive 'social' calendar
--inherent family history of autoimmune disorders (who doesn't??)
--wheat, wheat, and more wheat ingestion ('comfort foods' craved in times of high cortisol/stress, right? how did I know the carbs were killing me?)
--lack of nutritious food containing EPA DHA, vitamin A, sat fats, minerals, iodine, etc
--lack of play, exercise, movement (or ?overtraining perhaps for Oprah's case)
--weight gain -- which begins an endless self-perpetuating vicous cycle of all the above (Is it stressful to balloon out for no apparent reason? YES)



If you haven't done so already, take a look at Animal Pharm you will get a real kick out of Dr. BG's quick-witted take on things.


We are systematically looking for low thyroid (hypothyroidism) in everyone and findings oodles of it, far more than I ever expected.

Much of the low thyroid phenomena is due to active or previous Hashimoto's thyroiditis, the inflammatory process that exerts destructive effects on the delicate thyroid gland. It is presently unclear how much is due to iodine deficiency in this area, though iodine supplementation by itself (i.e., without thyroid hormone replacement) has not been yielding improved thyroid measures.

I find this bothersome: Is low thyroid function the consequence of direct thyroid toxins (flame retardants like polybrominated diphenyl ethers, pesticide residues in vegetables and fruits, bisphenol A from polycarbonate plastics) or indirect toxins such as wheat via an autoimmune process (similar to that seen in celiac disease)?

I don't know, but we've got to deal with the thyroid-destructive aftermath: Look for thyroid dysfunction, even in those without symptoms, and correct it. This has become a basic tenet of the Track Your Plaque approach for intensive reduction of coronary risk.

Comments (18) -

  • Bad_CRC

    1/25/2009 7:07:00 PM |

    Hmm, really?  So if I eat wheat (or was it 'carbs' generally?) and not enough animal fat, drink coffee, don't sleep enough, etc., Hashimoto's autoantibodies will start showing up in my blood?  And when I reverse the above, the antibodies will disappear and TSH, etc., will revert to normal?

    Any support for this in the literature?

  • dubyaemgee

    1/25/2009 8:12:00 PM |

    I suspect there needs to be some reeducation as to what is considered "normal" within the medical community as a whole. My TSH was last measured at 4.32, and is considered well within the range of normal, even though I've been complaining of hypothyroidism for a while now. Seems like we have to go into the doctor's office with steely determination to have these problems addressed.

  • mike V

    1/26/2009 2:03:00 AM |

    Drs Davis and BG:
    I think you are both on target with the attention you pay to hypothyroidism in relation to heart disease, and other related diseases such as obesity, diabetes, kidney and other hormone related problems.

    Question please:
    In your opinions:
    1 Is the high incidence of hypothyroidism in the population throwing 'off' the lab  norms for TSH, FT3, FT4 or can we assume the numbers used by most labs are based on world wide or historical values?

    2 Is 'Subclinical Hypothyroidism' real, or could it simply be a function of #1, or inadequate vitamin D3/iodine etc. I understand that 60% of the US population may be in that category.

    Thank you
    Mike V

  • Anne

    1/26/2009 2:26:00 PM |

    You mention the connection between wheat and thyroid. If you want to read more about that, go to The Gluten File. www.theglutenfile.com There you will find a section on thyroid disease.

    It is known that about 4-6% of those with Hashimoto's have celiac disease. I am sure that percentage would go even higher if one included those with non-celiac gluten sensitivity. There has been at least one study showing that thyroid antibodies disappear with the use of a gluten free diet.

  • Nameless

    1/26/2009 8:46:00 PM |

    Are there any studies showing wheat, vitamin D, etc. causing Hashimoto's? I suspect there isn't, but if population studies are looked into, perhaps you could find a correlation? Look at populations that generally don't consume much wheat, and see what their rates of Hashimoto's are. Or populations at upper latitudes vs those near the equator, and their rates of Hashimoto's.

    However, if wheat, lack of sleep, poor diet, etc. does cause Hashimoto's, wouldn't it alter the male/female ratio of who gets the disease? Why would women still be more likely to contract Hashimoto's, if the cause is diet?

    And in my case, several years ago I went to a low carb diet, restricted wheat, desserts consist of fruits/berries only, corrected my vitamin D levels, took fish oil, etc. I also tested negative for Celiac. Before these changes my thyroid tested normal (TSH in the low 1s). I was never overweight and exercised regularly too.

