Hey, People!
Hypothyroidism and Blood Sugar Problems Go Together Like a Big Boy and A Big Gulp
This week’s tip involves blood sugar issues and Hashimoto’s. This is one of those vicious cycles where one thing leads to another and together they make a downward spiral.
Did you know that both high blood sugar and low blood sugar levels can make your Hashimoto’s worse?
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.
Well, diabetes doesn’t happen overnight, it’s progressive. And often that progression passes through something called metabolic syndrome and insulin resistance on its way to diabetes.
According to Chris Kresser, L.Ac., Metabolic Syndrome is defined as a group of bad things appearing together, including:
▪ abdominal fat; “the muffin top”
▪ high cholesterol and triglycerides (caused by sugar being stored as fat in the liver)
▪ high blood pressure (caused by plaque build up in the arteries that comes from excess sugar and cholesterol)
▪ insulin resistance
▪ tendency to have blood clots (because sugar makes the blood more prone to clotting)
▪ our good friend, inflammation (the root of all evil – well, at least the root of autoimmune diseases like Hashimoto’s)
Metabolic syndrome is caused by a chronic state of too much sugar in the blood.This is caused by eating too many carbohydrates.
So really, metabolic syndrome could be called “hammering too many carbs disease”.
Because that’s what it is.
When you eat too many carbs, 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 knocking on the door, but the cells won’t let it in.
“I hear you knocking but you can’t come in.”
The pancreas responds by pumping out even more insulin (knocking louder, “Please, let me in!”) in an effort to get glucose into the cells, and this eventually insulin receptors get tired of it all and this leads to insulin resistance.
Studies have shown that the repeated insulin spikes that come with insulin resistance increase the destruction of the thyroid gland in people with autoimmune thyroid disease. Read all about them in this detailed post on blood sugar.
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? Less thyroid hormones are made by the thyroid and you get all the hypothyroid symptoms like fatigue, weight gain, brain fog, depression, joint pain, hair loss and on and on.
Low blood sugar or hypoglycemia can also cause problems with the thyroid.
Your body sees low blood sugar as a threat because severe or long term hypoglycemia can cause seizures, coma, and death. Not good things.
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.
The problem is that cortisol is involved in the “flight or fight” response. This response includes speeding up your heart rate and lung action, increasing blood flow to the muscles to get us ready to fight or to scream and run for the hills.
Cortisol’s job is to increase the amount of glucose available to the brain, help with healing, and to slow down certain things – like digestion, growth and reproduction – that aren’t so important when we were running from hungry lions on the African Savannah (flight).
Unfortunately for hypoglycemics, repeated cortisol release caused by episodes of low blood sugar makes the pituitary gland not work as well.
The pituitary is in charge of the thyroid and when it isn’t working properly, this can cause problems with the thyroid.
So either too much or too little sugar can mess with thyroid function and cause problems.
And, check this out. 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.
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 described above, that suppresses thyroid function.
A vicious cycle. If you want to heal your Hashimoto’s, you need to deal with blood sugar issues. And that means dealing with your sugar habit.
Digestive health is key to thyroid hormone conversion
Our bodies are not machines. They are groups of ecosystems all interacting with each other. And just like the health of ecosystems on our planet, problems in one ecosystem can cause a ripple effect and cause problems in other areas.
This is especially true with the ecosystem of the digestive tract and thyroid health. Our digestive system is teeming with life.
There are billions and billions of bacteria from many different species all living there. Many of them do important jobs for our bodies.
One of the jobs that they do is to help convert thyroid hormone from its inactive form T4 into a form that the body’s cells can actually use, T3.
This is a really good thing.
Unfortunately, people often don’t pay enough attention to maintaining a healthy ecosystem in their digestive tract. This is true of doctors and patients.
Many things can lead to the death of good bacterial species and the overgrowth of ones that aren’t so helpful.
Antibiotics, processed foods, too much sugar, antacids, NSAIDS and environmental toxins are just a few things that can turn that digestive garden of eden into a post industrial waste land.
When this happens, thyroid hormone doesn’t get converted as well.
Bacterial gut infections can reduce thyroid hormone levels, dull thyroid hormone receptor sites, increase reverse T3, decrease TSH and promote autoimmune disease.
