1. Autoimmune Thyroiditis and Related Conditions
2. What's Really Going on?
3. Can it be Stopped/Treated?
4. What Might Work?
5. My Results
OK so this is where my journey into thyroid distress started. When I was diagnosed with a thyroid problem (1st overactive, then underactive) I was screened for auto-antibodies. As is common with most hypothyroid sufferers I had high levels of anti-thyroid peroxidase antibodies (anti-TPO Abs) – Hashimoto’s.
A bit of background science detail here for anyone who’s new to this.
Thyroid peroxidase is an enzyme that means it helps change one biological molecule in the body into another. Its job is to free up iodine molecules in the thyroid gland so that they can be added to thyroglobulin to produce the thyroid hormones (T4, T3 etc.)
When the TPO auto-antibody attaches itself to the thyroid peroxidase enzyme it does two things (both bad).
1.It stops the enzyme doing its job (so there’s not enough T4 etc produced)
2.It attracts the other bits of the immune system to attack thyroid cells – hence the destruction of the gland.
Any more questions on the science happy to talk – antibodies were/are my thing.
So - we all know what the symptoms are.
But my question is what drives the immune system to turn on the body in the first place. And once it has can it be stopped?
Why does it happen
There’s lots of debate on this. All good and all with supporting evidence. Some believe it all starts in the gut when through infection, poor diet or some genetic disorder the gut starts letting foreign particles from our food straight into the bloodstream – so called ‘leaky gut’. This also results in gut inflammation. And whenever we have inflammation anywhere in the body we get an immune response to it (Hold that thought because it’s important if you’re thinking about doing something about it).
There’s a mountain of research on this. Having ploughed through some of it. My view is yes – this is right. My opinion’s not gospel. Your immune system’s geared up to recognise things that don’t belong (viruses, bacteria, toxins, foreign molecules) in your blood and to tackle inflammation.
Another explanation that in my view perhaps overlaps but is further 'upstream' is that some people are genetically susceptible to autoimmune disease.
That means with the right triggers – eg. pesticides in food, smoking, exposure to toxins (airborne, water-borne, food-borne) etc. – they produce auto-antibodies due to a malfunction in their genetics. Again I could bang on here but it’s pretty involved.
This is definitely true. That's one of the reasons thyroid probelms, diabetes often run in families. There’s a mountain of evidence of this since the human genome was sequenced (ie. we know how to read our genetics better than we ever have before).
There are 2 recognised groups of autoimmune diseases – the thyrogastric cluster (notice: thyroid + gut) and the lupus-associated autoimmune diseases (not covered here).
The thyrogastric cluster includes
1.autoimmune gastritis (stomach - anti-parietal cell Abs and anti intrinsic factor Abs). This can cause full-blown pernicious anemia if untreated and lead to poor B12 absorption
2.Hashimoto’s thyroiditis (thyroid - covered above)
3.Diabetes mellitus (type II) (pancreas – anti-islet of Langerhans Abs) lead to compromised insulin production
4.Addison’s Disease (adrenals – anti-adrenal cortex Abs) lead to compromised cortisol and DHEA production
Summary Hashimoto’s doesn’t necessarily travel alone. So if you’ve got it, it’s worth checking for other auto-antibodies because they may explain symptoms.
Note: one symptom of all of these is fatigue...
One more note here on gastritis and gut. If your gut's compromised – leaky/damaged – you may also lose the ability to absorb important things like iron, folate, and vitamin D from your diet. This leads to nutrient deficiencies with symptoms that also overlap with thyroid symptoms (funny that). More on this when I tackle gut and malabsorption.
Here's another link in - genetic predisposition towards the thyrogastric cluster has also been linked to 'female' hormones - oestrogen etc. It’s also more common in women.
Pregnancy and childbirth clearly change our hormone balances significantly, as does menopause. This is one reason why there’s a specific group of women who get autoimmune disease post-natally (I’m one of them) and around menopause.
Then you can happily add stress into the mix…
There’s no doubt stress affects hormone balance as it causes the adrenals to produce adrenalin (short term) and cortisol (long term) and cortisol acts on every cell in your body along with T3 to manage energy production and metabolism.
So by my reckoning there are four building blocks that lead so many of us to feel rubbish day-to-day.
Our immune system linked to our gut (damaged/leaky?) – to our adrenals (stress) – linked to our thyroid (autoimmune?) – then add some out of balance sex hormones and bazinga!
There’s no clear order that this happens in. To be sure what happened to you you’d have had to catch the first problem before the others set in. Sadly by the time you’re autoimmune and you figure out your have a thyroid problem there’s already 2 systems involved. Because – no surprise - all the systems work together. They all rely on each other’s hormones to work properly. If one goes it will be a house of cards unless someone intervenes.