    And this past month I was  diagnosed with Hashimoto's (high antibodies, TSH in the 3s, thyroid scan all lumpy). So... if there is a correlation, shouldn't my thyroid have improved, not gotten worse?

  • G

    1/26/2009 10:00:00 PM |

    Bad_CRC,

    I think you need to have the genetic susceptibility. On the animal pharm blog, I've listed a few that scientists have already correlated to Hashimoto's
    --VDR polymorphs
    --HLA polymorphs

    I'm certain there will only be dozens others b/c these things (autoimmunity) don't happen alone.

    Add'l, perhaps these things are also just signals for 'hibernation'...??  Perhaps we are only inducing ancient signals that are meant to protect and increase survival (low melatonin, high carbs, wheat/stress, fructose (from the Italian sodas I forgot to mention!), gaining weight, slowing down to Eat-Eat-Eat/stress, etc).

    Any thoughts?

    There are a few links in the literature regarding higher TSH, lower T3/T4 during winter months and lower vitamin D in the serum. Of course!

    -G

  • mike V

    1/27/2009 2:32:00 AM |

    G
    I have no personal doubt that how well you choose your parents is of primary importance.
    My late mother, and two brothers and sisters have all been  hypothyroid.
    As in most diseases, I think other immune factors can be involved, some in the womb, some exposures in early childhood, while the immune system is still being 'programmed', others from bacterial or viral exposures.
    It is said that vitamin D is quite important in a balanced immune system, but it starts very low in typical breast milk, and in very young children, and can remain low throughout life in much of the population.
    Iodine deficiency was a critical factor in people not living near the coasts, until iodized salt was introduced in the early 20th century.
    Lack of timely exposure to bright light is well known to "mess" with our biological clock, moods, and immunity.
    I did not become aware that I was hypothyroid until my forties, and since have not found nutrition a major factor, until perhaps vitamin D.
    With the exception of vitamin D, I have not personally been aware that other nutrition has affected my treatment.
    Is there any co-relation between Hasimoto's, and other auto-immune conditions?

    MikeV

  • Dr. William Davis

    1/27/2009 11:53:00 AM |

    Mike V--

    The newest data, e.g., the HUNT Study, are analyses of events based on TSH. It therefore factors out the effect of population distributions.

    You are correct, however, in pointing out that previous analyses were flawed precisely for this reason.

  • mike V

    1/27/2009 5:13:00 PM |

    As usual thanks to all for the education, and for all you do to penetrate the blood brain barrier between the specialties, Big Medica, and us (the great 'unwashed'. Smile)

    MikeV

  • Pat Elliott ND

    1/27/2009 5:44:00 PM |

    Hi Doc,
    We are seeing a very high % of our patients with zinc deficiency - similar to the whole vitamin D thing. Just wanted to share this with you since zinc is also correlated to blood sugar and cholesterol problems. Would love to see what you find in your patients with regard to this nutrient as well.
    Regards,
    Pat Elliott ND
    www.elliotthealthcare.com

  • Anonymous

    1/28/2009 3:51:00 AM |

    Pat Elliott  --

    How do you define a zinc deficiency? I've read that serum zinc is pretty inaccurate (as is copper or magnesium serum testing).

    Looking at other biomarkers, or a zinc taste test?

  • Lou

    4/1/2009 11:54:00 PM |

    I'm guessing that when "Nameless" took up the low-carb eating plan, they may have also increased eating soy.  Soy can really mess up the hormones.  I think we can blame soy for all this thyroid trouble and fibromyalgia and fatigue related troubles.  Add to that inadequate fish oils, butter, after years of telling us to avoid fats and sunlight (vitamin D) and you get a nice picture of what has happened to far too many of us.

  • scall0way

    11/10/2009 8:35:12 PM |

    I know this is an old post but I'm just going through all the thyroid-related posts. My TSH got flagged at a 9 when I went for a physical a couple weeks ago, and further tests came back with a Hashimoto's diagnosis.

    I just don't know. I follow a gluten-free diet, in fact I avoid all grains. I avoid all sugars, I don't consume any high-PUFA vegetables oils. I have not eaten any sort of soy (except for rare splashes of fermented soy sauce here or there) in a dozen years. I always cook any veggies I might eat  that call into the goitrogenic category. I supplement with 5000 IU of D3 in gelcap format daily. I consume most of my fats as sat fats/animal fats. I take fish oil, cod liver oil. I love to eat sardines.

