Marc Ryan – Page 3 – Hashimotos Healing

All posts by Marc Ryan

Hashimoto’s Health Tip: Thyroid Hormone Resistance

Aged wooden double door

Today’s health tip is about thyroid hormone resistance. This is a common cause of feeling like crap because when this happens in your body, the cells aren’t absorbing and utilizing thyroid hormone.

So you might be taking thyroid hormone and your lab work might all look great, but you still feel like they just scraped you off the tires of a Greyhound bus.

It’s as if thyroid hormone is knocking on the cell’s door and the cells are saying,

“I hear you knocking but you cain’t come in.”

“Please let me in? Please, please, please, please?” says thyroid hormone.

“I’d like to, really I would, but no.” answers the cells.

What is their problem?

Well, there are lots of possible reasons for this. Let’s focus on 1 today:

Inflammation: The Root of All Evil

Inflammation suppresses the hypothalamic-Pituitary-Thyroid axis, by reducing the body’s available stores of TSH , T4, and T3.

The pituitary/hypothalamus also regulates many other hormones, including sex hormones; therefore, taking thyroid hormone medication may help some symptoms of hypothyroidism, but will not help all symptoms (since the hormone supplementation does not do anything if the cause is the pituitary or hypothalamus).

Inflammation can also reduce the number and sensitivity of thyroid hormone receptors throughout the body. All thyroid hormone (in the form of T3) has to be able to get into the body’s cells in order to have an effect;

if there are not enough cells, or they are not sensitive enough, it doesn’t matter how many thyroid meds you take.

Inflammation also decreases conversion of T4 to T3. Ninety percent of the thyroid hormone produced by the body is in the form of T4, but much of that has to be converted into T3 to be used.

Which is why T4 thyroid medications are not a great idea–you may end up taking more and more, and you’ll definitely get _effects_ from them, but not necessarily the benefits that your body would receive if it were able to convert T4 into T3 and utilize it to begin with.

Basically: Hashimoto’s is an inflammatory condition, and you must address inflammation in order to heal.

This begs the question: How do we address inflammation?

By any means necessary, if you have Hashimoto’s this should be your job, hobby, passion and obsession 24/7, 365.

Here are some things you can do:

1. Optimize vitamin D levels in the blood via supplementation with D3. Inflammation inhibits the body’s ability to convert Vit. D from the sun, and of course in people with Hashimoto’s, inflammation is everywhere.

2. Get to know and love glutathione, since this helps prevent oxidative damage. Autoimmunity and stress depletes the body’s stores of glutathione. (This can be challenging and there’s more to this than simple supplementation…more on this to come.)

3. Fatty acid balance is also very important. Omega-six fats promote inflammation, and omega-3 fats are anti-inflammatory. The best way to get omega-3s is to eat a lb. of fatty fish (salmon, makerel, sardines, halibut, herring) per week.

Of course, you have to weight this with all the chemical toxins in fish. Smaller fish like sardines, generally have less.

At the risk of sounding like a broken record, let me repeat. Reducing inflammation is key for overall healing. And STRESS AND LEAKY GUT are also the all stars of the Professional Inflammation League (The P.I.L.).

People who find the most success in healing their healing their Hashimoto’s are the ones who deal with both of these things.

Leaky gut is to inflammation what money is to politicians. It’s a license to ill, people.

And a lot of people don’t really take the impact that stress has on their health seriously. For people with autoimmune disease, research has shown that over 80% experienced a very stressful event prior to its onset.





Today’s Hashimoment: Create Room to Heal

Having Hashimoto’s is a lot like being an alcoholic. It never goes away and you have to make big changes in your life that may involve giving up people, places and things. You have to create room to heal.

pink flower

What’s your Hashimoment? Please leave a comment below.



Hashimoto’s Health Tip: Triggers

Hashimoto’s is an autoimmune disease.

Did you know that a specific antigen can stimulate the autoimmune attack? For example, a food, mold, bacteria, a chronic virus or a parasite are all examples.

These are Hashimoto’s triggers, they instigate the attack on your tissue by your immune system.

Your immune system attacks proteins and all proteins are made of a sequence of amino acids. There aren’t that many amino acids in nature, so there are certain sequences that are the same.

If antibodies have been created to specific amino acid sequences, then anything that has this same sequence may be attacked. Sometimes, our own tissue has the same amino acid sequences as foods or other things in our environment.

Gluten, is, of course, a perfect example of a trigger. Every time someone who is gluten sensitive eats gluten, it provokes an attack on their thyroid. Gluten has also been found to be very similar in structure to cerebellar tissue. So when you eat gluten, your brain also gets attacked.

Here’s a longer blog post I wrote on this topic.

People can also develop an immune response to environmental toxins and heavy metals. In this case, your body can develop antibodies to a combination of your own tissue and this toxin.

So when you are exposed to these triggers, your immune system responds and your tissue is collateral damage. This can be true of common objects in your house like foam in your pillows or formaldehyde in your furniture.

There is a variety of testing available to find out which of these triggers you may have. With my patients I order tests to test for gluten antibodies (over 24 different proteins), antibodies for environmental toxins and antibodies for other foods that may behave like gluten.

Another thing you can do is to keep a journal. You should note what you eat, what you have been doing, what you were exposed to and how you felt. Over time you may be able to identify some of the common triggers in your diet and your immediate environment.

Today’s Hashimoment: Forgiveness

I spent the weekend at a spiritual retreat and was reminded of the importance of forgiveness. We must forgive our immune systems for attacking our body, forgive those who don’t understand what we are going through, forgive ourselves for not being perfect. It is in forgiveness that we find healing.



Understanding Hashimoto’s Antibodies


Some of the most common questions that I get from people who reach out to me are about antibodies.

There seems to be a good deal of confusion about them and also a good deal of emotion and expectation attached to these numbers going up or down.

In this post, we examine thyroid antibodies and, hopefully, dispel some of the myths around them.

What Are Antibodies?

First of all, what are antibodies, exactly? I like to use military analogies when describing the immune system. And antibodies are like military intelligence (hold the oxymoron jokes).

They are the part of the immune system that gathers information on the bad guys (bacteria, viruses, fungus, parasites, etc.) and then they label those bad guys. Kind of like putting a red flag on them.

The invader is called an antigen. Antibodies bind to these antigens like a lock and a key. Every cell has antigens and these are what the immune system recognizes. And every cell in our body has a self-antigen which are supposed to let the immune system know that our own tissue isn’t a bad guy.

Once the bad guys have been labeled, other parts of the immune system are signaled and they attack and, in most cases, kill the bad guys. In some cases these antibodies can neutralize the bad guys all by themselves and not have to wait for reinforcements.

With autoimmune disease these antigen signals get confused and the immune system ends up attacking our own tissue.

Over the last 50 years there has been a lot of research in this area.

HLA is the Place Where Bad Things Happen

There is a region on cells located on some of our genes called the HLA (or Human Leucocyte Antigen) System. Many of these are located on chromosome 6 (for those of you keeping count).

Mutations or defects of HLA has been linked to many different autoimmune diseases. Exactly what happens is not known, there are numerous theories, but the end result is that our own tissue gets attacked and destroyed by the immune system.

There is a specific class of HLA (class II) that has been linked to autoimmune thyroid diseases like Hashimoto’s and there are also specific antibodies that are important in the disease.

What Antibodies Are Linked to Hashimoto’s?

There are 2 autoantibodies that are important:

Thyroid Peroxidase Antibody (TPO Ab): This antibody is the one that is usually high in autoimmune thyroid conditions like Hashimoto’s. It is also known as microsomal antibody.

Thyroglobulin Antibodies (TgAb): These aren’t seen high as often as TPO Ab. They are usually ordered when thyroid lab results seem strange because these antibodies can interfere with thyroid hormone production.

TgAb is also used to monitor progress after surgery for removing the thyroid in thyroid cancer.

In Hashimoto’s, TPOAbs are present in nearly all (>90 %) patients, while TgAbs can be seen in approximately 80%.

What Antigens Do These Antibodies Like?

Antibodies against TPO (TPOAbs) and Tg (TgAbs) are of immunoglobulin G class, (IgG) and both are really good buddies with their antigens.

For TPO, it is for the enzyme thyroid peroxidase, which frees iodine and helps in the production of T4 and T3.

And for TgAb it is for Thyroglobulin, which is also used by the thyroid to produce T3 and T4.

When these 2 things get destroyed, over time, the body can’t make enough thyroid hormone. 

This results in hypothyroidism and all the familiar problems of Hashimoto’s: fatigue, constipation, depression, hair loss, cold hands and feet, brain fog, memory issues and lots more.

Unlike TgAbs, TPOAbs can activate certain parts of the immune system (complement) and are able to cause damage to thyroid cells.

However, there isn’t much evidence that both antibodies have a major role in the formation of Hashimoto’s or in the destruction of thyroid cells.

