People with eating disorders such as anorexia simply do not experience hunger and satiety in the same way people who have a healthy relationship with food do. New research suggests that the composition of gut bacteria, or the gut microbiome, may play a role in the behavioral aspects of anorexia and eating disorders. For instance, previous research shows a connection between mood disorders such as depression and poor gut microbiome diversity. Less than half of people with eating disorders fully recover, showing that conventional treatments are failing untold numbers of people, the vast majority of them women.
The study showed that patients with anorexia had lower diversity of gut bacteria than healthy individuals. They also found that the less diverse the gut microbiome was the more depression and anxiety patients suffered. The researchers also found that as a patient with anorexia began eating again their gut bacteria diversity was partially restored, which in itself aided in recovery.
Alterations in the gut microbiome can affect how a person’s body functions, how they think, feel, and behave, and how they interact with others.
The gut microbiome is critical not only to regulating mood and behavior, it also plays a vital role in regulating metabolic function, appetite control, and weight.
A better understanding of the role of the gut microbiome in anorexia can help researchers forge new directions in treatment around determining target weight goals, how fast the anorexic patient should gain weight, and what type of diet the anorexic patient should follow to best support the brain’s role in eating disorder behaviors.
The researchers are now investigating whether targeted probiotics could ease the renourishment and refeeding phase of anorexia recovery — many patients struggle with gastric and abdominal distress when reintroducing foods. Customized probiotic therapy could also support the mental and emotional aspects of recovery from an eating disorder.
Gut bacteria targeted in eating disorders
Past research has also shown a link between the gut microbiome and eating disorders, which affect an estimated 5 to 10 percent of the population. A 2015 study from France showed gut bacteria plays a role in eating disorders.
The study looked at mice who had an inflammatory reaction to a protein made by gut bacteria. In essence, the mice responded to these bacteria as if it were an allergy or sensitivity. This immune response caused eating disorders in the mice.
The gut bacteria that triggered this reaction is very similar in structure to a hormone called alpha-Melanocyte-stimulating hormone (a-MSH). a-MSH is a satiety hormone that tells you when to feel full. When the immune system attacks the gut bacteria similar to a-MSH, it also attacks the a-MSH due to their structural similarity. This immune reaction can then dysregulate signals around feeding, energy usage, and anxiety.
If you would like help understanding Gut Health, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
When the immune system mistakenly attacks the body
This study is evidence of a “cross-reactive” immune reaction, in which the immune system confuses something in the body with something infectious and attacks both. This is a very common mechanism in autoimmune reactions, such as with Hashimoto’s hypothyroidism, type 1 diabetes, or multiple sclerosis.
The research suggests that some eating disorders may have an immune reaction driving the psychological disorder.
Tips on addressing eating disorders nutritionally
Although eating disorders are highly complicated and require intensive, sometimes multi-faceted therapeutic approaches, it’s still important to be mindful of nutritional strategies to support the brain and the gut microbiome:
Eliminate processed carbs and sugars as they trigger addictive tendencies metabolically.
Keep blood sugar stable to curbing cravings, food obsession, and relentless hunger. You may need to eat small, frequent meals that include protein initially.
Base your diet on plenty of vegetables and a wide, ever changing diversity of vegetables. This will increase the diversity of your gut microbiome, which promotes psychological health and stability.
Supporting your brain chemicals, or neurotransmitters. Neurotransmitters affect your mood, thoughts about yourself, behavior, energy levels, and other aspects of how you feel and function. For instance, you may need serotonin or dopamine support. Serotonin is the neurotransmitter that allows us to feel joy and stave off depression. Dopamine, on the other hand, is necessary to feel self-worth, motivation, and to not experience constant cravings. Both serotonin and dopamine have been shown to play a role in eating disorders. If you have been starving yourself, binging and purging, undereating, or affecting your diet in other ways due to an eating disorder, there is a strong possibility you may be deficient in either one or both of these important neurotransmitters.
Ask my office for more advice on how to support a healthier approach to balanced approach to recovering from eating disorders.
