The Root Causes of Thyroid Disease
An estimated 12 percent of the population of the United States will develop a thyroid condition during their lifetime. (1) The incidence of autoimmune thyroid disease, Hashimoto’s (hypo) Thyroiditis, and Graves’ (hyperthyroidism) Disease doubled from 1932 through 1976. From 1976 through 2010 it went from a relatively rare, 10% of all cases of thyroid disease, to an estimated 90% of all cases of hypothyroidism.(2)
Autoimmune disease occurs when the immune system confuses our own body’s tissue as a foreign invader, attacking itself in a mistaken attempt to protect itself.
I turn to two wise, elderly, street smart aunts, Freida age 89, and Audrey, age 83, for a practical explanation.
Aunt Freida, G-d love her, she of thinning hair, poor eyesight, a beautiful singing voice, wisdom from the old country, and more than a little dementia, (at age 87 she plowed her 1987 Chevy Citation into a legally parked $80,000 BMW 750i. A week later she asked; Where is my car? “ “You wrecked it.” “ I did?”), after another calamity in my life, would shake her bony index finger at me, ala Bill Clinton and proclaim; “You are the cause of your own trouble.”
Aunt Audrey, age 83, a little less forgetful, just as outspoken, summed up my worldly troubles thusly: “You dumb boy, you.”
In a nutshell, Aunt Freida and Aunt Audrey, in their own way, summarized the root cause of thyroid disease better than any Harvard based researcher. The thyroid gland attacks itself, causing its’ own troubles. It gets in trouble, falling for the same insincere “lines” over and over again, because it is “dumb.”
The 6 Root Causes of Autoimmunity in the Thyroid Gland:
- Gastrointestinal permeability (leaky gut syndrome)
- Heavy metal toxicity
- Infectious diseases
- Adrenal insufficiency, or “burnout,”
- Iodine deficiency
- Nutrient deficiency.
While each is a seemingly disparate entity, the mechanism of action in every instance, be it a GI, toxic metal, infection, adrenal, iodine or other nutrient issue, is essentially the same.
Molecular mimicry is the term used when one set of tissues closely resembles another totally different set of tissues. Thyroid molecules, unfortunately, closely resemble, in one form or another, all of the above “disease” entities.
Eventually the immune system is alerted, produces antibodies to protect the itself from these “invading” entities, resulting in inflammation and end organ damage.
Following the American Association of Clinical Endocrinologists and American Thyroid Association’s self declared “standard” treatment of hypothyroidism, “replacement with levothyroxine,(4) and its’ companion declaration, “Any treatment of thyroid disease other than desiccated T4 (levoxyI, levothyroxine, or Synthroid), is outside the realm of medicine,(5) is patently ridiculous.
Without treating the root cause, the disease entity will continue ad infinitum. A 55 gallon drum of synthetic thyroid replacement hormone would never be sufficient treatment.
In the G.I. tract, gluten, lactose and night shades damage the intestinal lining, leading to improper nutrient absorption. Food particles are misinterpreted as foreign bodies, the immune system reacts by creating the above mentioned antibodies, setting in motion the (dysfunctional) autoimmune scenario cascade.
Mercury, in sushi, and dental fillings, perchlorate in fireworks and fertilizer, and
nitrates in fertilizer and processed or cured meats like hot dogs and bacon, are the molecularly similar heavy metal and toxic players.
Infectious disease mimics include Herpes, Ebstein-Barr, (Mononucleosis), and Hepatits C viruses, and Yersinia enterocolitica (food poisoning), and H. pylori (stomach ulcers) bacterial infections.
Excess cortisol is the body’s response to chronic stress leading to “burnout” or adrenal fatigue. Cortisol signals the brain to lower the production of other hormones until the stress passes. In this modern era of never ending stresses, our cortisol levels never” rest.” Cortisol is chronically high. Thyroid hormone is produced on the same pathway as cortisol and is “unwittingly” lowered. (‘You dumb thyroid, you.) In addition, the thyroid hormone that is produced is frequently ‘inert,’ the false flag reverse T3 we spoke ofpreviously.
