The impact of stress on the body has been well documented. Research has shown that stress has direct impacts on the immune system, the endocrine system and the nervous system.
Since Hashimoto’s is an autoimmune disease of the thyroid, stress has a profound effect on people who are afflicted with the disease because all these systems are involved.
It can be a cause of flare ups of symptoms, and can be a factor in the progression and worsening of the condition.
In addition, because having autoimmune disease is so stressful on the body’s physiology, people with Hashimoto’s can be very sensitive to stress.
And sometimes, they are unaware of the extent of stress’ destructive impact on their health.
Most people are conscious of it’s obvious forms: impossibly full schedules, driving in traffic, financial problems, divorce, losing a job, moving, losing a loved one and the many other emotional and psychological challenges of modern life.
But other things you don’t normally think of, can also tax the body.
These include blood sugar swings, gut dysfunction, leaky gut, food intolerances (especially gluten), chronic infections, environmental toxins, autoimmune problems and inflammation.
Not to mention the psychological toll that Hashimoto’s can cause by creating feelings of isolation, lonliness, depression and anxiety.
(To learn more, read my previous post on the physiology of stress in Hashimoto’s).
What this all boils down to is that external stress and stressful events can sometimes be very difficult to handle and it can be easy to feel overwhelmed emotionally and psychologically.
In fact, other research has also shown that for many (up to 80%) some major stressful life event often precedes a diagnosis of Hashimoto’s (this was true of my own experience, as well).
The reality is this, for some people, stress is the elephant in the room and the real problem, yet too little is being done to address it.
And this means that they may not be seeing the improvements that they expect in the way they feel and they may be disappointed by the results that they are getting.
In this post, I explore the impact of stress on the thyroid and the rest of the body.
In addition, I focus on how effective a solution meditation can be for relieving the destructive effects of stress.
One thing that’s important to understand is that stress can have a major impact on thyroid hormone conversion and absorption.
This is such a common thing that it’s basically a cliche for those who suffer from Hashimoto’s and hypothyroidism.
Let’s Review the Physiology
First of all, let’s look at basic physiology.
In the body, normally, the thyroid is signaled by the pituitary with TSH (Thyroid Stimulating Hormone). The purpose of this is to goose the thyroid into producing more thyroid hormone.
This occurs because of signals from the body that it needs more. If it’s cold or you need your heart rate to increase, or your metabolism to rev up or you needs to get things moving for sex, etc.
When this happens the thyroid releases T4 (about 97%) and a little bit of T3 (do the math – yup, 3%).
And this is the basic premise of thyroid replacement hormones like Synthroid.
It’s synthetic T4. The theory is that you just give it to the patient and tell them to call you in 6 months.
An everything should be hunky dory.
And the reason it doesn’t work is that thyroid hormone must be converted from T4 into T3 in order for the body to utilize it. This conversion happens differently in different parts of the body.
The problem with TSH only testing to determine thyroid hormone levels in the entire body is that the pituitary, which releases TSH, converts thyroid hormone differently than the rest of the body.
This is why you often see normal TSH with lots of hypothyroid symptoms (like fatigue, weight gain, hair loss, cold hands and feet, brain fog and other cognitive problems, depression and anxiety, etc.)
For a more in depth look at thyroid hormone conversion and how to improve it, check out this post.
Many doctors, somehow, are ignorant of this fact and instead of truly understanding what is happening physiologically, blame the patient for having symptoms when their lab tests say that they should be fine.
They tell their patients to eat better, get more exercise and relax and to come back in 6 months for more tests.
Only, they don’t order the right tests to determine whether or not thyroid hormone is getting converted properly and absorbed (for this you need to order the free fractions free T3 and free T4 and reverse T3.)
An important indicator of whether or not thyroid hormone is being utilized by the body is reverse T3 (rT3).
Basically, T3 is so biologically active (about 10 times stronger than T4) that the body has to have a way of disabling it.
