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Thyroid dysfunction and how it affects your liver

Thyroid dysfunction and how it affects your liver

Thyroid hormone imbalance affects liver structure and function. Thyroid health depends on liver and vice versa. Liver is the largest body organ which has many function. It is a processing, manufacturing, detoxifying and storage plant. Liver relies on thyroid hormones and it is a major user of them. Liver converts about 60% of T4 hormone into active T3 hormone and also plays a role in processing of excessive thyroid hormones. The D1 enzyme which does this conversion is mainly found in the liver and kidneys and is stipulated to determine T4:T3 serum ratio. This enzyme is completely inhibited by the antithyroid drug propylthiouracil (PTU) used in treatment of Grave’s disease. A good liver function is important for thyroid health. Thyroid hormone binding proteins have to be produced optimally in the liver as a smaller reservoir of bound T4 may result in greater fluctuations in the thyroid hormone levels.

Everything we absorb in our intestines is first delivered to liver via portal vein to be processed. Toxic molecules are processed into less harmful forms and go back to intestines through bile duct or through blood to be excreted in urine. Unhealthy gut will affect liver negatively. For example if you have microbial imbalance in your gut, you will have lots more toxic metabolites from these ‘bad microorganisms’. Regular bowl movement is also important for detoxifying the body. Thyroid hormonal imbalance affects the liver negatively as it does many organs in the body and as everything is connected, the burden on each organ increases. Liver may also struggle to detoxify the body, especially in any illness, when the load of toxic molecules increases.

Liver function tests to determine liver health:

Alkaline phosphatase (ALP)

Alanine transaminase (ATP)

Aspartate aminotransferase (AST)

Blood bilirubin

Liver detoxification profile, which measures how caffeine, paracetamol and aspirin are excreted from the body in saliva (usually ordered by integrative medical doctors).

Others: albumin, total protein, gamma-glutamyl transferase (GGT), lactate dehydrogenase, and prothrombin time.

Hypothyroidism and liver

Low T3 levels = sluggish liver= many negative health effects. Some people with hypothyroidism may have liver problems over time. Hypothyroidism can cause liver disease like symptoms. The symptoms connected to a poor liver function can be sore muscles, fatigue, muscle cramps, dull right-upper-quadrant abdominal discomfort. Other symptoms may include abdominal swelling, fluid retention, raised blood pressure, irritation and allergies. Sometimes there are no liver related symptoms at all until the liver disease progresses.

Liver function tests results commonly seen in hypothyroidism

Liver injuries or biochemical test abnormalities can be seen in hypothyroidism.

Decreased levels of alkaline phosphatase ALP test (enzyme in liver) usually due to lack of specific nutrients connected with hypothyroidism

Elevated aspartate aminotransferase (AST)

Elevated alanine transaminase (ALT) – less so than AST (commonly seen with fatty liver disease)

The ALT and AST are enzymes in the liver and the tests measure them in blood. Liver releases them in response to albumin and increased levels are indicative of liver damage.

Bilirubin – (product of breakdown of old red blood cells) may be reduced due to reduced bile flow and a reduced activity of an enzyme which directs bilirubin excretion. This can be rarely associated with cholestatic jaundice (symptoms are Itchiness, jaundice, pale stool and dark urine).

Biological changes and symptoms of hypothyroidism and liver connection

  1. Lipid metabolism is affected, higher total cholesterol levels seen and other lipids like LDL and triglycerides.
  2. Metabolism of cholesterol into bile salts lowered and consequently fat is not properly digested. Fat soluble vitamins (A, K, D and E) and the essential fatty acids are not properly absorbed.
  3. Problems with detoxifying hormones such as excessive oestrogens and other toxic molecules which may increase the risk of cancer and increases inflammation in the body
  4. Poor sugar control. Hypothyroid people store less glucose in the liver as glycogen and are more prone to hypoglycaemia and insulin resistance (see my previous blog). Insulin growth factor (similar to insulin and secreted by liver) is reduced.
  5. Not efficient production of copper binding proteins in liver causing metabolic syndrome problems (obesity, oestrogen dominance, insulin resistance)
  6. The liver plays a part in maintaining normal iron levels and when it is sluggish due to hypothyroidism, levels of iron become low. Dark circles under the eyes and tiredness may indicate low iron levels in the body.
  7. Non- alcoholic ‘Fatty liver’ (not necessary in an overweight person or person who drinks alcohol) represented by a reduced hepatic clearance and elevations in the amino transaminases. It is seen as build-up of fat and scarring in the liver. Nutrients such as choline, inositol, SAMe and betaine may help with fatty liver. Fatty liver may progress to liver scarring, damage and liver cirrhosis. There is a correlation of non- alcoholic liver disease and hypothyroidism, it was seen in 26 – 36% of patients with hypothyroidism in a study (5).
  8. Production of SAMe is reduced in liver which is linked to depression, high histamine (lots of allergies), insulin resistance, lowered glutathione levels and poor detoxification in liver, especially of excessive oestrogen.
  9. Hyperammonaemia (increased ammonia load) can be seen in severe untreated hypothyroidism as liver changes ammonia (a toxic by-product of protein metabolism) into urea, which is then excreted in urine.
  10. Poor detoxification of toxic molecules resulting in muscle pain, headaches, migraines and feeling tired

