Why Are So Many People Taking Thyroid and Gut Health Medications?
Over 20 million people in the United States have some form of a thyroid condition, and up to 60% are unaware that they have a condition. One in eight women will develop a thyroid disorder during her lifetime, and the number of people suffering from thyroid disorders continues to rise each year.
Hypothyroidism (underactive thyroid), where the body doesn’t make enough thyroid hormone, is one of the most common thyroid disorders. It may be characterized by weight gain, constipation, dry skin, hair loss, brain fog, depression, memory loss, intolerance, hoarse voice, fatigue, muscle weakness and pain, and wide range of other unpleasant symptoms.
The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then get carried to every tissue in the body. Every cell in the body has receptors for thyroid hormones. These hormones are responsible for the most basic aspects of our body’s function, impacting all major systems. They directly act on the brain, the GI tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gallbladder and liver function, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism, and body temperature regulation. In other words, optimal thyroid function is essential to good health.
I work with clients experiencing both clinical and subclinical symptoms of hypothyroidism, but who have been told by their doctor that their thyroid function is fine based on one or two labs drawn each year.
Using a functional and integrative nutrition approach, I help clients get to the root cause of their health issues. Often, this involves looking deeper at their biochemistry and lab work to identify IF their thyroid function is contributing to their issues.
The Potential Connection Between Poor Gut Health and Your Thyroid
Because I specialize in gut-related disorders, it is routine for me to work with clients who have chronic IBS, gastroparesis, leaky gut, celiac disease, and Crohn’s who also have a thyroid condition. Many years ago, I always wondered why this seemed to be the case. Now, the research is clear…
Gut bacteria play a major role in regulating the thyroid. You could say that thyroid and gastrointestinal problems kind of go hand in hand.
Bacteria is necessary in converting the inactive thyroid hormone T4 into the active form of thyroid hormone, T3. About 20% of T4 is converted to T3 in the GI tract. This requires an important enzyme called intestinal sulfatase. Guess where this enzyme comes from? Yep, you guessed it – healthy gut bacteria!
Intestinal dysbiosis, an imbalance between pathogenic (bad bacteria) and beneficial bacteria in the gut, significantly reduces the conversion to T3. Also, low stomach acid is all too common in those over 50, individuals taking antacids (PPI’s), and is a very common condition in those who have gut issues.
Inflammation in the gut also reduces T3 by raising cortisol. Cortisol decreases active T3 levels while increasing levels of inactive T3.
Intestinal permeability, or leaky gut, can be an underlying cause of autoimmune related thyroiditis (when the thyroid is attacking its own tissue). Essentially, there is a breakdown in the gut barrier which exposes the bloodstream to harmful foreign molecules. The immune system reacts an inflammatory response, and can eventually lead to a mistaken immune attack on the body’s tissues, like the thyroid gland. This autoimmune condition is thought to be related to 80-90% of the cases of hypothyroidism, the most common of which is Hashimoto’s.
Individuals with poor gut function may have thyroid symptoms but “normal” lab results. Often, this is because only a TSH and/or Total T4 lab value are checked (not that important T3!).
So, what can YOU do to be proactive if you think you may have signs/symptoms of a failing thyroid?
Tests to Check for Thyroid and Gastrointestinal Problems
- Discuss with your doctor having a comprehensive thyroid panel done that includes: TSH, T3, T4, Free T4, Free T3, Reverse T3, and thyroid antibodies.
Toxins, infections and certain foods act as triggers, while other foods and some supplements can reduce autoimmunity. If detected in the early stages, there is much you can do to optimize the health of your thyroid.
However, each person is unique. The thyroid is not always that straightforward, so a personalized approach needs to be taken.
Here are some basics in regards to thyroid and gut health!