If it isn’t disabled, it can cause hyperthyroid symptoms which can lead to heart attack, stroke, and dangerously low levels of cholesterol, and other symptoms like insomnia, palpitations, nervousness and anxiety.
(This is also why so many doctors are so hesitant to prescribe T3, because if the dosage given is too high, it can cause all the symptoms mentioned above and can even put patients at risk for cardiovascular events.)
So, in order to prevent this, the body makes rT3. It is mostly inactive, having about 1% of the power of T3. It is also what is known as a “T3 antagonist” which means it can bind to T3 receptor sites and block the action of T3.
As you can see from this illustration, rT3 is a kind of mirror image of T3 in it’s molecular structure, so it fits nicely into T3 receptors.
Think of it as a kind a break pedal for your body’s metabolism.
Normally, T4 is produced by your thyroid (or is delivered in the form of T4 medications, like Synthroid) and the body takes that and creates what is basically a balance of T3 to rT3.
When more T4 is converted to reverse T3 than into T3 and free T3, then the body may exhibit common symptoms of hypothyroidism, described earlier.
There is a medical condition called Wilson’s Syndrome (also known as Wilson’s Temperature Syndrome or Wilson’s Thyroid Syndrome, WTS) which is popular in some alternative medicine camps.
The American Thyroid Association does not recognize Wilson’s Syndrome.
The term was coined by an MD named E. Denis Wilson from Longwood, Florida (I’ve actually been there, oddly enough. :)).
He listed about 60 different symptoms associated with it (many of which are common to hypothyroid and Hashimoto’s patients).
Wilson believed this condition was brought on by stress and that it may persist even after the acute stress had passed.
The main diagnostic sign was a chronically depressed body temperature of 98.6 or lower. Wilson then recommended treatment of time released T3 and some herbs which are intended to increase T3 levels, and reduce reverse T3 levels over time.
While Wilson’s Syndrome and his treatment protocol for it are popular in some circles and are endorsed by some thyroid support groups, it has not been accepted by the wider medical community.
And unfortunately for Dr. Wilson (and the poor patient), a patient under his care in 1988 apparently died from taking excessive amounts of T3 (Though, there is some controversy about whether or not she took the medication as directed).
He was discredited by the Florida Board of Medicine and fined $10,000, given a 6 month suspension and required to take 100 hours of continuing education (in more orthodox care, no doubt).
Dr. Wilson was also subjected to psychological testing, accused of being a fraud and was not permitted to use his protocol unless “Wilson’s Syndrome” was proven to be a valid medical condition by his peers.
It has not, to date, been recognized as a valid medical condition. However, there are some practitioners who believe in Dr. Wilson’s theories and who continue to practice using his protocol.
As I mentioned, many doctors are fearful of prescribing T3 because it is so biologically active and in researching my book, How to Heal Hashimoto’s: An Integrative Roadmap to Remission I discovered that there really are causes for concern.
T3 affects cardiac muscle, contraction of the heart, and that it impacts the performance of sodium, potassium, and calcium channels in the heart.
This is why you must be very careful when taking T3, of which 90% is absorbed in the stomach.
Our thyroids naturally produce 97% T4 and 3% T3, for a reason. T4 must be converted in the liver, then in the gut by good bacteria and finally in the peripheral tissue.
So throwing caution to the wind and taking lots of T3, driving your TSH into the ground and not listening to the warnings of trained professionals may not be the best course of action.
There may be consequences to overdoing T3, especially over time, and these include bone loss, risk of heart attack and stroke, dangerously low levels of cholesterol (which is needed to make lots of hormones and is important for your brain) and more.
As always, my quest is to ask, is there a better way to approach this problem?
Well, it turns out there is. We’ll get to that in a moment. First, let’s see if Dr. Wilson may have been right about some things and let’s look at the many factors that can cause reverse T3 to become high.
In my opinion, there are parts of this that Dr. Wilson may have been right about.