Iodine, a member of the halogen family, is necessary for the production of T4. Fluoride, found in toothpaste, chlorine, found in swimming pool water, and bromine, found in flour, (a gluten-toxin double whammy), are also halogens. They mimic iodine, causing displacement and thyroid dysfunction. (You dumb thyroid, again.)
Lastly, a deficiency in a variety of nutrients, including selenium, magnesium, and zinc among others, creates molecular mimicry and autoimmune dysfunction.
Aunt Audrey was right. The thyroid is a dumb boy, or girl.
As a reminder, hypothyroid symptoms include brain fog, fatigue, weight gain, pale, puffy face, feeling cold, joint and muscle pain, constipation, dry, thinning hair, heavy menstrual flow or irregular periods, slowed heart rate, difficulty getting pregnant, and depression.(6)
Hyperthyroid symptoms represent the flip side of the coin; rapid heart rate, anxiety and panic, attacks, insomnia, weight loss, hair loss, elevated body temperature, tremors and diarrhea.
The risk of elevated blood pressure, Hashimoto’s Disease, and depression in relation to the thyroid can be seen with a TSH reading as low as 1.9. At 2.0, elevated markers for cardiac and carotid (c-Reactive Protein and Homocysteine) disease are evident. When the TSH is 3.3 or greater severe forms of depression, increased body mass index, and blood sugar abnormalities are common. These are all within the confines of a “normal” thyroid.(7)
On a positive note, hypothyroid children, thanks to better antibiotics, better diagnostic techniques, sanitation and treatment strategies, now survive into adulthood and pass on their genetic code. Sociologists tracking various patient populations, including hypothyroid patients, find these individuals lead relatively sedentary lifestyles, attract similarly quiescent (hypothyroid) mates, reproduce, and further extend the gene pool.(8)
Negative influences include the rise of autoimmune diseases, dietary and gastrointestinal health issues, environmental toxins and lingering, low grade and infections diseases.(9)
The Autoimmune-Gastrointestinal-Thyroid Connection
80% of our immune system resides in the gastrointestinal tract. Autoimmune disease occurs when the immune system confuses our body’s own tissues with outside foreign invaders. Without a healthy GI tract it is impossible to have adequate defense against disease.
Thanks primarily to our Standard, high sugar, high saturated fat, pro inflammatory, American (S.A.D.Diet, along with a healthy dose of environmental toxins, sleep deprivation, alcohol, chronic stress and liver disruptors, our small intestine, the site of the immune functioning cells in the GI tract, is under constant attack. This assault results in an outpouring of immune defenses, specifically a chemical called zonulin, that weakens and widens the attachments of the intestinal lining. Large particles that normally traverse the digestive tract due to its’ “tight” junctions, now “leak” into the bloodstream. (10)
The aggressors in this war are nightshades (potatoes, tomatoes, eggplant and peppers, excluding black pepper), sugar, industrial seed oils and “Mister Big,” itself, gluten.
Gluten, a protein found in barley, rye, and a cross between wheat and rye called triticale, is a major stressor of the junctional walls of the small intestine. Stressed enough, the normally “tight” junctions between cells of the intestinal lining are weakened, creating gaps in the lining, allowing toxins, microbes and food particles a clear path to the blood stream. Left unchecked, the body fights back by developing defenses, i.e. antibodies to its’ own tissue.
The thyroid is particularly vulnerable because gluten is structurally similar to thyroid tissue. The body misinterprets its’ normal thyroid tissue as an invader leading to autoimmune disease.
To identify autoimmune hypothyroidism, Hashimoto’s Thyroiditis, we measure Thyroid Peroxidase Antibodies (TPO) and Anti-Thyroglobulin Antibodies (TgAb). To identify identify autoimmune hyperthyroidism, Graves’ DIsease, we draw a thyroid-stimulating immunoglobulin (TSI) sample.