With Hashimoto’s, a particularly nasty species of bacteria called Yersinia enteroclitica has been found to be 14 times higher in some people with the disease.
Bottom line: Having a healthy ecosystem in your gut is very important for helping your thyroid work properly. It is also important for helping thyroid replacement hormone work properly.
All of which matters because if your thyroid doesn’t work properly and thyroid hormone doesn’t work properly then you feel like crap.
And you have all the symptoms of hypothyroidism: fatigue, weight gain, depression, hair loss, pain, constipation, brain fog, mental sluggishness and the unending desire to read posts from Hashimoto’s Healing to figure out what is actually going on. 🙂
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.
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 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.
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.
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.
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.”
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.)
Hypoglycemia
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.
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.
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 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.
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 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.
(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
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.
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!)
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:
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.
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 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.
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.
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://nahypothyroidism.org/insulin-resistance-can-trigger-hashimotos-disease/
http://chriskresser.com/thyroid-blood-sugar-metabolic-syndrome
http://diabetes.niddk.nih.gov/dm/pubs/statistics/
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
http://www.huffingtonpost.com/t-colin-campbell/low-fat-diets-are-grossly_b_740543.html
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
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
Hashimoto’s is the most common autoimmune disease in the United States. And one of the most common complaints for people with Hashimoto’s and hypothyroidism is that they have difficulty with weight loss.
This is even true for people who are taking thyroid replacement hormone (especially T4), exercising and eating well. It seems that no matter what they do they just can not get the weight off.
There are many reasons for this and in this post I will explore 4 secrets to weight loss that new research has revealed.
The old model of your metabolism and hormone levels, alone, being the reasons for success or failure of your weight problems is proving to be outdated.
In the old model, the primary reasons for difficulty with weight loss are: eating too much, or eating too much food laced with sugar, fat and salt ( this is a still a real problem for many). In addition, a lack of exercise and hormone related problems like not enough thyroid hormone or excess cortisol.
While these are very real issues and should be considered in any weight related treatment, they have been shown to not be the answer for many women (and men ) with Hashimoto’s struggling with their weight.
I recently attended a seminar taught by Dr. Datis Kharrazian, one of the world’s leading experts on the treatment of thyroid issues with functional medicine, called The Neuroendocrine Immunology of Exercise and he taught us about this new research that has discovered an entirely new model of causes for stubborn weight gain.
This model involves causes of weight problems that are related to the immune system. And this makes sense for people with Hashimoto’s because it is an autoimmune disease and a thyroid disorder.
If blood tests show that your TSH and T4 levels are “normal”, you are eating well and exercising and you still can’t lose weight, then this may be exactly what is going on with you.
According to Dr. Kharrazian, in the immune system model, there are 4 main reasons for stubborn weight gain.
They are:
* The mix of bacteria in your gut
* Intestinal permeability (also known as leaky gut)
* Low grade inflammation
* Immune reactive dietary proteins
Let’s explore each one of these in more detail.
An important thing to understand is that your body is an ecosystem, or really, a lot of interconnected ecosystems. And the digestive tract is one of the most complex and dynamic of them all.
Each one of us has their own unique mix of bacteria and other organisms that live in our guts. This mix is determined by our genetic profile, our diets, what medications we have taken and our environment.
There are an estimated 100 trillion different cells and over 1,000 different species of bacteria. 90% of these species belong to 2 families: Firmicutes and Bacteriodetes.
New research has shown that the balance of these 2 bacterial species matters for whether or not you are able to lose weight.
In obese and overweight people, there is more Firmicutes than Bacteriodetes. The balance between these 2 species of bacteria generates certain signals to specific genes in the intestines that produce more fat cells.
It is also interesting to note that, according to the research, Lactobacillus bacteria (the most common species sold in over the counter probiotics) actually increases body weight. Both dairy and non-dairy sources.
What that means is that while probiotics may be beneficial for the ecosystem of your gut they are not that helpful in helping you shed the pounds.
Firmicutes really like junk food. To feed them and gain weight, eat like your average American. To starve them and lose weight, read on.
The more important question is: how do you increase the Bacteriodetes? It seems these little critters really like plants. And the best way to increase their number is to increase the amount of plant based foods and fiber in your diet.