It seems a lot more likely that other parts of the immune system are signaled and that they bring in the Navy Seals of the immune system which attack and kill thyroid cells.

Antibodies Are The Definitive Test for Hashimoto’s

TPO and TgAb antibodies, however, are considered the definitive test for whether or not you have Hashimoto’s. Basically, if either one or both of these are found to be above the lab range values, then you are positive for the disease.

Most labs have the high end at about 25 to 35. Numbers vary considerably, but it is not unusual for people who have been diagnosed to have antibodies above 1,000.

Antibodies Do Not Attack Thyroid Tissue

As I stated above, in most cases these antibodies, themselves, do not attack and kill thyroid cells.

What’s also important to understand is that there are various stages of autoimmune disease and depending on where you are in the progression, you will have different degrees of thyroid tissue destruction and, therefore, different symptoms.

According to Dr. Datis Kharrazian, there are 3 stages of autoimmune disease. While these stages are not recognized by conventional doctors, they are very useful in determining exactly where you are in the progression of the disease.

And realizing that there are stages and that the stages get worse and worse, is also helpful for motivating you to do as much as you can to stop the progression. (Hopefully!)

You can read more about these stages here.

Antibodies Unleash the Attack, But They Aren’t The Destroyers

The antibodies are really involved in signaling the immune system and in setting off a series of events that results in the attack and destruction of the thyroid.

I have written extensively about what happens in this previous post.

The important thing to understand here is that the amount of antibodies don’t necessarily directly correspond to how severe the Hashimoto’s is.

There are many reasons for this, but one simple way to look at it is this: The amount of destruction that is done by the army (the immune system) depends on the strength and number of the soldiers.

As I said earlier, the antibodies are really like the CIA or some intelligence gathering part of the army. The front line soldiers are the killers. If you have lots of soldiers and they are all revved up and ready to dance, then you get more destruction.

If your army is weak and there aren’t that many soldiers, then the CIA tells them to kill, kill, kill, but they can only do so much damage.

On the other hand, even if there are only a few CIA agents and there is a large, aggressive army, you will still have massive destruction (and loss of thyroid function).

Where am I going with all this? The amount of destruction, which really is the cause of how crappy you feel, depends on the strength and number of soldiers, not on the number of CIA agents in the field.

This is why antibodies are not a good measure of progress and often don’t correspond with how well people feel.

Antibody Levels Are Not A Good Measure of Progress (or Lack Thereof)

Antibody numbers don’t correspond, directly, with tissue destruction. As I mentioned above, in some cases TPO antibodies have been linked to tissue destruction, but more often, this is not the case.

Many patients and doctors or practitioners track these numbers and use them as a measure of whether or not what they are doing is working. And many times, they will find that there is no correspondence.

Obviously, getting antibody numbers to drop is not a bad thing. But it is also not necessarily such a good thing, because it may not be an indication that the destruction or the progression of the disease has slowed.

How Do You Measure The Severity of the Attack?

In conventional lab testing there really aren’t tests that are done to look at this. One theory with Hashimoto’s is that the ratio between the CIA and the soldiers is important.

The soldiers are also known as the TH-1 system, the cytokines or immune proteins associated with this part of the immune system are the killers.

The CIA is known as the TH-2 part of the immune system and you can test for ratios between TH-1 and TH-2 cytokines.

If there is a lot more of the soldiers than CIA agents, then the prognosis is not good and the disease tends to be more severe.

With Hashimoto’s there is a tendency towards more TH-1 than Th-2, but this is not always the case.

On the other hand if the CIA is more numerous or more balanced and the control and command part of the immune system (TH-3 or the regulatory part of the immune system- what we can call the General) is also strong, then, usually the prognosis is better and you can calm the attack and slow or stop the progression of the disease.

In reality, the immune system isn’t linear and this is an oversimplification. Testing is available to look at the cytokines that represent these different parts of the immune system, but there are many other factors that make current tests for this unreliable and not that helpful.

However, you can use these ideas to help figure out what you need to do in order to calm the attack, slow the progression of the disease and, most importantly, feel better.

What To Do About It

The major cause of thyroid tissue destruction is something called apoptosis. This is programmed cell death.

Lots of crazy things happen on a molecular level (like cytoskeletal disruption, cell shrinkage, chromatin condensation, nuclear fragmentation, membrane blebbing, and DNA fragmentation – membrane blebbing, people!) to make this happen, but the easiest way to grok the root of it is to understand that it is initiated by inflammation.

Inflammation Is the Root of All Evil

The best way to slow the progression and minimize destruction is to do everything you can to stop inflammation and to strengthen the regulatory part of the immune system.

2 important anti-inflammatory agents are: Vitamin D and glutathione. These supplements strengthen the regulatory part of the immune system (TH-3 or the General).

(One important thing to note is that some people with Hashimoto’s have a defect with vitamin D receptors and may need to take more than is usually required by normal individuals.)

These are important anti-inflammatories.

Another player in the complicated drama of Hashimoto’s is TH-17. This is like a rouge agent that when numerous and aggressive can do major damage. TH-17 is highly inflammatory.

Natural supplements that reduce TH-17 include Turmeric and Resveratrol. Some Chinese herbs that have been shown to reduce TH-17 are Chang Shan or dichroa root and Huang Lian and Huang Qin whose active compound is berberine.

Also, it is very important to reduce the causes of inflammation in your diet. The three most inflammatory foods in our diet are gluten, dairy and soy.

Gluten has been extensively hybridized and deamidated and has been linked to the initiation and progression of thyroid autoimmunity.

Dairy products when commercially produced are full of antibiotics, hormones and god knows what else. They have also been linked to the initiation of various autoimmune diseases.

Soy is one of the most heavily genetically modified foods in our diet and is also quite difficult to digest.

Things That Reduce Antibodies

Some research has indicated that thyroid replacement hormone can reduce TPO antibodies, though there is also some indication that natural desiccated hormone can raise antibodies in some individuals (it seems to be those who have a particularly severe immune reactivity – i.e., they have lots of inflammation).

Selenium has been found to reduce TPO antibodies in a number of studies.

Bottom Line

Thyroid antibodies are important for determining whether or not you have Hashimoto’s but are not always a good indicator of how well what you are doing is working.

Do not get too excited if antibody numbers go up or down. It’s not the antibodies that are the problem as much as the other parts of the immune system that are attacking and destroying the thyroid.

Get excited about reducing inflammation. That should be your daily obsession. Really, its that important.

Thyroid replacement hormone and selenium have been shown to reduce TPO antibodies, but this may not work for everyone.

Hashimoto’s is complicated. It is a multi-system disorder that requires a multi-system approach. That’s why created my program: Healing Hashimoto’s: The 5 Elements of Thyroid Health. Click here to learn more.






http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3271310/– Technichal, but great info on what happens in Hashimoto’s










Hashimoto’s: Blood Sugar Blues

Depressed Overweight Woman

The human body is a wonderfully complex playground where hormones, immune cells, neurotransmitters, red and white blood cells, bacteria, and more all frolic.

With Hashimoto’s that playground gets invaded by a hurricane of inflammation and this disrupts many of the systems that produce these things.

In today’s post, we focus on how blood sugar problems can impact the thyroid and how Hashimoto’s and hypothyroidism can also make blood sugar problems worse.

It’s a two way street, people.

The Poor, Dear Pancreas

The endocrine gland that is responsible for helping maintain blood sugar balance is the pancreas. The poor, dear, much beleaguered pancreas.

What does the pancreas do? Quite a lot actually, we really should be nicer to it. It does endocrine stuff and non-endocrine or exocrine stuff.

Blood Sugar Balance and Absorption

On the endocrine side it produces insulin, glucagon and somatostatin. Insulin and glucagon are involved in blood sugar metabolism and somatostatin is involved in intestinal absorption.

The exocrine functions include secreting digestive enzymes into the small intestines. These breakdown proteins, fats and carbs in the diet.

Studies have found pancreatic function was significantly reduced in patients with hypothyroidism.

And, in many people today, the pancreas is under siege.

Sugar Junkies

Americans are addicted to sugar. In some measure, it’s their own doing. In other ways,  it is the food industry and public health officials who decided that fat was evil when it was discovered that cholesterol was linked to heart disease in the 1980s. The National Academy of Science made sweeping recommendations at that time to get rid of dietary fat.

Bye, Bye Fat – Hello Sugar

So fat was taken out of many processed, fast foods and in an effort to make it taste less like an old ping pong table, it was replaced with sugar.

Carb Roller Coaster

What has since developed is a nation of carb and sugar addicts riding the roller coaster of sugar highs and crashes.

On average, Americans hammer about 200 pounds of sugar a year, and diabetes is a serious threat to bankrupt our healthcare system in the next 20 years.

It is estimated that almost half the population born after 2000 will become diabetic.