Non-autoimmune causes of thyroid disease include deficiencies in the minerals necessary to create the thyroid hormone (tyrosine or iodine), deficiencies in the substrates necessary to convert T4 to T3 (selenium, zinc, or iron), deficiencies in the nutrients necessary to regulate hormones and metabolism (Vitamins A and D), deficiencies in adrenal output, and thyroid cancer.
To minimize leaky gut syndrome and to prevent or reverse autoimmune thyroid disease we recommend the 4 R’s (11) to:
“Remove” inflammatory foods such as gluten, dairy, corn, soy, eggs and sugar. Eliminate gastric irritants like alcohol, caffeine or drugs. Infections, even low grade infections need to be treated with herbs, antiparasitic and antifungal medication, anti-fungal supplements and antibiotics when appropriate.
“Replace” essential nutrients for proper utilization of foodstuffs. Digestive enzymes, hydrochloric acid and bile salts are needed for proper digestion.
“Restore” normal GI flora. Probiotics containing bifidobacteria and lactobacillus dosed from 25 to 100 billion units a day along with prebiotics and fiber.
“Repair,” L-glutamine along with zinc, omega 3 fish oil, vitamins A, C, E, slippery elm and aloe vera containing supplements rebuilds the damaged intestinal wall.
The Autoimmune-Heavy Metal-Toxin-Thyroid Connection
By age 10, a child born in the millennial year 2000 is exposed to approximately 80,000 chemicals that did not exist in 1970.
In 1974, glyphosate, commonly known as Roundup, a potent herbicide changed the face, in terms of toxicity, of agriculture. Those of us of a certain maturity remember well, via the magic of television advertising, the fate of side by side weeds growing through cracks in a driveway. An off screen hand delivered one shpritz from Roundup and 24 hours later, voila, no more weed.
Over the past twenty years, the incidence and prevalence of “mistaken identity,” i.e. autoimmune diseases has spiked dramatically. Evidence indicates that glyphosate (endocrine system, GI bacteria balance, DNA damage, cancer mutations (12), PCB’s (brain impairment), triclosan (present in soap, toothpaste, and bath towels, limb deformities), phthalates (fragrances, thyroid abnormalities), perfluorooctanoic acid (non stick cookware, microwave popcorn bags), among thousands of other chemicals, interferes with many metabolic processes in both plants and animals.(13)
Mercury, perchlorate and nitrates are chemically similar to the element necessary for T4 thyroid hormone production, iodine. When absorbed, they are mistaken for iodine, leaving the body less iodine to make thyroid hormone,resulting in hypothyroidism. The cells of the thyroid gland (as well as other cells in your body) become inflamed and damaged to the extent that the immune system no longer recognizes them as “self”. Antibodies to its’ own thyroid molecules are created resulting in hypothyroid autoimmune disease, Hashimoto’s Thyroiditis.
Mercury is found in sushi, cosmetics, vaccines, pesticides, dental fillings, and even coal fired power plant residue. Perchlorate is present in fireworks, fertilizer and rocket fuel. Nitrates are used in fertilizer and processed or cured meats like hot dogs and bacon. Spinach and celery contain natural nitrates. Skin care products, genetics and dental amalgams can also lead to heavy toxic exposure.
Avoiding these toxins is all but impossible especially for those living near coal fired power plants. HEPA filters are readily available to clean the air, water quality improves with filters as well. Consuming organic, grass fed meats, fish with lower mercury levels (salmon versus tuna for instance), and avoiding processed and cured meats (or using nitrate-free cured products) reduces nitrate exposure.
Liver detoxification is the body’s way of ridding itself of these toxins. We have successfully used intravenous glutathione, the most abundant antioxidant in the body, or N-Acetyl-Cysteine, its’ precursor, along with milk thistle, and Vitamin C in supplement form.
The Autoimmune-Infectious Disease-Thyroid Connection
Similar to gluten and toxic chemicals, infectious agents leave inflamed, damaged thyroid tissue in its’ wake. Again, the body produces antibodies to defend, but ultimately attack itself.