    Yet my thyroid apparently has slowly been getting worse over the last couple years. My TSH is definitely higher than it was in 2007, and that was higher than it was in 2006 - slowly been climbing over the last few years until finally the doctor red-flagged it.

  • Anonymous

    7/29/2010 10:42:48 AM |

    I have Hashimotos. Was diagnosed at 15. Had it long before then. I am convinced it is genetic when I look at other family members (although no-one else has been diagnosed). I am on 'correct' dosage of thyroid hormones but many of the symptoms still exist and I would LOVE to blame my GP but the fact is that they are overworked and are doing the best with what they have - like the rest of the population. Recently diagnosed with anxiety by a psychologist. Does this cover the hashimotos symptoms completely or partially? Who knows? All I know is that I am drunk now as I am bone tired from trying and failing from everything from relationships to work - alcohol seems to be the only way out...although my psychologist has told me it isn't - just being tired and weak I guess. I'm sure you will delete this post as soon as you see it blog owner, but before you do, I hope a few Hashimotos/anxiety sufferers see one person struggling to be better despite the messy interference of life. Having a temporary failure right now but will be back on the horse again tomorrow like every other day.

    Love you all.

    XXX.

  • buy jeans

    11/3/2010 6:58:15 PM |

    JMC at the blog animal pharm has linked some fantastic resources from Loren Cordain and how the Paleo diet reverses autoimmune diseases (incl JMC's own rheumatoid arthritis). Wheat is not the ONLY culprit. Legumes, Dairy/casein, nutr'l deficiencies, excessive fruit/HFCS, lack of exercise, lectins, etc are part of the equation for autoimmunity disorders as well.

  • PureAlan

    1/24/2011 10:46:15 AM |

    What a brilliant idea! Thanks for sharing this information. I have hypothyroidism for almost 4 years and it was terrible. I am currently taking porcine thyroid .  Now I'm gaining back my normal life.

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Thyroid: Be a perfectionist

Thyroid: Be a perfectionist

If you'd like to reduce LDL cholesterol with nearly as much power as a statin drug, think thyroid.

When thyroid is corrected to ideal levels, LDL cholesterol drops 20, 30, 40 mg/dl or more, depending on how poor thyroid function and how high LDL are at the start. The poorer the thyroid function (the higher the TSH or the lower the T3 and T4) and the higher the LDL cholesterol, the more LDL drops with thyroid correction.

(For those of you minding LDL particle size, such as Track Your Plaque Members, the "dominant" LDL species will drop: If you are genetic small LDL, small LDL will drop. If you have mostly large LDL because of being wheat-free and sugar-free, then large LDL will drop.)

One of the problems is that many healthcare providers blindly follow what the laboratory says is "normal" or the "reference range," which is usually nothing more than a population average (actually the mean +/- 2 standard deviations, a common method of developing references ranges). In other words, a substantial degree of low thyroid function, or hypothyroidism, can be present when your doctor adheres to the reference range provided by the laboratory.

What does it mean to achieve ideal thyroid status? My list includes:

--Normal oral temperature of 97.3 F first upon arising. (The thyroid is the body's thermoregulatory organ.)
--TSH 1.0 mIU/L or less
--Free T3 upper half "normal" range
--Free T4 upper half "normal" range
--You feel good: mental clarity, energy, upbeat mood. You lose weight when you try.

Iodine replacement should be part of any thyroid health effort. Iodine is not an optional trace mineral, no more than vitamin C is optional (else your teeth fall out). The only dangers to iodine replacement are to those who have been starved of iodine for many years; increase iodine and the thyroid can over-respond. I've seen this happen in 2 of the last 300 people who have supplemented iodine.

In my view, neglecting T3 replacement is absurd. While it is not clear to me why many otherwise healthy people have low T3 at the low range of "normal" or even in the below-normal range, people feel better and have better health--faster weight loss, reduced LDL, reduced triglycerides, they are happier and enjoy more energy--when T3 is increased to the upper half of the reference range. (Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)

It pays to be a perfectionist when it comes to thyroid. Not only do you feel better, but LDL cholesterol can drop with a statin-like magnitude, but with none of the adverse effects.

If interested, Track Your Plaque offers fingerstick blood spot testing that you can perform in your own home. Each test kit will test for: TSH, free T3, free T4, along with a thyroid peroxidase antibody (a marker for Hashimoto's thyroiditis, an autoimmune inflammatory condition of the thyroid).