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Numerous studies show a strong link between gluten intolerance and Hashimoto’s disease, an autoimmune disease that attacks the thyroid gland, causing hypothyroidism. This is because gluten has a molecular structure that closely resembles thyroid tissue — gluten sensitivity triggers an attack on the thyroid gland. Gluten (technically, the correct term is gliadin), is the protein found in wheat and wheat-like grains, such as spelt, kamut, rye, barley, triticale, and oats.
One of the immune system’s primary jobs is to protect the body from foreign invaders. Sometimes it may recognize a common food as a dangerous invader. When you eat that food throughout each day this can keep your immune system engaged in constant battle, making it hyper zealous, overly sensitive, and thus prone towards food sensitivities and autoimmunity.
Some people also have celiac disease, disease in which gluten triggers an autoimmune attack against the gut, the skin, or neurological tissue. Gluten sensitivity is more common than celiac disease, however, both show up in higher numbers in people with Hashimoto’s hypothyroidism.
If you would like help understanding Gluten Intolerance, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
If you have been diagnosed with hypothyroidism you should first test for Hashimoto’s by screening for TPO and TGB antibodies — the majority of hypothyroidism cases are caused by Hashimoto’s.
You should also screen for gluten intolerance or celiac disease given how common these conditions are in patients with Hashimoto’s. Likewise, people who discover they are gluten intolerant or have celiac disease should screen for Hashimoto’s.
It’s important to give up gluten completely if you have Hashimoto’s and gluten intolerance. Cheats and little bites are not ok as they trigger an immune response that ultimately destroys thyroid tissue. Also, it’s important to avoid foods that have been contaminated by gluten. Be careful when in a kitchen where gluten is used, with restaurant food, or with questionable packaged foods.
Cyrex Labs offers testing to identify gluten intolerance. However, sometimes the immune system can be so depleted that it produces too few antibodies to produce a positive test, even though you react to gluten. You can screen for this with a total immunoglobulin test.
However, given the evidence establishing a link between gluten intolerance and Hashimoto’s disease, you may be surprised how much better you feel by simply removing gluten from your diet as a start.
Many people have to remove other foods as well, such as dairy, eggs, or other grains. Following the autoimmune paleo diet for about a month and then reintroducing restricted foods one at a time every 72 hours can help you determine which foods trigger an inflammatory reaction in you.
Many people are able to put their hypothyroid symptoms into remission simply by following a diet that eliminates gluten and other trigger foods. Although autoimmune diseases such as Hashimoto’s can be successfully managed through diet and lifestyle strategies, it’s important to understand they can’t be cured. It’s just a matter of taming the immune system.
Ask my office for ways to manage your autoimmune Hashimoto’s hypothyroid condition.
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Autoimmune disease is a modern epidemic in which your body’s immune system, which normally helps defend you from pathogens, mistakenly attacks your own organs and tissues. Current research tells us multiple factors can play a role in causing autoimmunity, including viruses. More recently, a virus has been linked with celiac disease, an autoimmune disease in which symptoms are triggered by eating gluten.
Celiac disease linked with normally harmless virus in humans
Celiac disease affects one in 133 people in the United States, however only 17 percent have been diagnosed.
While former research has focused on genetic factors underlying celiac disease, a recent study found a link between celiac disease and reovirus, a normally harmless virus in humans.
The study found that mouse subjects with celiac-like disease have higher levels of reovirus antibodies than those without the disease. Those with reovirus antibodies also had high levels of a gene regulator that plays a role in loss of oral tolerance to gluten protein.
In the study, researchers took two different reovirus strains that infect humans (T1L and T3D), and tested them on mice. Both types triggered a protective immune response, but only the T1L caused the mice’s immune systems to act against gluten. This triggered a celiac-like condition in the mice.
The immune response triggered by the T1L virus was dependent on a molecule called interferon regulatory factor 1 (IRF1), which has been found in higher than normal levels in the small intestine of human children with celiac disease.
This suggests that early reovirus infection might raise the risk for developing gluten-related autoimmunity.
According to lead researcher author Bana Jabri, MD, PhD, director of research at the University of Chicago Celiac Disease Center, “During the first year of life, the immune system is still maturing, so for a child with a particular genetic background, getting a particular virus at that time can leave a kind of scar that then has long term consequences.”
