thyroid

THE GUT THYROID CONNECTION

What does the gut have to do with thyroid function? We see many patients with low thyroid function and autoimmune thyroid conditions. As a gut-health specialist clinic we will of course ask about your gut – but particularly so when we hear anything related to the thyroid or thyroid-associated symptoms. Why?

The gut and the thyroid are intimately linked and influence each other in many ways. Essentially – poor gut health suppresses thyroid function and low thyroid function causes inflammation and may contribute to leaky gut.

There is a myriad of contributing factors to gut-thyroid imbalances, such as stress and cortisol release which increase intestinal inflammation and permeability; and sluggish digestion and constipation, gallbladder issues and low stomach acid which can be caused by low thyroid function. However today I will go into a bit of detail about the two important mechanisms that link the thyroid and the gut: GALT and the MICROBIOME.

*Note: the subject is huge one and this blog is by no means an exhaustive explanation of all links.

GALT Tissue

Ever hear the statistic that 70-80% of the immune system, or rather immune tissue lies in the gut?1 It’s true. I’ll explain…

Apart from digestion – the most important function of the gut is to protect us from the unwanted microorganisms that we ingest when we eat, drink and breathe. The digestive tract runs from mouth to anus and if you think about it, this tract is essentially a hollow tube that is open to the outside world. This means we need a strong barrier and good soldiers to protect our bodies from the barrage of potential invaders every time we eat, drink, breath, kiss – you get the picture.

The body has an ingenious method of protection- its all about the GALT…GALT stands for Gut Associated Lymphoid Tissue2. The digestive tract is lined with vast amounts of this GALT – immune tissue and is comprised of immune cells such as B and T lymphocytes – the soldiers of the immune system. Due to the large amounts of GALT in the gut – any issues in the gut will have a profound effect on the body’s immune system as a whole.

Problems in the immune system occur when this barrier containing immune cells becomes damaged due to various causes such as stress, environmental toxins, low thyroid function and diet – this is called Leaky Gut or Intestinal Permeability.

When the gut lining is damaged it becomes inflamed and as a result larger particles from our food are able to pass through the inflamed gut tissue into our blood stream. This is not normal and the soldiers in our immune system get confused and mount an attack/response in order to protect us. A case of mistaken identity. This causes a massive amount of systemic inflammation and tissue destruction. This ‘hyped up’ immune system plays a key role in the development of autoimmune disorders such as Hashimoto’s - see more info about how to treat leaky gut HERE

The Microbiome

A little known fact is that good bacteria in your gut help to convert inactive thyroid hormone (T4) to the active from (T3) – by producing the enzyme intestinal sulfatase.  This enzyme is necessary for this conversion to take place. Some studies suggest about 20% of thyroid hormone is converted in the digestive tract this way. That’s huge!

This illustrates how important it is to have healthy populations of good gut flora in order to support your thyroid, and is commonly why people with compromised gut function also have thyroid symptoms. Additionally diverse populations of gut flora are essential for good gut-barrier function and healthy GALT tissue, and protect against leaky gut and pathogenic microorganisms.

Naturopathically, we say that everything in the body is linked and we like to look at the whole picture. When treating conditions such as Hashimotos we will always look at diet, environment, emotions, stress, sleep and any other factors that may be compromising your thyroid health – and of course address any underlying gut issues. 

Karen

BHSc (Naturopathy)

 

Veggie broth your thyroid will love

This recipe is a simple and effective way to get in some of the key thyroid minerals into your diet. In particular this broth is full of iodine and selenium, which can be found in kombu, an iodine rich seaweed vegetable(1), and shiitake mushrooms, a great source of selenium(2). As modern day Australian soils tend to lack in these minerals, it's important to looking further abroad and incorporate some 'exotic' foods into your diet to keep these minerals in check(3).*

This mineral rich veggie broth is perfect for the cooler months and can be enjoyed by itself or as a wholesome base to any soup or risotto.

* If you aren’t sure what state of health your thyroid is in, or if you are already supplementing to support your thyroid, check with your practitioner before trying this recipe.