This is almost entirely due to diet. As Thomas Edison said, “We’re digging our graves with our teeth.”

2 Different Types of Sugar Problems

Health is really all about balance. And nowhere is this idea more evident than when you look at blood sugar balance.

There are really 2 different kinds of blood sugar problems and many people have a mixture of both. These are hypoglycemia (or too little sugar in the blood) and insulin resistance (or too much sugar in the blood).

With Hashimoto’s either one or both of these blood sugar problems can make things worse. And just to remind you that this goes in both directions; its important to understand that hypothyroidism can also cause blood sugar problems all by itself.

(We have the makings of a vicious cycle.)


Your body is programmed to recognize low blood sugar as a threat because severe or long term hypoglycemia can cause seizures, coma, and death.

When your blood sugar levels drop below normal, your adrenal glands respond by secreting cortisol. Cortisol then tells the liver to make more glucose, bringing blood sugar levels back to normal.

Hypoglycemia is a condition in which there is not enough cortisol to raise blood sugar into the normal range.

The problem is that cortisol (along with epinephrine) is also a sympathetic nervous system stimulant involved in the “flight or fight” response. This can end up wearing out the adrenals.

In fact, we often see adrenal fatigue and hypoglycemia together.

Low Blood Sugar and Cortisol

Cortisol’s job is to increase the amount of glucose available to the brain, enhance tissue repair, and slow other functions – like digestion, growth and reproduction – that aren’t so important when you are running from hungry lions on the African Savannah (flight).

Unfortunately for these people, repeated cortisol release caused by low blood sugar can also suppress pituitary function.

And the pituitary is the master gland that instructs the thyroid. If this function isn’t working properly, then “Houston, we have a problem.”

And where do we have a problem? In the thyroid.

Low Blood Sugar Causes Thyroid Problems

Cortisol directly inhibits the enzyme (5’-deiodinase) which converts inactive T4 into active T3.  This can lead to low T3 levels.

In addition, elevated cortisol will cause thyroid hormone receptor insensitivity meaning that even if T3 levels are high enough, they may not be able to bind normally to receptor sites. And when this happens it doesn’t get into the cells.

Cortisol will also increase the production of reverse T3 (rT3) which is inactive.  (It’s kind of like the anti-hormone.)

rT3 can cause an increase in the production of substances known as thyronamines that can cause hypothyroid symptoms (like, low basal body temperature,fatigue, depression, etc.) along with insulin resistance symptoms of increased blood sugar.

Cortisol can also lower the levels of protein that binds to thyroid hormone so it can circulate in a stable structure.

And finally, elevated cortisol will slow TSH production by messing with hypothalamic-pituitary feedback leading to lower TSH production.

In my previous post on the adrenal glands we learned about the HPA (hypothalmus-pituitary-adrenal) axis.

Well, there is also an HPT  (hypothalmus-pituitary-thyroid) axis.

And much like wires going through a transformer on an electric grid, the HPT and HPA axis are very closely related and problems in one area can affect the other.

“When things go wrong, wrong with you, it hurts me too.” sings the HPA to the HPT axis.

Common Symptoms of Hypoglycemia

Common symptoms of hypoglycemia include (These come from a form called a Metabolic Assessment Form that I use in my practice that I got from studying with Dr. Datis Kharrazian):

(Many of these symptoms improve when you eat )

*Craving sweets

*Irritable if meals are missed

*Depend on coffee or other kinds of caffeine for energy

*Eating relives fatigue

*Feel shaky, or jittery

*Feel agitated or nervous

*Get upset easily

*Poor memory, forgetful

*Blurred vision

It’s important for hypoglycemics to eat often throughout the day and not skip meals.  Each meal should be a combination of protein, carbohydrates and fats. And, for these people, too many carbs will often cause serious problems with their  blood sugar levels.

Insulin Resistance

When you eat too many carbs and too much sugar, the pancreas secretes insulin to move extra glucose from the blood into the cells where glucose is used to produce energy.

But over time, the cells lose the ability to respond to insulin. It’s like insulin is a little dog barking outside the cell, but the cell won’t let it in.

“I hear you barking, but you can’t come in.”

The pancreas responds by pumping out even more insulin (barking louder) in an effort to get glucose into the cells, and this eventually causes insulin resistance.

Studies have shown that the repeated insulin surges that come with insulin resistance increase the destruction of the thyroid gland in people with autoimmune thyroid disease.

Let me repeat that, insulin resistance increases the destruction of the thyroid gland in autoimmune thyroid disease (Hashimoto’s).

As the thyroid gland is destroyed, what happens? Thyroid hormone production falls. And this causes hypothyroidism. Not good.

Insulin Resistance Can Lead to Thyroid Problems

Insulin resistance can also cause a reduced conversion of T4 to T3 hormones.

When this is addressed, the cells can once again start using glucose for energy and T3 production picks up.

So for a person who is insulin resistant, a lower carbohydrate diet may help restore better T4 to T3 conversion and often these people lose weight in the process ( a nice side effect).

For other people, other things like long-term chronic stress may be affecting their response to low carb diets.  As we have seen in my previous post, chronic stress can interfere with thyroid hormones in several ways.

Common Symptoms of Insulin Resistance:

(These are also from that form mentioned above):

(Eating generally doesn’t improve these symptoms )

* Fatigue after meals (this is the hallmark symptom)

* General fatigue

* Constant hunger

* Craving for sweets that isn’t relieved when you eat sweets

* Must have sweets after meals

* Waist girth equal to or larger than hip girth

* Frequent urination

* Increased appetite and thirst

* Difficulty losing weight

* Migrating aches and pains


Many People Have Symptoms of Both

Life is not a textbook. Many people are somewhere in the middle of this blood sugar odyssey and they have some symptoms of hypoglycemia and some symptoms of insulin resistance.

I put this question to my Facebook Support Group and of the 66 respondents with Hashimoto’s, 24 reported symptoms of hypoglycemia and 14 reported symptoms of insulin resistance.

16 reported some symptoms of both.

While this is hardly a scientific study, it does demonstrate how common this problem is in this population.

Virtually Everyone Has Some Insulin Resistance

On thing that’s important to understand is that whether you have high or low blood sugar, you probably have some amount of insulin resistance.

I explained how high blood sugar causes insulin resistance above, but insulin resistance can also cause low blood sugar.

This condition, called reactive hypoglycemia, happens when the body secretes excess insulin in response to a high sugar and carbohydrate meal.

For example: A burger on a sesame seed bun, french fries and a soda – causing blood sugar levels to spike and then drop below normal. (I’m not lovin’ it!)

Hypothyroidism Can Cause Blood Sugar Problems Too

If you eat like this and you have Hashimoto’s (and hypothyroidism), you are setting yourself up for a world of hurt.

Hypo-function of the thyroid can cause everything we just talked about because:

  • it slows the rate of glucose uptake by cells;
  • it decreases rate of glucose absorption in the gut;
  • it slows response of insulin to elevated blood sugar; and,
  • it slows the clearance of insulin from the blood.

These mechanisms present clinically as hypoglycemia. When you’re hypothyroid, your cells aren’t very sensitive to glucose (they are resistant).

So although you may have normal levels of glucose in your blood, you’ll have the symptoms of hypoglycemia (fatigue, headache, hunger, irritability, etc.).

And since your cells aren’t getting the glucose they need, your adrenals will release cortisol to increase the amount of glucose available to them.

This causes a chronic stress response, as I described in a previous post, that suppresses thyroid function.

Does this sound familiar?

In another post on Synthroid, TSH and T4, I wrote about how some people are functionally hypothyroid. In other words, they have enough thyroid hormone, but it’s not getting into the cells.

Many of these people also have enough sugar in their blood but its not getting into the cells. Its another vicious cycle.

And let me tell you this from clinical experience. It is really, really, really, really, really, really, really, hard to manage a Hashimoto’s patient or someone with functional hypothyroidism if he or she doesn’t stop this sugar happy carb fest.

In fact, I’m going to say it. It’s a deal breaker.

If this high sugar diet isn’t stopped, you might as well throw in the towel, pack it in, wave the white flag, say “Uncle”, hear the fat lady sing, and give up, because you’re done.

All the money you’re spending on supplements and therapies won’t work. Instead, the first thing you need to do is to balance your blood sugar.

How to Keep Blood Sugar in A Healthy Range

When balancing blood sugar, there are two things to consider. The first is fasting blood glucose, which can be measured first thing in the morning before eating or drinking anything.

In functional medicine we define normal range for fasting blood glucose as 75 – 95 mg/dL. Although 100 is often considered the top of the range for normal, studies have shown that fasting blood sugar levels in the mid-90s may set the table for future diabetes a decade later.

And although 80 mg/dL is often defined as low end of the range, plenty of healthy people have fasting blood sugar in the mid-to-high 70s (especially if they follow a low-carb diet – all you Paleo fans- time to do the wave).