Infectious agents linked to thyroid disease include Herpes simplex 1 and 2 (causing oral and genital herpes), Ebstein-Barr virus (mononucleosis, multiple sclerosis, lupus, chronic fatigue syndrome, and fibromyalgia), Yersinia enterocolitica (food poisoning from uncooked pork, and contaminated meat and dairy), Hepatitis C (blood or body fluids of an infected person), and H. pylori, (a bacteria that attacks the stomach lining creating ulcers).
Diagnosis is rather straightforward for all of the above infections. Herpes, Ebstein Barr, Hepatitis and H. Pylori are found in blood, Yersinia and H. Pylori grow in stool cultures.
Viral infections are susceptible to Humic Acid-Monolaurin, a free-radical scavenger and natural anti-oxidant. It binds positive and negatively charged ions boosting the immune system, and contains olive leaf a known anti-viral, anti-bacterial, and fungal agent.
Yersinia and H. pylori are treated with antibiotics like any other bacterial disease. To minimize the damage to the GI tract from the antibiotics, we maintain the it’s flora with pro and prebiotics. (A little chicken soup and Vitamin D wouldn’t hurt either.)
The Autoimmune-Adrenal-Thyroid Connection
In 1881, George Miller Beard, M.D., a neurologist and graduate from the New York College of Physicians and Surgeons, described a condition based on excess “nervous energy.” Constant over stimulation of the nervous system from the fast paced American lifestyle resulted in “neurasthenia,” burnout, or nervous exhaustion.
Symptoms of neurasthenia included nervous dyspepsia, insomnia, hysteria, hypochondria, asthma, sick-headache, skin rashes, hay fever, premature baldness, inebriety, hot and cold flashes, nervous exhaustion, brain-collapse, and forms of ‘elementary insanity. The best educated and most sophisticated Americans were the most afflicted. Theodore Roosevelt and Frederic Remington were two prominent figures of their day suffering from “neurasthenia.”
The “cure” was a withdrawal from the modern life, rest and a less hectic lifestyle. Critics countered that urban life in the late nineteenth century had produced a “pathetic, pampered, physically and morally enfeebled 97 pound weaklings, unworthy successors to the stalwart Americans who had fought the Civil War and tamed a continent.”.(14)
Physicians pigeonholed patients into this “nervous energy” category, relieving themselves of more vigilant diagnosis. Early signs of tuberculosis, heart failure and epilepsy were chalked up to neurasthenia and when later discovered to be in error, gave fuel to those who saw this “malady,” as a sham.
The term neurasthenia is no longer used to describe any medical condition, but the conditions that lead to its “discovery,” diagnosis and its’ symptoms are remarkably similar to a hormonal condition with distinct diagnostic criteria known as “Adrenal Fatigue.”
The adrenal glands, pea sized organs, sit atop of the kidneys. They produce hormones that regulate blood pressure, electrolytes balance, blood sugar, immune responses, digestion, and stress responses.
In regards to the latter, constant unremitting stress, as experienced by nearly everyone in today’s society, hijacks normal hormonal responses, redeploying the adrenals’ resources to combat the “evil” of the moment. The other adrenal functions, digestion, immune response, and thyroid hormone production, are temporarily put on hold or slowed until the stress has passed.
In an ideal world, the stress passes quickly, and the adrenals resume their business. In our non-ideal, one stress begetting another stress, begetting a third stress, ad infinitum, puts the adrenals in overdrive. The body is flooded with cortisol driving the adrenals to handle the stress but eventually cannot keep up resulting in “burnout.”
The thyroid is exquisitely impacted by the constant flooding and eventual depletion of cortisol. High levels signal the brain to lower the production of stressor hormones. Unfortunately thyroid hormone is produced in the same pathway and is unwittingly lowered.
Recall the critical step of converting T4 to the usable thyroid hormone free T3. Stress hormones affect the enzymes that convert T4 to T3 converting T4 into the inert unusable reverse T3.
