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 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.
When it comes to autoimmune Hashimoto’s hypothyroidism, dampening inflammation and immune attacks on the thyroid is the primary goal. One of the most powerful allies in this quest is to support your regulatory T cells (T reg cells). These are immune cells that do what their name implies — they help regulate the immune system. This means they play a role in either activating or dampening inflammation. The good news is that when it comes to Hashimoto’s, we can do many things to influence the T reg cells to dampen inflammation and quell Hashimoto’s flare ups and attacks so you can have more good days.
Ways to support T reg cells to manage Hashimoto’s
If you would like help understanding ways to support T Reg Cells to manage Hashimoto’s, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Following are some proven ways we can support our T reg cells to manage Hashimoto’s.
Vitamin D (cholecalciferol). Fat soluble vitamin D is a powerful supporter of the T reg cells, especially at therapeutic doses (around 10,000 IU a day).
Vitamin D is also important because studies show many people with Hashimoto’s have a genetic defect hindering their ability to process vitamin D. Therefore, they need higher amounts of vitamin D to maintain health. This can be the case even if a blood test shows sufficient levels of serum vitamin D. That’s because the defect is at the cellular receptor site, preventing vitamin D from getting into the cells.
Omega 3 fatty acids. The EPA and DHA in fish oil support T-reg cells. It’s important to make sure you take enough; it’s estimated 80 percent of the population are deficient in essential fatty acids.
Research shows a healthy dietary intake of supplemental omga-3 is 3,500 mg if you eat 2,000 calories per day.
The average EFA capsule is 1,000 mg. Most people in the US eat between 2,000 to 3,000 calories a day and therefore should take 4 to 6 capsules of fish oil a day. Dietary sources of omega 3 include cold water fish, nuts, and seeds.
Glutathione. Glutathione, also known as the master antioxidant, supports T reg cells and is a powerful support in dampening inflammation and managing Hashimoto’s. Straight glutathione cannot be absorbed well but there are other ways to take it, including reduced glutathione, s-acetyl-glutathione, liposomal glutathione, and glutathione precursors.
Glutathione precursors make glutathione inside the cells and include n-acetyl cysteine, cordyceps, Gotu Kola, milk thistle, and alpha lipoic acid. Don’t be shy to take large amounts of glutathione support to dampen inflammation.
Short chain fatty acids (SCFAs). SCFAs are powerful signaling compounds that influence the health of the body and brain. They are produced by healthy gut bacteria that come from eating a diet abundant in a diverse array of vegetables. The more abundant and diverse your gut bacteria the better your SCFA production.
This helps many functions in your body, including proper T reg cell function and dampening of inflammation and managing Hashimoto’s. You can also take the SCFA butyrate to support your SCFA levels, however, you’ll need to make sure you’re eating plenty of vegetables throughout the day too for this strategy to be effective.
Endorphins. Saving the best for last, did you know a powerful way to support anti-inflammatory function of T reg cells is to experience joy, happiness, love, and playfulness? All of these things produce endorphins, feel good chemicals that reduce inflammation. Methods for increasing endorphins include:
Socializing regularly with healthy people
Meditation and breath work
Massage and other forms of body work
Doing something playful regularly
Daily expression of gratitude via a journal or verbal affirmation
Regular exercise that gives you a “natural high” but doesn’t wear you out
These are some of the ways you can manage your Hashimoto’s hypothyroidism. Ask my office for more information.
If you’re getting your TSH levels checked to monitor your thyroid health, it’s best to get that done in the morning. Otherwise, your results may come back normal even though you have hypothyroidism.
All the body’s hormones follow a daily rhythm, including thyroid hormone. This means there are times of the day when it naturally higher or lower. Researchers tested the blood of hypothyroid subjects both before 8 a.m. and again between 2 and 4 p.m.
In hypothyroid patients both untreated and on thyroid medication, TSH dropped was substantially lower during the afternoon test. This means an estimated 50 percent of people with hypothyroidism are not being diagnosed.
In the untreated group, TSH was 5.83 in the morning and 3.79 in the afternoon. In the treated group, TSH was 3.27 in the morning and 2.18 in the afternoon.
A 2004 study also showed late morning, non-fasting TSH was 26 percent lower compared to the early morning, fasting TSH. This means even a late morning blood draw could result in a failure to diagnose. Do you really want to know what is going on with your thyroid? Schedule a FREE 15-Minute Consultation with Dr. Celaya.
TSH blood test timing and functional medicine ranges
The timing of your blood draw plays an important role in reading a thyroid panel. However, there is more to it.
Even with an early morning blood draw, many doctors will still fail to diagnose hypothyroidism because they use lab ranges that are too wide and that do not reflect genuine thyroid health.
Many doctors still use a hypothyroidism TSH range of 0.5 to 5.0 even though the American Association of Clinical Endocrinologists recommends 0.3 to 3.0.
In functional medicine, we use an even narrower range of .25 to 1.25. We also know that only looking at TSH can miss hypothyroidism.
For example, TSH may be normal but other thyroid markers are off. That’s why it’s important to order a thyroid panel that includes total and free T4 and T3, reverse T3, free thyroxine index (FTI), T3 uptake, and thyroid binding globulins. Many conditions can cause poor thyroid function, including inflammation, hormonal imbalances, and chronic stress. Ordering these other thyroid markers provides more insight into such imbalances.
