Clinical Pearls from Working in the Trenches
Hey, people!
Wow! Another year has flown by.
We’re celebrating the second anniversary of launching our website and Facebook group.
I am a big fan of looking back at the data and the experiences and analyzing what we learned.
And, hopefully, we can continue to build from that and improve what we are trying to do.
And that is to help and educate people to heal their Hashimoto’s.
Over the course of these 2 years, I have had over 1,500 consultations with people with this disease.
I’ve listened as people described their symptoms, their struggles and their health histories and I’ve also taken a number of surveys and polls at our Facebook support group which has now reached 22,000 Likes.
I want to thank everyone who has joined us for their continued love and support!
This is something we could not have achieved without you.
You truly inspire me day in and day out!
A PRACTICE NOT ANALYZED IS NOT WORTH LIVING
In this blog post I’m going to summarize the top 3 things that I think are really important (from a clinical and practical point of view) and I’ll share a few odds and ends that are just really interesting to me.
And, just so you know…
Much of what we have learned over last 2 years will be summarized in my new book which is due out at the end of April 2015 called Road Map to Remission: A Practical Guide to Hashimoto’s Healing
It’s basically an owner’s manual for living with a Hashimoto’s body.
You can learn more about it here: Check out a video series on my new book.
If you haven’t yet done so, sign up to get on our email list so you can get all the latest updates, videos and research on Hashimoto’s.
Here are my top 3 clinical pearls and a little discussion on each and why I believe they matter to you.
Pearl #1: The Digestive Tract Is Ground Zero For Hashimoto’s and Autoimmunity
The more I work with people and help them turn their lives around, the more I realize that the digestive tract and, in particular, the intestines are ground zero for Hashimoto’s and autoimmunity.
And I can’t tell you how many people have shared with me that their doctors said that diet doesn’t matter.
Saying diet doesn’t matter for Hashimoto’s and hypothyroidism is kind of like saying alcohol doesn’t matter to an alcoholic.
The importance of diet can not be overstated and this is really a “no brainer”.
Yet, I am also continually surprised at how many people refuse to accept this or want to negotiate a kinder, gentler half way approach that doesn’t involve them changing their diet and, of course, their lives.
Hashimoto’s is an autoimmune disease and that means that your immune system is attacking your your own tissue.
Tissue attack and destruction is induced by immune system stimulation.
Where is your immune system?
An estimated 70 – 80 % lives in your digestive tract.
So everything that passes through there interacts with your immune system.
Also, there is a lot of research evidence that shows a clear link between “leaky gut” or intestinal permeability and autoimmune disease.
The breakdown of your intestines is a breakdown in the barrier to your immune system and this clearly is a factor in the initiation of autoimmune disease.
But it is also an important factor in people’s symptoms because if this is not addressed you have constant immune stimulation and constant tissue attack.
And this is not reserved for only the digestive system.
It’s effects are systemic. It has a ripple effect all over your body.
My advice is always get off of gluten, dairy and soy 100% and for many, because of the state of their intestines, this is not enough.
They need to do more.
For almost everyone, we recommend a version of the Autoimmune Paleo diet designed for autoimmune disease and Hashimoto’s, in particular.
And while you’re doing this, it’s a great time to work with someone like me because you can get a lot accomplished by working aggressively to heal the gut, clean up the liver and reduce systemic inflammation at the same time.
I have gotten messages on Facebook and emails from hundreds of different women and men who have credited this mind shift and change alone with completely transforming their lives.
If you’re on the fence about your diet, you’re just prolonging your misery needlessly.
It’s such a simple part of the solution.
This last year I became a bit obsessed with this area of study and research.
In fact, I did a video series and created a special program for it.
If you haven’t had a chance to see that yet, here’s a link: SAVE YOUR BRAIN (FROM HASHIMOTO’S)
(There’s 3 parts. The first 2 describe the issues and the third tells you about the solution.)
Why did I decide to give his so much attention?
Because, brain fog and memory issues are the number 2 problem for everyone with Hashimoto’s.
(Fatigue is number 1 and that is often brain based, as well. So you could argue that this is priority #1)
And here’s why it matters.
When you lose your brain, you lose everything.
The problems that Hashimoto’s can cause are relatively minor compared to what happens if neurodegeneration and autoimmunity inthe brain progresses past a certain point.
This can be a major factor in Alzheimer’s or Parkinson’s type symptoms and it can lead further to something like Hashimoto’s Encephalopathy.
Because Hashimoto’s (often the combination of hypothyroidism and autoimmunity) does a double whammy on the brain.
This leads to massive inflammation of the immune system in the brain which, in turn leads to major destruction of neurons and brain tissue.
The immune system in the brain is not like the immune system in the rest of the body.
It has 2 speeds, balls to the wall and calm. There’s no middle ground.
And there’s no off switch. No regulatory part of the immune system to calm it down.
It goes crazy until it can’t go crazy any more.
And when the immune cells in the brain (the microglia) get excited and activated, they chew up everything around them.
This is not good.
This process also has a profound impact on how you feel.
The anxiety, depression and inability to handle stress are not coincidences, they are another example of how this process upsets thebalance of your brain’s neurochemistry.
Neurotransmitters like serotonin, dopamine, acetylcholine, catecholamines and GABA are all impacted and can become deficient in people with Hashimoto’s.
These are you “molecules of emotion”.
They are directly responsible for your emotional health and well being.
And guess what else has a huge impact on the brain?
The gut.
The digestive tract is really the body’s second brain.
And these 2 interact with each in very important and significant ways.
So this is really one big pearl of wisdom.
Focusing on healing these 2 areas long term may just give you the greatest return on your investment of time, energy and money.
Another epiphany I had this year was discovering something called the 80/20 principle.
This is often used in business and in marketing, but the idea has universal applications because it comes from a basic law of nature.
It’s also called the Pareto Principle because it came from an economist named Vilfredo Pareto.
He observed that 80% of the wealth in his country was owned by 20% of the people.
Ok, so what does this have to do with Hashimoto’s?
Stay with me for a moment…
Well, it turns out that this basic idea applies to just about everything in the natural world.
Look around you…
…Most people spend 80% of their time with 20% of their friends.
…Look in your closet, you wear 80% of those clothes 20% or less of the time.
And on and on.
You can apply this to everything, including your body and your health.
And it’s not about the numbers, ok?
It might not be exactly 80/20, it could be 85/15 OR 75/25.
The point is that there is an imbalance in cause and effect.
Relatively few things cause the majority of results.
Why does this matter?
Well with Hashimoto’s, this means 80% of our problems are caused by 20% of the things we need to work on.
Or let me put it another way:
If you are like many of the people that I have worked with, then 80% of your symptoms are caused by 20% of the choices you made today…
…now imagine if you could fix 80% of your symptoms fast by figuring out what those 20% are and then make some changes…
…and get that 20% to really count…
You see where I’m going with this?
Well, obviously, if this is true, we need to figure out what the 20% is.
And I believe that I have a good idea where to start.
Spoiler alert! You just learned 2 important parts of this 20%.
The brain and the gut.
If we had just 30 seconds together before I was whisked away in a black sedan by terrorists, here’s what I’d tell you.
This seems like an over simplification, but it’s one of those things that is a fundamental truth.
Many of us who struggle with Hashimoto’s spend an enormous amount of time searching for the right information, the right doctor, the right drugs or combination of drugs and the right supplements.
But often the solution is right in front of us and it doesn’t require doing anything more.
It requires a steadfast devotion to doing less.
We’ve been conditioned in our consumer driven society to always want more.
And we’ve also been conditioned to think the answer is in a pill.
The pill that will deliver more is seductive and difficult to resist.
But the truth, for many, the most successful things you can do to feel better requires the ruthless application of simplifying your life.