8 Basic Tips for a Healthy Thyroid:
- Heal the Gut & Cut Out Inflammatory Foods
This will look different for each person based on the situation. However, it is important to identify the cause of your gut related issue. This involves identifying and removing inflammatory foods. Gluten (see below) and dairy are common — dairy especially if you are experiencing sinus like issues, migraines, post-nasal drip, and diarrhea. Refined sugar, artificial sweeteners, and processed artificial foods are also inflammatory! Specific food sensitivities are common and testing may be necessary. (Food Sensitivity Testing used at JBS). Next, it is essential to rebalance the gut with healthy bacteria, restore the integrity of the lining of the gut, and feed it with food and supplements that will help the gut thrive. - Eat Protein
Although a vegan eating plan may work for some, it is not typically best for those who suffer from a thyroid condition. This is because two essential nutrients are needed for thyroid function: zinc and selenium. A deficiency in either of these can prompt a thyroid condition). These nutrients play a role in the important conversion from T4 to T3. Low protein diets (or only plant based protein) often doesn’t provide enough. Selenium and zinc can both be found in animal protein sources (fish, chicken, turkey, beef). Brazil nuts are highest in selenium…some practitioners may recommend 2 Brazil nuts/day to meet the recommended dose. However, depending on the source of the nut, amounts can vary. - Don’t Overdo the Cruciferous Veggies
Avoid large amounts of cruciferous and brassica vegetables (cabbage, turnips, Brussels sprouts, rutabagas, broccoli, cauliflower, and bok choy). Although they are healthy and full of nutrition and essential vitamins and minerals, they can be goitrogenic (form goiters in the thyroid) for some people (when consumed in excessive amounts). Steaming or cooking these foods briefly to reduce their goitrogenic effect is a good idea, instead of eating them raw. For those who enjoy juicing, be mindful about how many different cruciferous vegetables are in your juice. Even Dr. Oz admitted he had to cut back on juicing after developing signs of hypothyroidism! - Avoid Gluten
Going gluten-free really isn’t a fad. Gluten-containing foods can increase inflammation in the body and has been shown to have a connection with autoimmune disease. It’s common that when people have one autoimmune condition like celiac disease, they are at risk for another autoimmune condition like Hashimotos. I have seen patients with elevated thyroid peroxidase antibodies (TBO) improve symptoms and feel much better after following a strict gluten-free diet. Be mindful not to overindulge in too many gluten-free processed products – try to go for naturally gluten free foods. - Skip the Soy
Isoflavones found in soy may hinder thyroid function. Large amounts of soy products can aggravate hyperthyroidism and iodine deficiency in adults. This again is where some vegetarians may run into trouble if they replace meat with numerous soy products: soy milk, soy yogurt, and tofu. After a while everything is processed and can slowly negatively affect your thyroid if you already have a genetic predisposition. Also read food labels and be aware of how much soy may be lurking in your foods…such as mayo, condiments, snack foods, and more! - Include Healthy Carbs
Carbs do get a bad rap, and some people actually may not be getting enough. To my paleo and ketogenic friends, you can actually worsen your thyroid function if you strictly limit your carbohydrates. Your body perceives it as starvation mode, and the thyroid is the first hormone that becomes jeopardized. Carbohydrates promote the release of insulin, and insulin is required for proper thyroid hormone metabolism. Excessively limiting carbs has its consequences on your thyroid. Everything in moderation, right? Consider complimenting meals with small amounts of carbs such fruit, quinoa, millet, buckwheat, root vegetables, and brown rice. - Remove Environmental Toxins
There are so many chemicals in products we use every day that are toxic to the thyroid and our bodies in general. Things that we assume are safe are not! Things like personal care items, cosmetics, cheap supplements, cleaning products, plug ins, air freshener, and detergents all contain toxins. (Check out 12 – ingredients to avoid). Some people are more sensitive than others, but for those with thyroid issues, it is essential. Personal care and cosmetic products contain endocrine disruptors like fragrance, parabens, petroleum distillates, and more. Also, consider switching to safer cleaning products. (DIY HouseHold Cleaners) - Focus on Stress Management
This may be the most important step! Stress impacts the thyroid in multiple ways, especially when cortisol levels rise or fall. It also reduces that conversion again of T4 and T3 and works on other glands like the pituitary and the hypothalamus, critical to the thyroid function. If stress is an issue, think about taking mindful steps to reduce it. Consider mindful breathing exercises, yoga, tai chi, counseling, exercise, etc. Make time in your life to foster healthy relationships that bring you joy and connection.
Lifestyle change is essential! If you are planning to take steps to improve your thyroid, take it one step at a time. Personally, I started with food, then began to take inventory of my exposure and next took steps to eliminate toxins and exposure in my environment.
Remember, each person is unique and a personalized plan is needed.
If you think your thyroid may not be functioning optimally, or you have gut related struggles and display typical signs and symptoms, I would love to hear from you!
Take steps TODAY to reclaim your health and achieve your wellness goals!
On the Journey together! ~ Julie 😉