Image courtesy of Pommes Pommes

Image courtesy of Pommes Pommes

Makes about 4 cups

Ingredients

  • 5 cups water
  • 2 (2-inch width) pieces kombu
  • 1/2 cup dried shiitake mushrooms
  • 2 carrots, , sliced
  • 1 zucchini, sliced
  • 2 stick celery, diced
  • 3cm knob ginger, sliced
  • 2-3 cloves garlic, sliced
  • 3cm knob of turmeric, sliced
  • 1 whole brown onion, sliced
  • Salt and pepper to taste

 Method

  1. Combine the water and kombu in a larger saucepan and soak the kombu for at least 8 hours or overnight.
  2. Add in the vegetables, turmeric, ginger and garlic and place the saucepan over low heat and bring to a simmer. Continue to simmer and then remove the kombu from the water just before it comes to a full boil.
  3. Add the shiitake mushrooms, and continue simmering for about 10 minutes.
  4. Remove the saucepan from heat and let the shiitake mushrooms steep in the broth for 5 minutes more.
  5. Remove the shiitake mushrooms and vegetables from the broth and pour the broth through a fine-mesh strainer set over a large bowl.
  6. Add salt and pepper to taste

Created by Naturopath Rachel Larsson

When to get help and when to do it alone.

We live in a wonderful time when we can access any information we want with just one easy click of the button.  For example, when I typed ‘gut health’ into Google I got a massive 133 MILLION hits! There is so much benefit to having access to this information, as you can get inspired, cultivate hope and discover some tools to help manage your health. However, having this much information has its down sides and can leave you feeling confused, overwhelmed or can even be dangerous.

In clinic I frequently hear my patients start a sentence with ‘I was reading about…’ or ‘I was Googling the other day and…’ Whilst I love hearing that they are taking an interest in their health, unfortunately the sentence usually ends with ‘now I’m confused’ or ‘I don’t know what to do’.

So, how do you know when you are out of your depth in addressing your health alone and when you need some professional help? To help you decide when you need to close the laptop and pick up the phone, ask yourself these five questions.

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1. Does your diet or supplement provide you with an immediate improvement and/or if you were to stop your treatment, would this effect be long-term?

If not, you have probably been providing yourself with Band-Aid support and not addressing the underlying issue. A great example I see a lot in clinic is constipation. Before coming to see me many patients have developed a dependency on strong coffee, laxatives or supplements to ensure a daily bowel motion. It needs to be understood that constipation is symptom of something else going on(1) and can be tricky to treat. There are many causes of constipation including an imbalance of your gut flora, SIBO (small intestinal bacterial overgrowth)(2) or nervous system issues, such as a side effect from a medication or low intestinal serotonin levels. Did you know 95% of the serotonin in our body is found in our gastrointestinal tract? Having enough serotonin is important because it signals the muscles along our digestive tract to contract and relax. This is called motility and it is necessary for regular bowel movements(3).

 

2. Do you feel overwhelmed, stressed or anxious when thinking about your health?

If so, these emotions may be making your symptoms worse(4).  When your body experiences these emotions, it enters a state of fight or flight which causes our nervous system to tip into sympathetic nervous system dominance(5). Our sympathetic nervous system is necessary for our survival, as we use it when we need to escape danger or act quickly. However, this part of the nervous system inhibits our ability to rest and digest properly(6)(because who cares about digesting when you are running away danger). Experiencing daily stress, anxiety and overwhelm regarding your health may only be making you health worse. How ironic! A proven example of this relationship is stress and its ability to worsen or flare symptoms of Irritable Bowel Syndrome(7). 

 

3. You have a sense that there is something else underlying the issue and are finding it difficult to get the big picture?

The perfect example of this is acne and congested skin. I meet many people that have ‘tried everything’; they have invested a lot of time and money into topical treatments, medications and diets without any improvement. Potentially this is because they are only treating one part of the problem.
Acne and skin congestion is considered a complex multi-system disease, rather a skin condition. Our skin is a huge organ and the health of it is a result of your diet, nutritional status, gut health and gut bugs, nervous system, hormones and immune system (8). So whilst the oral contraceptive pill or antibiotics may help manage your skin (9,10) if you stop these, your skin may go back to where it started. To make an effective long-lasting change in your skin, you need a holistic inside-out and outside-in approach.

