The Thyroid-Gut Connection

If you have experience with hypothyroidism you have probably heard that it is a genetic condition, that there are lifelong medications available, but that is about all we can do. I’d bet that there was no mention of gut or adrenal health, let alone the connection between the areas.

In conventional medicine, an endocrinologist is the expert in hormones and gut health is left for the specialty of gastroenterologists.  But, there is a connection between the adrenals, thyroid and gut! We need to address all pieces of the puzzle if you want the best chance to restore the function of your thyroid.

Leaky Gut and Hypothyroidism

Hashimoto’s, or autoimmune thyroid, is the number one cause of hypothyroidism in North America. While not all causes of hypothyroidism are well understood, we do know that if you have an autoimmune condition, then your immune system is not behaving as it should.

And where is 70-80% of your immune system located? Your gut!

Your digestive system is essentially a long tube from your mouth to your rectum that is lined with a semipermeable layer of cells. This separation acts like a strainer to allow only some key nutrients to be absorbed and passed. At the same time, the intestinal lining should keep harmful proteins from entering.  When our small intestines get damaged, such as the case in “leaky gut”, the straining, absorption and secretion functions become impaired and infectious agents, food particles, and other proteins that make their way through the lining of the intestine. Exposure to these “non-self” proteins or antigens stimulates the immune system to produce antibodies.

Producing antibodies is normally a good thing! It tags the foreign particle to be removed from the body. However, the issue lies in a term called “molecular mimicry.”  What happens in molecular mimicry, is that the non-self protein that has been tagged for destruction resembles an amino acid sequence of self proteins, aka body tissues. When this happens, your immune system can mistake your tissues as foreign and begin to attack the target tissue, in addition to causing inflammation in the body.

Over time, after repeat exposure, the body will respond by creating antibodies, which can set off a cascade of autoimmune destruction of the thyroid tissue — resulting in Hashimotos and eventually hypothyroidism

Potential Causes of Leaky Gut:

  • GMO Foods
  • Prescription medications: NSAID & Antibiotics
  • Alcohol & Caffeine
  • Mold Exposure
  • Gluten & Dairy
  • Food Sensitivities
  • Processed Sugar
  • Cosmetic Products
  • Harsh Household Chemicals
  • Contaminated Water
  • Packaged Food & Teflon
  • Emotional & Mental Stress

Common Symptoms of Leaky Gut

You may be thinking “I don’t have any gut issues, what does this have to do with my thyroid?”. Leaky gut symptoms can affect the whole body and everyone responds differently. In fact, it is possible to have sensitivities, dysbiosis, other gut conditions, even celiac disease without any obvious gut symptoms.

While many do experience GI symptoms such as gas, bloating, diarrhea, intolerances or sensitivities,  others may find their thyroid is impacted first. Leaky gut can also causes issues in these areas of the body:

o   Sinus & mouth: colds, food sensitivities

o   Brain: depression, ADHD, anxiety, headache

o   Skin : rashes, rosaces, psoriasis , eczema, acne

o   Thyroid: hashimotos, graves hypothryoid, metabolism

o   Colon: constipation, diarrhea, IBD, IBS

o   Joints: Rheumatoid arthritis, fibromyalgia & chronic fatigue

o   Adrenal fatigue

As our gut health goes undetected or ignored, sometimes for years or decades, the intestinal damage and gut lining is not preforming at its best. For some patients, the diagnosis of autoimmune disease is their first sign that something is wrong in the gut.

This is why I like to focus on the gut and address any concerns when treating autoimmune disease. But beyond autoimmune conditions, your gut does support your thyroid in many other ways.

Your Gut Creates Active Thyroid Hormone

The thyroid is a butterfly shaped gland that sits at the front of your neck.  The main hormones produced by the thyroid gland are thyroxine (T4) and triiodothyronine (T3). Thyroxine (T4) is considered mostly inactive and is secreted in response to Thyroid Stimulating Hormone (TSH), a pituitary hormone. TSH is your brain’s signal to your thyroid that the body needs more thyroid hormone.

Your thyroid produces T4 in response to TSH and then your body needs to convert it to the active form, Triiodothyronine.  T3 is responsible for your energy, metabolism, body heat and much more. T4 is primarily converted to T3 in the liver, kidneys and gut! About 20% of your thyroid hormone conversion takes place in the gut. Our healthy gut flora play an important role in making sure we get the appropriate amount of T3. Because  T4 accounts for about 95% of all hormone produced by your thyroid, T3 being the other 5%, peripheral conversion is such a  vital process in ensuring you are receiving adequate thyroid hormone. If your gut is not functioning optimally you can experience symptoms of hypothyroidism, even if you thyroid is healthy.

If you have low stomach acid you will not be able to break down and thus absorb the nutrients you consume. Taking Betaine HCL, like the digestive enzymes, will take the pressure off the digestive system.  Ask your doctor about adding this to your regimen.

Inflammation Plummets Thyroid

Inflammation in our bodies increases our risk for a variety of chronic health concerns. A healthy gut flora will inhibit pro-inflammatory cytokines like IL-6, TNF-alpha, NFK-b and upregualte anti-inflammatory cytokines like IL-10. Don’t worry about these terms. What is most important is to  know when our gut micro biomes are not happy, inflammation goes up. When inflammation increases, cortisol, our stress hormone follows. It is cortisol that causes issues to our thyroid because it down-regulates, or reduces the conversion of inactive T4 to active T3.

Constipation Impairs Thyroid Hormone

Constipation can create hormone imbalances that lead to increased levels of estrogen. As estrogen levels increase, so do proteins aimed at keeping the hormone bound. The same mechanisms that lead to excess estrogen being bound can cause thyroid hormone to also become unavailable.