Comments (18) -

  • Anonymous

    7/27/2009 1:24:46 PM |

    Interesting... my mother was put on a statin about a year and a half ago due to "hypercholesterolemia" (dx of course by a basic lipid panel).  Around the same time she was also put on thyroid medication.  Her LDL dropped and we all assumed it was the statin...

  • Nameless

    7/27/2009 6:35:06 PM |

    Low carb diets can influence T3 by lowering it. Certain beta blockers can inhibit 5'-deiodinase too.

    What do you think about studies like this one:
    http://www.reuters.com/article/healthNews/idUSTRE55B67D20090612

    Where they theorize that low thyroid function may be linked to longevity? I believe that has been found in certain species of rodents too and low metabolic rates for elephants (as the article researchers comment on).

    I'm not saying everyone should go around being hypothyroid, but am curious what your thoughts are. Perhaps lowered thyroid function is a part of aging?

  • sdkidsbooks

    7/28/2009 1:51:24 PM |

    I'm still wrestling with my pcp over my thyroid. I'm back on Armour 90mgs but my tsh is 5.6, which is needs to be lower, as you say 1.0.  My dr keeps telling me she doesn't want to increase the rx because she's afraid I will get atrial fibrillation. She doesn't test for anything else but tsh

    Currently, my morning temps are 96.3, I have trouble losing weight and my LDL is just at the upper range of normal and my LP(a)is 34. I'm not taking statins and am following all of the heartscan blog diet/supplement recommendations. I want to get my LDL down, lower my LPa and regulate my thyroid. Is it risky to take more Armour to lower my tsh?  I am taking 220mcgs of iodine should I increase that?

    Jan

  • Anonymous

    7/28/2009 4:01:32 PM |

    I'm a little confused about the iodine thing. I Googled around and found several studies implying that iodine supplementation can increase incidences of hypothyroidism.

    Here and here are two of the studies I saw. In the referenced-by section of the last one is an interesting study where excess iodine was found to be the root of goiter and thyroid troubles in some Peace Corps workers in West Africa.

    I started googling more specifically and found more sites that warned about iodine-induced hypothyroidism, but the majority stated the opposite (that iodine can help hypothyroidism).

    I'm not trying to contradict or anything, but I was wondering if you were aware, that's all. I mean, imagine the result if someone on the AAD (with all the prepackaged food) felt hypothyroid symptoms, and was told by a doctor to increase iodine intake, when they really had more than enough intake already...

    Perhaps you've already taken this into account. If you have the time I'd like to know your thoughts on it.

  • Dr. William Davis

    7/28/2009 4:19:18 PM |

    skids--

    Time for a new doctor, one who will listen to reason.

    Anon with question about iodine. Please put "iodine" into the Heart Scan Blog site specific search and you will find the several discussions we've had about this important issue.

    There is no question: We need iodine for health and many--not all--people are deficient.

  • Nameless

    7/28/2009 5:31:33 PM |

    I have read in a number of places that iodine can worsen Hashimoto's, although Dr. Davis feels it won't. Maybe he is right too, but he has never explained why high dose iodine is typically stated in various thyroid articles as something to avoid if you have an  autoimmune disease (besides potentially causing a hyper flare).

    The mechanism for worsening Hashimoto's would be:  iodine increases thyroid hormones, which in turns increases thyroid antibodies, which  then slowly kills off your thyroid quicker. Typically synthetic T4 or armour is used for hashimoto's, which can result in lowered antibodies (usually). I know of two studies where low-dose T4 decreased inflammation + antibodies in Hashi people too.

    I don't doubt that supplementing iodine if you are deficient is a good thing. But I am  not sure if large doses are a good idea if you have an autoimmune issue going on.

  • Kismet

    7/28/2009 7:35:55 PM |

    Anon read:
    Iodine: Deficiency and Therapeutic Considerations
    http://www.thorne.com/media/Iodine13-2.pdf

    The paper makes a compelling case that iodine is not necessarily the culprit. The hypothyroidism & life span data has me still worried, though. But that's nothing new.

    From a purely CVD perspective T3 & T4 look like an interesting target...

  • Dr. William Davis

    7/29/2009 2:51:17 AM |

    Nameless--

    I said nothing about Hashimoto's. I am talking about people in general. Perhaps you noticed that I am not sitting in front of you providing personal information!

    You are correct: If you are in the throes of active Hashimoto's thyroiditis, you should not take iodine, no more than a raging fire requires more kindling.