Detoxification processes in liver and hypothyroidism

Phase one of liver detoxification may be low with hypothyroidism, that is toxic substances in the body will not be properly processed into less toxic, more water soluble molecules so that they can be farther processed in phase II. The liver processes metabolic body products (such as body steroid hormones), microorganisms, contaminants, insecticides, pesticides, food additives, medications, heavy metals and other toxins in the 1st phase. If the phase I is low, the body will have a higher toxic load, one can feel unwell, sluggish, tired, itchy, have allergies, headaches, migraines, etc. Cytochrome P450 enzymes are involved in this phase of detoxification and they do not work properly if you have a low thyroid or iron deficiency (these commonly co-exist).  Also, if you are sensitive to coffee for example and it keeps you awake and hyper, your phase I of detoxification might not be working properly.

Phase II will be affected as a consequence of poorly functioning phase I and hypothyroidism, especially glycination (vitamin B2 and magnesium are important for glycination) which can make a person less tolerant to aspirin, nuts and preservatives such as benzoic acid. Phase II is sluggish if one has a low protein diet. Alkaline diet may also help (lots of vegetables). Bone broth with lots of vegetables may provide lots of glycine. Glycine is found in many meats with highest content in gelatins. Having meat and broth from pigs or chicken feet /drumsticks contains high amounts of glycine.

One indicator of sluggish phase II might be strong smell of urine after eating asparagus.

Remedy for improving your liver detoxification: optimal hormonal replacement (hormonal replacement with levothyroxine- T4 only may is not be optimal for many people), avoidance of toxins, alcohol and remedies to keep the gut and liver healthy.

Remedies: Apart from optimal hormonal replacement and good anti-inflammatory diet, B vitamins (including vitamin B12), natural vitamin C, glutathione (and precursors- selenium, vitamin E, glycine, glutamine and cysteine) and magnesium may help. Since absorption of all vitamins and minerals is lowered with hypothyroidism, this also have an impact on detoxification processes. Improving stomach acid and home remedies such as apple cider vinegar might help. Cruciferous vegetables, bitter vegetables (mustard greens), Swedish bitters, red beets and green tea may also be beneficial. Also, if you are low in iron (also common with thyroid conditions), the detoxification will not work properly. Phase I of detoxification is inhibited by grapefruit juice so if your detoxification is low in phase I, as commonly seen with hypothyroidism, grapefruit juice is not recommended (but oranges and lemons are fine). Grapefruit juice is only recommended for people whose phase I is too fast (like in people who are sensitive to chemicals). Phase I and II work together and need to be optimal and in balance.

Healthy, anti-inflammatory diet is important for people with thyroid autoimmunity. It might be important to avoid toxins and certain medications as well as alcohol. There are products on the market, which integrative doctors can prescribe for the improvement of liver detoxification phases, such as P2 Detox powders. However they only are prescribed if liver struggles with optimal thyroid function due to other reasons other than thyroid problems.

 

Let’s examine the other spectrum of thyroid dysfunction-hyperthyroidism:

Liver and Hyperthyroidism

Some liver injury is relatively common with hyperthyroidism. Untreated hyperthyroidism can lead to fatty change to cirrhosis of liver (scarred and enlarged) and in few cases even liver failure. Excessive T3 can cause death of liver cells. People with untreated Graves’ disease may have heart problems due to congested liver.

The problem with Graves’ disease and hyperthyroidism is that the antithyroid medications can be toxic to the liver. Sometimes jaundice may result as a consequence of antithyroid medications and there might be some mild liver injury due to the antithyroid therapy. This is especially important for children. PTU is mainly known for its possible higher toxicity to liver as in about 30% liver enzymes are elevated with PTU-(15). Rarely, PTU has been associated with a severe liver disease and liver failure. The signs of a liver toxicity can be: loss of the appetite, severe fatigue, urine turning dark and brown, pale stools, yellowing of skin and eyes (jaundice), abdominal pain, nausea and general itching. Contact your doctor immediately if you have any negative symptoms with antithyroid meds as early identification of clinical signs of liver troubles is important. Medication is discontinued if liver function is affected and liver health monitored.