Along with other researchers, Jabri is investigating the possibility that other viruses can play a similar role in autoimmunity.
If you would like help understanding the Viruses that trigger celiac disease and other autoimmunities, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Chronic viral infection makes the short list for autoimmune factors
Research increasingly indicates viruses and bacteria may play a role in the development of autoimmunity.
Viruses and bacteria trigger an immune response in the body. Some researchers suggest that the antibodies we produce in response may also attack our body’s cells. This may be because they resemble the virus or bacteria, confusing the immune system into the attack.
If you already experience lifestyle-induced chronic inflammation, this makes the immune system hyper zealous and thus more likely to erroneously attack self-tissue.
The viruses suspected in connection with autoimmunity are varied, and some are linked to multiple conditions:
- Hashimoto’s autoimmune thyroiditis is associated with Epstein Barr virus (EBV), herpes simplex 1 and 2, hepatitis C, and cytomegalovirus (CMV).
- Multiple Sclerosis is associated with EBV and measles virus.
- Rheumatoid arthritis is associated with EBV, hepatitis C, E-coli bacteria, and mycobacteria.
- Lupus is associated with EBV.
- Type 1 diabetes is associated with coxsackievirus B4, cytomegalovirus, mumps virus, and rubella virus.
- Guillain-Barré syndrome is associated with EBV, CMV, and campylobacter bacteria.
Know your viral exposure
Having a viral or bacterial infection is not a guarantee of developing autoimmunity, because other factors must come together for it to occur. However, it’s a good idea to take viral exposure into account when looking for the root causes and treatment of your autoimmune condition.
Some practitioners say regardless of other medical protocols, patients with autoimmunity do not go into remission unless they also address their chronic viral and bacterial infections.
Because viral infections usually occur well before any autoimmune symptoms develop, it can be difficult to make a definitive link between a specific infection and a your autoimmune disorder.
Therefore, if you are seeing your doctor about your autoimmune condition, remember to mention any infections you know you’ve had, even back in your childhood; some viruses such as Epstein Barr can persist in the body for decades without obvious symptoms. Lastly, if you don’t seem to be able to heal, ask about testing for hidden chronic viral infections as well as bacterial gut infections.
Other autoimmunity risk factors
Although there is a genetic component to autoimmunity, the following factors are linked to an increased risk of develop an autoimmune condition:
- Females. Women represent about 75 percent of autoimmune cases. Researchers speculate women’s hormones or their active immune systems make them more vulnerable to developing autoimmunity.
- Young to middle-aged. While the elderly can develop autoimmunity such as rheumatoid arthritis, autoimmune conditions more frequently show up in youth or middle age.
- African American, Native American, or Latinx heritage. These ethic groups represent higher rates of autoimmunity than others.
- Family history of autoimmunity. If your family members have had autoimmunity, you are at higher risk.
- Environmental exposure to toxins or heavy metals. There is evidence relating toxic exposure to higher rates of autoimmunity.
- Intestinal hyper-permeability (leaky gut). Leaky gut is present not only in all autoimmune diseases, but in other chronic illnesses such as heart disease, depression, and more.
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If you are on an elimination diet for your Hashimoto’s hypothyroidism, the holidays might be a source of serious anxiety. Sticking to a specialized diet can be enough of a challenge on a normal day. When we add in travel, unfamiliar restaurants and grocery stores, family events and social outings, the challenge — and potential consequences — can seem insurmountable. However, with some good planning you can not only survive but thrive during the holiday season.
Below are time-tested suggestions to help you navigate the holidays with ease when you have Hashimoto’s hypothyroidism.
Look at your holiday schedule to see which events or plans pose challenges. Write them down and plan out what you need to do to avoid pitfalls.
Travel. Whether you drive or fly to see family and friends, plan ahead for your food options.
Airlines allow you to bring pre-made food even if it’s in a soft-sided cooler pack.
However, airlines won’t allow you to carry on any items in glass jars so make sure your pre-made items are canned or in a box.
If you are unsure about what you can bring on a plane each airline has a webpage where the food rules are listed.
Easy items to bring on the airplane or in the car include:
- Canned fish
- Protein bars
- Dried fruit (but not too much!)