If you really want to get better and find remission, become passionate about doing less.
And look at every part of your life. Especially at those things that you do compulsively.
Eat less sugar.
Watch less tv.
Read less news.
Spend less time with people who don’t support you or bring you joy.
Do less of the things that cause you stress.
And when you identify those things that are among the 20% that cause 80% of your misery.
Give them up 100%.
At the end of the day, this approach not only makes you healthier, it also gives you a much more rewarding life.
These were some interesting observations I have made:
1. More than 80% of the people I worked with had Mono and were exposed to the Epstein Barr Virus.
Clearly this virus is somehow involved in Hashimoto’s. How? The research is far from definitive. Theories include activation of NF Kappa Beta, activation of rouge B cells and proteins like IL-8.
Other common infections that are involved in the initiation of Hashimoto’s include Lyme disease, Yersenia and Herpes Viruses.
2. The most common symptom is fatigue.
Of all the many potential symptoms of Hashimoto’s fatigue is by far Public Enemy #1.
And fatigue is often brain based which means it is the result of neurodegeneration caused by hypothyroidism and autoimmunity in the brain that we mentioned above.
3. The disease is progressive. My teacher and mentor, Dr. Datis Kharrazian and others have identified 3 stages. Read this post to learn more about this.
4. Many people have more than one autoimmune disease or at the very least antibodies to other tissues.
The truth is that most doctors don’t test for or look for it. But, very often, it’s there.
One of the most common places for these additional antibodies is to brain tissue, especially cerebellar tissue.
And one thing I stress is that this matters because it means that the stakes are very high.
Autoimmunity to different parts of the body is the same basic process and it just finds different tissue.
And some of the places it can go can be life threatening.
This part of the equation must be taken very seriously.
And at it’s root what is autoimmunity?
Destructive inflammation.
And this means that reducing inflammation needs to be job 1.
And the best way to do that is to create an anti-inflammatory life.
This is without exception a simpler life because all the common excesses are known to cause more inflammation.
Well, that’s all for now.
I can’t wait to see what this next year will bring!
And if you’re not aware of it, I offer a free 30 minute Hashimoto’s Healing Discovery Session.
In it you can share your story with me. Tell me where you are and where you want to be.
I’ll make some recommendations that I think will help right away and we can discuss how else I might be able to help.
I set aside time every week to talk with people who have Hashimoto’s and I’d love to talk to you.
You can schedule a free session by clicking here.
Just a warning. These are all booked out 2 to 3 months in advance.
If you have a more pressing issue and you’re interested in working with me, shoot me an email at [email protected] and we’ll set aside time for you sooner.
Best,
Marc
Gliadin, a gluten protein
However, because of misinformation and the inconvenience of going gluten free, many people ignore these warnings or don’t think this really applies to them.
I have had a number of people write me and tell me during consultations that they need to see “peer reviewed studies” about gluten and Hashimoto’s before they are going to commit to going gluten free.
In this post we examine a boat load of research on this subject and we seek to demonstrate, once and for all, why eating gluten is not a luxury you and your thyroid (and lots of other important parts of your body – like your brain) can afford.
Celiac Disease is an Autoimmune Disorder
According to the Celiac Support Association “Celiac disease, also known as celiac sprue or gluten-sensitive enteropathy, is a genetically linked autoimmune disorder that can affect both children and adults…”
Yes, celiac disease is an autoimmune disease. It’s not just a food allergy or sensitivity.
What do we know about autoimmune disease?
When you have one, it’s easy to get others.
Like Hashimoto’s, for example.
To read more about this, check out my previous post that looks into this in depth.
“…In people with celiac disease, eating certain types of grain-based products sets off an immune mediated response that causes measurable damage to the small intestine.”
Another key point. I and many other specialists in this field believe that the small intestine is ground zero for autoimmune diseases of all kinds.
This damage to the small intestines has systemic consequences.
These include the immune system, the endocrine system, the nervous system and the brain. This is no small matter (pun intended).
“…This, in turn, interferes with the small intestine’s ability to absorb nutrients in food, leading to malnutrition and a variety of other complications.”
Yes, the other complications include an inability to convert and absorb thyroid hormone, major deficiencies in important vitamins and minerals like iodine, iron, selenium, magnesium and vitamins like B, D and plenty more.
Pretty much guaranteeing hypothyroidism and thyroid gland dysfunction.
“…The offending amino acid sequences are collectively called “gluten” and are found in wheat, barley, rye, and to a lesser extent, oats* (WBRO). Related proteins are found in triticale, spelt, and Kamut.”
Indeed, these “offending amino acid sequences” are not just found in these grains, they are found in many foods like dairy, soy, coffee, corn, potatoes, and lots more.
The reality is gluten may just be the tip of the iceberg and going gluten free may not be enough to effectively treat autoimmune disease.
Some people do not get better by only going gluten free. This is not because they don’t have a problem with gluten.
There are many other foods that have a similar amino acid sequence to gluten and these may also be a problem.
Because it is these amino acid sequences that the immune system attacks and that resemble our own tissues. (To learn more about this, check out this previous post).
Tissue transglutaminase is an enzyme that repairs damage in the body. People with celiac disease often make antibodies that attack this enzyme.
Well, studies have shown that people with transglutaminase and gliadin antibodies also have a much higher levels of TPO and TgAB antibodies.
Celiac Disease and autoimmune thyroid disorders share a common genetic link, namely, the DQ2 allele.
This is a subtype of a region of cells called the HLA (or Human Leucocyte Antigen) System.
There is a region on cells located on some of our genes called the HLA. Many of these are located on chromosome 6 (for those of you keeping count).
Mutations or defects of HLA have 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.
With Celiac disease and autoimmune thyroid diseases we see an increase in both types of antibodies that lead to attack on these tissues.
Collin et al found 5.4% of 335 adult celiac patients, of whom 83% complied with a gluten-free diet, had autoimmune thyroid disease (autoimmune hypothyroidism or Graves’ disease).
Counsell et al found that 14% (15 out of 107) of celiac patients had thyroid disorders (3.7% hyperthyroid and 10.3% hypothyroid).
The same authors also noted a high prevalence of thyroglobulin antibodies (11%) and thyroid microsomal (TPO) antibodies (15%) in their CD patients.
Likewise, Velluzzi et al found the prevalence of thyroid peroxidase antibodies to be higher in CD (29.7%, 14 out of 47 patients) than in healthy controls (9.6%).
This is another area of misinformation. Most doctors test for 2-4 gluten antibodies.
Current testing for Gluten-Reactivity and Celiac disease (CD) includes serum IgG and IgA against gliadin and tissue transglutaminase-2 (tTG2).
These antibodies are measured against minor components of a wheat protein called alpha-gliadin.
Here’s the thing, wheat consists of multiple proteins and peptides including, alpha-gliadin, omega-gliadin, glutenin, gluteomorphin, prodynorphin, and agglutinins.
And there are many we still do not know about.
And the important thing to understand is that any of these antigens can cause an immune response.
So, even if you tested negative to celiac, you could still have gluten sensitivity or silent celiac disease because you may not have tested for the right thing.
This is a really interesting question that is controversial and no one really knows.
But, here’s what we do know.
Autoimmunity doesn’t just happen for no reason. It is the result of a perfect storm of factors.
You need the genetic predisposition (like the HLA DQ2 allele mentioned above), you need exposure to some antigen (Often Yersenia, Epstein Barr, Coxsackie, Lyme disease or some other pathogen), these produce antibodies and somehow you get the breakdown of mucosal IgA and tight junction proteins.
Ground zero is the intestinal mucosa.
One theory is that gluten, which is sticky and invasive (like a thief who can get into anywhere it wants), gets into the intestines, into the spaces between the intestines (the tight junctions) and eventually into the bloodstream.
Then the immune system kicks in.