Always include a test for autoimmune Hashimoto’s hypothyroidism
In addition to these markers, anyone with symptoms of hypothyroidism should also test for Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland.
Why? About 90 percent of hypothyroidism cases in the US are caused by Hashimoto’s. To screen for Hashimoto’s, order TPO and TGB antibodies.
Thyroid medications may be necessary to support thyroid function, but they do not address the autoimmunity attacking the thyroid gland. Failing to manage Hashimoto’s increases the risk of developing other autoimmune diseases such as pernicious anemia, rheumatoid arthritis, vitiligo, and Type I diabetes. It will also make it more difficult to manage your symptoms.
If you struggle with chronic exhaustion, insomnia, poor immunity, and persistent low blood sugar symptoms, you likely have poor function of the adrenal glands, which sit atop the kidneys and secrete stress hormones. However, your conventional doctor may have told you there is no such thing as adrenal fatigue based on guidance from The Hormone Foundation. What they may not understand is that there is a continuum of adrenal function and that the brain plays a role in adrenal fatigue.
The debate about adrenal fatigue versus primary adrenal insufficiency
The term “adrenal fatigue” has become a household word in the chronic illness world, and for good reason. The adrenal glands are our frontline against stressors large and small. In our constantly chaotic and nutritionally-depleted lives, these hard-working little glands can become worn down, sometimes to the point of barely working, right along with the areas of the brain that govern them.
What’s confusing is a recent statement by The Hormone Foundation which claimed adrenal fatigue does not exist and is not supported by any scientific facts, and that primary adrenal insufficiency is the only real version of adrenal dysfunction.
However, according to integrative physician Richard Shames, MD, both adrenal fatigue and primary adrenal insufficiency exist along the same continuum but are separated by the severity of symptoms and treatment methods. In a nutshell, adrenal fatigue can also be referred to as mild adrenal sufficiency.
Primary adrenal insufficiency is caused by damage to the adrenal glands, such as by an autoimmune condition like Addison’s disease that attacks and destroys adrenal tissue. Primary adrenal insufficiency is diagnosed through blood tests and can be treated with medications that replace adrenal hormones.
Symptoms of primary adrenal insufficiency include:
Loss of appetite with weight loss
Craving salty foods
Dizziness, low blood pressure
Feeling lightheaded when standing up
Gastrointestinal symptoms such as nausea, vomiting, and abdominal discomfort
Adrenal fatigue describes when lab tests don’t support a diagnosis of primary adrenal insufficiency but a person still experiences adrenal-related symptoms such as:
Excessive fatigue and exhaustion
Feeling overwhelmed by or unable to cope with stress
Craving salty foods
Functional medicine practitioners diagnose adrenal fatigue by considering symptoms as well as results from a 24-hour saliva cortisol test.
Current blood tests are good at diagnosing severe forms of adrenal insufficiency such as Addison’s disease but not mild adrenal insufficiency, or adrenal fatigue.
This debate between adrenal fatigue and primary adrenal insufficiency is reminiscent of the former debates about “mild” hypothyroidism. Twenty years ago, many endocrinologists denied mild hypothyroidism as a true diagnosis because they believed that as long as a patient was within conventional TSH reference ranges they could not possibly be sick.
However, doctors trained in functional medicine recognize that a functional reference range — a narrower TSH range that reflects optimum thyroid health — means that a serious thyroid problem can exist within the conventional TSH range.
As testing and recognition of adrenal fatigue, which affects many people, continues to gain medical acceptance, we will start to refer to it as mild adrenal insufficiency.
The role of the brain in adrenal fatigue
It’s important to understand the brain plays an important role in adrenal fatigue. This explains why nutrients to support your adrenal glands may not go the full mile when the real problem is happening between your ears.
Adrenal fatigue has at its roots poor function of the hypothalamus-pituitary-adrenal (HPA) axis. The HPA axis refers to the feedback loop between your body and areas of your brain that govern adrenal function. Unrelenting stress beats up this entire system, not just the adrenal glands, and it is more complicated and involved that simply low cortisol. The problem is compounded by the brain’s predilection for efficiency, in this case becoming so efficient at stress until the tiniest thing triggers a big stress response. Or, you are so advanced you are too tired to respond to anything.
How the adrenals become fatigued
When our bodies experience stress, no matter how small or large, our adrenals pump out hormones such as adrenaline and cortisol to help us fight or take flight. Our bodies are designed to return to baseline after a stressor so the nervous system can return to a “rest and digest” state necessary for daily function.
However, in our chronically stressed modern lifestyles, our bodies are constantly reacting to stressors, many we are not even aware of, such as dietary triggers, toxins, and even electromagnetic frequencies.
This constant state of high-stress hormones damages tissues in the body and brain and is linked to:
Insulin resistance and diabetes
High blood pressure
Increased belly fat
Removing all stressors in life is impossible, but there is much we can do to support adrenal function and buffer the damage of stress.
Have you ever wanted to know everything there is to know about your thyroid? This 7-part video series will cover thyroid lab testing, nutrition and infections that affect the thyroid, toxins, thyroid hormone conversion, lifestyle, and adrenal interplay.