Especially oligosaccharides (found in Jerulsalem artichokes, and onions, leeks, garlic asparagus and jicama, etc.) and monosaccharides (found in pears, grapes, peaches, apples, pineapples, apricots, bananas, yams, carrots, onions, and sweet potatoes). And other plant based fibers that come from green leafy vegetables, green tea, etc.
These get fermented in the colon by the good guys and help you to become a mean, lean weight loss machine! But, just so you know, this is not something you can change in 5 minutes or 5 days. It may take a few months to alter this environment.
While it is true that people with Hashimoto’s often suffer from intestinal permeability or leaky gut syndrome, new research shows that this can also lead to fat around the organs.
In leaky gut, the intestines lose their ability to keep tiny particles of all sorts of stuff out of the bloodstream. It turns out that there may be a connection between a fatty liver and the breakdown of the gut barrier system.
In addition, zonulin, a protein that is used by the intestines to bind tight junctions, leaks into the blood stream when people have a breakdown of this barrier. It is also increased with obesity associated insulin resistance.
Finally, the toxins that are produced by bacteria known as lipopolysaccharides have also been linked to obesity and the onset of diabetes.
Bottom line: If you want a smaller gut, you need to heal your leaky gut.
Autoimmune disease is a disease that is closely linked to inflammation. So is type 2 diabetes, so is eating a lousy diet and eating too much sugar, salt and fat.
What research is now showing us, is that obesity is also an inflammatory condition. It is becoming less clear which came first. One thing we now know is that adipose tissue (fat tissue) produces inflammation in the body all by itself.
So you have the creation of this destructive cycle of abnormal gut bacteria and leaky gut leading to a process (insulin and leptin resistance) which makes glucose not able to enter cells. When glucose can’t enter cells it gets converted into fat in the liver (triglycerides). These fat cells start the whole process all over again.
Leptin is one of the main hormones involved in hunger, metabolism and the control of how energy from carbs and fats get stored and used. It comes from the Greek word ‘leptos’ meaning thin.
The amount of leptin produced directly correlates with weight loss or weight gain. (Women have significantly higher circulating leptin than men).
Leptin resistance is very similar to insulin resistance. With insulin resistance, long term elevated levels of insulin make your muscle and fat cells more resistance to the action of insulin.
Chronic elevated levels of leptin end up making you eat way too much. And abnormal gut bacteria and leaky gut feed this process as well (pun intended ;)).
This whole process creates more fat tissue which causes more inflammation, and on and on it goes, snow balling and making it harder and harder to lose weight.
So you can see, while this is kind of complicated, it is hugely important to do everything you can to reduce inflammation that is the root cause of everything that we have just examined.
Certain proteins can also add gasoline to the flames of inflammation.
Everything that is living in our world is made of proteins. With autoimmune disease the immune system confuses our own proteins with that of an invader like a virus or a food we are allergic to.
There are some proteins in our diet that can cause an immune response that can also lead to inflammation and add more insult to injury.
These proteins are found in gluten, dairy and soy and in some other foods called cross reactors. You can learn more about them in this post.
These need to be eliminated from the diet if you want to lose weight because this will begin to unwind the vicious cycle of inflammation at the root of the immune system’s influence on weight gain.
Bye bye inflammation, bye bye weight.
Have you had trouble losing the pounds even though your lab test numbers look “normal”?
Do you eat well and exercise, but still can’t lose the pounds?
Do you experience the common symptoms of inflammation like brain fog (inflammation of the brain), joint pain (inflammation of the joints), thyroid nodules (inflammation of the thyroid) and weight gain (body wide inflammation).
Need help? Schedule a 30 minute Hashimoto’s Healing Discovery Session: Click here to set up a time to chat.
The Neuroendocrine Immunology of Exercise, Dr. Datis Kharrazian, 2013
Diabetes. 2007 Jul; 56(7): 1762-1772. Metabolic endotoxemia initiates obesity and insulin resistaence.
Hashimoto’s is the most common autoimmune disease in the United States. It is a thyroid disorder and an autoimmune disease. The autoimmune part of the equation makes virtually everything a challenge and this is particularly true when it comes to trying to figure out what to eat.
One of the absolute truths about Hashimoto’s is that no 2 people have the same version of the disease. There are too many variables, people are at different stages of progression, and they have other autoimmune, endocrine, digestive or systemic problems.