Antigen presenting cells like macrophages (those Pac man cells that munch the bad guys) start attacking and they stimulate the T helper cells.
These are either TH-1 or Th-2 (check out this previous post that describes this works with Hashimoto’s in detail) and these lead to pro-inflammatory immune cells and proteins, more antibodies, cross reactions – generally, all hell breaking loose.
And, finally as this plays out and is repeated over and over again every time you eat a piece of bread, a pastry, some cake, a doughnut, etc. you are unknowingly pushing your body further and further into autoimmunity.
Your immune system is so juiced it doesn’t know which way is up and eventually, you loose self tolerance.
And loss of self tolerance means the immune system starts attacking your own tissue.
Another problem caused by gluten is that it makes thyroid hormone less effective.
An interesting study published by the American Thyroid Association found “…This study examined 68 patients with Hashimoto’s thyroiditis alone and 35 patients with Hashimoto’s thyroiditis and celiac disease.
The average dose of levothyroxine needed to treat patients with Hashimoto’s thyroiditis alone was lower than the average dose required to treat patients with Hashimoto’s and celiac disease.
When the patients with celiac disease went on a gluten-free diet while staying on the same dose of thyroxine, their TSH level decreased, indicating that their absorption of thyroxine had improved.”
We see this clinically all the time.
When patients go gluten free, they often must reduce their dosage of thyroid replacement hormone because it starts to work so much better.
Well, thyroid hormone produced by your thyroid and thyroid replacement hormone have the same structure.
Gluten prevents thyroid hormone produced by your thyroid from being absorbed, as well.
One idea that is often discussed in this context is something called molecular mimicry.
This is what happens when the immune system identifies certain proteins or protein fragments (amino acid sequences) and then attacks everything that has that amino acid sequence.
With autoimmunity, when the immune system attacks a virus like Epstein Barr, for example, it activates certain kinds of B cells.
These differentiate into plasma cells and one theory is that these may also stimulate anti-self B cells.
These are present in normal people and are there because our immune system constantly gets rid of old dead cells from our body.
But somehow these viral fragments cause other immune proteins called complement to stick to our own tissue and when they accumulate the immune system starts attacking that living tissue as well.
Viruses may also down regulate the T suppressor cells that call off the attack and this keeps the carnage going.
This is what happens to the thyroid. Thyroid cells get attacked as does the enzyme thyroid peroxidase and the protein thyroglobulin.
There is plenty of evidence that gluten is involved with firing up autoimmunity, but I could not find any actual research to support the claim that gliadin proteins closely resemble thyroid tissue (which is something that many bloggers in this area repeat).
There is no question exposure to gluten leads to autoimmunity, destruction of the small intestine, systemic inflammation and destruction of the thyroid.
But whether this type of molecular mimicry is at play is not clear. (I invite any readers to show me this actual research.)
However, at the end of the day, this hardly matters. There are so many other reasons not to eat gluten. And here’s another really big one.
Another really good reason to stay far away from gluten is that it has been linked to destruction of the brain, especially the cerebellum.
The brain is profoundly impacted by Hashimoto’s.
Check out this video (SAVE YOUR BRAIN (FROM HASHIMOTO’S) to learn more.
This is the reason why the second most common symptom for people with Hashimoto’s is brain fog and memory issues. (The most common symptom is fatigue.)
A condition of advanced neurodegeneration that results from Hashimoto’s is called Hashimoto’s Encephalopathy.
This destroys parts of the brain in much the same way that Alzheimer’s does.
And this is caused by autoimmunity in the brain.
One area of the brain that can be impacted is the cerebellum. And a common symptom of impairment to the cerebellum is ataxia.
Ataxia is uncoordinated movement is due to a muscle control problem.
It leads to a jerky, unsteady, to-and-fro motion of the middle of the body (trunk) and an unsteady gait (walking style). It can also affect the limbs.
You can test this by doing the DUI test. Close your eyes and imagine you are walking on a tight rope, put one foot in front of the other.
If you lose your balance or fall over, this may indicate some impairment of the cerebellum.
Guess what else causes ataxia?
Gluten.
In fact, a study from Brain a Journal of Neurology, 2003 found “Gluten ataxia is therefore the single most common cause of sporadic idiopathic ataxia.”
The most common cause of ataxia that has no known explanation.
So when you combine Hashimoto’s with brain autoimmunity and gluten, you have a recipe for really bad things.
The final pièce de résistance of this post is something that is related to gluten but adds a whole other layer of badness.
That is glyphosate or Monsanto’s marquee product Roundup.
Glyphosate is sprayed on wheat and many other grain crops just before harvesting to make them dry out more uniformly.
Well, it turns out that this chemical also does a number on the small intestine, may be responsible all by itself for the destruction of the intestinal lining and the initiation of a host of diseases.
Fish exposed to glyphosate develop digestive problems that are a lot like celiac disease.
Celiac disease is associated with imbalances in gut bacteria that can be fully explained by the known effects of glyphosate on gut bacteria.
Characteristics of celiac disease point to impairment in many cytochrome P450 enzymes, which are involved with detoxifying environmental toxins, activating vitamin D3, catabolizing vitamin A, and maintaining bile acid production and sulfate supplies to the gut.
Glyphosate is known to inhibit cytochrome P450 enzymes.
Deficiencies in iron, cobalt, molybdenum, copper and other rare metals associated with celiac disease can be attributed to glyphosate’s strong ability to chelate these elements.
Deficiencies in tryptophan, tyrosine, methionine and selenomethionine associated with celiac disease match glyphosate’s known depletion of these amino acids.
Celiac disease patients have an increased risk to non-Hodgkin’s lymphoma, which has also been implicated in glyphosate exposure.
So Let’s Review:
Here are 5 reasons to never touch gluten as long as you live that are supported by about 30 peer review studies listed below.
1. Celiac Disease is an Autoimmune Disease with striking similarities to Autoimmune Thyroid Disease.
2. People with Celiac, and Gluten Sensitivity have higher levels of thyroid antibodies and visa versa.
3. Gluten can destroy your small intestines and cause deficiencies in important nutrients, vitamins, and minerals absolutely necessary for proper thyroid function.
4. Gluten and Celiac Disease block the absorption of thyroid hormone.
5. Gluten can cause neurodegeneration in your brain.
And a Bonus
6. Commercial wheat also has lots of glyphosate, a chemical that can make all of what we have just mentioned a whole lot worse.
In life we must always make decisions based on risk and benefit.
The risk of the destruction that gluten can cause in people with Hashimoto’s so far outweighs the benefit that it is really no contest.
