If you think you might have thyroid disease have a thyroid ultrasound done and comprehensive thyroid labs including TSH, free T4, free T3, antithyroperoxidase antibodies, antithyroglobulin antibodies, thyroglobulin and reverse T3.
Look for nutrients deficiencies. This is an important part of the hashimotos picture. Often with hashimotos these will be magnesium, Vit D3, some might have low ferritin, some hemachromatosis (iron overload), low B1.
Selenium is important in hashimotos as it helps bring down antibodies.
A good test to check for mineral deficiencies is Genova’s Nutreval. Contact me regarding having this test done.
The other level of testing is for the gluten intolerance and is more of an IgG – an IgG 4 specifically – type reaction. There has been data saying Hashimoto’s is strongly driven by IgG 4 factors, so many types of foods can cause these IgG 4 reactions, and wheat is a more common one. The difference is with this reaction, we would not expect there to be damage to the intestines or damage to the thyroid but there can still be immune complications and worsening of symptoms. Now these reactions are more common than celiac.
If TSH is good and free T3, free T4 or reverse T3 are not, look for allergies, infections, toxins or lacking nutrients.
We make a lot of reverse T3 when we are sick and not feeling well, and then we shut it off again. Even with normal health, we make more Reverse T3 than active T3. Therefore, the proposal that reverse T3 blocks T3 is the opposite of the truth. Reverse T3 actually encourages T3. When you receive too much of it, that actually slows the mechanisms and your body then eventually goes back to a state of balance unless some underlying stressor occurs. The solution for reverse T3 is not to give T3 –stomping on the gas pedal when you are not in good control of the truck or when your body is sick and strained somehow. The solution is to figure out “Why is the reverse T3 being formed?”
Too much thyroid hormone
People given too much thyroid hormone can have greater rates of palpitations leading to a stroke through atrial fibrillation, greater risk of dementia, greater risk of osteoporosis, higher rates of muscle tissue wasting leading to overt death, and much higher rates of premature brain aging. These complications are real. Whenever your TSH is pushed below a specific range and a doctor is telling you that it is safe, it is not safe.
So the symptoms of too much thyroid can look like the symptoms of too little thyroid – counterintuitive and difficult for people to grasp – many doctors get it wrong and they overdose patients, subjecting them not only to danger but also not controlling their symptoms. You cannot make someone lose weight or become more energetic by just giving them more and more thyroid because their body is going to dump out the thyroid faster and faster. With dosing, it takes gentle working to move the TSH somewhere close to 1.0 – perhaps slightly below it – and the free hormones should be at a reasonable range.
The more active one autoimmune process – such as Hashimoto’s Disease – the greater your risk of having other autoimmune diseases form is – such as Lupus or rheumatoid arthritis or celiac. Therefore, it is good to keep these antibodies under control not only for your symptoms but also for your long-term health and minimizing complications.
So what are the main variables that affect that? Well, a couple of the big ones are other things that affect your immune system and the biggest ones there are going to be infections and allergies. Moreover, infections are commonly things from outside your body but they can also be internal. Candida and dysbiosis can be a big factor with this. Any chronic, low-grade infections inside the intestinal tract or the sinuses or the blood – such as Epstein Barr Virus – can drive that elevation in antibodies. Then allergies can also be triggers for that. Anything you are exposed to through the air, your diet, or your skin – that can aggravate your immunity and therefore raise your reaction to other things your body – is inclined to.
A good screening for general food reactions. Wheat is common, but the most common are dairy and eggs. They are rather typical, and from there on, we can see almost any food reactive for one person here or there. You may have a common reaction like one of those three or it could be something altogether different. It’s good to check for this via a lab test. It is kind of difficult to notice the more delayed intolerances by trial and error, meaning you could not necessarily peg which food makes you feel bad based upon day-to-day symptoms.
I use Meridian Valley Labs.