The second, and more important thing to measure is post-prandial blood glucose. This is measured 1-2 hours after a meal.

Several studies have shown that post-prandial blood glucose is the most accurate predictor of future diabetes and is the first marker (before fasting blood glucose and Hb1Ac) to indicate blood sugar imbalances.

Normal post-prandial blood sugar one to two hours after a meal is 120 mg/dL, but most normal people are under 100 mg/dL two hours after a meal.

How This Applies to You

How does this apply to you? If you’re hypoglycemic, your challenge is to keep your blood sugar above 75 throughout the day.

The best way to do this is to eat a low-to-moderate carbohydrate diet (to prevent the blood sugar fluctuations I described above), and to eat frequent, small meals every 2-3 hours (to ensure a continuous supply of energy to the body.

If you’re insulin resistant, your challenge is to keep your blood sugar below 120 two hours after a meal.

The only way you’re going to be able to do this is to restrict carbohydrates.

Buy A Blood Glucose Meter

Everyone should buy a blood glucose meter. The technology has gotten to the point where they are very precise and quite inexpensive.

How low-carb do you need to go?

Its different for everyone. (But, for most people with Hashimoto’s it is recommended to reduce carbs significantly.)

First, figure out your carbohydrate tolerance by buying a blood glucose meter and testing your blood sugar after various meals.

If you’ve eaten too many carbs, your blood sugar will remain above 120 mg/dL two hours after your meal.

Finally, if you have Hashimoto’s, it’s also important that you take steps to make sure your thyroid is properly balanced as well.

As you have seen, this thing works in both directions.

Sugar problems can mess with thyroid function, and thyroid disorders like Hashimoto’s can cause sugar problems and put you at greater risk for hypoglycemia, insulin resistance and if nothing is corrected, diabetes.

It’s Really Complicated – But There Is A Solution

As you can also see, there are layers and layers here that may need to be addressed and worked on.

Hashimoto’s is so much more than a thyroid problem. Its a multi-system problem and it requires a multi-system approach.

That’s why I created my program: Healing Hashimoto’s: The 5 Elements of Thyroid Health.

In it you will discover how all these systems interact and cause vicious cycles and you will also learn how to correct these imbalances and heal.

In the meantime, put down the happy meal and step from away from the counter! 🙂


http://www.ncbi.nlm.nih.gov/pubmed/16530289: Study on insulin resistance and inflammation

http://www.eje-online.org/content/134/1/21.extract : Cytokines and autoimmune disease

http://www.ncbi.nlm.nih.gov/pubmed/3500324: Impact of immune cells on TSH

http://care.diabetesjournals.org/content/24/8/1448.full: Study on Glucose Tolerance and Neuropathy




http://www.ncbi.nlm.nih.gov/pubmed/939192 : Study on impact of thyroid hormone on insulin secretion.

http://www.ncbi.nlm.nih.gov/pubmed/2013384 : Influence of the thyroid on pancreatic function

http://diabetes.diabetesjournals.org/content/16/9/643.full.pdf+html: Effects of thyroid function on insulin secretion

http://www.ncbi.nlm.nih.gov/pubmed/19364696 : Excess thyroid hormone and carbohydrate metabolism


The Thyroid: A Fundamental and Clinical Text, Lewis E. Braverman & Robert D. Utiger, Ninth Edition, Lippincott, Williams & Wilkins, 2005

Why Do I Still Have Thyroid Symptoms? (When My Lab Tests Are Normal), Dr. Datis Kharrazian, Elephant Printing 2010

Is Fibromyalgia Undiagnosed Hashimoto’s?

Fibromyalgia_tender_pointsHashimoto’s is the most common cause of hypothyroidism in the United States. An estimated 20 million people suffer from some form of thyroid disease.

Up to 60 per cent have no idea that they have a thyroid problem.Women are five to eight times more likely than men to have thyroid issues.

Fibromyalgia is a multi-symptom disorder that affects an estimated 5 million Americans 18 or older. Between 80 and 90 percent of people diagnosed with fibromyalgia are also women.

This week, I was thinking about the number of patients that I have seen that have been diagnosed with both conditions.

Many People Have Been Diagnosed with Both

I put the question to my Facebook support group and 74 people with Hashimoto’s responded.

Almost all of them confirmed that they had been diagnosed with both or had all of the symptoms of fibromyalgia.

This is hardly a scientific study, but it does give us some evidence that there is a lot of overlap between the 2 conditions.

As I said, several patients have come to me with a pre-existing diagnosis of fibromyalgia, or FMS, for which they have received little effective treatment or relief.

Many doctors treat these symptoms using drugs rather than uncovering the root cause of the patient’s issues.

Diagnosing Fibromyalgia

Diagnosing fibromyalgia is admittedly difficult. For years it has involved assessing the presence in the patient of multiple symptoms that indicate the syndrome.

Currently, there are three main symptoms which must be present for a fibromyalgia diagnosis. They are:

1.    Widespread pain

2.    Sleep problems

3.    Fatigue

The only existing blood test available is the FM/a, which tests for a lowered cytokine level suggestive of fibromyalgia, but the test is controversial and not yet considered definitive.

I do not mean to diminish or discount a diagnosis of fibromyalgia. What I am curious about is the link between FMS and Hashimoto’s.

Studies Show A Clear Link

Studies have come to indicate there is a component of thyroid dysfunction associated with FMS. A 2007 study by the Division of Rheumatology at the Department of Internal Medicine at the University of Pisa looked into a possible link between fibromyalgia and Hashimoto’s Hypothyroidism. It concluded that the presence of thyroid autoimmunity may predispose one to fibromyalgia.

This opens up the possibility that the opposite may be true: what if in some cases the various symptoms that point to a diagnosis of fibromyalgia are, in fact, just Hashimoto’s (which is often undiagnosed)?

In my own experience, I can tell you that a lot of fibromyalgia symptoms are present in my Hashimoto’s patients.

Is there a connection between the two?

In a review published in Thyroid Science by John C. Lowe and Jackie Yellin at the Fibromylgia Research Foundation, the authors wrote that, based on the available research, “inadequate thyroid hormone regulation is the most likely underlying mechanism of the symptoms and objective abnormalities of patients who meet the criteria for FMS.”

In the authors’ view, only hormone therapy has been seen to result in the mitigation of fibromyalgia symptoms. This, obviously, points to a connection between fibromyalgia and thyroid autoimmunity.

In fact, 2 neuroscientists at Stanford (Dr. Ian Carroll, MD and Dr. Jarred Younger PhD) are currently doing a clinical trial investigating T3 treatment for fibromyalgia.

Fibromyalgia and Hashimoto’s Share A Lot of Symptoms

So, at the very least, FMS and Hashimoto’s share a great number of symptoms. If you are diagnosed with FMS, it is highly advisable that you be tested for Hashimoto’s.

If you aren’t familiar with which tests to order for Hashimoto’s, check out my previous blog post for an in depth discussion on this.

Let’s Break it Down

Since there is so much overlap, I have decided to illustrate how virtually all the common symptoms of fibromyalgia can be caused by hypothyroidism (and, often, Hashimoto’s).

According to WebMD the most common symptoms of fibromyalgia are those in italics below. We will examine how hypothyroidism leads to each group of symptoms and why.

Chronic Pain

Chronic muscle pain, muscle spasms, or tightness: Muscle-related symptoms are common with patients with hypothyroidism. The symptoms vary, but in a recent series of studies 79% of patients reported some kind of myopathy (muscle pain).

The exact reasons why are not known, theories include impaired glycogenolysis (the breakdown of glycogen to glucose – a reminder of why blood sugar balance is so important), reduced mitochondrial activity (mitochondria are the cell’s energy producers) and a decrease in production of ATP (Adeosine triphosphate), the actual fuel in the cell.

A recent study also showed increased lactate production during exercise with hypothyroid patients – this is also consistent with mitochondria problems.

Tension or migraine headaches: Any of the causes above or below can lead to tension and headaches.

Jaw and facial tenderness: Jaw and facial tenderness can also be caused by the same factors that lead to other muscle pain.


Moderate or severe fatigue and decreased energy: Fatigue and decreased energy are some of the most common symptoms of hypothyroidism and Hashimoto’s.

There are many factors that lead to this including too little thyroid hormone production, the affect of too little thyroid hormone on the adrenals and blood sugar metabolism and the problems with ATP and mitochondria mentioned above.


Insomnia or waking up feeling just as tired as when you went to sleep: Sleep issues are also incredibly common with hypothyroidism. Instability of thyroid hormone levels due to poorly managed autoimmunity, T3 building up and being released into the bloodstream, and the thyroid’s affect on the adrenals can all lead to insomnia.

With hypothyroidism, too little T4 can lead to a slower breakdown of cortisol. It then builds up in the body and this impacts the HPA axis (hypothalmus-pituitary-adrenal axis). See my past blog post for an in depth look at this.