http://www.csaceliacs.org/celiac_disease_defined.jsp
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2111403/ Celiac Disease and Autoimmune thyroid disease
http://www.ncbi.nlm.nih.gov/pubmed/18176874 North Italian prevelance of CD in autoimmune thyroid
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC96126/: CD and autoimmune endocrinopathies
http://www.eje-online.org/content/130/2/137.abstract Autoimmune thyroid disorders and celiac disease
http://www.ncbi.nlm.nih.gov/pubmed/15244201 Antigliadin antibodies in celiac disease
http://www.ncbi.nlm.nih.gov/pubmed/9872614 Autoimmune thyroid diseases and celiac disease
http://www.ncbi.nlm.nih.gov/pubmed/12919165 Risk factors of thyroid autoimmunity
http://www.ncbi.nlm.nih.gov/pubmed/11768252 Autoimmune thyroid disease in celiac patients
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3725235/ Celiac disease and autoimmunity: excellent overview
http://cvi.asm.org/content/8/4/678.full Celiac related autoimmune endocrinopathies
http://www.direct-ms.org/pdf/LeakyGutMS/Fasano%20Celiac%20other%20autoimmune%20disease.pdf Systemic Autoimmune disease and celiac
http://en.wikipedia.org/wiki/Anti-transglutaminase_antibodies EMA and transglutaminase antibodies
http://www.thyroid.org/patient-thyroid-information/ct-for-patients/vol-5-issue-6/vol-5-issue-6-p-3-4/ The effect of celiac disease on levothyroxine dosage
http://www.nature.com/cmi/journal/v8/n2/full/cmi201065a.html Antibodies in Celiac disease, implications beyond diagnosis
http://www.wjgnet.com/1007-9327/13/1715.asp Dutch study of patients with Hashimoto’s and Celiac disease
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730948/ Celiac disease and autoimmunity in the gut and elsewhere
http://jeffreydachmd.com/2014/01/hashimotos-thyroid-disease-molecular-mimicry/
http://www.todaysdietitian.com/newarchives/110310p52.shtml Research connects Celiac and Hashimoto’s
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1808742/ Gliadin, TPO and other antibodies in latent autoimmune diabetes patients
https://www.enterolab.com/StaticPages/EarlyDiagnosis.aspx Before the Villi Are Gone
http://en.wikipedia.org/wiki/Human_leukocyte_antigen Define HLA
http://thyroidbook.com/eating-gluten-increases-need-thyroid-hormones/
http://www.hindawi.com/journals/ijad/2011/865432/ Transglutaminase enzyme involved in Alzheimer’s
http://www.csaceliacs.org/celiac_disease_defined.jsp
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077662/ Hashimoto’s Encepheopathy and Cerebellar Ataxia
http://www.ncbi.nlm.nih.gov/pubmed/12566288 Gluten Ataxia
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945755/ Glyphosate, pathways to modern disease: Celiac sprue and gluten intolerance
https://www.cyrexlabs.com/Portals/0/Docs/ClinicalApplications/ClinicalAppArray3.pdf
“Why Isn’t My Brain Working”, Dr. Datis Kharrazian, 2013 Elephant Press
For many people who struggle with Hashimoto’s, diet is a huge issue.
Yet, many doctors ignore the role of diet in the initiation, and progression of this and other autoimmune diseases.
But, if you have Hashimoto’s, and you are like a lot of people we’ve worked with, then you know that what you eat has a huge impact on your health and how you feel.
This just makes sense. Where is your immune system in your body?
Over 70% is found in and around your digestive tract. This is where it lives.
What you eat has a profound impact on autoimmune diseases like Hashimoto’s.
In this series of posts, we’ll examine a key factor in healing your Hashimoto’s by looking into something that is really common but often overlooked.
SIBO or small intestine bacterial overgrowth.
I recently attended a lecture taught by my teacher and mentor, Dr. Datis Kharrazian.
Dr. Kharrazian is a relentless researcher.
He is always exploring other people’s research and doing his own in order to help us understand why people are getting sick and how we can fix it.
In a recent lecture that I attended called “The Neuroendocrine Immunology of Small Intestine Bacterial Overgrowth”, he shared a lot of really valuable information on many aspects of SIBO that new research has revealed.
Determining whether not you have SIBO can be really, really important for people with Hashimoto’s because of the role that the small intestines play in thyroid hormone conversion and absorption.
When you have Hashimoto’s and hypothyroidism this leads to problems with motor functions in the small intestine.
There are thyroid hormone receptors all over the gut. The vagus nerve fires into the gut.
If they aren’t getting enough thyroid hormone, things don’t move as well through there and that leads to overgrowth of bacteria.
And too much of this bacteria can interfere with levothyroxine absorption.
This is why some people take Synthroid, Armour, Cytomel, Naturethroid or another thyroid replacement hormone and it doesn’t feel like it’s working.
That’s because it isn’t.
With SIBO you can’t absorb thyroid hormone very well.
And autoimmunity shuts down T3 receptors.
Again, thyroid hormone doesn’t work if it can’t bind to receptors and can’t be absorbed.
So, even though you are taking thyroid hormone, it isn’t working – you have all the symptoms like fatigue, brain fog and memory issues, weight gain, hair loss, depression, etc.
Many researchers also believe that autoimmune disease originates in the intestines.
A leaky gut or damaged intestine has been found in every autoimmune disease that has been tested including rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), celiac disease, multiple sclerosis, type I diabetes and, yes, Hashimoto’s.
In the small intestine this damage leads to immune system stimulation, the wrong types of things in the blood stream and, ultimately, a systemic problem that results in the loss of self-tolerance.
This means that the immune system gets so overwhelmed it can’t tell what is our tissue and what is a bad guy that must be attacked.
There are many causes of the breakdown of the intestines.
These include NSAID use, alcohol, gluten and other dietary proteins, bacterial overgrowth, environmental toxins and more.
And once this breaks down it alters the whole ecosystem of the gut.
It’s hard to know which came first.
And at the end of the day, it doesn’t really matter.
What matters is what causes it and what we can do to heal it.
SIBO has a number of possible symptoms, but mostly these involve bloating, gas, diarrhea and/or constipation.
The hallmark symptom is bloating and discomfort after eating certain foods.
Basically here’s what happens.
The wrong type of bacteria end up getting into the small intestine. The migrate from the large intestine and take over.
They feed on certain types of foods like sugars, galactans, fructans and starch.
In reality, SIBO should be considered with abdominal discomfort after eating any of the following things:
– Starches
– Sugars/fructose
– Fructans
– Prebiotics
– Probiotics
– Fiber supplements
– Rice or pea powder from metabolic powders
– Galactans
You may notice that many of the foods listed here can also aggravate candida. And sometimes candida is blamed for what is actually SIBO.
The causes of SIBO matter because when we understand the causes, we can figure out how to fix them.
These include:
1. Too little stomach acid.
Hashimoto’s and hypothyroidism leads to lower production of gastrin and stomach acid. This is super common.
And ironically, many people develop GERD or acid reflux and are prescribed proton pump inhibitors and antacids that just make everything worse.
(We’ve discussed this in depth in this post)
2. An immune suppressed gut.
Many factors can lead to immune suppression in the gut. 2 important ones are long term corticosteroid treatment and chronic stress.
In either case, lots of cortisol or corticosteroids cause the immune system to shut down and allows the party to get out of control.
With Hashimoto’s the body is under a great deal of physiological stress, all the time. So extra emotional stress and abnormally stressful events often result in people getting a lot sicker.
This is one of the reasons why.
3. Injury to the gut nervous system (known as the ENS or enteric nervous system)
The gut has been called the body’s “second brain” because it has it’s own nervous system and produces many of the neurotransmitters that are also produced in the brain.
Well, just like our other brain this can degenerate and break down with age and with diseases like chronic celiac disease, sceleroderma and IBS.
And just like neurodegeneration in the brain, this can be permanent. But also, just like the brain this second brain has remarkable plasticity and it can relearn things and rewire itself, too.
The gut brain and our main brain are both loaded with thyroid hormone receptors. With Hashimoto’s and hypothyroidism, there is often too little thyroid hormone or it’s not getting absorbed properly.
This can result in damage to the enteric nervous system (the gut brain).
4. Problems with the Vagus nerve
The Vagus nerve is a central highway for communication between the brain and the gut. When the vagus nerve stops firing into the gut this slows down everything.
This is a major cause of slower motility and constipation.
Thyroid hormone has a direct affect on movement through the entire gastrointestinal tract.
Thyroid hormones increase intestinal neurotransmitters, increase blood flow to the intestines and support the repair and regeneration of the intestines.
Hypothyroidism can slow movement through the esophagus, can affect muscle function in this area and can affect the nerves that cause movement.
Hypothyroidism also has an affect on the vagus nerve and this can lead both directly and indirectly to slowing movement through the intestines.
5. Anatomical or structural changes to the small intestines or illeosecal valve
Surgery to the gut (like appendectomy or resection), diverticulitis and scarring due to inflammatory bowel disease can all lead to this.