Regular liver functions should be done while on antithyroid medications to monitor liver function within 3 months after starting on antithyroid medications, especially important with PTU. Liver function test before starting the therapy would also be beneficial to monitor for changes.

Liver function test commonly seen in hyperthyroidism:

– Elevated levels of alkaline phosphatase (in 64% of cases (14)). Alkaline phosphatases act by splitting off phosphorus (an acidic mineral) from many molecules to try to create an alkaline (basic) pH in the body. An increased level of alkaline phosphatase may be due to hyperthyroidism, and decreased level to hypothyroidism.

-Increase in the enzymes-aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels (in about 27- 37% 0f cases) (13). They are markers of liver health, may be elevated during antithyroid medication therapy, also indicate thyroid dysfunction as thyroid hormones modulate liver function.

-Elevated bilirubin (due to the thyroid hormone effects on liver) -jaundice can be seen due secretion of bilirubin

– Elevation of γ‐glutamyl transpeptidase GGT, gamma-GT (elevated levels are seen in liver injury)

 -A low cholesterol level is seen in hyperthyroidism. It is related to changes in the expression of certain genes and regulation of certain cell receptors. Cholesterol is needed for making many hormones (such as progesterone, cortisol), formation of vitamin D, formation and health of cell membranes and production of bile salts. Thus low cholesterol leads to many health problems.

– Iron levels become abnormal due to changes in liver functioning.

-Abnormal sugar control due to increased release of glucose form liver and other thyroid hormone effects on hormones and pancreas function

-The by-products of protein breakdown are toxic (such as ammonia) and need to be detoxified by liver which can become overwhelmed. They increase in blood and urine, causing headaches and nausea.

Detoxification process in liver is impaired due to hyperthyroidism and increased toxic load in the body.

Things which may help: healthy, organic food. Fish is high in methionine which is needed for detoxification of excessive thyroid hormones in the liver. L-carnitine, known as acetyl-L-carnitine or carnitine, is synthesised in the liver, kidney, and brain and actively transported to other areas of the body. In order for carnitine to be made in the body, essential amino acids, such as lysine, methionine, vitamins: B3 (niacin), B6 and iron are required. L- carnitine may help with Graves’ disease as shown in some studies. Glutathione is synthesised in many parts of the body but the main side of production is in the liver. It is a molecule consisting of three amino acids:  L-cysteine, L-glutamic acid and glycine. Boosting natural N-Acetyl-Cysteine (NAC) levels might be helpful for people with autoimmune disorders as it believed to be a rate limiting amino acids for the formation of glutathione. Curcumin, an active ingredient of the Indian spice turmeric might help as it is anti-inflammatory and helps with detoxification process in liver. However how curcumin works in individuals with GD may vary depending on cytokine profile of an individual. Chlorophyll, the green pigment in plants contains high amounts of magnesium. Having green drinks every day can detoxify the liver and provide this mineral. Magnesium is also available in oil and gel forms that can be put on skin. Vitamin C helps to displace toxic halogens from the body in place of iodine. It also has positive effects on liver detoxification. It works in synergy with copper mineral. Vitamins B help with detoxification of the liver. Brewer’s or nutritional yeast has glutathione building nutrients. Beet juice is a great liver detoxifier; it also helps to remove bad form of estrogen from the liver and oxygenates the blood. Beets are important as they provide body with lots of methyl groups. Cruciferous vegetables help in many detoxification processes in the liver and are very important for glutathione function and removal of many toxins from the body, including heavy metals. Sulfation is the main pathway, which detoxifies steroid hormones, thyroid hormones, neurotransmitters, paracetamol, xenobiotics and phenolic molecules. Nutrients, which are needed for this step, are cysteine, methionine, molybdenum, glycine and taurine. Taurine is found in meats, seafood and eggs. Turkey meat is very high in cysteine. The process of sulfation can be increased by increasing sulfur containing foods (onion, garlic). Those foods contain sulfur amino acids, such as cysteine. After the final phase of detoxification, the molecules are released in urine, stool and sweat. Infra-red sauna may assist in releasing those molecules from the body as well as a good hydration and enough fibre in the diet. Dandelion root tea might also benefit the liver. Milk thistle is another beneficial herb but some people with Graves’ disease might be sensitive to milk thistle.