 

4. Are you following advice that is supposed to help you and yet you feel worse?

You’ve starting eating healthier and have invested in cupboard full of supplements, yet you feel worse than ever with less energy, stomach pains, poor sleep and your mood has taken a turn. What could be going? It’s no surprise that we are all different - what works for someone may not work for you. A great example of this is if you have an underlying histamine issue. Histamine is a naturally occurring substance that we create in our body and is present in many foods. It is especially high in aged foods including bone broths, fermented foods, kombucha and kefir (11) and in some probiotics, which are readily promoted for gut healing (12). If you have tried any of these and feel worse, histamine sensitivity may be your issue. Perhaps you need the guidance from someone who acknowledges or understands the issue of histamine to help guide you back to health.

 

5. Is integrative medicine a better fit?

That is, are you required to take medications or are you under the care of practitioner who has limited understanding, interest or awareness of the role diet and gut healing plays in our wellbeing? If you answered ‘yes’ and you are trying to make supplement and dietary changes alone, you may be putting yourself in danger. Thyroxine (thyroid medication) is a great example of something that needs to be monitored closely. A change in supplements, medications and diet may alter the dosage needed to keep your thyroid in balance. If these interactions aren’t understood and accounted for, you may start to experience symptoms of thyroid imbalance (fatigue, shakiness, anxiety, gut issues)(13, 14). A practitioner that will consider these interactions is important in ensuring you a safe road to good health.

 

Closing Thoughts

Before you have lost all hope and motivation, spent years of your time and a mountain of money, reach out and get some professional support.  We love that you have taken the initiative in trying to help yourself and we want to be there for you to reach your health goals in a safe and effective way.   

By Rachel Larsson

BHSc (Naturopathy), BPH (Nutrition)            

Seven ways to care for your thyroid

When I was sixteen I was an avid runner who loved competing in long distance events. One day I collapsed at the finishing line, pale as a ghost, with my heart beating too slowly and not pushing enough blood around my body. I felt terrible and it was all rather dramatic.

Leading up to this day, I had been having funny turns at school. At the time, with the wisdom of a sixteen year old, I thought it was funny to be having these “drop –attacks”. They occurred while I was walking along and then bam! I’d find myself on the ground. Along with this I felt irritable, had gained weight and was feeling extremely tired. My teachers and family put this down to “raging hormones” or “growing pains”, shrugging it off as normal adolescent behaviour.  

Eventually I was diagnosed with thyroid disease due to an autoimmune condition called Hashimoto’s Thyroiditis. I started taking Thyroxine, a synthetic form of thyroid hormone and began to feel better. I was traveling along reasonably well until I woke one morning and found that half of my face was paralysed. Yep, paralysed. I wasn’t even able to fully close my eyelids on that side. 

Can you imagine how horrific it was to see only the right side of my face moving as I screamed out to my mum? 

This time I was diagnosed with yet another autoimmune disease called Bell’s palsy. This is a condition in which the facial nerve, supplying the muscles of my face, was attacked by my own immune system. After a course of strong steroids, I was one of the fortunate ones who fully recovered after 6 weeks. For others it can take months or even years to recover. 

Prior to this double whammy of “bad luck” I had been a fit and healthy girl. Being a farm girl, I was more active than most. However I loved eating fruit and tomatoes, and this habit took its toll on my teeth. Six months prior to falling ill, I needed to have several dental fillings and in those days it was mercury amalgam. Was it just a coincidence that I fell ill with two auto-immune conditions after getting several mercury fillings? Had I known then what I know now, I would have avoided mercury fillings (aka silver fillings) at all costs . I explain my reasons for this below. 

As an Integrative GP who has lived with thyroid disease and clearly remembers living with Bell’s palsy, I’ve been intrigued as to why I had this “bad luck”.   There is so much more to autoimmune thyroid disease than just treating it with Thyroxine and this is a quick summary of what I’ve learnt.

1. Never look at the thyroid in isolation

In my case it’s clear that my immune system was going ballistic. It didn’t know what was friend or foe, and it is a good idea to ask why.

2. Start with gut health

Over 85% of our immune system lives in the gastrointestinal tract and there is very exciting emerging evidence that links gut health to a range of conditions including auto-immune diseases. Don’t worry I’ll be sharing this with you soon!