Stiffness upon waking or after staying in one position for too long: Hypothyroidism tends to cause a slower relaxation of tendons and some studies have shown high serum creatinine kinase levels. The levels are almost invariably in the MM isoenzyme that is the type of creatinine kinase found in skeletal muscles.

High levels of this enzyme are normally found in people who have been under extreme stress or who have just completed heavy exercise.

Reduced tolerance for exercise and muscle pain after exercise: This certainly could be caused by what we just discussed. In addition, there are a host of issues that hypothyroidism can cause that relate to reduced tolerance for exercise. Check out my previous post on this.

Brain Function

Difficulty remembering, concentrating, and performing simple mental tasks (“fibro fog”): According to Dr. Datis Kharrazian, the role of the thyroid on the brain is profound. Thyroid function impacts brain inflammation, plasticity, neurotransmitter activity and general brain function.

Thyroid hormone impacts all neurotransmitter receptors in men and women.

All of them.

So hypothyroidism can impact serotonin, dopamine, acetylcholine and gaba levels.

These neurotransmitters have a huge influence on memory, concentration and mood. Especially acetylcholine. Hypothyroidism can lead to acetylcholine deficiency and inefficient nerve firing.

This can cause memory loss and poor concentration.

Brain fog is brain inflammation, plain and simple. It is really important not to ignore it, like many doctors do. The consequences can be really bad.

Feeling anxious or depressed: As we just discussed, thyroid hormone impacts all neurotransmitter receptors. Gaba is an inhibitory neurotransmitter, it keeps you calm.

Hypothyroidism can impact gaba synthesis, release and reuptake. All of this can lead to increased anxiety.

Dopamine and serotonin are responsible for enabling us to experience joy and enjoy activities in our life and to get pleasure out of what we do. Hypothyroidism can also impact these neurotransmitters and can lead to deficiencies in both serotonin and dopamine.

Increase in urinary urgency or frequency (irritable bladder): Acetylcholine deficiency can impact urinary urgency and frequency.

Abdominal Issues:

• Abdominal pain, bloating, nausea, and constipation alternating with diarrhea (irritable bowel syndrome): Studies in human and dogs of hypothyroid patients have demonstrated a decrease in the electric and motor activity of the esophagus, stomach, small intestine and colon.

Digestive dysfunction is also incredibly common with hypothyroid patients. Leaky gut has been implicated in the formation and progression of various autoimmune diseases including Hashimoto’s.

Neurological Issues:

Neuropathic symptoms including parasthesias (tingling or prickling sensation caused by issues with peripheral nerves) and painful dysthesias (an abnormal, uncomfortable sense of touch) are also common with hypothyroidism.

The most common type of neurological symptom in hypothyroid patients is carpal tunnel syndrome.

Sensitivity to one or more of the following: odors, noise, bright lights, medications, certain foods, and cold: Neuropathies involving the cranial nerves (those that control smell, hearing, vision) have all been reported. Hearing loss due to hypothyroidism is the most common and has been reported in 31%-85% of patients.

There are many theories on how hypothyroidism impacts nerves, but some studies have shown demyelination (the loss of the coating around nerve fibers), and axonal degeneration (degeneration of the nerve branches).

Numbness or tingling in the face, arms, hands, legs, or feet: Certainly, this can be caused by what we just discussed.

A feeling of swelling (without actual swelling) in the hands and feet: This could be neurological or it could simply be caused by the destructive inflammatory process that is at the root of Hashimoto’s.

Bottom Line

As you can see, there is a plausible argument to be made that almost all of the symptoms of fibromyalgia could be rooted in hypothyroidism and Hashimoto’s.

Of course, this begs the question of what to do.

As with all things related to this disease, we are once again reminded that this is a multi-system disorder.

It’s much more than just a thyroid problem and it requires a multi-system approach if you want to manage it successfully.

This is exactly why I created my program: Healing Hashimoto’s: The 5 Elelments of Thyroid Health.

In it, I teach a step by step strategy for finding and healing your issues in all of these systems.

For more information, check out my program here.


http://www.thyroid.org/media-main/about-hypothyroidism/ : Statistics on thyroid disease

https://med.stanford.edu/clinicaltrials/trials/NCT00903877 : Clinical study using T3 to treat fibromyalgia

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856434/?tool=pubmed : Paper on leaky gut

: A review of the evidence on the link between fibromyalgia and hypothyroidism

http://www.ncbi.nlm.nih.gov/pubmed/21085966 : Study linking fibromyalgia and autoimmune thyroid disease

Rodcolico C, Toscano A, Benvenga S, et al. Myopathy as the persistently isolated symptomaology of primary autoimmune thyroidism. Thyroid 1998;8:1033

Monzani F, Caraccio N, Siciliano G, et al. Clinical and biochemical features of muscle dysfunction in subclinical hypothyroidism. J. Clinical Endocrinol Metab 1997;82:3315

Goti I. Serum creatinine phosphokinase isoenzymes in hypothyroidism, comvulsions, myocardial infarction and other diseases. Clin Chim Acta 1974;52:325

Kowalewski K, Kolodej A. Myoelectrical and mechanical activity of the stomach and intestine in hypothyroid dogs. Am J Dig Dis 1977;22;235

Bhatia PL, Gupta DP, Agrawal MK, et al. Audiological and vestibular function tests in hypothyroidism. Laryngoscope 1977;87:2082

Dyck PJ, Lambert ED. Polyneuropathy associated with hypothyroidism. J Neuropathl Exp Neurol 1970;29:631

The Thyroid: A Fundamental and Clinical Text, Lewis E. Braverman & Robert D. Utiger, Ninth Edition, Lippincott, Williams & Wilkins, 2005

Why Isn’t My Brain Working? Dr. Datis Kharrazian, Elephant Press, 2013

Hashimoto’s: How the Adrenals Cause All Kinds of Problems

Adrenal Collage

The human body, like the planet earth, is made of many ecosystems all interacting and influencing each other. With Hashimoto’s many of these ecosystems are altered and dysfunctional.

And one example of this is the interaction between the adrenal glands and the thyroid.

The Adrenals: Little Gland, Big Trouble

The adrenals are two little glands, about almond size that sit on top of the kidneys.

The one on the right kidney has a triangular shape and the one on the left kidney has a sort of half moon shape.

Each of the adrenals has different inner and outer parts or zones. The inner zone or the medulla is what secretes adrenalin and norepinephrine and just the right amount of dopamine.

These are the stress hormones.

The outer zone……(cue Rod Serling)

You’re traveling through another dimension — a dimension not only of sight and sound but of mind. A journey into a wondrous land whose boundaries are that of the imagination. That’s a signpost up ahead: your next stop……

The outer zone of the adrenal cortex,

this is where 3 different types of hormones are secreted: glucocorticoids, mineralcorticoids and androgens.

These hormones are all made from cholesterol (See? It does do good things.) and are critical to every day function.

Cortisol, the Star of the Show

Of the glucocorticoids, cortisol is the star.

It is stimulated by ACTH from the pituitary. This is very much like the relationship between TSH (also secreted by the pituitary) and T4.

ACTH and cortisol are the analogous hormones of the adrenals.

What does cortisol do?

It regulates blood sugar levels, increases body fat, defends the body against infections and helps the body adapt to stress. It also helps to convert food into energy and is anti-inflammatory.

What doesn’t it do might be a better question.

There are other hormones produced by the adrenals, but let’s not go there right now. Keep your focus here on the cortisol’s reason for being (or raison d’être, as the French would say).

Stress, the Femme Fatale of the Body

Ok, so let’s take a look at few different ways that stress, the femme fatale of the body, causes hypothyroid symptoms.

Most people are aware of the obvious forms of stress that affect the adrenal glands: impossibly full schedules, driving in traffic, financial problems, divorce, losing a job, moving, losing a loved one and the many other emotional and psychological challenges of modern life.

But other things you don’t normally think of, also place just as much of a burden on the adrenal glands.

These include blood sugar swings, gut dysfunction, leaky gut, food intolerances (especially gluten), chronic infections, environmental toxins, autoimmune problems and inflammation.

All of these conditions sound the alarm and cause the adrenals to pump out more stress hormones.

So really, stress can be thought of as anything that disturbs the body’s natural balance (or if you like, homeostasis).

Adrenal stress is one of the most common problems encountered in modern clinical practice, because nearly everyone is dealing with at least one of the things I just discussed.

Signs and Symptoms of Adrenal Stress

Symptoms of adrenal stress are many, because the adrenals (like its buddy, the thyroid) can affect every system in the body.

Symptoms of Adrenal Stress

Some of the more common symptoms are:

* Fatigue, also a thyroid symptom

* Headaches, splitting headaches especially

* Decreased immunity

* Sleep issues. Difficulty falling asleep, staying asleep and waking up feeling exhausted even after you had enough sleep.