Link of thyroid autoimmunity with autoimmune liver diseases

There is a rare association between thyroid autoimmunity and liver autoimmunity such as primary biliary cirrhosis (PBC) as a part of autoimmune polyglandular syndrome and it is due to common genetic factors with the presence of high titre of antinuclear antibody (ANA) and presence of anti-mitochondrial antibodies (AMA). Hashimoto’s thyroiditis is more frequently associated with PBC than Grave’s disease. A case study reported association of Hashimoto’s thyroiditis, primary biliary cirrhosis, and myasthenia gravis (16). However, the most common autoimmune illness associated with PBC is Sjögren’s syndrome.

Please note this blog is for educational purposes only. Consult your health care practitioner regarding any problems and before trying any remedies and supplements mentioned in this blog.

References:

  1. De Nardo D, Franconi G, Sabino D. [Hyperammonemia during hypothyroidism: an unusual biohumoral finding normalized by hormonal replacement treatment]. Ann Ital Med Int. 11999 Jul-Sep; 14(3):196-201.
  2. Doron Rimar, MD,  Eti Kruzel-Davila, MD, Guy Dori, MD, PhD, Elzbieta Baron, MD and Haim Bitterman, MD. Hyperammonemic Coma—Barking Up the Wrong Tree. J Gen Intern Med. 2007 Apr; 22(4): 549–552.
  3. Iglesias P, Bayón C, Méndez J, Gancedo PG, Grande C, Diez JJ. Serum insulin-like growth factor type 1, insulin-like growth factor-binding protein-1, and insulin-like growth factor-binding protein-3 concentrations in patients with thyroid dysfunction. Thyroid. 2001 Nov; 11(11):1043-8.
  4. Miell JP, Taylor AM, Zini M, Maheshwari HG, Ross RJ, Valcavi R.Effects of hypothyroidism and hyperthyroidism on insulin-like growth factors (IGFs) and growth hormone- and IGF-binding proteins. J Clin Endocrinol Metab. 1993 Apr; 76(4):950-5.
  5. Chung GE, Kim D, Kim W, Yim JY, Park MJ, Kim YJ, Yoon JH, Lee HS. Non-alcoholic fatty liver disease across the spectrum of hypothyroidism. J Hepatol. 2012 Jul; 57(1):150-6.
  6. Dr.G.Deepika, N.Veeraiah, Dr.P.N.Rao, Dr.D. Nageshwar Reddy. Prevalence of hypothyroidism in Liver Cirrhosis among Indian patients. Journal of Pharmaceutical and Medical Research. 2015 June (3). URL: https://www.woarjournals.org/admin/vol_issue2/upload%20Image/IJPMR031302.pdf
  7. Huang MJ, Liaw YF. Clinical associations between thyroid and liver diseases. J Gastroenterol Hepatol. 1995 May-Jun; 10(3):344-50.
  8. R. Malik H. Hodgson. The relationship between the thyroid gland and the liver. QJM: An International Journal of Medicine. 2002 Sep; 95 (9): 559–569.
  9. Biscoveanu M, Hasinski S. Abnormal results of liver function tests in patients with Graves’ disease. Endocr Pract. 2000 Sep-Oct; 6(5):367-9
  10. Saro Khemichian, MD and Tse-Ling Fong, Hepatic Dysfunction in Hyperthyroidism. Gastroenterol Hepatol (N Y). 2011 May; 7(5): 337–339.
  11. Kubota S, Amino N, Matsumoto Y, et al. Serial changes in liver function tests in patients with thyrotoxicosis induced by Graves’ disease and painless thyroiditis. Thyroid. 2008; 18:283–287.
  12. Baethge BA, Levine SN, Wolf RE. Antibodies to nuclear antigens in Graves’ disease. J Clin Endocrinol Metab. 1988; 66:485–488. 13. Morita S, Arima T, Matsuda M. Prevalence of nonthyroid-specific auto-antibodies in autoimmune thyroid diseases. J Clin Endocrinol Metab. 1995;80:1203–1206. [PubMed]
  13. Thompson P, Strum D, Boehm T, Wartofsky L. Abnormalities of liver function tests in tyrotoxicosis. Mil Med 1978; 143:548–51.
  14. Doran GR. Serum enzyme disturbances in thyrotoxicosis and myxoedema. J R Soc Med 1978; 71:189–94.
  15. Williams KV, Nayak S, Becker D, Reyes J, Burmeister LA. Fifty years of experience with propylthiouracil‐associated hepatotoxicity: what have we learned? J Clin Endocrinol Metab 1997; 82:1727–33.
  16. Rajaraman S, Deodhar SD, Carey WD, Salanga VD. Hashimoto’s thyroiditis, primary biliary cirrhosis, and myasthenia gravis. Am J Clin Pathol. 1980 Dec; 74(6):831-4
  17. Toru Shizuma. A Literature Review of Concomitant Primary Biliary Cirrhosis and Graves’ disease. Department of Physiology, School of Medicine, Tokai University, Japan. Journal of Gastrointestinal & Digestive System. URL: https://www.omicsonline.org/open-access/a-literature-review-of-concomitant-primary-biliary-cirrhosis-and-gravesdisease-2161-069X-1000269.php?aid=47593&view=mobile
  18. Liver phases 1 and 2 detoxification pathways. URL:http://balancedconcepts.net/liver_phases_detox_paths.pdf