Chronically elevated cortisol levels release inflammatory cells which desensitizes thyroid receptors to thyroid hormone. Like diabetics who don’t respond to insulin, you may have adequate thyroid hormone, but inadequate thyroid utilization.
Increased circulatory cortisol increases estrogen in the blood stream. Estrogen increases thyroid binding globulin, tying up T3 and T4, reducing hormone levels to achieve the conversion to free T3.
Elevated cortisol levels with its’ inherent state of chronic inflammation can trigger “leaky gut syndrome,” latent infections leading and autoimmune diseases. Sound familiar?
How do we know if it is’ Adrenal Fatigue? Take the Quiz.
Is it Adrenal Fatigue?
- I wake up tired in the morning .
- I need an energy drink mid morning (coffee/tea/ etc)
- I crave sugar or salt (esp. mid afternoon)
- I have difficulty concentrating
- I have need a nap mid afternoon
- By 8 P.M. I’m ready for bed
- If awake after 9 P.M., I am most alert
- I psoriasis, eczema or skin allergies
- I often nod off reading or watching TV
- I have low blood pressure
Add up your Overall Score ____: 3 or less Yes: Satisfactory level. Between 4 and 6 : Possible Cortisol Excess 7 or greater Probable Cortisol Excess
The Adrenal Stress Index Panel from Diagnos-Tech measures cortisol levels on four occasions throughout a single day. Cortisol levels normally are high upon awakening and then quickly fall and flatten out by noon.
Treatment begins with reducing stress (easier said than). Proper diet, yoga, Pilates, Qi Gong, meditation, massage and infra red sauna are a few techniques used to successfully control stress. For some a complete lifestyle change may be the only way to better health.
Supplements that enhance the adrenal glands include the adaptogenic herbs Rhodiola, Ginseng, and cordyceps (our Fatigue Fighter), DHEA (the “stagecoach stop” that makes all the other hormones work better), and 5 HTP (for sleep, well-being and mood regulation), Adrenal Glandulars (to balance cortisol and replenish catecholamines (dopamine, norepinephrine, and epinephrine), and if still no relief Cortef, low dose cortisone).
The Autoimmune-Iodine-Thyroid Connection
Iodine is necessary for the production of T4. It must come from the diet as the body does not make iodine. Most of the iodine in the world resides in the ocean, hence seafood, and especially seaweed are good sources. As a rule iodine is also added to salt.
Iodine deficiency, as noted above, leads to hypothyroidism. Iodine is a member of the halogen family, as are fluorine, chlorine, and bromine. These other halogens can mimic iodine, causing displacement and thyroid dysfunction.
Fluoride is found in toothpaste, infant formula; processed cereals; wine; beer; soda; tea (higher in decaf), insecticide anesthetics, antibiotics, SSRI inhibitors (Prozac, Zoloft, etc.), and antiviral medications.
Chlorine is typically found in plastics, pesticides, paper products, unfiltered drinking water, bath water, Splenda (sucralose).
Bromine/Bromide is typically found in brominated flour products, citrus flavored soft drinks, chemical additive used in municipal water purification, pesticides, dyes, leaded fuel additive, and OTC antitussives (cough medicines). (15)
Remedies for low iodine include plenty of sea vegetables and saltwater fish. Supplements include using a low dose, 225 micrograms, (I liken it to a homeopathic dose to stimulate your bodies own iodine production). Higher doses, up to 12.5 milligrams, can lead to hyperthyroidism, and if unchecked, burnout, and hypothyroidism.
A water filter, using a fluoride free toothpaste, avoiding food dyes, gluten containing breads, organic produce, and using glass containers can minimize the damage.
The Autoimmune-Supplement-Thyroid Connection (16)
Selenium converts T4 (the inactive, or storage form of thyroid hormone) to T3 (the active form). WIthout adequate selenium thyroid hormones remain inactive. Selenium protects the body against hydrogen peroxide into iodine. Selenium neutralizes hydrogen peroxide formed from this reaction. Adequate selenium reduces TPO (autoimmune) levels. Brazil nuts. meats, fish, and shellfish are all rich in selenium. The dose is 200 mcg/day.