* Mood swings

* Sugar and caffeine cravings, (have a hankering for a Red Bull? It could be your adrenals)

* Irritability or lightheadedness between meals, a blood sugar and adrenal problem

* Eating to relieve fatigue, another blood sugar problem

* Dizziness when moving from sitting or lying to standing, it affects your blood pressure

* Gastric ulcers, ulcers in the stomach can be caused by the adrenals

Treat the Adrenals to Heal the Thyroid

Weak adrenals can cause hypothyroid symptoms alone without any problem in the thyroid gland itself.

In such cases, working on the adrenals themselves may be the key to improving thyroid function.

The most significant indirect effect the adrenals have on thyroid function is through their affect on blood sugar.

Low or high cortisol – caused by any of the chronic stressors listed above – can cause hypoglycemica, insulin resistance or both.

Blood sugar imbalances cause hypothyroid symptoms in a variety of ways. (More on this in an upcoming post).

But adrenal stress also has more direct impacts on thyroid function. And, (darn the luck!) hypothyroidism has a direct impact on adrenal function. (I feel a vicious cycle coming on!)

Everything Causes Everything

Let’s reflect on non-linearity for a moment, none of this happens in one direction. Hypothyroidism impacts adrenal function and adrenal function, in turn, impacts the thyroid.

First, what happens with the adrenals when the body is in a hypothyroid or functionally hypothyroid state?

There is a very clear link between hypothyroidism and hypoadrenalism. When there is trouble from this, it is often linked to problems in a part of the brain called the hypothalmus.

The Hypothalmus, Boss of the Boss

The hypothalamus is really like the boss of the boss. (The pituitary is the master or boss endocrine gland and the hypothalamus is the pituitary’s boss.)

You know, like when the boss is real arrogant and always doing bossy things and then, all of a sudden, the boss’s boss shows up and he gets put in his place?

Well, the pituitary and the hypothalamus’ relationship is nothing like that. (Just wanted to see if you were paying attention.) 😉

Their relationship is more like, “Hey, we have this amazingly complex, super complicated body to run, do you want to help each other? Cool. Oh and by the way, this is not linear.”

HPA Axis, The Axis of Goodness

With the adrenals, this little benevolent, enlightened dictatorship is called the hypothalmic-pituitary-adrenal axis or the HPA axis. These 3 run the whole show.

The HPA axis plays a major role in regulating immune function, digestion, energy use, mood and thrill of thrills, sexuality.

This HPA axis is controlled by hormones (in a non-linear fashion) and it is totally manipulated by stress.

Stress is like the femme fatale of the HPA axis. It’s the mean wife of the boss’ boss.

Where am I going with all of this?

Well, a dysfunctional HPA axis, like the troubled empire ruled by the mean boss’ wife, can cause all kinds of problems.

With Hashimoto’s, one of the reasons why people continue to feel exhausted even though they are taking thyroid hormones is because of a messed up HPA axis.

And adrenal stress can lead directly to a messed up HPA axis.

Hypothryoidism also impacts the HPA axis. When you are hypothyroid it leads to elevated cortisol due to decreased clearance and a negative feedback loop (The HPA axis doesn’t work properly.)

This, in turn, inhibits thyroid function because cortisol inhibits the enzyme (5’ deodinase) that is responsible for converting T4 to the form the body uses, T3.

It can also inhibit TSH. Hmmmm…..

Thyroxine Treatment Can Cause Adrenal Problems

Something else no one ever tells you is that treatment with T4, like Synthroid or Levothyroxine, can cause adrenal problems.

If someone has adrenal insufficiency, then they are at risk for thyroxine making the problem worse!

Even if the adrenal insufficiency is not that bad, it may have an effect on thyroid conversion, tissue uptake, and thyroid response. And not in a good way.

If the T4 to T3 conversion doesn’t happen as it should, the body can become overloaded with unused T4.

If it is converted, but the T3 cannot enter the cell walls due to adrenal insufficiency or iron deficiency, the T3 cannot be used, and may pool or build up in the blood.

Studies have shown that very high levels of T3 can be toxic to the liver.

Sometimes this T3 pools and then releases or dumps into the blood stream. When this happens, you may suddenly feel all the hyper symptoms like heart palpitations, insomnia, nervousness, etc. This is one of the reasons why some Hashimoto’s people experience hyper to hypo cycles.

In many cases, T4 and TSH blood tests will appear normal, but the patient will feel really lousy.

If a doctor raises the thyroxine dose in this situation, things may become worse. How bad depends on the degree of adrenal insufficiency.

Symptoms may include all the symptoms mentioned above.

And check this out! (This comes from the warning label for Synthroid, but is true of all synthetic T4 drugs.)

“Patients with concomitant adrenal insufficiency should be treated with replacement glucocorticoids prior to initiation of treatment with levothyroxine sodium.

Failure to do so may precipitate an acute adrenal crisis when thyroid hormone therapy is initiated, due to increased metabolic clearance of glucocorticoids by thyroid hormone.”

What this means, in plain English, is that in cases of hypothyroidism, the adrenals need to be evaluated before putting patients on thyroid replacement hormone.

How many people with Hashimoto’s and hypothyroidism do you think have adrenal insufficiency?

I put this question to my Facebook support group and 100% of the 85 respondents with Hashimoto’s said they had most of the symptoms of adrenal insufficiency mentioned in the list I posted above. Granted, that’s not a scientific study, but it certainly is emblematic of this problem.

Have you ever heard of a doctor checking for this prior to beginning treatment?

It’s not very common, believe you me. Many doctors dismiss adrenal insufficiency as one of those make believe disorders.

The Flip Side

The other side of this is the many ways that adrenal stress can cause hypothyroidism.

As we discussed above, it messes with the HPA axis and this, in turn, messes with the HPT (hypothamus-pituitary-thyroid) axis. Communication gets all garbled all around.

And we all know how important good communication is. Especially when you have a super complicated body to run.

Adrenal Stress Can Lead to Autoimmunity

The GI tract, lungs and the blood-brain barrier are the main immune barriers in the body.

They prevent the bad guys from entering the bloodstream and the brain.

Adrenal stress weakens these barriers, weakens the immune system in general, and promotes poor immune system regulation.

Cortisol can impact this in both directions. Too little cortisol causes the immune system to rev up and can lead to an over aggressive immune response.

Too much cortisol can weaken the immune system and make you more vulnerable to attacks or unable to defend yourself.

When these immune barriers are breached large proteins and other antigens are able to pass into the bloodstream or brain where they don’t belong.

If this happens over and over again, the immune system gets thrown out of whack and we become more prone to autoimmune diseases – such as Hashimoto’s.

Adrenal Stress Leads to Thyroid Hormone Resistance

In order for thyroid hormone circulating in blood to work, it must first activate receptors on cells.

Inflammatory immune cells called cytokines have been shown to make thyroid receptor sites less sensitive.

With insulin resistance, where the cells gradually lose their sensitivity to insulin, we see a similar pattern. There it is insulin, here it is thyroid hormone.

It’s like thyroid hormone is knocking on the cell’s door, but the cells don’t answer.

“I hear you knockin’ but you cain’t come in.”

A perfect example of this in practice is the Hashimoto’s patient who is taking replacement hormones but still suffers from hypothyroid symptoms – often in spite of repeated changes in the dose and type of medication.

In these patients, inflammation is depressing thyroid receptor site sensitivity and producing hypothyroid symptoms, even though lab markers like TSH, T4 and T3 may be normal.

Adrenal stress reduces conversion of T4 to T3

93% of the hormone produced by the thyroid gland is T4, it is inactive in that form and must be converted into T3 before it can be used by the cells.

The inflammatory cytokines I just mentioned not only disrupt the HPA axis, they also interfere with the conversion of T4 to T3.

The enzyme 5″-deiodinase is responsible for the conversion of T4 into T3 in peripheral tissues such as the liver and the gut.

Both Th1 and Th2 inflammatory cytokines – IL-6, TNF-alpha, IFN-gamma and IL-1 beta – have been shown to suppress the conversion of T4 to T3.

In patients without thyroid illness, as levels of IL-6 (a marker for inflammation) rise, levels of serum T3 fall.

These inflammatory immune cells make T3 and TSH levels go down and reverse T3 levels go up.

So, adrenal insufficiency leads to poor conversion and adrenal stress due to inflammation can lead to this, as well. Giving us a lovely double whammy.

Adrenal stress causes hormonal imbalances

Cortisol also acts on the liver. When it is high, caused by chronic stress, this decreases the liver’s ability to clear certain hormones, like excess estrogens from the blood.

Excess estrogen increases levels of thyroid binding globulin (TBG), the proteins that thyroid hormone is attached to as it’s transported through the body.

When thyroid hormone is bound to TBG, it is inactive. Meaning it doesn’t work.