 

Supplements I take to feel better

Supplements I take to feel better

I had a subtotal thyroidectomy due to Grave’s disease. The supplements in the picture above help me feel better while on optimal thyroid hormonal replacement. They are suggestions you might consider. However as we are all individuals, speak to your own health care practitioner before taking them, as always.

Brewer’s yeast or nutritional yeast

I find it a very calming remedy. I feel better when I take it, usually a teaspoon per day in the morning. I use it as my source of vitamins B as I do not tolerate synthetic vitamins well. I prefer Brewer’s yeast over nutritional yeast (they are grown and processed slightly differently). I put Brewer’s yeast directly into your food, I like it on scrambled eggs but I also put it into sauces or soups before serving. It is slightly bitter in tasting so I like to mask the taste a little.

Brewer’s and nutritional yeast is are made from yeast called Saccharomyces cerevisiae (used in baking, beer making process) which is grown and then deactivated (it is no longer alive) for nutritional supplement. It is a very rich source of natural vitamins B, chromium, potassium and selenium. It can help to improve insulin sensitivity (as it contains B1 and chromium), it helps the immune system function properly (rich in selenium) and also supports the adrenal glands (so important for thyroid patients) with vitamins B. Brewer’s yeast and nutritional yeast generally to not contain vitamin B12 unless it is fortified with it so if you are deficient in B12 you need to supplement with it separately. Also some products are not gluten free is you are sensitive to gluten.

Aussie favorite Vegemite is also a yeast spread (not gluten free), rich in vitamins B.

Brewer’s yeast can interact with some medications such as monoamine oxidase inhibitors (for treatment of depression), meperidine (pain medication) and diabetic medication. It is also on advisable in certain conditions. Some people may be allergic or sensitive to Brewer’s /nutritional yeast.

Vitamin C

My favorite supplement is natural Vitamin C powder from organic acerola cherries. Firstly because it is a complete vitamin C not just ascorbic acid. It is a powerful antioxidant, detoxifying vitamin and support for adrenal glands. I dissolve a teaspoon in some water and drink it few times a week. I had noticed it gave me an energy boost so I take it before midday. I see benefits of vitamin C powder for my general well being but as with any supplements, it is advisable to ask your doctor before taking it.

Rhodiola rosea (Arctic root, golden root)

It is a great herb to take for adrenal support. It is helpful for the first stage of adrenal exhaustions but not for later stages when cortisol is low. Basically, it is useful during stressful times. It is an adaptogen, a buffer for all endocrine organs involved in stress reactions. However, when a person feels chronically stressed for a long time, exhausted most of the time and has difficulties getting out of bed, it usually indicates later stages of adrenal exhaustion and low cortisol. Rhodiola may not be as effective as it reduces the secretion of cortisol in stressful situations thus balancing the output of adrenals.

Rhiodiola can be useful in Grave’s disease sometimes cases but it is specifically used and recommended in hypothyroidism. Rhodiola influences beta-endorphin and can lift mood. It can also enhance thyroid function, thymus gland function and improve adrenal gland reserves.

I take it for few weeks when I feel stressed but not exhausted. It is considered safe in recommended doses and is wildly used in Russia and Scandinavian countries. It is not recommended in people with bipolar disorder and for pregnant/breastfeeding women.

Licorice root

Licorice has been approved by The German Commission E for ulcer treatments. It also has other important effects. Licorice is useful for exhausted adrenal glands, which is very common with hypothyroidism. Licorice root contains plant components mimicking the effects of cortisol. Therefore it might be useful when you feel ran down, tired and stressed and when cortisol is low (in the later stages of adrenal exhaustion).

I take licorice supplement when I feel ran down, stressed and tired. I usually take it for about 3 weeks at a recommended dose and then take a break.

Licorice is considered safe in low doses. People with cardiovascular, renal and liver problems should take caution. Licorice may interact with warfarin, corticosteroids and oestrogen therapies. Not to be taken with bipolar disorders, in those taking hypertensive and hypoglycemic medications. It can raise blood pressure after prolonged use. Pregnant and breastfeeding women are not advised to use it as the safety in pregnancy has not been established. Apart from these cases, it is recommended in literature to take it sporadically at recommended doses and to have a break after 4-6 weeks of use.