A common thing we can do is to get someone off the worst, most reactive foods, and take things to repair the intestinal lining. Glutamine and n-acetyl glucosamine work well for this. There is a blend called Perma-Clear of these I especially like and see work well. You can then retest 6 or 12 months later, and typically what will happen is many reactions will calm and a few will persist. Those that persist are likely long-term reactions. They are unlikely to change – good or bad. However, the ones that diminished you know were more elevated because the gut was irritated. This is common if you are eating plenty of foods to which you are reactive. You could be eating many things that are culprits for you. That alone can actually bother the gut in ways to makes new reactions. So we call those the functional intolerances as opposed to the long-term intolerances.
There is a test that has been popularized, called an iodine challenge test. Dr Christianson highlights that this test is not accurate. The rationale is someone takes a dose of iodine, and then afterward a urine collection is done. The thought process is that because iodine is passed through the urine, if you need it you will pass less. If you take a big dose and not much comes out in your urine during the next day you must have needed a particular amount of that whereas if most of it does pass out during the next day, you actually have enough and you did not need it. It seems logical enough. It made sense to me.
However, after following through on all the data behind it, it turns out it is not accurate. The rate at which we eliminate iodine is rather constant through the urine but it takes many, many months to readjust after we are exposed to a big change. If we get much more or much less, it does not show up during a day. The other problem is if we are exposed to plenty of it, much of it goes through our bile and our stool or through our sweat. We get rid of unusually high doses through other mechanisms.
Therefore, the test is not accurate and the doses commonly recommended greatly exceed the doses that are safe for anyone, especially for people with hashimotos. Now the paradox is you can develop thyroid disease from too little iodine. However, you can also develop it from too much. Because the amount of iodine we are normally exposed to is very little, the body has a mechanism that pulls iodine inside the thyroid. This lets the thyroid get first choice on it.
Now because that mechanism concentrates iodine so much, if we ever get too much iodine in our bodies, the gland has to shut itself off or it would make too much hormone, and dangerously so. That could make our heart give out – there would be so much thyroid hormone circulating. Whenever we get too much, it is toxic for our thyroid just as much as too little, if not more so. Moreover, if you have thyroid disease, which can occur even with amounts that would be healthy for someone else, especially if your dose changes rather abruptly. So as little as 300-400 micrograms above low intake can trigger issues for someone with thyroid disease, even if it has not been diagnosed or if it has not come to the surface just yet. So you do need iodine, but in tiny amounts.
If you have thyroid disease, it’s better that you use non-iodized salt. Redmond salt is a good choice.
The benefit of sea salt is that it does have a significant amount of magnesium, which regular table salt does not. So just do iodine-free sea salt daily for home use. Be on a low salt diet in general, and then use sea salt for what you do at home. It is better because of the magnesium content.
Consider IgG4 food intolerance testing 2. Minimize your intake of soy foods
3. Consume un-pasteurized Kimchee, sauerkraut, yogurt, kefir or use probiotics regularly.
Detox your body
Toxins building up inside the thyroid cause thyroid disease. Consequently, detoxification is an essential step towards healing thyroid disease. If someone has persistent symptoms even after the dose is right, a big reason is the presence of the toxins that caused the disease first. They are often still in the body and causing many symptoms besides the thyroid disease.