- Coconut butter packets (not in a jar)
- Nut butter packets (not in a jar)
- Homemade energy bars
- Cut fruits and veggies
If you are driving overnight bring along a pre-made dinner and breakfast in a cooler.
If you plan to eat in restaurants along the way, research them in advance and call ahead if needed to verify gluten-free or other diet needs. Trying to figure it out in the car is likely to create poor results and leave you either hungry or sick.
Bring digestive enzymes to help your system break down food proteins.
Bring Gluten Flam by Apex in case you get glutened.
Stay hydrated — it’s one of the best remedies for recovering from food reactions.
Being a guest at a party or holiday meal
Educate your host. When your host is aware of your food limitations and the medical reasons for them they are in a better position to support you. Explain your diet and why it’s important for you to stick to it.
Send a list of ingredients you can eat or even a couple simple recipes well in advance so they can accommodate you (keep in mind their kitchen may not be gluten-free).
Bring your own food. When your host understands the importance of sticking to your diet they may welcome you bringing your own dish.
Bring food to share. It helps others to appreciate your dietary protocol when they can try your food. Bring something simple but delicious such as soup or pumpkin pie. They may not even realize it’s different — until you tell them. You may even provide a welcome surprise for another guest with food allergies who didn’t plan ahead.
Eat ahead of time. If you are unsure about what will be served, eat ahead. You can also tell the host ahead of time that you need to eat light due to a medical issue.
Always have an emergency snack in your purse and car. You never know when you’ll find you can’t eat what’s offered or get stuck in traffic or at an appointment. Having an emergency snack on hand can make or break your day. See the food list above for ideas.
Family and friends’ attitudes
This can be one of the hardest parts of the holidays for those on a restricted diet. The hard work of smoothing this over likely has to start with you, but the effort can really pay off.
Educate your family and friends. Explain your health condition and how your special diet helps it. Also explain what symptoms you experience when you eat the foods you are supposed to avoid. Not everyone will want to listen, but those who do are more likely to become your allies.
Find an ally. If someone in the room is on your side, whether sibling, parent, partner, or friend, it can make a big difference when others pressure you to “Just have a slice of pie!” Decide on a secret signal to let them know to speak up on your behalf in front of others.
Direct the conversation elsewhere. Nobody wants to spend the whole party telling the crowd about their Hashimoto’s brain fog, IBS, arthritis join pain. Try not to draw attention to your special food, and if asked, give a simple answer such as, “I’m on a medical diet for health reasons.” The use of the word “medical” tends to get more respect than other options.
If someone refuses to understand, or if you receive rude comments, share a link to the “Spoon Theory” of chronic illness.
Don’t take your health for granted. Schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Host your own event
One great way to enjoy holiday food is to host your own event. If you have the reserves, cooking a full meal for family and friends can be a great way to show them how amazing your “weird” diet is. It can also help bridge the gap of understanding and respect that commonly emerges in family groups.
If you don’t have the bandwidth for hosting a dinner party, create a potluck with specific food rules. Assign some dishes and explain why you need to keep certain foods out from under the roof.
More and more areas have autoimmune paleo, or AIP meetup groups, and the holidays are a great time to organize an AIP potluck. Many people on special diets have nobody who understands. Having a room full of people who understand and appreciate their needs — not to mention a room full of foods everyone can eat — can create new friendships and really make the holidays shine again.
Falling off the wagon
The holidays are about celebration and sometimes a bit of excess. If you fall off the wagon don’t punish yourself. Just get back on and keep goimg. If you start each day with intention it’s easier to stay on track.
However, don’t use the holidays as an excuse to throw caution and dedication to the wind. You worked hard to get where you are, do you really want to backtrack to square one?
Learn to say “no”
The holidays are full enough of stress. Sometimes we get invitations to events we’d rather not attend, unwanted requests to help with tasks or events for community or kids, or pressure from friends and family to try foods we know we ought not to eat.
It’s hard for most of us to say no especially when we’re worried about hurting the feelings of friends or family. But remember, your health is paramount and sometimes a “no” is the most appropriate and self-loving answer.
A simple way to say no is, “No, but thanks for asking.” Don’t give justification or any reason for them to attempt to dismantle.