 

 

 

Thyroid, kidneys and autoimmune disease connection

Thyroid affects function of many organs. Thyroid and kidneys have a close relationship. Thyroid hormones, T3 predominantly, but also T4 regulate the renal blood flow and the glomerular filtration rate (GFR). T3 thyroid hormone is important in the production of many kidney regulating molecules such as renin. Sub-optimal thyroid hormonal replacement can affect the health of kidneys negatively. Kidneys can eventually decrease in size in hypothyroidism or increase in size in hyperthyroidism (although prolonged, severe and untreated hyperthyroidism may eventually result in deterioration of kidneys). Thyroid hormone have effects on cardiovascular system and the flow of blood into the kidneys. Hypothyroidism can result in abnormalities in renin release. This can cause constriction of blood vessels and fluid retention. This situation is very bad for the heart. In hypothyroidism, the glomerular filtration rate (GFR) can decrease substantially. Opposite goes for hyperthyroidism. Untreated hyperthyroidism can cause kidney damage or make chronic kidney disease worse.

On the other hand, people with renal diseases can have worsening of their symptoms of hypothyroidism as protein bound thyroid hormones may be lost by ‘leaky’ kidneys. People on thyroid hormonal therapy and renal problems may need to take higher doses of hormones.

However thyroid hormones are not the only thyroid related molecules which can affect the kidneys. Thyroid Stimulating hormone produced by pituitary gland in our brain to stimulate thyroid hormonal production in the thyroid also has effects on kidneys. Thyroglobulin molecule produced in thyroid may also affect kidneys in autoimmune thyroid disease. Therefore, optimal and normal levels of these two molecules are also important.

Thyroid autoimmune disease can also affect kidneys. When I was six years old I was diagnosed with kidney problems and spend three months in a hospital. I was on a strict gluten free diet in a hospital, I had to spend most of my time in bed and had daily injections of antibiotics and some others. I remembered my kidneys feeling ’heavy”, my urine was dark brown, I felt very weak and had nausea. I had cravings for bread and bread rolls and one breakfast I attempted to steal one bread roll from the breakfast table I shared with my hospital friends. Unfortunately, despite hiding it, I was discovered by a nurse and the bread roll was taken from me. Looking back I believe my kidneys problems were directly related to my thyroid autoimmunity problems. Fortunately, I have recovered without farther problems.

Thyroid autoimmune disease may be connected to immune complex glomerulonephritis (inflammation and swelling of the tiny filters called glomeruli in kidneys) which causes the kidneys to stop working properly. Generally people with glomerulonephritis recover completely with medical care. It is very rare for it to cause complication such as renal failure.

 It is interesting that it was found that the kidneys can express thyroid hormone stimulating receptor (TSHR) (4, 8). Perhaps it serves as a boost system/ protective back up system for kidneys when thyroid hormonal level is low and thyroid stimulating hormone levels are high as seen in hypothyroidism. It was found in a study (9) that exogenous thyroid stimulating hormone improves renal function in patients with normal healthy thyroid hormonal levels. Also it was shown in a study that injecting recombinant human TSH improved estimated glomerular filtration rate (eGFR) in kidneys in patients with thyroid replacement therapy, which means their kidney function was improved.

Therefore it is possible that kidneys can be a target of thyroid autoimmunity as TSHR is expressed in thyroid but also in other organs such as kidneys. It is the main molecule to which antibodies are produced in Grave’s disease.

Another molecule to which antibodies are produced in thyroid autoimmunity (more so in Hashimoto’s thyroiditis) is thyroglobulin, a molecule present in thyroid. Increased levels of thyroglobulin, a molecule which is the building block of thyroid hormones, secreted by thyroid into blood, indicate thyroid damage. Higher levels are seen in thyroid autoimmunity or thyroid cancer. Kidneys were also found to express a protein which is very similar to thyroglobulin (4,10). The function of this similar protein in kidneys is stipulated to be on the DNA level in regulating kidney cell growth. The anti-thyroglobulin antibodies found in autoimmune thyroid disease complex with this similar protein and also with thyroid thyroglobulin (secreted from thyroid into blood) to form immune complexes and produce inflammatory processes in the kidneys. Another issue with immune complex glomerulonephritis is that another molecule called megalin (a receptor that binds thyroglobulin in kidneys), Megalin is regulated by thyroid stimulating hormone. Thyroid stimulating hormone binds to TSH receptors (as mentioned previously thyroid stimulating hormone receptor was found to be expressed in kidneys). The immune system has lower tolerance for this molecule in kidneys in thyroid autoimmunity, especially Hashimoto’s thyroiditis.  Megalin is also important for uptake of other molecules by kidneys such as albumin and vitamin D-binding protein. This might be connected to lowered vitamin D level in people with thyroid autoimmunity.