Firstly, high rT3 is an indication of a metabolic problem and not just thyroid deficiency.
There is also no doubt that stress has profound effects on thyroid hormone metabolism.
With stress, cortisol levels often go up. The increased cortisol levels contribute to this disconnect in the body between the TSH and peripheral tissue T3 levels.
Stress reduces T3 levels in the tissues and increases reverse T3 and this results in hypothyroidism in the tissues of the body and potential weight gain, fatigue, and depression.
This vicious cycle of weight gain, fatigue, and depression that is associated with stress may be helped with supplementation with timed-released T3, but the risks that I mentioned do remain.
The reduced immunity from chronic stress has also been thought to be due to excess cortisol production; but the associated reduction in tissue thyroid levels are shown to play a larger role in the decreased immunity seen with stress.
As with stress, treatment with prednisone or other glucocorticoid has been shown to suppress the enzyme 5 alpha dieodinase, reducing T4 to T3 conversion and increasing T4 to reverse T3, causing a relative tissue hypothyroidism that is not detected by TSH testing.
There are also many other potential causes of high reverse T3 including: insulin resistance, leptin resistance, inflammation, yo-yo dieting, iron deficiency, chronic pain, chronic stress, serious diseases like liver, kidney, and heart disease, traumatic events and shock, serious burns, surgery, toxic chemical and heavy metal exposure, and deficiencies in other vitamins and minerals that are vital for healthy thyroid hormone production like: zinc, selenium, chromium, vitamins B6 and B12, and vitamin D.
Again, the thing that many of these conditions have in common is that they are very stressful for the body.
Now that we have established how destructive stress can be and how important it is for proper thyroid function to do something about it, let’s have a look at treatment options.
Treatment involving additional T3 can, without question, help some patients. Taking natural desiccated hormone (which uniformly has four parts T4 and one part T3) can be helpful.
Adding synthetic T3 to treatment using only T4 may also be helpful for those who don’t do well with natural desiccated. (to learn more about thyroid hormone and how to assess which one is right for you, check out my previous post.
However, treating high rT3 only by adding more T3 is not always the answer and it sometimes doesn’t address the underlying problem: STRESS
The reality is that T3 speeds up your body’s metabolism. This can add more stress because it can disrupt sleep, make you feel more nervous or anxious, give you palpitations and generally amp everything up.
So, regardless of whether or not you decide to add T3 to your treatment plan, you still need to do something to counteract the affects of stress on your body.
Meditation, as just about everyone knows, is an ancient technique for improving well being, mindfulness and a sense of balance and modern research has revealed that it has real physiological benefits.
Meditation can be done lying down, seated or standing. It involves breathing and visualizations or focused attention or deliberate lack of visualizations, the simple practice of letting go.
Let’s take a look at some of these benefits now and, in particular, look at how these practices may be used to reduce rT3, decrease the destructive impact of stress and help us solve the problems at hand without adding more medication or spending more money on supplements.
Meditation has been shown to cause improvement in various cardiovascular, neurological, autoimmune, and kidney diseases.
It has also been widely used in medical and psychological treatment therapies for stress-related physical and mental disorders.
I looked at a number of papers which analyzed the results of modern diagnostic techniques (like functional MRIs, positron emission tomography, single-photon emission computed tomography, functional electro-encephalogram, and diffusion tensor imaging).
These all assess the function and integrity of connections of the brain and show us how meditation benefits the body, mind and spirit.
The following are the results of various studies on the effects of meditation on the brain and the body. Many of these studies were done on people who had practiced meditation regularly for a prolonged period of time.
The benefits of meditation, like the benefits of exercise, are better and more prolonged if you continue to practice and do it. If you treat it like a fad and stop doing it, chances are the benefits will stop too.
Long term benefit is the result of long term commitment (just like marriage 🙂 ).
The prefrontal cortex is the part of your brain right behind your forehead. It controls cognitive behavior, personality expression, decision making, and moderating social behavior.