Zinc aids in conversion of T4 to T3 and is a key nutrient for adequate production of TSH. TSH, recall is the gauge by which the body determines if it has too much, not enough, or just enough circulating thyroid hormone. Zinc is present in beef. Dose is 25-35 mcg.per day
Protein is necessary to transport Thyroid Stimulating Hormone to the tissues.
Magnesium is needed for production of TSH
Iodine was previously discussed.
Manganese is crucial for thyroid hormone production and also works as an antioxidant to protect the gland from free radical damage.
Vitamin C – is extremely important for helping deliver iodine into T4.
It is plain to see thyroid production and utilization gets fooled over and over again into not functioning properly by the environment, our food supply, infectious diseases, and “adrenal burnout.” A healthy thyroid is essential for a healthy life. We need to be ever vigilant to the myriad of ways it can go off the rails lest we suffer inordinately.
- Clearfield, W., “Patient Mysteries: Are You Thyroid Deficient?, Part 1,” Healthy
Beginnings, July 31, 2015, P.15.
- Amino, N., “Autoimmunity and Hypothyroidism,” Baillieres Clin Endocrinol Metab. 1988 Aug;2(3):591-617.
- Cooper, D.S.,Hashimoto’s Disease, U.S. Department of Health and Human
Services division, http://www.womenshealth.gov/publications/ourpublications/
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- Garber, J.,Cobin, R., Gharib, H., et al., Clinical Practice Guidelines For Hypothyroidism In Adults, Endocr Prac. 2012; 18(No.6) 989. Hollowell JG et al. J Clin Endocrinl Metab 2002 87(2)489-499
- Guarva, S., Hypothyroidism, “Science Based Medicine” “https://www.sciencebasedmedicine.org/hypothyroidism–facts–controversies-and- -pseudoscience/
- Clearfield, W., “Patient Mysteries: Are You Thyroid Deficient?,” Healthy Beginnings, August 31, 2015, P. 8.
- Hertoghe, Thierry, Reverse Physical Aging: Hormone & Nutritional Therapies, A4M Lecture Series, Las Vegas, NV, Dec. 14, 2014, p. 44.
- Cooper, D.S.,Hashimoto’s Disease, U.S. Department of Health and Human Services division, http://www.womenshealth.gov/publications/our-publications/fact-sheet/hashimoto-disease.html#c
- Cooper, D.S.,Hashimoto’s Disease, U.S. Department of Health and Human Services division, http://www.womenshealth.gov/publications/our-publications/fact-sheet/hashimoto-disease.html#c
- Rothenberg, R.,”Thyroid Optimization,” from lecture notes, Bio-Identical Hormone Replacement Seminar, February 25, 2015, P. 31
- Reasoner, J., LeakyGut Syndrome in Plain English – and How to Fix It, http://scdlifestyle.com/2010/03/the-scd-diet-and-leaky-gut-syndrome/, Accessed September 6, 2015.
- Swanson, N, Leu, A., Abrahamson, J, et. al., Genetically Engineered Crops, Glyphosate and the Deterioration of Health in the United States of America;Journal of Organic Systems, http://www.organic-systems.org/journal/92/abstracts/Swanson-et-al.html; Vol. 9 No.2(2014)
- National Resources Defense Council, Position Paper, Neglect at Your Own Risk: Your Thyroid and Environmental Toxins, http://www.nrdc.org/living/healthreports/thyroid.asp, accessed 9/6/2015.
- The Birth of Modern Culture, Digital History, http://www.digitalhistory.uh.edu/disp_textbook.cfm?smtID=2&psid=3313, accessed September 7, 2015.
- Osborne, D, Nutritional Regulators of Thyroid Hormone, The Thyroid Summit, https://www.glutenfreesociety.org/the-thyroid-summit-why-you-should-watch-this-free-event/, accessed September 8, 2015.
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