Immune complex glomerulonephritis can occur with Grave’s disease (as it was in my case), especially in children and it is possible that it may be triggered by an infection or gluten/casein sensitivity. However it can also occur in older people as discussed in a study of a 60 year old hyperthyroid woman with long-standing Graves’ disease treated with methimazole (6).

The rates of kidney involvement in people with thyroid autoimmunity can be as high as in 10–30% of cases (2) and it is much higher in the case of Hashimoto’s thyroiditis when compared with Grave’s disease. Around half of people with Hashimoto’s thyroiditis have a moderate increase in the level of urine albumin due to abnormal permeability of kidneys which is associated with renal damage. It might be therefore advisable (as suggested in scientific study (1) for kidney function to be monitored with thyroid autoimmunity, especially for Hashimoto’s thyroiditis patients.

Basically if your thyroid is off, the kidneys will not function optimally and vice versa. The renal blood flow, glomerular filtration rate, electrolytes and kidney structure and size will be affected. Kidney function test: eGFR and serum creatinine levels can be an indicator of thyroid function for people with thyroid problems. Serum creatinine levels are decreased in hyperthyroidism and increased in hypothyroidism. GFR is increased in hyperthyroidism and decreased in hypothyroidism. Kidney stones can be connected to hypothyroidism. It may relate to the altered kidney filtration rates and imbalances between calcium and magnesium with possible magnesium deficiency.

It is important to have normal blood pressure for kidney health which can also be a reflection of a thyroid function. Cranberry juice has a positive effect on kidney health in general.

References:

  1. Domenico Santoro, Carmela Vadalà, Rossella Siligato, Michele Buemi, and Salvatore Benvenga. Autoimmune Thyroiditis and Glomerulopathies. Front Endocrinol (Lausanne). 2017; 8: 119.
  2. Ronco P, Debiec H. Pathophysiological lessons from rare associations of immunological disorders. Pediatr Nephrol (2009) 24(1):3–8.
  3. Yuqian Luo, Yuko Ishido, Naoki Hiroi, Norihisa Ishii, and Koichi Suzuki.The Emerging Roles of Thyroglobulin. Advances in Endocrinology. Volume 2014 (2014), Article ID 189194.URL: https://www.hindawi.com/archive/2014/189194/
  4. Sellitti DF, Akamizu T, Doi SQ, Kim GH, Kariyil JT, Kopchik JJ, Koshiyama H. Renal expression of two ‘thyroid-specific’ genes: thyrotropin receptor and thyroglobulin. Exp Nephrol. 2000 Jul-Oct; 8(4-5):235-43.
  5. Zheng G, Marino’ M, Zhao J, McCluskey RT. Megalin (gp330): a putative endocytic receptor for thyroglobulin (Tg). Endocrinology. 1998 Mar; 139(3):1462-5.
  6. Horvath F Jr, Teague P, Gaffney EF, Mars DR, Fuller TJ. Thyroid antigen associated immune complex glomerulonephritis in Graves’ disease. Am J Med. 1979 Nov; 67(5):901-4.
  7. Michele Marinò, Gang Zheng and Robert T. McCluskey. Megalin (gp330) Is an Endocytic Receptor for Thyroglobulin on Cultured Fisher Rat Thyroid Cells. Journal of Biological Chemistry. URL: http://www.jbc.org/content/274/18/12898.full
  8. Dutton CM, Joba W, Spitzweg C, Heufelder AE, Bahn RS. Thyrotropin receptor expression in adrenal, kidney, and thymus. Thyroid 1997 Dec; 7(6):879-84.
  9. Flore Duranton, Anouchka Lacoste, Patrick Faurous, Emmanuel Deshayes, Jean Ribstein, Antoine Avignon, Georges Mourad and Àngel Argilés. Exogenous thyrotropin improves renal function in euthyroid patients, while serum creatinine levels are increased in hypothyroidism. Clinical Kidney Journal, Volume 6, Issue 5, 1 October 2013, Pages 478–483. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4438406/
  10. Wu H, Suzuki S, Sellitti DF, Doi SQ, Tanigawa K, Aizawa S, Akama T, Kawashima A, Mishima M, Ishii N, Yoshida A, Hisatome I, Koles NL, Katoh R, Suzuki K. Expression of a thyroglobulin (Tg) variant in mouse kidney glomerulus. Biochem Biophys Res Commun. 2009 Nov 13;389(2):269-7.
  11. Gopal Basu and Anjali Mohapatra. Interactions between thyroid disorders and kidney disease. Indian J Endocrinol Metab. 2012 Mar-Apr; 16(2): 204–213.