Hypothyroidism can lead to the loss of control of the ileosecal valve that is the doorway between the large and small intestine.
When this stops working as it should it lets lots of critters from the large intestine into the small intestine.
Just like Hashimoto’s, SIBO has different degrees of severity. These are important because the more serious it is the more work you may have to do to resolve it.
I. Asymptomatic:
Abnormal small intestine bacterial overgrowth tests and mild or no symptoms.
Bloating after meals.
II. Moderate Symptoms:
Bloating with malnutrition and constipation.
Bloating with nutritional deficiencies.
III. Severe Symptoms:
Bloating with anemia, low albumin, low cholesterol
Bloating with weight loss, chronic diarrhea and malabsorption
If you are a person who has trouble taking supplements because you just react to everything, then you may fall into the more severe symptoms category.
Here’s an overview from the Journal of Clinical Gastroenterology on the prevalence of SIBO in other conditions:
15% of the elderly
33% of people with chronic diarrhea
34% of people with chronic pancreatitis
53% of people using antacid medication
66% of patients with celiac disease with persistent symptoms.
78% of people with IBS
90% of alcoholics
What really stands out for me there are 2 of those statistics.
More than half the people on antacid medication and 9 out of 10 alcoholics suffer from SIBO.
That shows you how destructive alcohol can be to the small intestines.
And, the fact is that alcohol degenerates the enteric nervous system of the gut very aggressively.
In the conventional medical model there are 2 types of testing for SIBO.
Both are flawed and not definitive.
1. Direct: Endoscopic Aspiration and Culture
This is a direct endoscopic aspiration and culture of the small intestine.
This requires a gastroenterologist, it’s expensive, it’s invasive (they have to go in and get a sample).
The problem with this is that many of the bacteria removed from the small intestine can’t be analyzed because they don’t survive in culture.
Samples must be handled properly for accurate results.
To recap: It’s expensive, it’s invasive and sometimes tests don’t reveal all the bacteria involved.
2. Indirect: Breath Testing for Hydrogen and Methane
This type of testing involves breath testing for hydrogen and methane.
This test can be inaccurate if someone has recently had antibiotics.
It may not be useful in determining all species of bacteria.
The optimal window for timing for collection is different for different people because transit time is different for different people.
To recap: You may get false negatives due to different transit times or antibiotic use.
Actually, the best test for SIBO is a trial diet and/or a stool test that looks for invasive species.
In our next post, we’ll look at this diet and how to treat all 5 different causes of SIBO and the various levels of seriousness.
http://www.ncbi.nlm.nih.gov/pubmed/17698907 – SIBO and hypothyroidism -antibiotic therapy didn’t affect thyroid hormone levels
http://www.ijem.in/article.asp?issn=2230-8210;year=2014;volume=18;issue=3;spage=307;epage=309;aulast=Patil
Link between SIBO and hypothyroidism
http://journals.lww.com/theendocrinologist/abstract/1995/05000/absorption_of_oral_thyroxine.9.aspx –
“It is markedly decreased in conditions in which there is a decrease in the effective small intestinal absorptive surface, including short bowel syndromes sprue, and other malabsorptive conditions.”
http://www.europeanreview.org/wp/wp-content/uploads/451-4561.pdf – Levothyroxine absorption in health and disease
http://gutcritters.com/thyroid-function-and-gastrointestinal-distress/ – LPS and thyroid receptors
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/ SIBO Study
http://www.ncbi.nlm.nih.gov/pubmed/12388159?dopt=Abstract – Infection leads to poor thyroid hormone absorption
http://www.ncbi.nlm.nih.gov/pubmed/18372241 – LPS reduced T3
http://chriskresser.com/inflammation-strikes-again – Low T3 Syndrome
http://www.naturalendocrinesolutions.com/articles/sibo-thyroid-health/
http://neurosciencestuff.tumblr.com/post/38271759345/gut-instincts-the-secrets-of-your-second-brain Great article on the enteric nervous system
http://www.ncbi.nlm.nih.gov/pubmed/16336493 : glial cels in the gut cause neurodegeneration
http://www.jneuroinflammation.com/content/7/1/37 : neurodegeneration in IBD
http://ajpgi.physiology.org/content/ajpgi/303/8/G887.full.pdf : enteric glia cells are protective, damage to them leads to neurodegeneration
Prevalence of small intestine bacterial overgrowth diagnosed by quantitative culture of intestinal aspirate in celiac disease. J Clin Gastroenterol, 2009 Feb; 43 (2): 157-161
The Neuroendocrine Immunology of Small Intestine Bacterial Overgrowth, lecture notes, Dr. Datis Kharrazian, November 2014.
The Paleo Approach, Sarah Ballantyne, PhD, Victory Belt Publishing 2013
Should You or Shouldn’t You?
Every year when flu season rolls around I get questions concerning whether or not to get a flu shot.
As with everything Hashimoto’s related, this is a seemingly simple question wrapped in a crazy complicated not-so-fast answer.
The Centers for Disease Control (CDC) recommends that everyone aged six years of age and older get a flu vaccine.
However, when you have Hashimoto’s you are not “everyone” and there are some unique challenges that need to be factored in first.
Some People with Hashimoto’s Get Wiped Out By the Flu Shot
In my experience in working with over 2,000 people with Hashimoto’s, I have found that some patients just get completed wiped out after getting the vaccine.
So, naturally, I have tried to figure out why. (‘Cause that’s how I roll.)
One person who has some great insight into this is infectious disease specialist Dr. Kent Holtorf, an MD I have a lot of respect for.
He’s a clinician and researcher and he operates outside of big pharma.
One thing he recommends is that people with mitochondrial dysfunction, chronic neurological illnesses, and fibromyalgia not get vaccinated because he has seen it “devastate” them.
I thought this was interesting because we have looked into the connection between fibromyalgia and Hashimoto’s (here’s a link if you missed that post) and these 2 patient populations have a lot in common.
So I would add Hashimoto’s patients to this list.
Because people with Hashimoto’s also have mitochondrial dysfunction, many have chronic neurological issues and more importantly, they also have an overzealous immune system.
Viruses and Hashimoto’s
And while viruses have not been definitively linked to the initiation of Hashimoto’s, upwards of 80% of the patients I have treated have been exposed to Epstein Barr virus somewhere in their history.
Of course, Epstein Barr (which is in the herpes family) and influenza virus are not the same.
However, the same part of the immune system is stimulated by the the influenza virus.
And if this is the part of the immune system that is over excited, then it stands to reason that bad things may happen if we make it mad.
It’s not nice to fool mother nature.
The Influenza B Virus and Hashimoto’s
In fact, there is also strong evidence that the Influenza B virus is also involved in the formation of Hashimoto’s, in some people.
So, what does that tell us?
That tells us that, for some people, the influenza vaccine (which is the exposure of dead fragments of the influenza virus to the immune system) may result in an aggressive immune response.
Which may result in a flare up of Hashimoto’s because this is also the part of the immune system that attacks the thyroid.
And for some of those people, that flare up may be “devastating”. I have seen this happen in my patients and this is precisely what Dr. Holthorf is describing, as well.
And these effects can be severe and long lasting because they may fire up the process that led to Hashimoto’s in the first place.
Of course this is not true of everyone. Some people with Hashimoto’s can tolerate the vaccine and do just fine.
Should You Get a Flu Shot?
Like so many things with Hashimoto’s, there is no simple yes or no answer.
If you are among the group that is triggered by viruses, then you run the risk of igniting the fire that already burnt you.
Another question is, what is your risk of exposure?
If you mostly stay home or work from home and have limited contact with other people, your risk of exposure to the flu will be small.