So, generalizing about what kind of diet is the best is kind of like asking, “Where do I build my house on this minefield?”
You build it where it won’t set off the mines. Some people estimate that 70 – 80% of the immune system is found in the gut.
Whatever the actual percentage, there is no doubt that what goes through your digestive system has a huge impact on your immune system. Huge.
This concept is just common sense, but many doctors and health care practitioners ignore it. Why? One doctor friend of mine put it to me this way.
He said, “I don’t bother trying to change people’s diets. It’s easier to get an alcoholic to stop drinking than to get people to change the way they eat.”
People are attached to food. It has cultural, emotional and psychological roots that run deep. However, if you have Hashimoto’s and you want to learn to manage it properly, you need to abandon all of that. It will not serve you.
Many people with Hashimoto’s also have intestinal permeability, also known as leaky gut. A healthy GI tract is one that one has a lush forrest of villi, all held tightly together.
This keeps the bad guys, like bacteria, chemicals, environmental toxins and undigested food out of the blood stream. Unfortunately, chronic inflammation turns this lush forrest into a desert and poor diet, blood sugar imbalances and chronic stress open up wide chasms that a molecular 18 wheeler could drive through.
Many people believe that this actually sets the stage for the onset of autoimmune disease when the immune system shorts circuits and starts confusing other stuff with our own tissue. The one food that is most often implicated in this is gluten.
Many people also believe that the best way to heal autoimmune disease is by healing the gut. ( I am one of those people. ) So this begs the question, what heals the gut?
The first step to healing the GI tract is to remove all the foods that are creating chronic immune responses. Eventually, you can add them back in one at a time (hopefully). When you do you will begin to discover your own unique set of land mines.
And instead of rummaging around in the dark there are now also diagnostic tests available to help determine which foods cause an autoimmune response in you (More on this in a moment). This can save you a lot of trial and error and can help you identify the really bad ones.
The foods that tend to be the worst are those that you, invariably, love the most. Like ice cream, cheese, bread, and pasta. And there is a biological reason for this. Both foods made from gluten and milk have proteins that are very similar in structure to morphine.
They are called casomorphin in milk and gluteomorphin or gliadorphin in wheat products. Now wonder we love them, we’re freakin’ addicted to them!
There are a few different camps out there for autoimmune disease diets. Most of them involve elimination and provocation. In other words, you take foods out and put foods back. The biggest differences seem to be which foods you put back.
Once again, the reality is that some people can put some foods back and others can’t. Remember, your Hashimoto’s is not your brother’s or sister’s Hashimoto’s. You have to find your own way. There are some foods that some people will have to eliminate from their diets forever. FOREVER.
And this is the real challenge. Because some people will suffer more from cheating than others. But, even if you feel like the damage wasn’t so bad and you can live with it, it may be destroying valuable tissue like your brain or something that you might want to use later in life.
Cheating can have serious and, sometimes, silent consequences, like the destruction of important tissue.
Here’s a quick overview of the most popular diets currently being used.
The Paleo diet or Paleolithic diet, also called the Cave man diet or Hunter-Gatherer diet, is one in which you are told to eat like our nomadic ancestors. Centered around common modern foods, this diet consists mainly of fish, grass-fed pasture raised meats, eggs, vegetables, fruit, fungi, roots, and nuts, and excludes grains, legumes, dairy products, potatoes, refined salt, refined sugar, and processed oils.
Critics argue that this diet is essentially just the Atkins diet with a few updates, but it has a loyal following. And if you really ate like our Paleolithic brethren, that is, you hunted around the African plains with a spear and a few rocks, you would eat a diet that was largely plant based with a few lucky days of meat binging thrown in.
And you would spend a lot of time running and doing old school cross fit maneuvers as you escaped hungry lions and hyenas. Definitely a formula for good health – if you didn’t get eaten.
The autoimmune version of this diet removes grains, eggs, beans, legumes, dairy, soy, refined sugar and salt, all processed oils and nut based oils, and night shades (tomatoes, eggplants, peppers and potatoes) and, sometimes, nuts.
Its really restrictive, but can be quite effective. The real issue seems to be – can you come up with a diet plan that isn’t basically all meat all the time? And you definitely can. You need to make a conscious effort to have plenty of fruit and vegetables.