    Let me restate: Iodine is--in the general population-- a necessary trace mineral. Humans cannot live without it.

  • Nameless

    7/29/2009 3:32:38 AM |

    Dr. Davis,

    I didn't mean to infer that you should provide detailed info here, or were even mentioning hashimoto's at the moment.

    I just know it came up in past iodine threads, and the autoimmune issues weren't really spoken about in detail then. Since someone here asked about it, I thought I'd make a comment. People sometimes don't get fully tested if they have a thyroid issue (actually based on how doctors treat thyroid people, I'd say most don't get proper testing). I just had a concern that if someone has an autoimmune thyroid issue, excess iodine could be a rather bad thing. So it's worth getting both your thyroid and iodine status fully checked out, before you supplement with large doses.

  • Anna

    7/29/2009 1:36:01 PM |

    "So it's worth getting both your thyroid and iodine status fully checked out, before you supplement with large doses."

    This is definitely true, but in reality, in conventionally practiced medicine,  it hardly ever happens.  I have been treated for hypothyroidism with T4 (and sometimes T3) for more than three years.  For almost 15 years my thyroid function has been tested, initially with just TSH, then with TSH and total T4, then finally the past few years with free T4 and free T3 tests.  Only my new doctor ever tested for thyroid antibodies.

    And autoimmune hypothyroidism usually presents quite differently from plain hypothyroidism - with stops and starts to the symptoms, or even periods of hyperthyroidism.

  • liverock

    7/29/2009 2:10:03 PM |

    Dr Davis
    Re your comment on what stops T4 to T3 conversion.

    Adequate selenium is required to form thyroid hormone and with the increasing amounts of heavy metals (which are selenium antagonists,)we all are absorbing, selenium levels are dropping.

    "Selenium is a cofactor for 5’-deiodinase, the enzyme required to convert T4 to T3. A low 24 hour urinary selenium level likely correlates with overall selenium deficiency and decreased tissue availability of T3 due to decreased conversion of T4 to T3."

    Rocky Mountain Analytical Lab Report.
    www.rmalab.com/index.php?id=16

  • trinkwasser

    7/29/2009 6:18:46 PM |

    "Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one."

    Statins? (grins)

    Agreed, if there's something we could avoid to prevent this it would majorly benefit all those poor folks whose doctors refuse to treat hypothyroid. Who are legion.

  • Dennis Mangan

    7/30/2009 12:58:09 PM |

    Anyone interested in the topic of iodine supplementation and who wants lots of detail ought to read Dr. Guy Abraham.

    http://www.optimox.com/pics/Iodine/opt_Research_I.shtml

    Will answer any conceivable question you thought you had.

  • Jessica

    8/4/2009 11:08:04 PM |

    I was going to post a response to your question:

    "(Crucial question: Why is the 5'-deiodinase enzyme that converts T4 to T3 inhibited, resulting in reduced free T3? What is in our diets or environment that is exerting this effect? I don't have answer, but we sorely need one.)"

    But it looks like LiveRock already posted 1/2 of what I was going to post and that is that selenium is needed to convert T4 to T3.

    The other 1/2 of the problem of T4 to T3 inhibition is Vitamin D. My dad (family physician) said that the 5'deiodinase enzyme is a D dependent enzyme. Crank up the D and add selenium and see if the conversion problem still exists.

    He almost always puts patients on iodine PLUS selenium (no more than 400 mg) as well as several of the B vitamins (riboflavin, etc) for thyroid management.

    Have you read Dr. Brownsteins book, "Iodine: Why you need it, why you can't live without it?" it's a fantastic read.

  • dearthyroid

    8/14/2009 2:42:16 PM |

    Thanks so much for this post.  It's always so interesting to me to read up on iodine in relation to thyroid health.  I have Hashimoto's myself and know that there's so much controversy surrounding iodine... I don't know quite what to believe just yet.  Either way, thank you for your explanations about thyroid levels and cholesterol and treatment. The thyroid and liver are connected in a very powerful way that often gets overlooked.

    Thank you!

    Liz Smile

  • grace

    8/28/2009 12:16:47 AM |

    Great post!thanks for sharing.now i know that low carb diets can influence T3 by lowering it,try to put some thyroid medication by thyroid kits.

  • lightcan

    10/16/2009 10:55:45 AM |

    What about fluoride? I've read that it affects the thyroid. Is there a mechanism by which it might affect the conversion of T4 to T3?

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