On the other hand, if you have school aged children who love to share every germ and virus imaginable, then your risk is considerably higher.
Also, there’s the question of whether or not you have other serious health conditions, in addition to Hashimoto’s.
If you have a serious chronic illness like emphysema, diabetes or heart disease, catching the flu could have life-threatening consequences for you.
You’ll have to weigh the risks of getting the vaccine and triggering a Hashimoto’s flare up against the potentially serious complications from catching the flu.
Generally, if you’ve had a flu shot in the past and didn’t have an adverse reaction, then you’re probably ok to have another.
Another thing to be aware of is that it’s kind of a crap shoot with the flu vaccine because the manufacturers simply make an educated guess about which strain will be prevalent next year.
And they are not always right.
What about those of us who don’t want to play with mother nature, but also don’t want to get the flu?
Fortunately, there are some really excellent natural solutions for this.
These include herbs and essential oils that have broad spectrum anti-viral properties and can help protect against both the cold and the flu.
Chinese medicine has a wide variety of broad spectrum anti-bacterial and anti-viral herbs that have been used for centuries to treat many infectious diseases.
In fact, there are whole schools of Chinese medical thought that are based on some very famous texts that taught early Chinese doctors how to treat infectious diseases.
2 of the most famous are The Shan Han Lun or On Cold Damage by Zhang Zhong Jing (thought by many to be the Hippocrates of Chinese Medicine) and Wen Bing Xue or Warm Disease Theory authored by five medical geniuses of the Qing Dynasty.
These texts were (and still are) the clinical manuals for generations of doctors who had to treat epidemics long before the advent of vaccines.
And they have saved countless lives.
Let’s take a look at some effective herbs that you can use both to protect you from the flu and to treat it if you get it.
And I’ll also show you where you can get an excellent herbal formula that has these herbs in it.
Ban lan gen (Isatis indigtica root): Ban lan gen has broad spectrum anti-bacterial effects and has shown to be effective against influenza viruses.
Ye ju hua (Chrysanthemum indicum flower): Has both anti-viral and antibacterial properties. In one study, 501 patients were treated with good results.
Jin yin hua (Honeysuckle flowers): Very effective in treating colds and influenza. Broad spectrum antibiotic effects. In one study involving 393 children an herbal formula made with an herbal inhalant showed marked preventative effects.
Gang mei gen (Ilex asperella root): An effective herb for treating cough and lung issues.
There is an excellent herbal formula that I take whenever I travel or am around sick people and which I prescribe to my patients called Gan Mao Ling.
This formulation has all these herbs and a couple of others in it and it is available at this website: Click here to check it out!
Take 6-8 tablets prior to being around people who may be sick and 3-6 tablets 3-4 times a day if you feel like you are coming down with the flu.
Often this is preceded by a scratchy throat and congestion.
Another way to protect yourself is to use an inhaler that has essential oils with anti-viral properties.
This is excellent for children and for traveling, as you can carry it with you and just take a quick inhale when you need it or fear that you may have had some exposure.
The influenza virus is air borne, so you can attack it where it lives.
Ravensarra is an excellent oil that is known for it’s broad spectrum anti-viral and anti-bacterial properties. It is also great for asthma because it is anti-spasmodic and it’s an expectorant (helps clear out phlegm).
Mentha piperita or peppermint is also an excellent oil which is anti-microbial, analgesic, anti-infectious, it has broad spectrum anti-bacterial properties, and it’s great for clearing out mucous. It’s also very beneficial for your brain.
Eucalyptus oil is a great decongestant, aids breathing by opening up your airways.
Picea mariana or black spruce is anti-spasmodic, helps clear out mucous and is broad spectrum anti-fungal, anti-bacterial and anti-viral. and it’s a great anti-inflammatory!
Here’s a wonderful inhaler that has all these oils in it: Click here to check it out!
It’s great as a preventative and for clearing your sinuses when you have a cold or flu. I love using these when I travel, especially on a plane where you bound to get exposed to something.
You can take this as often as you need to. It’s pretty potent, a little goes a long way!
Those are 2 excellent solutions to the flu and they are quite effective.
The key is to take them before you have been exposed or as early as possible when you feel it coming on.
http://www.healthcentral.com/chronic-pain/c/5949/145399/fibromyalgia/
http://www.ncbi.nlm.nih.gov/pubmed/12428064
http://www.thyroid-info.com/hashimotos-encephalopathy.htm
http://www.ncbi.nlm.nih.gov/pubmed/18240111
http://www.ncbi.nlm.nih.gov/pubmed/20625285
http://www.ncbi.nlm.nih.gov/pubmed/18788945?dopt=Abstract&holding=f1000,f1000m,isrctn
http://www.virologyj.com/content/6/1/5#B104
Chinese Medical Herbology and Pharmaclogy, John and Tina Chen, 2001
The Aromatherapy Practitioner reference Manual, Sylla Sheppard-Hanger 1994
Think Like A Fox
Not Like A Hedgehog
I recently read a book called the Signal and the Noise by Nate Silver.
It’s an in depth look at how to use data and other information to make better predictions.
What does that have to do with Hashimoto’s?
Well, Hashimoto’s is very complex and there is an extraordinary amount of noise, that is information and advice that may or may not be helpful.
And as someone who is trying to solve problems and help others with this complex problem, I thought that learning how to better interpret the data and the information might give all of us some clues about how to get better results.
Ultimately, solving this problem requires that you be a detective and to be a good detective you have to look at the available information and be able to make predictions about whether or not what you are going to do will work.
Because if you are wrong, there are consequences.
And sometimes those consequences can result in you feeling a whole lot worse.
And pushing this thing in the wrong direction.
Our recent look at people’s experience with iodine is a perfect example of this (see our last post).
In the book there is a reference to a professor of psychology and political science named Philip Tetlock.
He identifies 2 distinct types of writers and thinkers: Foxes and Hedgehogs.
Hedgehogs are type A personalities who believe in Big Ideas – in governing principles about the world that behave as though they were physical laws and they are the foundation of everything.
Like Karl Marx and class struggle or Sigmund Freud and the subconscious. Or many MDs and Synthroid.
Foxes, on the other hand are scrappy creatures who believe in lots of little ideas and in taking a multitude of approaches toward a problem.
They tend to be more tolerant of nuance, uncertainty, complexity, and dissenting opinion.
If hedgehogs are looking for that one big meal, while foxes are gatherers.
Well, it turns out that foxes are a lot better at making accurate predictions.
And better predictions usually means better results.
So, to get better results with your Hashimoto’s, think like a fox.
How Foxes think:
They are multidisciplinary: They incorporate ideas from different places regardless of their origin on the ideological spectrum.
(Both doctors and alternative care practitioners are right about some things and wrong about others. Evaluate the message regardless of the messenger.)
They are adaptable: They find a new approach – or pursue multiple approaches at the same time – if they aren’t sure the original one is working.
(If lab tests show your TSH and antibodies going up as a result of a treatment, this is not necessarily a good thing. No matter how it is rationalized or justified.)
They are self-critical: They are sometimes willing (if rarely happy) to acknowledge their mistakes and accept responsibility for them. (Can your doctor admit when he or she is wrong or stumped?)
They are tolerant of complexity: They see the universe as complicated, perhaps to the point of seeing many problems being unpredictable.
(Hashimoto’s is the very definition of complexity.)
They are cautious: They express their predictions in terms of what will probably happen and qualify their opinions.
(There are no absolutely certain outcomes.)
They are empirical: They rely on observation and real data rather than theory.
(They use what exists, not what they want it to be or what will sell more of the products they created or endorse.)
Foxes are better forecasters and, therefore, get better results.
How Hedgehogs think:
They focus on one or 2 things that are the answer or the solution. They may view the opinions of “outsiders” skeptically.
(Synthroid is the only answer.)