Therefore, what happens is that the thyroid has a mechanism that allows it to build more iodine inside itself than there is outside the rest of the body. It concentrates it strongly against a gradient. The iodine inside the thyroid may be present at a concentration fifty or one hundred times above what is in the rest of the body. It is good, because is needed. However, the problem is that many, toxins have a chemical similarity to iodine that is great enough to where they also get concentrated inside the thyroid. The same thing actually occurs to some extent in the brain. The brain is not concentrating iodine but it has a chemical property called the blood-brain barrier. What happens with the blood-brain barrier is that some things that enter the brain cannot always leave easily. Those chemicals diffuse into it but rather than flowing out, they are trapped inside and they tend not to leave so you end with concentrations in the brain much higher than they are in the rest of the body. The thyroid and the brain are both tissues that have numbers of toxins much higher than the rest of the body can carry. This is also why many with thyroid diseases have symptoms related to alteration in brain function, anxiety, depression, and short-term memory losses. . Over time, the presence of these toxins inside the thyroid starts to create an immune response. The body starts getting the immune cells activated, attacking these tissues carrying the toxins. The immune cells are secreting chemicals and antioxidants that would ideally help the breakdown and the removal of the toxins. In doing so, all the inflammation causes the cells to start getting reactive against the proteins present inside the thyroid gland. Often this dramatically worsens when the immune system is more active such as during an infection. Over time, we are sensitized to the gland. Therefore, that is how the disease starts but that is also what prolongs it. So the more wastes in the gland – even after the disease has already started – the greater the immune response will be
has been shown clearly that even independent of your thyroid levels being right – as far as your dose being where it should be – and other factors being correct, the presence of high amounts of immune antibodies still can cause symptoms. The immune system is an important variable and one big factor that controls it is how many toxins are inside the gland.
To some extent, these issues come up for other autoimmune diseases – this presence of environmental toxins. We are exposed to more chemicals now than at any other point during human history. . Throughout our life, we are building up more and more toxins. More things are entering us.
In our homes, we have carpeting. We have paints. We have fabrics and furniture and all these things are off-gassing formaldehyde and plastic residues. Our food is often carried in plastic and stored in plastic. We get exposure from this, these things go throughout our body, and they just continue building up in important parts of us. Some studies on some individual chemicals have been shown them to be harmful only when they are in amounts above our typical exposure levels.
Hair mineral test
Hair is also used as a testing material. I use MineralChek for this. The sample is sent into the laboratory and analysed. Generally, if people have elevated levels of calcium or magnesium on a hair sample they have too little in their body and in their stores. Other nutrients have actually a good correlation between what is in your hair and what is in your body. Two that correlate accurately are selenium and manganese. So in general, the more of these you have in your hair, the more you have in your body and vice versa.
Undergo general detox annually. This can be as simple as a 10 day cycle of limiting all food to a detox meal replacement twice daily with 1 ‘lean and green’ meal consisting of 4-6 ounces of fish or lean poultry + unlimited green vegetables. Mediclear SGS by Thorne is my favorite detox meal replacement. . The most critical step for effective detox is reducing the day to day burden, keeping what is coming in at a low threshold, and one of the larger sources of wastes to which we are exposed, would, of course, be our diets. In the diet, we are exposed to things primarily as by-products used in foods to help prevent pest growth or pesticide. We do also have a great deal of waste with just food processing and food storage so we get preservatives as well. Then by-products from containers and carriers of plastic derivatives – they will build up in foods. Overall, organic is not perfect. There are shortcomings and there are ways things said to be organic may truly not be. It can certainly happen that it can be mislabeled. There could be improvements with the regulations and with how foods are identified as organic. . The easiest step to start with is by eliminating any chemicals you can. So do just minimize your chemical burden completely. Any vague ingredient that would not have appeared on the farm a century ago – do not eat it. In addition, if there is an ingredient list a paragraph long – do not even bother reading it. Just put it back. An extremely good trend lately has been the whole clean-eating revolution. It is just common sense – good advice. Eat simple foods – things in a minimally processed state. This includes meat, fish, poultry, produce, grains – ideally intact, whole grains – beans, nuts and seeds, some dairy foods and eggs. Simply avoiding packaged and pre-made foods can lower your chemical burden substantially. One of the things you do not always hear is that the chemicals in foods also play tricks with our apatite. Food producers add artificial flavorings and ingredients knowing that they will make you want to eat and buy more than you need.
Worry more about getting more produce than choosing organic. If you are already doing well at getting produce, then start thinking about choosing organic to replace that produce with the highest number of pesticides. A current list of the highest sources of pesticides can be found on the Environmental Working Group’s “Dirty Dozen” list: www.ewg.org.