It must be taken from TBG to become “free” before it can activate the receptors on cells. (These are the free-fraction thyroid hormones that you see on lab tests as “free T4 [FT4]” and “free T3 [FT3]“.)

When TBG levels are high, the percentage of free thyroid hormones drops. This shows up on labs as low T3 uptake and low free T4/T3.

When stress is not the cause, the most common reason for elevated TBG are birth control pills and estrogen replacement (i.e. Premarin).

What To Do?

Here’s the tricky thing about adrenal stress: it’s almost always caused – at least in part – by something else.

These causes include anemia, blood sugar swings, gut inflammation, food intolerances (especially gluten), essential fatty acid deficiencies, environmental toxins, and of course, chronic emotional and psychological stress.

Sound familiar?

These are also all the things that make Hashimoto’s worse.

You can’t ignore them or pretend like they aren’t there like so many doctors do. We have to deal with all of them.

All of them. Half measures don’t lead to half results, they often lead to no results.

When they exist, these conditions must be addressed or any attempt to support the adrenals directly will either fail or be only partially successful.

So much more than a thyroid problem. Hashimoto’s is a multi-system problem.

Need help? I offer a free 30 minute Hashimoto’s Healing Strategy Session. In it you can share where you are, where you want to be and I can give you some recommendations that will help right away.

Book your session now: https://hashimotoshealing.as.me/strategy

How Do We Support the Adrenals?

This has been a long, exhausting blog post. It’s time to rest (for the sake of our adrenals). In an upcoming post I’ll look at all the things we can do to love our adrenals back to health. 🙂 Stay tuned!



https://cfids-cab.org/cfs-inform/Neuroendocrin/tsigos.chrousos02.pdf – Adrenal stress leads to Hashimoto’s

http://www.karger.com/Article/Abstract/87001 -HPT and HPA responses during repeated stress

The Thyroid: A Fundamental and Clinical Text, Lewis E. Braverman & Robert D. Utiger, Ninth Edition, Lippincott, Williams & Wilkins, 2005

Hashimoto’s Thryoiditis, Izabella Wentz, Wentz LLC publishing, 2013


5 Ways That Stress Causes Hypothyroid Symptoms






Hashimoto’s: The Liver and The Thyroid


Hashimoto’s: The Liver and the Thyroid

Hashimoto’s can cause a host of problems all over the body, but one place in particular where we can see it’s influence is on the liver and gall bladder.

In this post we explore these relationships and explain why a healthy liver is so important for healing your Hashimoto’s.

With Hashimoto’s The Liver and Thyroid Affect Each Other In Many Areas

The body is not a machine, like our earth it is a group of interacting ecosystems that all talk to one another and influence each other in both good and bad ways.

The liver and the thyroid are a perfect example of this. Here is a brief breakdown of how they interact:

* 60% of thyroid hormone is converted from T4 to T3 in the liver. Both T3 and T4 are glucoronidated and sulfated there. (More on that in a minute).

* Thyroid hormone influences the way that cholesterol and other lipids are synthesized and broken down (and where does this happen? – yes, the liver). With Hashimoto’s and hypothyroidism, this is often slowed down resulting in high cholesterol and other lipids like LDL and triglycerides.

* Thyroid hormone affects detoxification pathways in the liver and affects insulin growth factor and cytochrome P450 enzymes which metabolize lots of drugs and environmental toxins. When this slows you can have toxins build up.

* On the autoimmune side, research has shown a link between autoimmune thyroid and autoimmune liver diseases.

*Very high levels of thyroid hormone (T3) can raise bilirubin levels and can actually be toxic to the liver because it damages mitochondria.

How Does the GallBladder Fit In to This?

The liver has several pathways through which it metabolizes hormones, filters toxins, and cleans the blood. Byproducts from these processes are dumped into the gall bladder to help get them out of the body.

Low thyroid function slows down this whole process, making the liver and gall bladder sluggish and congested and helping to make gallstones.

Gallbladder x-rays in hypothyroid patients can show a bloated gall bladder that contracts sluggishly. This slows down the flow of bile which can lead to slower breakdown of fats and cholesterol and other toxins that are broken down in the liver.

This whole process can also lead to the formation of gall stones. Many people with Hashimoto’s have gall bladder issues.

How Is Thyroid Hormone Converted in the Liver?

Thyroid hormones are converted into their usable form in the liver (60% happens there), you can see how low thyroid function can create a vicious cycle.

Hypothyroidism messes with liver function and fewer thyroid hormones become active. So it goes until you have all of the common symptoms of too little thyroid hormone: fatigue, brain fog, joint pain, hair loss, weight gain, depression, etc.

Thyroid hormone is converted primarily through 2 processes:

Glucornidation and sulfation, let’s break these down:

According to Dr. Datis Kharrazian, DC, these processes are supported in the following ways:


Glucoronidation is an important process for converting thyroid hormone.
This pathway is supported by B vitamins, magnesium, and glysine, click here to learn about food sources of B vitamins and magnesium.


Sulfation involves binding things partially broken down in the liver with sulfur containing compounds. It is one of the major detoxification pathways for neurotransmitters, toxins, and hormones (like thyroid hormones).

Vitamin B6 and magnesium are important for sulfur amino acid metabolism, as are foods containing sulfur such as: eggs, cheese, meat, poultry, nuts and legumes. Click here to learn more about food sources of vitamins and minerals.

Its important to choose animals products wisely, buy organic whenever possible because organic foods have far fewer toxins like antibiotics, hormones, and pesticides which can all cause problems of their own.

Another important point about sulfating is that it requires sulfate which is often poorly absorbed by the digestive system, especially by people with Hashimoto’s who often suffer from intestinal permeability or leaky gut syndrome. Sulfate is the oxidized, inorganic form of sulfur produced by an oxidation step called (you guessed it) sulfoxidation.

This step is made possible by an enzyme that is called sulfite oxidase which uses the essential mineral molybdenum, click here to see food sources of molybdenum.

 Problems with sulfoxidation can be seen in people who are sensitive to foods that contain sulfites (garlic) or dugs and food additives (in dried fruit and herbs, preservatives, in salad bars used to keep vegetables looking fresh).

(These people may also have an abnormally strong odor in their urine after eating asparagus. For these people one should consider molybdenum supplementation or organic sulfates like sodium sulfate or magnesium sulfate.)

The Emotions of the Liver & Gall Bladder

In Chinese medicine, we view interactions in the body in the context of body, mind and spirit. This can be really helpful to see how these physical problems can affect you emotionally and psychologically.

In the book, Between Heaven and Earth by Harriet Beinfeld, L.Ac. and Efrem Korngold, L.Ac., the liver is described as something like a military commander in the body. It formulates tactics and strategies, moving blood and energy (qi) throughout the body.

The thyroid is part of the endocrine system which is viewed as qi and is derived from the yang energy of the kidneys. So the ancient Chinese recognized this relationship and how important one is for the other. The liver needs that qi to have the energy to do its job, and if it is clogged or blocked it can’t facilitate the movement of that energy throughout the body.

Anger, Irritability and a Short Fuse Are Symptoms of Liver Issues

When the liver gets stuck or clogged, the most common emotion that people experience is anger. This can be directed outwardly at people you know (usually people closest to you: family, co-workers, or friends), or this anger can be directed inwardly and result in depression and feeling of self-hatred and low self-worth. Or sometimes you have a combination of these two.

It is also interesting to note that in Chinese medicine the nervous system, tendons and ligaments and the eyes are thought to be part of the sphere of influence of the liver. So many people with Hashimoto’s also have issues in all of these areas: eye problems, tendon issues, and cognitive issues affecting the brain.

Gall Bladder Issues Make You Unable to Make Decisions

The Gall Bladder stores and secretes bile, this stimulates flow through the stomach and intestines and is very important in helping us to absorb and eliminate different foods as well as different ideas and concepts.

So proper bile flow and production also help us with proper judgment, clear thinking and decision making. If there are Liver/Gall Bladder issues we can end up taking actions without thinking them through, or making decisions and not following through on them or simply getting stuck, unable to decide what to do.

How Can You Help the Liver, Gall Bladder and (Indirectly) The Thyroid?

Here are some important herbs for helping the liver and gall bladder.

Ginger: this common food contains chemicals that have been shown to increase bile secretion and to reduce cholesterol levels by up regulating an enzyme responsible for bile acid production (cholesterol-7-alpha-hydorxylase).

Dandelion: The root of this common weed promotes the production of bile and its delivery to the gall bladder. It causes the gall bladder to contract and release bile.

Milk Thistle: This herb increases the solubility of bile and has been shown to significantly lower cholesterol concentrations in the gall bladder. It has potent anti-oxidant activity which supports detoxification and it prevents depletion of glutathione in the liver, which is often depleted in people with Hashimoto’s.

 It also has anti-inflammatory properties and it promotes protein synthesis to replace damaged liver cells.