Studies have found lower levels of T3 (but not T4) in the pre-frontal cortex of brains of deceased Alzheimer’s patients. (Hypothyroidism can impact glucose metabolism in the brain which can have profound effects on brain function.)
Meditation has been found to improve a number of activities associated with the prefrontal cortex such as differentiating among conflicting thoughts, determining good and bad, future consequences of current activities, working toward a defined goal, predicting outcomes, and expectation based on actions.
This is the mid-part of the brain associated with emotion, learning and memory.
Problems with focus, attention and various symptoms that resemble ADD are associated with thyroid hormone resistance.
Meditation has been shown to bring more blood flow to this area of the brain (oxygen, sugar and thyroid hormone are all carried by the blood).
And this part of the brain was shown to be more developed and thicker in subjects who had practiced meditation regularly.
Meditation activates areas in the brain, which are responsible for motivation, memory, emotion, i.e., hippocampus, amygdala, and anterior cingulate.
This activity exerts protective effects on the brain generally by increasing blood flow and helping to reduce inflammation by clearing out harmful byproducts that come from the body’s metabolic processes, i.e., oxidative stress.
Meditation also improves concentration and cognitive function( like memory) this may be due to activation of reward or motivation circuit in the hippocampus/limbic system.
Stress reduces the growth of neurons in the brain and promotes the destruction of brain cells in adult hippocampus, therefore causing memory impairment, and meditation relieves stress, and increases neuronal growth, making it really helpful in dementia syndromes.
(And just so you know, dementia and Alzheimer’s is the second leading cause of death in the US. Chances are, you or someone you love is going to be impacted by this.)
Meditation also increases levels of inhibitory (GABA- a calming neurotransmitter) neurons, therefore reducing anxiety and depression.
It’s also interesting to note that increased bridging of hemispheres of the brain (corpus callosum, which acts as a bridge between two hemispheres) is increased in thickness and enhanced in meditator.
This may indicate greater connectivity, possibly reflecting increased integration of the two hemispheres during brain activity involving pre-frontal regions.
What that means is meditation actually gives you a bigger brain. 🙂
Several studies have shown how the parasympathetic system is more predominate during meditation. This causes a decrease in heart rate, blood pressure, and oxygen metabolism.
However, a recent study suggested that both the parasympathetic and sympathetic systems were stimulated as there is variability in heart rate during meditation.
This may suggest that both parts of the nervous system are actually activated. This could also explain why meditation produces that feeling of calm and awareness at the same time.
These are the molecules of emotion.
Often with Hashimoto’s and hypothyroidism we find deficiencies in one or more of the neurotransmitters, such as: serotonin, dopamine, acetylcholine and GABA.
This is one of the reasons why anxiety and depression are such common symptoms for Hashimoto’s patients.
Meditation has been shown to increase blood plasma levels of melatonin, resulting in the feelings of calmness, decreased feelings of pain and better sleep.
Levels of serotonin metabolites in the urine of meditators are elevated suggesting increased serotonin in the brain.
Increasing serotonin can also increase dopamine levels and concentration and sustained focus of meditation can also increase acetylcholine levels.
Another possible reason for the impact of meditation on neurotransmitters is how it affects the hypothalamus and the thyroid axis.
With aging and hypothyroidism, TSH levels rise and activities in the body slow. This can cause resistance to TSH and problems with the thyroid-hypothalmus-pituitary axis.
But the opposite effect to that is seen in long-term practitioners of meditation, which may be due to more efficient functioning of the pituitary-thyroid axis.
Nitric oxide levels also increase during meditation, increasing blood flow. (This can be very beneficial for those who suffer with cold hands and feet and poor circulation.)
Regarding stress, in a study that had people do meditation for 4 months, cortisol decreased significantly in long-term practitioners during meditation and remained somewhat low afterward.
Which means that rT3 levels may also be reduced. (I have seen this in some of my patients who practice meditation.)
