Inoca International Newsletter: Thyroid Health

Dr Ailsa Care recently provided the following blog to the Inoca International Newsletter. She is a member of the Medical Advisory Board for Inoca and if you’re familiar with the practice you’ll know it’s a cause close to our hearts.  The read the newsletter in full, click here.

Do you feel tired all the time, low in mood, struggle to lose weight despite not having a great appetite, feel cold, have dry skin and hair loss? If so then you may have issues with your thyroid gland.

The thyroid is a gland which is shaped like a butterfly and sits over the lower part of your trachea (windpipe). It is responsible for regulating our metabolism including energy production and temperature regulation as well as affecting the balance of our other hormones.

The most common reason for an underactive thyroid is an autoimmune condition called Hashimotos thyroiditis. This means that your body’s immune system is attacking your thyroid gland impairing its ability to produce thyroid hormones. In the early stages of Hashimotos you may initially have positive thyroid antibodies and normal levels of thyroid hormones or sometimes even high levels. As more thyroid tissue is destroyed it is unable to keep up with demands and the levels of thyroid hormones drop and TSH (thyroid stimulating hormone) rises as the brain senses the low thyroid hormones and tries to push the thyroid into producing more.

Another reason for an underactive thyroid is if there are not enough of the right nutrients required to make the thyroid hormones and /or convert the hormones to their more active form.

Essential nutrients for the thyroid include:

  • selenium
  • Iodine
  • Magnesium
  • Zinc
  • Tyrosine
  • Vitamin A
  • Vitamin D
  • Vitamin E
  • Vitamin B complex
  • Vitamin C
  • Iron

Factors that inhibit thyroid function

  • Stress
  • Trauma – physical or emotional
  • Halogens – fluoride, chlorine, bromine compete with iodine for receptor sites
  • Toxins – pesticides, heavy metals eg mercury, cadmium, lead
  • Medications – lithium, amiodarone, combined contraceptive pill, proton pump inhibitors, steroids e.g prednisolone. If you are taking any of these medications regularly please don’t stop taking them but speak to your doctor about checking your thyroid function.
  • Gut dysbiosis – an imbalance in the microbes in your gut
  • Infections – viruses, bacteria, parasites. Especially EBV Epstein Barr Virus which causes glandular fever)
  • Autoimmunity eg coeliac disease

There can be a genetic predisposition to develop autoimmunity but it is other factors from our environment which cause those genes to be switched on – these factors include dietary triggers such as dairy, soy, eggs, gluten and other modern grains like corn, Gut dysbiosis, SIBO, hypochlorhydria, stress and exposure to environmental toxins.

Dr Alessio Fasano describes the autoimmune triad which includes genetic susceptibility, intestinal hyperpermeability and environmental triggers (stress, poor sleep, food reactions/allergies, toxic exposures, infections, nutrient deficiencies)

In intestinal hyperpermeability, commonly referred to as “leaky gut”, the usual tightly regulated intestinal lining is disrupted and allows the passage of complex food proteins (the product of inadequately digested food) or microbes from the gut into the blood stream to circulate. These complex food proteins and microbes are recognised by the immune system as foreign and an attack is mounted. This is of course an appropriate response but the problem comes when these complex food proteins or the microbes look like tissue elsewhere in the body. The result of this is a process called molecular mimicry in which the immune system mistakes self tissue for food or microbes it has already reacted against and mounts an attack against that self tissue. For example, it has been shown that gluten proteins look very much like thyroid tissue, so many patients with Hashimotos find it beneficial to exclude all gluten from their diet and we find over time that the levels of thyroid antibodies fall.

It makes sense, therefore, to reduce the chance of developing autoimmunity and also in established autoimmune disease, to ensure we are digesting our food as thoroughly as possible. (See Newsletter Issue 8 for tips to support digestion).

Look after your gut microbiome by feeding the “good bacteria” with plenty whole foods, fruits and vegetables containing fibre. You can even add some fermented foods like natural live yoghurt, kefir, sauerkraut, kimchi or take a quality probiotic. I liken the population of microbes in our guts to the human population in a city. You want the majority to be working hard, living in harmony, each having a beneficial role in that community and the criminals to be in a minority. The more good microbes there are the more the bad microbes are crowded out keeping the “crime rate” low.

Stress – this can not only be psychological but also physiological due to toxic exposure, infections, hormonal imbalance etc. (See Newsletter Issue 6 for information on the vagus nerve and how we can support it which helps us manage stress). Consider what you consume in terms of what you eat – processed food provides fewer nutrients, contains potential toxins and is harder for us to digest than whole foods, what you listen to or watch (TV, radio, films, conversations). Many people are watching or listening to less news as they find it increases their anxiety levels which especially late in the evening can cause disturbed sleep.

Sleep – getting a good nights sleep is essential to good health. It is a time when we complete digestion of food we have eaten, we process emotions, consolidate memories, process toxins and make repairs.

Toxins – every day we are exposed to so many potential toxins in the air that we breathe, water we drink, food we eat, products we apply to our skin and clean our environment with. This is not meant to scare you but more to prompt an awareness and gradual change to less toxic, more natural products. The UK based Pesticide Action Network produces a list of the most and least pesticide contaminated fruits and vegetables (in the USA Environmental Working Group) so we can concentrate on eating organic for the most contaminated and so reduce our exposure.

Start reading product labels and as you replace personal care products look for those without parabens and phthalates which have been implicated in autoimmunity and shown to disrupt thyroid function.

Iodine – deficiency of this essential nutrient for thyroid function is relatively common. The thyroid hormones T4 and T3 consist of a tyrosine molecule with either 4 or 3 molecules of iodine attached. However, it is a delicate balance and too much iodine can also be a problem for thyroid health. Dietary sources of iodine include seafood, seaweed, milk, eggs.

Support your immune system to fight infections by making sure your vitamin D levels are optimal (either your GP can check this or fingerpick tests are available privately through companies like Medicheck and Thriva in the UK). Optimal levels of vitamin D are 70-150 nmol/l.

You may find this information a little overwhelming. If you do, consider taking it one step at a time and look at just one thing that you can easily change and start there. Also you may wish to seek some guidance from a health professional such as a nutritional therapist or functional medicine practitioner.

I always like to recommend a book to provide more in depth information for those interested. My recommendation this time is Slow Butterfly by Dr Amy Gajjar. This book very gently takes the reader through each area which affects thyroid function. Remember we can’t do it all at once, it is about gradually putting in place multiple small changes which shift us towards improved health.