The current list includes apples, bell peppers, carrots, celery, cherries, grapes, kale, lettuce, nectarines, peaches, pears, and strawberries. So those particular ones, you do want to go out of your way to find organic sources. The ones not on that list, they are not as big a factor.
Change to organic for high priority foods . Eat simple foods. If a food was not present prior to the 1930’s, don’t eat it. Reduce your chemical burden at home with green cleaning products and air filters.
When you are taking thyroid medications – synthorid, levoxil, cytomel, desiccated thyroid, you are getting iodine. The medications and the active hormones inside the medications are iodine based.
T4 means four iodine atoms for every T, every tyrosine. You are getting iodine already in your thyroid replacement. Therefore, if you want to keep your iodine load low to minimize your antibody score, you have to watch out for your other sources, so it is not a good idea to take multivitamins that have iodine.
Trace minerals, you want the trace minerals there as it is one of the main reasons you are taking a multivitamin to begin with. Look for the inclusion of selenium, manganese, and vanadium. A few newer ones such as vanadium, molybdenum, and chromium are important for those who have thyroid disease. Some include it, some do not, but you want to make sure they are in there.
The preferred blood test for vitamin D is called the serum 25 hydroxy vitamin D. Ideally we see that score in the 40-65 nanogram per mil range. It could take none for some folks that have quite a bit of sun exposure, or it could take ten-thousand units a day to get someone loaded up if they are low in it.
The adrenal glands have three layers inside them. The outside layer makes a hormone called aldosterone and that regulates how much salt and water you carry in your body. That is a big part of how we keep our blood pressure in proper check and properly regulated. The middle layer makes primarily cortisol and forms a big part of regulating your blood sugar but it does a bit more. It also does affect inflammation. It does also have an effect on your thyroid hormones. Adequate amounts of cortisol are needed for thyroid hormones to be used by the cells. Too much cortisol, however, can block the inner portions of the cell from using thyroid hormones. Either too much or too little cortisol can disrupt the thyroid. The innermost portion, a little deeper than the area that makes cortisol, makes hormones such as testosterone and estrogen. It is job is to make reproductive type hormones. The testicles and the ovaries make these hormones primarily, but there are versions of them also made here by the adrenal glands. The innermost portion makes adrenaline, a hormone that is an instant instigator of the whole fight-or-flight response. Therefore, these various layers have different jobs.
Melatonin is a nighttime hormone made by the pineal gland, a small thing inside the brain. In a healthy system, melatonin and cortisol are opposites. When you are making plenty of cortisol, you would not be making melatonin, and vice versa. If cortisol does have a good spike in the day, then a drop off later in the day stimulates the nighttime secretion of melatonin. If cortisol is not made in a high enough amounts early or if it is not dropping off rapidly as the day progresses, you do not get that surge of melatonin at night –a big part of not getting good-quality restorative sleep and that further disrupts the whole cycle. It further makes it more difficult to create cortisol at the right times.
Stress and blood sugar are both managed by adrenal function. Many that feel tired or anxious after thyroid dose optimization have adrenal dysfunction. Conventional doctors only identify the worst forms of adrenal shutdown like Addison’s disease and the worst forms of adrenal overactivity like Cushing’s syndrome. Many with real adrenal issues make enough hormone but they make the wrong amounts at the wrong times. This is only detectable by salivary tests because they sample many readings over the course of the day. Contact me to do the Genova saliva adrenal test.
1. Maintain regular habits of when you wake, sleep and eat. Think of your adrenal glands like babies, they do better on predictable schedules.
2. Brief intense exercise is good for the adrenals. Too little exercise, or prolonged low intensity exercise is not.
3. Eating foods that keep your blood sugar stable will also help your adrenal glands. These include lean proteins, vegetables, high fibre starches and healthy fats. Examples include poultry, mixed stir fry vegetables, pinto beans and almonds.
4. If lifestyle changes alone do not help, consider a combination of blood and salivary testing for adrenal function.
Contact me at sm_telo(at)yahoo.co.uk for any of the tests mentioned in this article.