Beta endorphins are your body’s natural opiates. This is what low dose naltrexone helps to increase. Well, it turns out you may not need that medication if you meditate regularly.
Levels of beta endorphins are also increased during meditation producing a state of deep calmness with increased tolerance for stress and challenges. (That’s the buzz you get from meditating, running or exercising – feels good!)
Finally, Hashimoto’s and many other forms of chronic disease are caused by destructive inflammation.
And the reality is that stress is very inflammatory.
Especially long term chronic stress that goes untreated for years. Prolonged stress alters the effectiveness of cortisol to calm inflammation because it decreases tissue sensitivity to the hormone.
Immune cells can become insensitive to cortisol’s regulatory effect. As a result, non-stop inflammation is thought to promote the development and progression of these chronic diseases.
Cytokines are the immune modulators and controllers of the defense system of our body. Their levels are definitely influenced by meditation.
IL-6 and TNF-alpha are increased, IL-4 and IL-12 levels remain stable, interferon-gamma-secreting cells increased and IL-10- secreting cells decreases these results are according to a pilot study (see below).
More studies need to be done on this and I think there is a possibility that meditation and qi gong (which is what that pilot study looked at) may also have a modulating effect on the immune system.
The immune system doesn’t exist in a vacuum, it is in constant communication with the endocrine system, the nervous system, the digestive system and the brain.
Given all the positive impacts of meditation on all these other systems, it is not hard to imagine that meditation may also have a calming effect on the immune system.
This is particularly important in autoimmune diseases like Hashimoto’s where an overzealous immune system is attacking and destroying thyroid tissue.
Calming that activity is very, very important. And as we have seen there is ample evidence that meditation does this.
Meditation has many positive effects for Hashimoto’s patients. But like a proper diet, it is not a fad.
In order for it to be most effective you must do it and it must become a daily part of your maintenance of health and well being.
I am currently involved in a long term experiment of my own. I meditate a minimum of 15 minutes daily and I am combining this with qi gong and HIIT training.
My goal is to see to what extent diet and exercise can have a positive impact on my Hashimoto’s. I am roughly 9 months into this and I feel amazing.
I’m in the best shape of my entire life and more importantly I have lots of energy and feel a generally high level of contentment.
And when I’m faced with challenges, disappointments and set backs, they seem smaller and less significant and I am much more skilled at letting them go and not dwelling on them.
You know, all of this science and research is great for skeptics and for understanding how these things benefit us, but the proof is in the pudding.
How do you feel every day?
That’s what really matters.
If your current treatment strategy isn’t making you feel better (and I mean significantly better), then it may be time to look at other things like meditation.
It costs you nothing but a few minutes a day.
It doesn’t require a prescription.
You don’t need a doctor or a guru.
All you need to do is sit and breath.
Stress can kill you, literally. Medication can sometimes help and can also be a unending sinkhole of frustration. especially when your doctor doesn’t really have a good sense of what to do next.
Meditation is the gift that keeps on giving. Take a look at these studies and, more importantly, start doing it and start feeling the rewards.
They are definitely cumulative. Like a good wine they just keep getting better and better with time. 🙂
No more excuses, do it and see how amazing you feel!
Want a free guided meditation audio that you can listen to today? Click here and it’s yours.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/ 30 Years of studies on stress’ impact on the body.
http://www.ncbi.nlm.nih.gov/pubmed/18190880 Up to 80% of people reported a major stress event prior to autoimmune disease onset
State of Florida, Department of Health. February 12, 1992. Final Order Number: DPR9200039ME Dr. Wilson’s final sentencing decree
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http://www.umasatyayogaanatomy.com/uploads/6/2/1/2/62123413/molecular_mechanisms_of_meditation.pdf Self explanatory
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So now, not only is it my profession, it’s my passion, and it’s personal. I’ve been joking with people lately saying it’s a blessing and a curse. A blessing because I really get it, and a curse because I really got it! ?