Panax ginseng:This herb has been shown in several studies to have numerous positive impacts on liver function. It has been shown to reverse fatty liver in animals and can be really helpful in cleaning toxins out of the liver. It also has really important benefits for the immune system like promoting Kupffer cells (specialized immune cells located in the liver) and can be beneficial in balancing the immune system by increasing key proteins like IL-8.

Herba sargassi, Laminaria Kun Bu: These seaweeds have important detoxification properties and can be used to treat metabolic toxicosis with arthritis, rheumatism, dermatitis and psoriasis. They are quite mild and have very few if any side effects. In addition, they are rich in trace minerals and are helpful in reducing swelling, particularly in the lymphatic glands.

A word of caution with seaweeds: They contain iodine which can be problematic with some Hashimoto’s folks.

Fructus Gardeniae: This herb is the seed pod of the gardenia plant. It has potent anti-bacterial and anti-viral properties and can be used to reduce liver and gallblader congestion and infections.

Caution: Liver infections can be quite serious, consult a trained physician if you suspect that you have any form of hepatitis or liver disease.

Rhubarb Root: This herb is a potent laxative that can be used to treat acute gall bladder and pancreatic infections. It has potent anti-bacterial, anti-fungal and anti-viral properties.

Dosage is critical with this herb and too much can cause gastric pain and diarrhea. Never use during pregnancy or lactation or with gout, hemorrhoids or oxalic acid stones. Consult a trained professional before using this herb.

Herbs That Help With Anger and Irritability

There is a very effective herbal formula in Chinese Medicine whose name is translated as Rambling Powder. The name comes from the title the first chapter of a book by Zhuang Zi, “Rambling Without A Destination” that includes stories about wandering freely with an open mind. It is a reference to how this combination of herbs can help one feel less constrained emotionally, feel happy and less stressed.

It has several variations and contains a number of herbs that are very helpful for the liver including buplerum, mint, atractylodes and more. With modifications, it has also been used successfully to treat eye issues, hypertension, hepatitis, anemia, depression, irritability and anger.

Hashimoto’s Requires A Multi-Prong Approach

Hashimoto’s has so many moving parts and affects so many systems of the body that you really need to have a treatment strategy that looks at all these different areas and gives you solutions for all of them.

That’s why I developed my program: Healing Hashimoto’s: The 5 Elements of Thyroid Health. In in we explore the 5 major systems of the body and learn how they impact us physically, emotionally and spiritually.

Because true healing requires more than simply taking a few pills or herbs. It requires a complete overhaul of your body, mind and spirit. And it is a tremendous opportunity for growth and for healing all aspects of your life. Click here to learn more.


Between Heaven and Earth, Harriet Beinfeld, L.Ac. and Efrem Korngold, L.Ac., Ballantine Books, New York, 1991

Chinese Herbal Medicine Formulas and Strategies, Dan Bensky & Randall Barolet, Eastland Press, 1990

Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal? Datis Kharrazian, DC, Morgan James Publishing, 2010

The Thyroid, A Fundamental and Clinical Text, Ninth Edition, Lewis E. Braverman and Robert D. Utiger, 2005 Lippincott Williams and Wilkins

Severe hyperthyroidism induces mitochondria-mediated apoptosis in rat liver.
Upadhyay G, Singh R, Kumar A, Kumar S, Kapoor A, Godbole MM.
Source: Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Laukkarinen J, Kiudelis G, Lempinen M, Raty S, Pelli H, Sand J, Kemppainen E, Haglund C, Nordback I. Increased prevalence of subclinical hypothyroidism in common bile duct stone patients. J Clin Endocrinol Metab. 2007 Nov;92(11):4260-4. Epub 2007 Aug 28

Inkinen J, Sand J, Nordback I. Association between common bile duct stones and treated hypothyroidism.  Hepatogastroenterology. 2000 Jul-Aug:47(34):919-21

Food Sources of Vitamins & Minerals

Veggies - artichoke tomato greens

Wouldn’t it be great to have a list of food sources of vitamins? Well, look no further! In our continuing effort to provide you with all things healthy and beneficial here’s a pretty comprehensive list.

A word of caution: If you are following an autoimmune protocol there will be some foods here that you can not eat. However, I wanted to provide a pretty comprehensive list so that you can get a sense what’s available outside of a multi-vitamin.

VITAMIN A: red pepper, dandelion greens, carrot, apricot, kale, mustard greens, watercress, sweet potato, parsley, spinach, turnip, swiss chard, cantaloupe, broccoli

VITAMIN B1: rice bran, wheat germ, sunflower seeds, peanut, soybean, pinto bean, peas, millet, lentils, almonds, turnip greens, collard greens, kale, asparagus

VITAMIN B2: salmon, trout, cod, mackerel, perch, oysters, mushrooms, almonds, hijiki

VITAMIN B3: rice bran, peanuts, red pepper, wild rice, kelp, sesame seed, peaches, brown rice, mushrooms, barley, almonds, apricot

VITAMIN B5 (PANTOTHENIC ACID): beef, chicken, salmon, mackerel, sardines, barley, rice, avocado, plums, raisins, almonds, dates

VITAMIN B6: banana, barley, brewer’s yeast, molasses, soybeans, wheat bran, brown rice, liver, beef, cabbage, carrots, potato, yams

VITAMIN B12: beef liver, beef kidney, ham, sole, scallops, eggs, oats, soybean

miso, soy sauce, tempeh, pickles, amasake, nut and seed yogurts, sourdough bread, algae, spirulina and chlorella, brewer’s yeast

BIOTIN: beef liver, peanuts, eggs, peas, cauliflower, mushrooms, filberts

VITAMIN C: red pepper, currants, kale, parsley, turnip greens, mustard, spinach, green bell pepper, broccoli, Brussels sprouts, cauliflower, lemon, orange, red cabbage

VITAMIN E: soybean oil, corn oil, navy bean, oatmeal, green peas, brown rice, turnip greens, sweet potatoes, parsley

VITAMIN K: spinach, cauliflower, cabbage, carrots, soybeans, liver, oats

BIOFLAVONOIDS: lemon, lime, grapefruit, orange, red pepper, prune, parsley, apricot, plum, cherry, walnut, buckwheat

BORON: soybeans, prunes, raisins, almonds, rosehips, peanuts, hazelnuts, dates, honey, wine

CALCIUM: sesame seed, kelp, agar, dulse, collard greens, kale, turnip greens, almond, soybean, mustard greens, filbert, parsley, dandelion greens, brazil nut, spoon cabbage, watercress, chickpea, white bean, pinto bean, horseradish, pistachio, red pepper, figs, sunflower seed

CHROMIUM: beer, brewer’s yeast, brown rice, beans, mushrooms, potatoes

COPPER: oysters, liver, chocolate, cocoa, mushrooms, almonds, pecans, avocado, rye, walnuts

FLOURIDE: seafood, seaweed

FLOURINE: tea, sardines, salmon, mackerel, shrimp, kale, potatoes, spinach, apples

FOLIC ACID: liver, asparagus, lima beans, spinach, swiss chard, kale, cabbage, sweet corn

IODINE: kelp, dulse, agar, swiss chard, turnip greens, summer squash, mustard greens, watermelon, cucumber, spinach, asparagus, kale, turnip

IRON: dulse, kelp, rice bran, pumpkin seeds, beans, lentil, parsley, walnut, apricot, almond, raisins, swiss chard, spinach, dates, fig, kale, cucumber, cauliflower, cabbage

LYSINE: chicken, yoghurt, ricotta, cheese, avocado

MAGNESIUM: kelp, wheat bran, wheat germ, almonds, cashews, soybeans, brazilnut, dulse, peanut, walnut, filbert, sesame seed, lima beans, peas, millet

MANGANESE: oatmeal, whole wheat, peas, beans, egg yolk, spinach, kale, bananas, nuts, pineapple, sunflower seeds

MOLYBDENUM: buckwheat, eggs, oats, soybean, lima beans, barley, lentils, sunflower seeds, liver

PANTHOTHENIC ACID: liver, broccoli, mushrooms, eggs, peanuts, oils, peas, soybeans, sweet potatoe

POTASSIUM: dulse, kelp, soybean, lima bean, rice bran, banana, red pepper, white bean, pinto bean, apricot, peach, prune, sunflower seed, chickpea, lentil, almond, raisin, parsley, sesame seed, avocado

SELENIUM: brazil nuts, brown rice, brewer’s yeast, eggs, garlic, liver

SULFUR: kale, watercress, brussels sprouts, horseradish, cabbage, cranberry, turnip, cauliflower, raspberry, spinach, red cabbage, kelp, parsnip, leek, radish, cucumber, celery

ZINC: oysters, herring, liver, oatmeal, wheat bran, maple syrup, brewer’s yeast, sunflower seeds, soybeans, mushrooms, sardines, pecans, pumpkin seeds