Some people with Hashimoto’s do very well on this diet and it can dramatically improve the health of your gut on its own. Add some supplements that heal the intestines, as well, and you could have a winning formula. (More on that in an upcoming post)
The flip side of Paleo is the Vegan autoimmune diet. It is, essentially a gluten and, in some cases, grain free vegan diet. No meat, no dairy, no eggs, no animals, and no fish. And in some cases, no grains or beans.
Critics of this diet argue that you don’t get enough amino acids from plants alone and many Hashimoto’s folks are also iron, B12 and Vitamin D deficient and its hard to virtually impossible to effectively keep those levels up without animal products or supplementation.
It also takes a lot of things, pardon the pun, off the table. So it doesn’t leave you a lot left to eat.
But this diet also has its loyal fans and can be very effective in reducing the inflammation that drives the autoimmune process and destruction of the gut. If supplements are added here, and you eat enough, you can also have a winning formula with this approach.
Some people think that one way to figure out which version of the autoimmune diet is best for you might be to use blood typing. Those with blood types that need meat (Type O) might do better on Paleo, those who are not big meat eaters (Type A) may do better with the Vegan version.
The remaining blood types (B and AB) might need some hybrid of the two. Which ever you chose it is vitally important to eat as much variety as you can within all these restrictions and to supplement with iron, Vitamin B12 and Vitamin D as it becomes necessary.
All of these autoimmune diets remove lectins. Lectins are nature’s answer to insects long before Monsanto began its evil march towards domination of our food supply.
They are, basically, natural pesticides that live in plants to help them survive the ravages of fungi, bacteria and viruses. They are kind of like natural toxins.
Lectins are carb binding proteins that protect plants and have other functions like protein synthesis and delivery in animals. They’re pretty sticky molecules, which makes them cause problems in our intestines because they get stuck there and start eating away at the walls.
It is believed that lectins leave leaky gut in their wake, in a trail of savaged villi. Once they have wrought their carnage, they breach the walls of the intestines and leak into the bloodstream with lots of other unwanted particles. And the immune system goes nuts trying to deal with it all.
Foods with the highest amounts of lectins are: grains of all kinds (wheat being the worst), legumes (soy being the worst), nightshades (mentioned earlier), and oils made from seeds. GMO foods also have lots of lectins because they are used in genetic modification to enhance pest and fungal resistance.
Salt: Recent studies have indicated that that high salt levels may push the initiation of autoimmunity by driving the TH-17 pathways. Basically, its an on switch.
Problem. Lots of Hashimoto’s people have low blood pressure and desperately need salt. Iodine can also be bad for some Hashimoto’s people. Answer: Moderate salt without iodine (unless you are iodine deficient – there’s always a caveat).
Sugar Issues: Many Hashimoto’s people have blood sugar issues and if their blood sugar goes too high or too low it can really impede their progress. Some of these diets are so restrictive that people’s blood sugars end up dropping and spiking and they wind up defeating the very program that they are on.
Answer: Find the foods you like, eat them often. Start the day with a protein. Don’t ever skip meals.
Anemia: Many Hashimoto’s patients develop anemia for a host of reasons. This can completely undermine any dietary changes you are trying to make. Test for iron deficiency and red blood cell counts and make sure you are supplementing with iron if necessary (especially if you are choosing the vegan route). Vitamin C can also enhance iron absorption.
Cross Reactors: These are foods that have a similar protein structure to gluten and our own tissue. Like gluten, they may have to permanently avoided because they drive the autoimmune attack and disease progression.
Parasites, Candida and Other Critters: Some people with Hashimoto’s may also also require additional treatment of the ecosystem of their intestines. These can further complicate dietary restrictions and supplementation.
Adrenal Issues: The adrenals play a critical role in intestinal permeability and with insulin resistance. Cortisol causes the intestinal walls to open further and it makes insulin not work a well. So stress management and adrenal love are also really important.
Other Autoimmune Diseases: Many Hashimoto’s people have other autoimmune diseases in various stages of progression and some of these can have a huge impact on the digestive system, such as Type I diabetes, adrenal autoimmunity, liver autoimmune, Crohn’s disease and more. If these factors are present, adjustments must be made accordingly.