So what to do? How can you sort out an over-keen immune system?
For me number one has been reducing stress. It has to be because I know stress first suppresses my immune system, then allows it to 'bounce back'. This happens in pregnancy. It also happened with illness and as a result of the (sometimes enormous, crushing) stresses life dishes out.
Next I have to be honest – I tackled my ‘female’ hormones. They were out of whack and that’s just never good (for me or those around me ;-)) I’ll deal with this and specifically oestrogen dominance tomorrow. This one was relatively easy for me to sort and led to a drastic improvement.
Next I changed my diet and supported my gut (more on this tomorrow). I don’t eat anything containing wheat. Many of you do this already. It took me a while. I also (sniff!) have had to stop drinking. It makes me feel physically rubbish even if I feel mentally happier (I’m a happy drunk…)
Next I discovered the adrenal disaster. so I supported my adrenals, thyroid, gut with whatever was needed. I’ll cover supporting your systems and supplements later. Although I will deal with those that seem to be good for immune support below.
What to take...
This is by no means either prescriptive or complete or what I advise you to do. It’s just worked for me (so far…)
Some herbs that are thought to calm the immune system down but it’s best to see a qualified herbalist before you go here.
BE VERY CAREFUL because there are some things that are commonly thought to ‘help’ the immune system are actually going to stimulate it. People cpmmpnly think Echinacea is ‘good’ for the immune system. They take it when they get a cold to stimulate the immune system to help fight the cold. This is probably the opposite to what you want to do if you’re autoimmune. Just a thought ?. There’s evidence for this too. Echinacea (and spirulina) have been seen to stimulate autoimmune flares in some patients.
I guess spirulina could be a problem because of the iodine content. If you can’t use all the iodine up in your thyroid to make hormones because your anti-TPO Abs are blocking that process that iodine could build up. I know there’s a lot out there on iodine and everyone needs to be aware of what their own circumstances on this one.
So what’s safe (or is thought to be) in helping your immune system ‘calm down’
(I’m using these)
•Green tea – has been shown to reduce autoimmune response in rats and reduce inflammation. Full of antioxidants that combat chemical stressors ion the body. Loads of flavours available – why not.
•Quercertin has also been shown to be anti-infammatory.
•A-lipoic acid (found in dark green leafy vegetables) is crucial in the body in regulating glucose balance – has been tested with diabetes II patients with visible improvement. If you’re healthy and you can metabolise green veg you should be OK on this one. You can also get it as a supplement.
•Ashwagandha (a decent ref. webmd.com/vitamins-and-supp...
Vitamins (some good old favourites here…)
•Omega 3,6 fatty acids + vitamin E - reduce inflammation and therefore immune response to inflammation
•Vitamin D - suppresses autoimmune reactions
•Selenium – German study 70 women aged mean 47.5 years on selenium supplementation showed mean TPOAb concentration decreased significantly to 63.6% vs untreated women. That’s good enough for me.
For gastric-anti parietal cell Abs/gut related deficiencies (you can test for these deficiences via Myrios tests at home to keep a handle on things)
•I get a B12 shot every 3 months
•I take vitamin D and folate supplements and can confirm I am absorbing them OK
•I get an iron infusion every ~18 months as my ferritin stores get depleted. I have issues absorbing dietary iron
The ‘Medical Option’ – Immune Suppressants.
There’s also the well-publicised medical option involving drugs that suppress the immune (and therefore autoimmune) system.
Having worked in the drug industry I would hate to have to take these. There are medical conditions where it’s absolutely necessary eg. after transplants to avoid transplant rejection. I can’t even go there but there may be GOOD reasons if your doctor prescribes these. Just make sure you find out what those reasons are because it’s a very big deal and these drugs will do their job but do have risks and side-effects.
My autoimmune antibodies have done something very interesting since I embarked upon the sorting-this-out-plan.
First off results for anti-TPO Abs (IU/ml) I only have 4 readings – sorry for the big gap in the middle…too busy being stressed!)
2002 – on initial diagnosis 725 (ref range. <35) USA
2010 – on 100mcg thyroxine 374 (ref range. <30) Australia
2011 – on 100mcg thyroxine 175 (ref range. <35) UK
2013 – on 0mcg thyroxine + nothing 137 (ref range. <35) UK
2013 – on 50mcg thyroxine +adrenal support etc. 85 (ref range. <35) UK
The final two measurements are interesting because they’re going down but the jury’s still out…
Uselessly the tests they use for gastric-parietal cell Abs are +/- tests so no idea what those are doing.
So that’s about it – another long one – sorry but it is complicated.
Tomorrow I’m going to go shorter and tackle oestrogen then onto Gut, Liver and Supplements/Diet…
Thanks for reading. Happy to field comments/questions.