My general approach is to start with diet and nutrition, and whilst I believe no one diet fits all, I generally recommend removing any food allergens, especially gluten. I know. I get it. I too had a carb addiction, and it took me four months to quit the habit. Yet, there is evidence that patients with thyroid autoimmune disease have autoimmunity suggestive of coeliac disease (gluten allergy) and type 1 diabetes. It is definitely best to avoid gluten to prevent further problems, and for a number of my patients I have seen their thyroid function improve as a result. 

Next is healing the gut, which is one of the most exciting and interesting areas of medicine. Call me crazy, but I feel everything from depression and autism to arthritis and asthma, relates to gut health. For some, healing the gut means incorporating bone broths (or glutamine/glucosamine/turmeric supplements), and herbs like slippery elm, omega 3, and probiotics into your routine. Often there are accompanying mineral deficiencies such as magnesium and zinc, which when corrected contribute to the healing process. 

I recommend seeing a dietician/nutritionist who has training in GAPS or paleo diet to really help you fine-tune your diet and treat the cause of autoimmunity.

3. Manage the adrenal gland

During medical school I learnt very little about the adrenal gland. I got the impression that they were somewhat insignificant glands that hung out above the kidneys, rarely causing trouble.  How wrong that was! 

When supporting the thyroid gland, we can’t ignore the adrenals. They are responsible for producing our stress hormones (cortisol, adrenaline, noradrenaline), DHEA, sex hormones and mineralocorticoids (aldosterone; responsible for salt/water balance). Cortisol excess impairs thyroid function. As the gross majority of us live in a chronic state of stress, the constant fight or flight response, increases demand on our adrenal glands and in turn our thyroid gland. 

The adrenal gland is key to the mind/body connection and I will endeavour to explore the adrenal gland in future articles as a holistic approach for managing and supporting the adrenal gland is required. 

4. Remove the triggers!

There are a number of known factors that inhibit proper production of thyroid function. These are called “goitrogens” and include mercury, pesticides, lead, cadmium, halogens (fluoride etc.) and medications such as lithium. These are known “endocrine disruptors” and taking the steps to educate yourself about environmental pollutants so you can limit your exposure is so very important. If your thyroid is under strain, eating excessive amounts of certain foods such as isoflavone phytoestrogens from soy and thiocynates in cruciferous vegetables (broccoli, kale, cauliflower, cabbage) can tip the balance, impairing thyroid function. Best not to consume too many kale smoothies if your thyroid is strained! 

5. Support the thyroid – give it the fuel it needs.

The thyroid gland needs iodine for production of thyroid hormone. The majority of the Australian population are iodine deficient and will require supplementation or review of dietary intake. Unfortunately, an excess of iodine can also interfere with thyroid production, so getting your levels right is essential. It is best to do this under the care of trained integrative medical doctor or naturopath, who may choose to check levels (known as a corrected urinary iodine level). Iron and vitamin D are critical for proper production of thyroid hormones, and levels need to be optimised in management, alongside a number of other essential nutrients including vitamin E, B, and C. 

6. Gotta love zinc and selenium!

When it comes to thyroid health, zinc and selenium are the top two minerals that I prescribe. The production of thyroid hormone and the homeostatic feedback loop takes a bit of patience and perseverance to fully understand. A key point is that the thyroid releases T4, a mostly inactive hormone, which requires conversion to the active form T3. Zinc and selenium are essential in this conversion, with zinc also improving the responsiveness of cells to the thyroid hormone. If you are zinc and selenium deficient this pathway won’t be running at full steam, and I know I felt much better after optimising my own zinc and selenium levels. 

The thyroid contains the highest concentration of selenium, an essential trace element and powerful antioxidant, in the body. Studies have proven that selenium deficiency worsens autoimmune disease. Other research suggests that selenium is protective in prevention of disease also, especially against the harmful effect of mercury.

NB. I encourage you do to your own research on mercury (a good resource to start is http://thegooddoctors.com.au/health-podcast/dental-mercury-amalgam-an-environmental-and-health-issue/doctors) and if you elect to have it removed, do so with a dentist trained in safe removal. In a future article I will share my experience of getting mercury safely removed.