And this is just an overview to give you a sense of the complexity, difficulty and variability of what you are dealing with. There are many more issues that can come into play and undermine your progress. These include, the gall bladder, neurotransmitters and the brain, low stomach acid and more!
There is some terrific diagnostic testing available today that can help to decipher some of these puzzles. We can test for intestinal permeability, cross reactors, additional autoimmune issues, etc. These tests are not that expensive if your doctor won’t order them or doesn’t know that they exist.
Diet is critically important in the successful treatment of Hashimoto’s, but a diet that works for someone else may not work for you. You need a program that is tailor made for your unique set of circumstances and related issues.
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
http://www.biomedcentral.com/1472-6823/5/10
http://www.marksdailyapple.com/lectins/#axzz2O1CpwpQ5
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1115659/
Prevalence of celiac disease in autoimmune thyroiditis. Minerva Endocrinol 2007 Dec;32(4):239-43
Celiac disease and autoimmune thyroid disease. Clin Med Res 2007 Oct;5(3):184-92. Review
Synthroid
Hashimoto’s patients are often aware of their sensitivities to gluten (and other foods), but one thing that they are often unaware of is that some thyroid hormones have fillers and inactive ingredients that may be triggering a gluten-like reaction.
These fillers are almost never part of the conversation and it is important to understand that they could be actively winding up an autoimmune attack on your thyroid.
One of the more common fillers used in both Synthroid and Unithroid (both synthetic forms of T4) is confectioner’s sugar. This contains corn starch which many sources will tell you is a gluten free product. However, unless the starch is produced in a way that no proteins whatsoever remain, small amounts in the starch may cause a reaction.
Some studies have shown that corn proteins cross react with gluten and this means that these fillers could cause problems because your immune system will react to them in the same way that it does to gluten.
Why should you care? Because if you have Hashimoto’s and you have celiac disease or gluten sensitivity, every time you take your hormone medication you may be causing an immune flare up.
You may, unknowingly, be creating a kind of daily vicious cycle of immune wind up. Not good.
One of the symptoms that you should look for if you are taking these thyroid hormones is that you feel fatigued and run down with thyroid hormones. This is almost always related to sensitivities to the inactive ingredients in the hormones such as dyes and fillers.
If you are taking the hormones and you feel exhausted, this could be a good indicator that you are having a response to the “inactive ingredients”. This could happen if you recently went on the medication, recently switched medication or, in some cases, if the manufacturer changed some of the inactive ingredients in manufacturing. In any case, this is something that you need to rule out.
There is a lab we work with called Cyrex labs that has a comprehensive cross reactivity test and this is recommended to anyone who has Hashimoto’s or any other autoimmune disease. Testing for cross reactivity to corn is another way to confirm that the reaction you are having is due to cross reactivity.
If your body has developed antibodies for corn or other foods and it reacts to them in the same way that it reacts to gluten, you must eliminate these foods from your diet. Forever, or suffer the consequences.
What are the consequences? The problem with gluten and other cross reactive foods is that they trigger the immune system and when they do this your immune tissue attacks your own tissue.
One important thing to realize is that when you have an autoimmune disease, you often have multiple tissues being attacked and these can include your brain, your joints, the lining of your intestines, your skin, etc.
There are many possible tissues and sometimes those symptoms that you feel that seem unrelated are not unrelated. They are a direct consequence of an autoimmune flare up.
There are some other ingredients in thyroid hormones that may also cause reactions. The other ingredients in Synthroid are: acacia, lactose monohydrate, magnesium stearate, povidine, talc and a number of different food dyes (different for different dosages).
Acacia is a TH-2 stimulator and may cause problems if you are TH-2 dominant. (If you aren’t familiar with this, I will explain in detail in an upcoming post, stay tuned.) Lactose is a common sensitivity for many people as well.