Saying no can be difficult and scary for those who aren’t used to using it. However, the more you practice, the easier it gets and the less “bad” you will feel for saying it.
Ask my office for more advice on managing your Hashimoto’s hypothyroidism through diet and functional medicine protocols.
Schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya to get to the root cause of your health issues.
Your doctor says you have hypothyroidism and this explains feeling like crap, the crazy weight gain, and your distressing hair loss. But how do you know if Hashimoto’s is causing your hypothyroidism? Hashimoto’s is an autoimmune disease, meaning the immune system is attacking and destroying the thyroid gland.
Hashimoto’s is responsible for more than 90 percent of hypothyroid cases. Chances are strong it’s the cause of your low thyroid function too.
But if your doctor does not want to screen for Hashimoto’s or if you would like to be sure, here are some tips to help you figure out if you have Hashimoto’s hypothyroidism.
You feel worse despite taking your thyroid medication
One of the most common signs of Hashimoto’s is you still have symptoms despite taking your thyroid meds. In fact, your doctor prescribes ever increasing doses as your thyroid function deteriorates. You may even notice no difference if you forget to take your meds. Why don’t thyroid meds help in many cases of Hashimoto’s? Because the immune system continues to attack and destroy the thyroid gland even though the meds may make your TSH levels look normal.
You swing back and forth between low thyroid and high thyroid symptoms
Swinging back and forth between under active and over active thyroid function is another common sign of Hashimoto’s. One week you suffer from fatigue, headaches, constipation, depression, and low libido. The next week you have insomnia, a racing heart, anxiety, and tremors. This is because a flare up that damages thyroid tissue causes excess thyroid hormone to spill into the bloodstream. You may be misdiagnosed with anxiety or even bipolar disorder.
If you run blood tests during these surges and crashes you will see TSH also peaks and dips. TSH may even test as normal for short periods as its moves between these swings. This can lead to a misdiagnosis if you drew your blood during that time.
You have pernicious anemia, celiac disease, or other autoimmune diseases
Autoimmune diseases such as Hashimoto’s are the result of an imbalanced immune system. It’s very common for people with one autoimmune disease to develop more. This is because the imbalanced system becomes overly sensitive and loses tolerance to new tissues in the body.
If you have hypothyroidism and other autoimmune diseases, chances are you also have Hashimoto’s. Pernicious anemia (an autoimmune disease that causes B12 deficiency), celiac disease, or a gluten intolerance are all commonly linked to Hashimoto’s.
If you think you might have Hashimoto’s, see if any of these symptoms apply to you.
If you would like help understanding if your Hypothyroidism is Hashimoto’s, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Under active thyroid symptoms
- Feeling tired or sluggish
- Feeling cold — hands, feet, all over
- Require excessive amounts of sleep to function well
- Weight gain despite adhering to a low-calorie diet
- Gaining weight easily
- Difficult, infrequent bowel movements
- Depression and lack of motivation
- Morning headaches that wear off as the day progresses
- Outer third of eyebrow thins
- Thinning of hair on scalp, face, or genitals, or excessive hair loss
- Dryness of skin and/or scalp
- Mental sluggishness
Over active thyroid symptoms
- Heart palpitations
- Inward trembling
- Increased pulse rate, even at rest
- Feeling nervous and emotional
- Night sweats
- Difficulty gaining weight
Symptoms are important but a blood test provides the proof you may need to convince doctors or family members. Look for these markers:
Thyroid peroxidase antibodies (TPO Ab). In most cases of Hashimoto’s the immune system attacks TPO, an enzyme that triggers thyroid hormone production.
Thyroglobulin antibodies (TGB Ab). You should also test for antibodies to TGB, which the thyroid uses to produce thyroid hormones.
Thyroid stimulating hormone antibodies (TSH Ab). This test can identify Graves’ disease (hyperthyroidism), although sometimes TSH antibodies can be elevated in Hashimoto’s. On lab tests, this marker is often labeled thyroid stimulating immunoglobulin (TSI). If your autoimmune thyroid condition is advanced, you have multiple autoimmune diseases, and/or you react to bioidentical thyroid meds but not synthetic, you may also have antibodies to T4 and T3.