Low levels of circulating thyroid hormone can cause impaired gut motility and constipation, which can perpetuate the cycle of hormone imbalance.

This is another example of how gut function is crucial to having adequate levels of thyroid hormone available.

Healing Your Gut

There are a variety of approaches to treating autoimmune and thyroid conditions. In my opinion, you cannot look at the thyroid in isolation. You must also heal your gut if you want to optimize thyroid health, balance hormones and reduce autoimmunity.

When developing treatment protocols I take a holistic approach which is unique and specific to meet each individuals needs.  Functional and comprehensive lab testing is valuable in conjunction with your story, to ensure proper treatment.  While many physicians test TSH alone, this is not enough to understand the complete picture.  TSH, free T4, free T3, thyroid antibodies, and reverse should all be considered if you are presenting with symptoms of thyroid disease.

With that in mind, here are 4 basic steps I take with patients looking to heal their guts and improve thyroid health. Again, it is highly recommended you find a practitioner  that is trained and able to work with you to get to the root cause of your symptoms prior to starting any course of treatment.

4 Steps to Heal the Gut for Good

1. Remove Inflammatory Triggers

Food Sensitivities

A free way to identify possible food sensitivities is to remove the potential irritant for 3-6 weeks. This is called an elimination diet. Top food allergens to remove are  Gluten, Dairy, Eggs, Corn, Soy, Nuts, Beans/Legumes (including peanuts).

Overexercising

While I love to see patients moving their bodies, overexercising is a source of stress on our bodies and creates inflammation. If paired with under-eating this is a recipe for disaster. This is why it is so important to eat the right foods, at the right times for the right reasons.

Chronic Stress

As we mentioned above, chronic stress can alter your gut microbiome and creates inflammation. Stress or cortisol is a major hormone that impacts the HPA-axis (hypothalamic-pituitary-adrenal). If you throw your HPA axis out of whack,pretty much all the hormones in your body will be affected.

Unnecessary Medications.

Medications such as NSAIDs, unnecessary antibiotics, birth control, anti-depressants and proton pump inhibitors (PPIs) may negatively affect gut health. Do not discontinue any medications before talking with your doctor.

Bacteria, Yeast, Parasites.

Ask your doctor if gut dysbiosis or overgrowth of bacteria, yeast or parasites may be contributing to chronic gut complaints or thyroid issues. Testing is an option to see if any critters are living happily undetected.

  1. Nourish the gut lining

Amino Acids:

Amino acids proline, glycine and glutamine are critical to gut health. Proline, which is high in bone broth, supports collagen and helps to tighten the tight junctions that have become leaky. Glycine supports detoxification of your liver and cellular pathways. L-glutamine is used as fuel by intestinal cells to heal the gut lining.

Coconut oil:

Coconut oil is amazing for leaky gut due to its antimicrobial effects. Coconut can be used in smoothies, cooking as well as in your coffee.

Curcimin

Tumeric is an amazing herb that is beneficial to your overall health and reduces inflammation.

Zinc Carnosine:

Zinc increases healing time and boosts immune function.

Vitamin D:

The Vitamin D receptor plays a role in intestinal barrier integrity as well as it enhances healing of the colonic epithelium. Therefore, a deficiency in vitamin D may compromise the barrier and increase risk of damage and inflammation.

Digestive Enzymes.

Digestive enzymes are the catalyst to break down nutrients that we consume. Digestive enzymes can help heal leaky gut by taking the stress of the GI tract. They help to break down difficult-to-digest protein and sugars like gluten, casein and lactose.

Betaine HCl & Pepsin

If you have low stomach acid you will not be able to break down and thus absorb the nutrients you consume. Taking Betaine HCL, like the digestive enzymes, will take the pressure off the digestive system.  Ask your doctor about adding this to your regimen.

Berries

Not only are berries a rich source of antioxidants but also they are high in flavonoids, which reduce intestinal inflammation and protect the gut. Berries are an easily digestible form of fibre and are a healthy way to satisfy sugar cravings.

4. Rebalance the microbiome

Fermented Vegetables.

Diets rich in fermented foods are key to your health regime. Other strategies include constant exposure to soil based organisms by spending time outdoors, being around animals and eaten locally grown foods.

Probiotics.

Taking targeted strains for your unique symptom picture is the best way to approach probiotics. Gut bacteria diversity is extremely important. Ask your doctor about strains that would be best for you. Saccromyces boulardi is one strain that has been shown to protect against pathogens, increase beneficial immune response, protect gastrointestinal barrier function, and promote enzymatic activity so you can better absorb nutrients from your food!

Note: If your digestive symptoms get worse or you experience extreme gas or bloating when probiotic foods or supplements are introduced, I recommend reducing or eliminating probiotics and talking with your doctor about SIBO testing or fructose intolerance.

Getting to the root of your gut issues is an important step to healing your thyroid and your health. I am passionate about holistic care, and understand the importance of conventional and functional lab testing and can interpret them in conjunction with your story.

 

RESOURCES:

  1. Mahmood AFitzGerald AJMarchbank TNtatsaki EMurray DGhosh SPlayford RJ.  Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes.Gut. 2007 Feb;56(2):168-75. Epub 2006 Jun 15.
  2. Kong J, Zhang Z, Musch MW, Ning G, Sun J, Hart J, Bissonnette M, Li YC. Novel role of the vitamin D receptor in maintaining the integrity of the intestinal mucosal barrier.Am J Physiol Gastroint. Liver Physiol. 2008 Jan; 294(1):G208-16

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