And, of course food dyes can cause all kinds of problems all by themselves. Click on this link to learn more. Here is a list of which dyes are in each common dosage of Synthroid:
25 mcg: FD&C Yellow No. 6 Aluminum Lake
50 mcg: None
88 mcg: FD&C Blue No. 1 Aluminum Lake, FD&C Yellow No. 6 Aluminum Lake, FD&C Blue No. 10 Aluminum Lake
100 mcg: FD&C Yellow No. 10 Aluminum Lake, FD&C Yellow No. 6 Aluminum Lake
200 mcg: FD&C Red No. 40 Aluminum Lake
If you experiencing symptoms of autoimmune flare up like exhaustion, joint pain, brain fog, etc. and you are careful with the things you know may cause flare ups (gluten, dairy, coffee, etc.), you should check the inactive ingredients of your thyroid hormones. You may be causing flare ups without knowing it.
Resources:
http://www.feingold.org/effects.html
http://www.ncbi.nlm.nih.gov/pubmed/22298027
http://www.rxlist.com/synthroid-drug.htm
If you have Hashimoto’s, the chances are that you have gluten sensitivity or gluten intolerance (whether or not it has been diagnosed). Research has shown a strong correlation between the two.
One important thing that you need to understand is that there are other foods that can act like gluten in your body. And your immune system reacts to them in the same way that it reacts to gluten.
These foods are called cross reactors and even if you are diligent about avoiding gluten, you may be not making the progress you want because you are not aware of these other foods.
Basically, when your body creates antibodies against gluten, those same antibodies notice antibodies in other foods. When you eat those foods, even though they don’t contain gluten, your body reacts like they do.
In the same way that even a small amount of gluten can trigger an immune response, even a small amount of these foods can cause inflammation and an immune response.
Proteins are made from long chains of amino acids (like those pictured above), and it is the exact sequence of these amino acids that determines how the protein is formed and what it does. The way that the amino acid chains are folded, bent and buckled in different ways determines what the function of that protein is.
An antibody is a Y shaped protein produced by immune cells in your body. This antibody is like a lock and the sequence of amino acids is the key that unlocks it. There are different classes of antibodies, IgE, IgA and IgG. All 3 play a part in allergies and food sensitivities and reactions.
IgE is responsible for allergies, like someone’s face blowing up after eating shellfish. IgG and IgA are responsible for food sensitivities and intolerances. They are found in high concentrations in the gut, and also in the lymph fluid, in saliva and in tissues themselves.
When antibodies are made, they recognize specific short sequences of amino acids in a protein. Some of these sequences are more likely to cause antibodies to be created. This is why certain foods tend to cause more allergies and sensitivities than others (gluten, for example).
Gliadin Protein
Since antibodies are formed to these sequences, anything that has them is attacked by the immune system. So, depending on what antibody or antibodies your body forms against gluten, it may or may not cross-react with other foods.
But, if your body makes antibodies for sequences in other foods, then you are not only sensitive to gluten, you are sensitive to all those other foods.
There is a lab called Cyrex labs that tests for these cross reactors and they offer the following list of foods that may cause a gluten like response in your body:
You may notice that some of these are grains that are commonly thought to be gluten free. They may be, but they may also cross react which means they cause the same problems that gluten causes in your body.
And just like we discussed in our last post, only tiny amounts of these foods are needed to cause inflammation and an immune response.
In my program, Healing Hashimoto’s: The 5 Elements of Thyroid Health, you will discover more about the tests available to you and learn what you can do to minimize the damage from exposure to gluten and cross reactive foods, and how to clear out circulating antibodies. Click here to learn more.
Resources:
Autoimmunity, 2008 Feb;41(1):116-121
http://publications.nigms.nih.gov/structlife/chapter1.html
If you are someone who has Hashimoto’s, you have probably already heard about how important it is to be gluten free. Many patients with Hashimoto’s also have gluten sensitivity. In fact, there is a good deal of research that suggests a kind of chicken-or-the-egg argument regarding gluten sensitivity and autoimmunity. Meaning, we aren’t really sure which came first.
Let’s face it, the gluten of today ain’t your grandfather’s gluten. Wheat has been all kinds of modified and there are many economic and political pressures to create a super wheat that will reign supreme in today’s industrial agriculture food system.
Firstly, it has been bred to have more gluten, and to be disease resistant , insect and heat resistant and to survive all kinds of difficulties.
It is also deamidated. Deamidation is a process that creates a dough that has more plasticity and is easier to work with. It also makes wheat based products useful as binding agents and fillers and for emulsifying, forming films, and making stuff more stretchable.
Wheat is in almost everything that is processed. It is used by food scientists in meat products, sauces, soups and as a clarifying agent in red wine.