They are stalwart: they stick to the same “all-in” approach – new data is used to refine their original model. To confirm their bias.
(See? You didn’t do well on Armour, Synthroid is the only answer.)
They are stubborn: Mistakes or bad decisions are blamed on bad luck or weird circumstances – a good theory had a bad day.
(Removing the thyroid removes the disease. And Synthroid is the only answer, you just need to increase the dosage.)
They are order seeking: They expect that the world will be found to follow a relatively simple set of rules.
(It’s just a thyroid problem. Synthroid is the only answer.)
They are confident: They rarely hedge their predictions and are reluctant to change them.
(You read too much on the internet. Synthroid is the only answer.)
They are ideological: The expect that solutions to many problems are manifestations of some grander theory or struggle.
(Sythroid is the only answer. It was the #1 prescribed drug in the US in 2013. I rest my case.)
Hedgehogs are weaker forecasters and, therefore, don’t get great results.
Here are 3 broad principles to be more fox-like:
1. Think probabilistically. In other words, think about a range of possible outcomes. Don’t make broad assumptions.
For example, take the theory that everyone needs more T3. Reality is more nuanced: Some people need more T3, others don’t and some people get worse with the addition of T3.
The same is obviously true of iodine and a number of other things. You may fall anywhere on that continuum. Find out what is true for you.
2. When the facts change, change your mind.
There’s nothing worse than stubbornly holding onto a belief that has been proven to be untrue.
This is why I’m opposed to protocols. They force you into a pre-existing solution.
There are so many variables, so many moving parts.
Let the facts on the ground dictate your approach.
3. Look for consensus.
Time and experience generally has a way of revealing the truth.
Sometimes there are big innovations, but these events are pretty rare.
Lastly, beware of magic bullet solutions.
With Hashimoto’s, after working with and talking to hundreds of people with this disease, I can tell you that there is nothing that works for everyone.
NOTHING.
You just need to learn to be like a fox and accept that.
Hashimoto’s Thyroiditis: An Autoimmune Disease
I’ve worked with an awful lot of people with Hashimoto’s (this is all I do) and I’ve spent years studying and looking at research on how this condition impacts the body. And I’ve also lived with the disease, myself, for many years.
WHAT I’VE LEARNED FROM LIVING WITH & TREATING HASHIMOTO’S
By far, the most important thing I have learned is that Hashimoto’s is much more than a thyroid problem. It’s an autoimmune disease, but it’s not just an immune system problem either. It’s an all-over-your-body problem.
Your body is not a machine. Like the earth, it’s a complex group of ecosystems that all interact. And these ecosystems can all be adversely affected by Hashimoto’s. When this happens you get a downward spiral of vicious cycles all feeding on one another.
With Hashimoto’s and hypothyroidism you often wind up with a multi-system disorder. It creates webs that can lead to problems with virtually all the major systems of the body.
These include issues with the brain, the adrenals, the liver and gall bladder and problems with the digestive tract like acid reflux, leaky gut, as well as body wide pain and inflammation and more.
All of this can result in anxiety and depression, gall stones and poor liver detoxification, poor absorption of vitamins and nutrients, poor conversion of thyroid hormone, blood sugar imbalances, terrible fatigue and immune responses to various triggers from foods to environmental toxins and chemicals.
Hashimoto’s is not a simple condition that can just be fixed by some thyroid replacement hormone and/or a surgical removal of the thyroid. This works for some, but millions of others have done one or both of these things and don’t feel any better at all.
You have to be able to see the big picture. Then you have you have to isolate each system and look at the interactions and start working on healing the whole body. This requires several steps.
The first thing you must do is find the most destructive triggers and eliminate them. After that, you need to identify which systems are involved and start repairing them.
When you do this, something magical happens. All of those vicious cycles get turned on their head and start having a positive impact on the other systems. When that happens, you can stop triggering the immune system and start to restore balance. Then the body can heal itself.
In the beginning, this will give you glimpses of more good days than bad ones and if you stay the course and work on the big picture you can even sometimes get this condition into a state that resembles remission. (But remember that’s not permission to go back to everything that got you sick in the first place.)
To put it another way. You must adopt a Hashimoto’s lifestyle. That is what I teach my patients and what I try to share about in my Facebook support group and here on my blog. Healing Hashimoto’s requires you to go all in.
1. Step One: Understand Which Systems Are Impacted
The first step is to get a proper diagnosis that will lead you to understanding which systems make up your unique web of vicious cycles. The key is to work with someone who understands this.
In my practice, I specialize in treating people with Hashimoto’s. I know which diagnostic tests are appropriate and I have worked with hundreds of people with this disease and lived through it myself so I’ve seen a lot of permutations and variations.
2. Step Two: Take Your Diet Seriously
Hashimoto’s is an autoimmune disease. 70% of the immune system is found in your digestive tract. What you eat has a huge impact on the state, quality and severity of your autoimmune disease. Anyone who tells you otherwise has no idea what they are doing, plain and simple.
Some foods serve you, some cause you harm. In my practice I prescribe a special Hashimoto’s diet that is the foundation of the work we do. I have found that people who won’t make the dietary changes that they need to heal are just setting themselves up for failure.
3. Step Three: Heal Your Adrenals
For a lot of people with Hashimoto’s the adrenals are a critical piece of the puzzle. Did you know that the label on Synthroid and other thyroid replacement hormone warns that if a patient has adrenal insufficiency they should not be prescribed the drug?
That’s how important the adrenals are. They can be the difference between you turning this thing around and you treading water and not improving or just continuing to get worse. In my practice we do proper testing evaluation and treatment of the adrenals.
4. Step Four: Heal Your Gut
This is really closely related to Step Two. The gut is where your immune system lives. Many really smart people believe that issues in the gut like intestinal permeability (leaky gut) are actually one of the root causes of Hashimoto’s and other autoimmune diseases.
When you heal your gut, you heal everything else: your brain, your immune system, your thyroid, your adrenals and more.
5. Step Five: Remove the Triggers
You have to find and eliminate the triggers that drive your autoimmune flare ups and the progression and destruction of this autoimmune disease. We’ve already mentioned the dietary triggers. Where are the other ones?
Environmental toxins and chemicals (these include some drugs) can be triggers. Blood sugar imbalances can be another important trigger.
Stress can be another trigger and if ignored can torpedo your progress.
In my practice we take you through all of these steps and we teach you along the way how to identify what your unique set of issues, triggers and solutions are.
Then we create an action plan and help guide you out of the woods. You can heal your Hashimoto’s, but healing requires acceptance, and it requires adopting a new lifestyle that will support your body and your immune system and that will provide you with the foundation to get lasting results.
And last but not least, remember to have fun. To laugh and enjoy the life you have. There is a lot in this struggle that is not fun, but what we try to do is to empower you with the knowledge you need, but also make it enjoyable and entertaining.
Because there’s nothing worse than doing all this work and not being able to enjoy the process. A sense of humor can be healing all by itself.
Lastly, I offer a 30 minute Hashimoto’s Healing Discovery Session. In it you can share where you are and where you want to be. I can help by giving you some suggestions that will help right away and we can discuss which other programs or services may help you reach your goals.
Here’s a link to set up a time to chat.
I look forward to chatting with you!
Best,
Marc
One of my favorite organizations, the Environmental Working Group, released their 2014 list of produce with highest amount of pesticides.
This is a real concern for those of us with Hashimoto’s and hypothyroidism because studies have linked pesticide concentrations with a significant increase in thyroid disease.
They found an association of organochlorines and fungicides with hypothyroidism. And a 12.5% higher increase in thyroid disease than in the general population.
According to the study “Exposure to these classes of pesticides and thyroid dysfunction is plausible given that the main effects of these compounds are thought to be elevation of TSH levels and reduction of circulating thyroid hormone (T3 and T4).”