When your test comes back negative despite massive symptoms
Don’t despair if your test comes back negative even though you have all the classic symptoms. Because the immune system and inflammation wax and wane, you may have had your blood draw during a time the immune system is not attacking the thyroid gland. However, if you’re test is positive this confirms Hashimoto’s hypothyroidism and that the immune system should be a target for therapy. Ask my office for more advice on managing Hashimoto’s hypothyroidism using functional medicine.
Don’t take your health for granted. Schedule a FREE FREE 15-MINUTE CONSULTATION with Dr. Celaya.
While most doctors prescribe antacids to lower stomach acid for heart burn and acid reflux, the real culprit may be that your stomach acid is already too low. This is called hypochlorhydria and it plays a role in autoimmune diseases such as Hashimoto’s hypothyroidism.
Sufficient stomach acid, or hydrochloric acid (HCl), is necessary to:
Protect the body from pathogens. When we consume food, bacteria and other microorganisms come along with it. Stomach acid helps neutralize the ones we don’t want in our bodies. HCl also acts as a barrier against bacterial and fungal overgrowth of the small intestine. This is important to preventing inflammatory compounds into the bloodstream where they can trigger Hashimoto’s hypothyroidism.
Activate pepsin. HCl triggers the production of pepsin, which helps break down proteins to be absorbed in the small intestine. When proteins are not adequately digested, they can escape into the bloodstream where they trigger inflammation food sensitivities.
Digest proteins. If you have ever made ceviche or marinated meat in vinegar or lemon, you can see how acid breaks it down. Our stomach acid works much more quickly and efficiently than this.
Activate intrinsic factor. Stomach acid helps activate intrinsic factor, a glycoprotein made in the stomach that is necessary for absorption of vitamin B12.
Stimulate delivery of bile and enzymes. Adequate stomach acid stimulates release of bile from the liver and gall bladder and digestive enzymes from the pancreas. This also supports digestion of carbs, fats, and vitamins A and E.
Close the esophageal sphincter. Located between the stomach and the esophagus, the esophageal sphincter protects the delicate tissue of the esophagus from the strong acids of the stomach.
Open the pyloric sphincter. Stomach acid helps open this gateway between the stomach and the small intestine.
Absorb vitamins and minerals. Absorption of folic acid, ascorbic acid, beta carotene and iron are made more bioavailable by HCl in the digestive tract. Low stomach acid can cause poor absorption of calcium, magnesium, copper, chromium, manganese, selenium, vanadium, zinc, molybdenum and cobalt.
The gut is the seat of the immune system and all of these functions are vital for healthy gut function that can help you manage your Hashimoto’s hypothyroidism and prevent inflammation and flare ups. If you want to get to the root cause of your thyroid or acid refulx problems, schedule a FREE 15-minute consultation with Dr. Celaya.
Hypochlorhydria is under diagnosed
An estimated 90 percent of the population suffers from hypochlorhydria (low stomach acid), yet most of us have never heard of it.
When stomach acid is too low your body cannot digest food thoroughly. The food in the stomach begins to rot and putrefy, the small intestine attempts to reject it, and the rotten food moves back up into the esophagus. While the food is not acidic enough for the small intestine, it is far too acidic for the esophagus.
In addition, low stomach acid leads to bacterial overgrowth, gut inflammation, increased food sensitivities, and higher risk for inflammatory disorders such as Hashimoto’s hypothyroidism.
Key hypochlorhydria signs and symptoms include:
- Burping, bloating, gas after meals
- Upset stomach after eating
- Nausea when taking vitamins and supplements
- Indigestion, heartburn, acid reflux
- Desire to eat when not hungry
- Undigested food in stool
- Gut infections
- SIBO (small intestine bacterial overgrowth)
- Iron deficiency anemia
- Deficiencies of vitamin B-12, calcium, and magnesium
Taking supplemental HCl can help support your own production and help you better digest your food. Take just enough so it doesn’t cause burning. If taking even a little bit causes burning, you may have ulcers and an H. Pylori infection, which are not uncommon with hypochlorhydria.
Schedule a FREE 15-minute consultation for more advice on improving your digestion, relieving your heartburn symptoms, and managing your Hashimoto’s hypothyroidism.