Of the 27 million Americans who suffer from thyroid dysfunction, more than half are due to an autoimmune disorder called Hashimoto’s disease, in which the immune system attacks and destroys thyroid gland tissue.
“Thyroid replacement hormones are a first line of defense for many doctors, prescribed with the promise of wiping out a number of symptoms in one fell swoop. But taking that approach is turning a blind eye to what caused the thyroid to become depressed in the first place,” writes Dr. Datis Kharrazian in “Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal: A Revolutionary Breakthrough In Understanding Hashimoto’s Disease and Hypothyroidism.” The underlying causes can range from irregular immune function and poor blood sugar metabolism to gut infections, adrenal problems, and hormonal imbalances.
It is a necessity for patients with Hashimoto’s disease to get their guts in good working order before they see improvement and actually feel better. We asked Dr. Raphael Kellman, founder of the Kellman Center for Functional & Integrative Medicine in Midtown, to explain the crucial relationship between gut health and thyroid health.
Danielle Sullivan: What is the connection between microbiome health and autoimmune disease, and Hashimoto’s disease in particular?
Dr. Kellman: From my experience, the microbiome is the key to healing and reversing autoimmune conditions including Hashimoto’s Thyroiditis. The gut microbiome is comprised of trillions of bacteria living within the intestine along with the vast majority of the immune system. It’s no accident that they are in such close proximity. The bacteria are highly involved with immunity, educating, and regulating the immune system, helping it to recognize the difference between friend, our own healthy tissue, and foe. These microorganisms maintain the integrity of the gut wall, fortifying it, protecting the body.
A healthy microbiome lowers inflammation; produces beneficial compounds like vitamins, neurotransmitters, natural antibiotics; and short chain fatty acids that are very important to the health of the intestine and brain. If the ecology becomes unbalanced and unhealthy, we lose these protections. Yeast, parasites, and less beneficial bacteria overtake the system, intestinal permeability begins, inflammation grows out of control, and very often the immune system begins to attack the body’s own healthy tissue. In the case of Hashimoto’s, the victim is the thyroid. Once this process is switched on, however, other areas of the body may come under attack as well.
DS: How important is it to heal the gut in order to have optimal thyroid health? Will thyroid health ever really be functional if the gut is not?
DK: The thyroid and microbiome are intricately intertwined. To start, a portion of thyroid hormone gets activated or converted in the intestine. If that isn’t possible because the intestine is damaged or microbiome unbalanced, the body experiences a low thyroid state. An unhealthy gut leads to widespread inflammation and autoimmunity perpetuating antibody production that may attack healthy thyroid tissue.
Additionally, GI issues may lead to nutrient deficiencies that can affect many systems, including the thyroid. On the other hand, the gut is very sensitive to changes in thyroid hormone and requires an adequate amount to contract properly, sort and digest food, and expel waste. Without it, intestinal conditions are more likely. The intestine and thyroid need each other, so it’s imperative to work on both to improve the whole.
DS: How does gluten affect the gut balance? Does it affect everyone with thyroid disease or only those who have celiac or a wheat allergy?
DK: For many, gluten can produce problems in the body triggering intestinal permeability, inflammation, and immune responses. It’s a fallacy that only those diagnosed with celiac disease need to avoid it. Anyone with an autoimmune condition should steer clear of it. Most chronic diseases today stem from inflammatory conditions, which can often be traced back to inflammation in the gut. By eliminating gluten and eating a diet low in inflammatory foods, we can start to reverse damage that has been done.
DS: What symptoms present with an imbalanced gut?
DK: Symptoms can manifest in many systems since the microbiome is connected to everything in the body. Frequently, patients have intestinal complaints like constipation, diarrhea, bloating, heartburn, gas, and abdominal pain.
For some, they may suffer mood changes, depression, anxiety, difficulty concentrating, brain fog, and even memory problems. Skin conditions are also very prevalent as well as sugar cravings, insulin imbalances, craving unhealthy foods, fatigue, weight gain, and joint pain. Whenever we see inflammatory markers go way up on testing, it’s a sure sign of microbiome imbalances.
DS: What is the best probiotic for those with Hashimoto’s disease?
DK: Saccharomyces boulardii is very useful in autoimmune conditions, helping to rebalance the immune system and clear out pathogens. We often see antibody levels drop as a result of administering this strain. B. infantis 35624 targets inflammation in the intestine, especially levels of TNF-alpha, helping to resolve it. I also recommend a good, broad-range probiotic rich with different strains of both Lactobacillus and Bifidobacterium. There are many great products out there now like Ther-Biotic by Klaire Labs.
DS: What is the best food plan for someone with an autoimmune disease, and Hashimoto’s disease in particular?
DK: It’s important to gear eating towards improving the health of the microbiome while limiting or omitting inflammatory foods like gluten or dairy for some people. Prepackaged, processed, fast, high-sugar, and chemical-laden foods should be avoided. Prebiotic fibers are those found in certain plants that feed healthy gut bacteria helping them to thrive and reproduce. Onion, garlic, Jerusalem artichoke, jicama, and asparagus are all examples of foods that are good for the microbiome.
The diet then should include mainly plants with clean, grass-fed, and wild proteins as side dishes. Fermented foods like kimchi, sauerkraut, yogurt, and kefir help to infuse the intestine with mega doses of beneficial bacteria.
It’s a grave mistake to overlook or underestimate the role of gut bacteria in autoimmune conditions. Frequently, doctors focus on viruses and toxins, which are known triggers, however, these things are filtered through the microbiome. Healthy bacteria have the ability to protect the body from these attacks, washing them away. There is no pill that can match the power these super organisms have in their ability to correct the immune system, lower inflammation, detox, and protect the body. These benefits come from deep inside a healthy gut, so we must do our part to make sure our greatest health ally thrives.
Danielle Sullivan, a mom of three, has worked as a writer and editor in the parenting world for more than 10 years. Find Sullivan on her blogs, Just Write Mom and Some Puppy To Love.