An Apple A Day Doesn’t Keep The Doctor Away Anymore
Nonorganic apples once again topped The EWG’s Shopper’s Guide to Pesticides in Produce report, making it the fourth year in a row that the fruit that has the reputation of keeping the doctor away, may now be having the opposite effect thanks to better living through chemistry.
Kale, collard greens, and hot peppers were frequently contaminated with insecticides that are particularly toxic to human health, prompting their “Dirty Dozen Plus” status.
The moral of the story? Grow your own in an organic garden and/or buy organic at your local farmer’s market.
1. Apples
2. Strawberries
3. Grapes
4. Celery
5. Peaches
6. Spinach
7. Sweet Bell Peppers
8. Nectarines (Imported)
9. Cucumbers
10. Cherry Tomatoes
11. Snap Peas (Imported)
12. Potatoes
+ Hot Peppers
+ Kale/Collard Greens
It’s not all bad news! This produce contained the lowest pesticide levels.
1. Avocados
2. Sweet Corn
3. Pineapples
4. Cabbage
5. Sweet Peas (Frozen)
6. Onions
7. Asparagus
8. Mangoes
9. Papayas
10. Kiwi
11. Eggplant
12. Grapefruit
13. Cantaloupe
14. Cauliflower
15. Sweet Potatoes
One of the biggest challenges about living with Hashimoto’s is that there can be many set backs.
And if you do not have the ability to bounce back quickly and be resilient, then this may compound your suffering.
Because if you have multiple setbacks, one after the other, and you are still having trouble getting over the first, then you can become mired in gloom, despair and defeat.
One of the best ways to develop resilience is to practice mindfulness and detachment. The more you strengthen your detachment muscles, the easier it is to bounce back.
Detachment allows you to view your emotions from a bit of a distance.
This way you can see that feelings are not facts and emotions are not emergencies. They are just feelings and emotions and they come and go.
And you have a choice about how much importance you are going to give them. It’s all about your perception of them.
A great practice for developing detachment is meditation. Simply sitting, breathing and observing your thoughts.
Even as little as 5 minutes per day can help you develop the ability to observe your mind.
And as you watch it, you will observe thoughts and emotions rush in. Instead of holding onto them, return to your breath or to observing something in your physical body and let those thoughts and emotions go.
It can be challenging at first, but it gets easier.
And once you get a glimpse of the world outside of attachment to these feelings, thoughts and emotions you realize what a prisoner you can be to them.
Getting some degree of freedom from them can have a big impact on our ability to heal.
Sit, breathe and let go.
Please share with us your thoughts, experiences or tricks for finding detachment.
Did you know that low thyroid function is often caused by some other condition first, and often adrenal gland stress is the culprit?
Chronic adrenal stress can:
* Affect communication between the brain and glands that produce hormones. The hypothalamus and pituitary gland are the directors of hormone production and chronic adrenal stress can mess up communication with the thyroid.
* Increase thyroid binding activity, keeping thyroid hormones from getting absorbed by the cells of the body.
* Interfere with the conversion of T4 to active forms of T3 that the body can use.
* Affect detoxification pathways that clear out unnecessary thyroid hormone, when these get stuck in the body you can develop thyroid hormone resistance making cells lose their sensitivity to thyroid hormones.
* Weakens the immune barriers of the gut, lungs, and brain and weaken the immune system, in general.
When this happens, you can have more immune flare ups and this can trigger your Hashimoto’s and make it worse.
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, dairy and soy), 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.
We can’t ignore them or pretend like they aren’t there like so many doctors do. We have to deal with all of them.
Here’s the thing, we have maxed out our stress cards (like our credit cards for stress).
With Hashimoto’s your body is under so much physiological stress, all the time, that extra emotional stress will often totally wipe you out.
This happens because we’ve emptied our accounts and now we have to reinvent our lives and this means what you do everyday.
We have to start putting relaxation and fun back into our “stress savings” accounts.
Seriously, you have to replenish this account. It’s not enough to say “Yeah, I have nothing in that account.”
Because just like your bank account if you aren’t putting money back in and you’re always just taking money out, what happens?
Eventually, you go broke and you got all these creditors after you and lose your house and your car and eventually, you wind up on the street.
Talked about stressed out!
That’s what’s happening in your body. You wind up with the functional equivalent of being homeless inside your own body.
And, really, we have plenty of opportunities to take positive actions regarding stress every day, and often these wind up being missed opportunities and actually lead to more stress.
Here are 5 common mistakes people make every day dealing with stress.
The most important thing you can do is start becoming aware of this.
Are you…
1. Working through lunch (or other meals)?
This is a really common problem. many people don’t take the time to relax and enjoy their meals. This is a huge opportunity to relax and if you are stressed during your meal, it has a big impact on your digestion and absorption of food and vital nutrients.
2. Using your break time to vent and complain?
What you focus on is what becomes reality. Put that energy into manifesting something positive, like healing.
Go for a walk, appreciate the things around you instead.
3. Doing too many things at once?
Try slowing down and doing one thing at a time. So many people spend their days multi-tasking themselves into a totally stressed out state of mind (and body).
4. Not asking for help?
How often do we let our pride stop us from asking for help when we really need it? There’s no shame in admitting you need help and reaching out to someone and asking.
5. Denying there’s a problem?
So many people pretend they have stress under control when they really don’t, at all.
It is a very powerful trigger of autoimmunity. It can completely torpedo your progress.
You can’t just pretend it’s not here.
It’s here and it’s here to stay, so you need effective strategies for having less of it.
Every day.
Please share with us your best stress relieving practices.
In today’s health tip, I’d like to talk about remission from Hashimoto’s.
Remission should be the goal for all of us. We should all strive to get Hashimoto’s to a place that can allow us to have our lives back.
And we should all work hard to stop the progression and the proliferation of the underlying autoimmune process.
The stakes of not doing this are just too high.
But how do you define remission? And what happens when you get there?
The problem with focusing on this as a goal is that this implies that once we reach it, we’re done.
And this begs the question: How do we know when we get there?
One way that some people define remission is normal blood work including normal or undetectable antibodies.
There are several problems with this.
Many, many people have normal blood test results and feel awful.
And antibody numbers are not static, they are changing all the time. Getting them into a normal range is not a guarantee that they will stay there.
And there are lots of reasons why blood tests can look normal and you can still feel terrible. The immune system can release TSH and thyroid hormones all by itself, and this can throw off your results and make them less meaningful.
Also, your pituitary absorbs thyroid hormone differently than the cells in the rest of your body, so it may be getting enough thyroid hormone while the rest of your body is not.
Again making your blood test results less meaningful.
So, blood test results aren’t a great measure of success. As I have said repeatedly, how you feel, on the other hand, is diagnostically important and clinically relevant with Hashimoto’s.
This is actually a really important measure of success.
And the other problem with viewing remission as an end point is that if we do get there, it is a natural tendency to get complacent and to just go back to the same old behavior and diet that contributed to you being sick in the first place.
That’s just human nature.
So, I invite you to see remission as a journey and not as a destination. And to view it as a path and not a place you reach.
If you think about it his way, it involves a higher level of acceptance and commitment. Because it’s not conditional and it’s not something you’re ever finished with.
Remission is an ever evolving journey and if you are committed and vigilant and open to the possibilities of personal growth and transformation then it becomes like a kind of garden that just keeps rewarding you with new gifts.
Because here’s the other thing, you never know how good it could be and if you just settle for normal blood test results, then you might be putting a cap on this that stops you from going to a much higher place.
The possibilities are endless, people, when you think of it this way.
What we need to do is to create a lifestyle that supports healing and remission every single day. And strive to do that at every opportunity.
That’s a whole different ball game.
What are your thoughts on this? Please share them with us.