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7. Never forget the mind body spirit connection

is a risk factor for autoimmune thyroid disease. There is clearly a link between our stress hormones and thyroid hormones. Thyroid hormone has the same precursor, tyrosine, as our stress hormones including noradrenaline and adrenaline. When under stress, Tyrosine is preferentially used for production of stress hormones, impacting normal thyroid function. High cortisol (seen in stress) and low cortisol levels (seen in adrenal fatigue resulting from prolonged stress) have a negative impact on thyroid production and how the tissues respond to the thyroid hormone. 

A holistic approach to autoimmune thyroid disease includes addressing the impact that stress has on our body, especially our gut health, as this is where the majority of our immune system lies. Meditation, exercise, living a soul driven life and having fun is all very important in stress prevention and ensuringa healthy body, including a healthy thyroid gland. 

Om Namo Narayani,

Dr. Fiona

How seeing a naturopath can better your health.

As a naturopath, we often see patients that have suffered years of ongoing, unresolved complaints and have been searching for answers without any luck. You may have a feeling that 'something more can be done', looking for a natural approach or are sick of getting prescribed antibiotics for the common cold. What about a desire to understand your body or wanting to have optimal, thriving heath and not feeling like you are just surviving? Does any of that sound familiar? If so, naturopathy may be for you. 

Naturopath's have the exciting, complex and rewarding job of looking and treating you as a whole person. What does this actually mean? This means that when you come in with a concern, for example you feel tired all the time, we will look beyond how much sleep you are getting. We will also consider your personal health history, family history, blood tests, medications, stress levels, physical examination, diet, allergies and so much more. We do this because we want to understand your unique situation as we appreciate the many causes that contribute to you feeling this way. An understanding of who you are is so important in giving you the best treatment.

The beauty of naturopathy is that the therapies we use are well tolerated and can actually be a support to conventional medicine. Although our remedies have traditional beginnings, many of them have substantial scientific evidence that support there use and efficacy. Naturopathy is also wonderful and unique in that there is no 'one fix' approach to a problem. It has a broad scope of treatment and can use the following remedy options according to your circumstance. 

  • Herbal medicine as liquids, tablets and teas
  • Dietary advice to promote food as medicine and nutritional supplements
  • Lifestyle and environmental advice to promote mindfulness and wellbeing
  • Flower essences have an energetic basis and can enhance the emotional aspects of healing.   

Using the example above, if your 'feeling tired all the time' was caused by high levels of stress we could look at using one or a combination of diet modification, herbal medicine, nutrient supplementation and mindfulness techniques. Interestingly this means that if your friend were to need help because they also felt tired all the time due to stress, we may actually consider completely different herbs, nutrients and dietary advice because we would consider their unique circumstances.  

In essence, naturopathy is based on the principle that the body has an inherent ability to heal itself. We follow these six philosophies when treating you:  

  1. The healing power of nature  (Vis Medicatrix Naturae)
  2. Identify and treat the cause (Tolle Causum) 
  3. Treat the whole person (Tolle Totum)
  4. Do not harm (Primum Non Nocere)
  5. Doctor as teacher (Docere)
  6. Prevention (Preventare)
Herbal Medicine in melbourne

At Narayani Wellness, your naturopathic experience is truly unique as we have a supportive community of passionate naturopaths and integrative doctors working together. We believe more can be achieved by having these two approaches as it has greater potency and efficacy than doing things separately. Our approach to patient care embraces the combination of traditional philosophy with functional testing, and we find we get better results with our patients with the addition of functional testing. Functional testing allows us to look at the finer processes that occur within our bodies. This includes looking at how our cells function, our energy production pathways, how we clear toxins, how we make our brain chemicals, hormone profiles and how we can achieve healthy bowel functions. Our focus is to put you first and we realise the best relationship is one built on trust. All of this keeps us on our toes which motivates us to do professional development and stay current with research to continually benefit you.

We realise that Spring is a time we focus on our health and 'recover' from Winter woes. For some, this means the annual struggle of hay fever or a time to address old health issues that flared up from a change in your diet and exercise. With Spring well and truly here and the excitement of warmer days coming, maybe this is the right time for you to see a naturopath and regain your health.