This new super gluten and deamidated wheat messes with your small intestine. It gets deep into the folds (villi), and it confuses the immune system into thinking that it is a foreign invader. The result is a gradual destruction of your intestines. It can also destroy your nerves, your brain, your thyroid and lots of other tissues.
And this is where the chicken-or-the-egg argument comes in. This breakdown of the intestine causes intestinal permeability, but it also causes the immune system to not recognize its own tissue and to start destroying it. So you get this vicious cycle of your intestines leaking, your immune system going crazy and and both things making each other worse. And being gluten free is often the only thing that reverses this process and stops the destruction.
Proteins are made from amino acids. The body doesn’t have very many of them to work with so they are creatively arranged and rearranged in different combinations. The problem is many of these arrangements look a lot like each other. Especially in certain pieces. In fact, some pieces are exactly the same.
For example, gliadin (gluten) proteins look a lot like proteins in your cerebellum (foggy brain?). Myelin basic proteins look a lot like streptococcus proteins. In fact, when your immune system is making antibodies, antibodies for one of these proteins fit receptors on the others. So these antibodies work for both.
Many Hashimoto’s patients have celiac disease or gluten sensitivity. And when they eat gluten, they get flare ups. Sometimes they don’t test positive for allergies to gluten, but this doesn’t mean that they don’t have it.
This is because most doctors only test 2 antibodies to gluten, anti-gliadin antibodies IgA and Transglutaminase IgA. 40% of people test negative for these, even when they are intolerant to gluten.
There are 22 other gluten antibodies that you could have. I work with a lab called Cyrex labs that tests for all of these.
The idea of cross reactivity is this. Those similar amino acid sequences result in an autoimmune attack whenever you have any gluten or anything that acts like gluten. (In my next blog post we will explore what other foods have a similar amino acid sequence to gluten and may act just like gluten in your body.)
This means, if you have antibodies to gluten and you have autoimmune disease, you get flare ups every time you eat those foods. Every time. The immune system is not designed to cheat when you do. It doesn’t disarm antibodies, once created, they work forever.
Back to my original question – and this is an important one because there are many people who think that being almost gluten free is still almost good.
I’m sorry to say the data says NO. A study in the Journal of Neurology, Neurosurgery and Psychology looked at this question and their answer?
“Even minute traces of gliadin are capable of triggering a state of heightened immunological activity in gluten sensitive people.” Crap!
What they are saying is even a little bit, just an eeny weeny bit of gluten, triggers a major immune response. That translates to a flare up of your symptoms and further tissue destruction.
I’m afraid its true, people. One thing you need to realize is that you only need a tiny amount to get a response from your immune system. Antibodies have memories better than elephants.
You have to be vigilant. And you have to do the right testing so that you know what you are dealing with. Its also a good idea to work with people who are aware of these things and who think about how they may affect your care. You also need to know that there are hidden sources of gluten.
Many people are not aware that you can also react to gluten from things that are not food or stuff that may be in the air. Handling wheat based dog foods, breathing in flour from the air in a bakery, kissing, and skin lotions are common examples where hidden gluten can be found.
Common Sources of Hidden Gluten:
1.) Licking envelopes or stamps
2.) Sauces for meats, salads, etc
3.) Tooth paste
4.) Shampoo
5.) Frying oils
6.) Shared cutting boards or utensils
7.) Grain based sweetener (i.e. malt, corn sugar)
8.) Thickening agents used in processed foods
The bottom line is this – Be careful and read your labels.
If you are careful and you eliminate these triggers, you can significantly calm your immune system and slow or stop tissue destruction. There are also some herbs and botanicals that can reduce the damage done from gluten if you are accidentally exposed to it.
Still not convinced?
Check out this other article on Celiac and Hashimoto’s, I looked at over 30 peer reviewed studies on this issue.
Comments, thoughts, suggestions? I’d love to hear your comments on this.
Marc
Resources:
http://en.wikipedia.org/wiki/Genetically_modified_wheat
Autoimmunity.2008 Feb;41(1):116-121.Celiac disease in Northern Italian patients with autoimmune thyroid disease
Autism File. 2009;31:56-64
J Neurol Neurosurg Psych. 1997;63:770-775