 

 

 

 

Mercury and thyroid

Mercury and thyroid

Mercury stops thyroid hormone T4 conversion into its active form T3. Mercury also reduces thyroid hormone production in the thyroid gland by interfering with iodine binding. It also inhibits thyroid hormone action. Mercury is toxic to all body systems including the immune system. It tends to accumulate in endocrine glands such thyroid. It disrupts the energy houses of cells and affects the balance of minerals in the body, especially zinc, copper, magnesium, calcium and lithium. The reason is the binding of mercury to sulphur groups on Metalloprotein (MT) which is involved in metals transport and detoxification.  Zinc mineral in some ways counteracts the effect of mercury while copper tends to accumulate in the body with mercury. Lithium might be low with mercury toxicity. Mercury can cause the major body detoxifying molecule- glutathione to be depleted by binding to and inactivating sulphur components of the system.

Mercury toxicity has been connected to thyroid autoimmunity and autoimmunity in general. Not all studies (5) have found the correlation of thyroid autoimmunity to mercury exposure. However some did. A study (1) has found that Methylmercury, at low levels generally considered safe, was associated with subclinical autoimmunity and antinuclear antibodies among reproductive-age females. Another study (2) has found that the removal of dental amalgam decreases anti-TPO and anti-Tg autoantibodies in patients with autoimmune thyroiditis.

Mercury can be found in amalgam, dental fillings. Most can contain as much as 50% mercury which is mixed with other metals. They are those dark, silvery grey dental fillings. Even though amalgam dental fillings are considered relatively safe, there is a controversy regarding their safety. Mercury particles may be released from amalgam fillings and provide a small dose of this toxic metal daily. Having MRI scans may release more mercury from dental fillings (5). The higher number of amalgam dental fillings, there greater possibility of getting more mercury into the system. Some people have an immune system which is very sensitive to mercury. Perhaps those who are stressed, have low selenium level or low iodine levels, lowered zinc levels, heavier toxic load and disturbance of healthy gut bacteria (which help to remove heavy metals) might be more sensitive to lower levels of mercury.

In recent years the mercury containing amalgams are not as frequently used, being replaced by white resin composite fillings. One of the ways mercury can get into our body is through ingestion of contaminated fish and shellfish especially large fish such as Bluefin tuna, swordfish, mackerel, marlin or shark. Fish tend to accumulate mercury and cannot dispose of it properly. Environmental mercury pollutes our oceans. Mercury can get to the environment from many industrial processes as well as volcanic eruptions. It is also present in clay minerals. There are still some products containing mercury such as mercury containing lamps, thermostats or fluorescent tubes and bulbs.

Thimerosal is a mercury containing antifungal and antibacterial compound used to preserve some medical preparations. Some people are allergic to thimerosal. Thimerosal has been taken out of childhood vaccinations but there are still multi -dose influenza vaccine preparations containing thimerosal. The presence of mercury in vaccines is controversial.

Some red tattoo inks also contain mercury and cadmium, another toxic metal. Mercury has been banned from cosmetics. However, some unregulated make up products, skin lightening creams may possibly contain mercury so make sure you buy products from reputable companies. Look for ingredients containing mercury or calomel (mercury chloride mineral).

Mercury testing may be done through urine, blood, stool test, and hair mineral analysis.

One of important minerals which helps to remove mercury from your body is selenium which is a part of the glutathione system. People with thyroid autoimmunity may be deficient in selenium. It might be also more important mineral for people with mercury containing fillings in their teeth to have optimal selenium levels.

Mercury is very difficult to remove from the body naturally and takes a long time. Green leafy vegetables, sulphur rich foods (garlic, onions), vitamin C, coriander, cruciferous vegetables (such as wasabi) and fermented foods support the body in removal of toxic metals. Having adequate levels of selenium and vitamin E are important. Brazil nuts are quite rich in selenium and you can consume 2 daily to get enough selenium (if you are not allergic or sensitive to nuts). Glutathione helps to remove heavy metals and glutathione enhancing nutrition/supplements were discussed previously. Brewer’s or nutritional yeast has glutathione building nutrients.

Stress reduction and adequate rest are also important. There are quite a few liver detoxification products on the market. Milk thistle has long been used in liver disease and helps boost glutathione levels. Milk Thistle and coriander (Cilantro) have mercury and other detoxifying properties. However ragweed (common in Graves’ disease) allergy has been connected to milk thistle allergy. Therefore it might not be suitable for all. Lipoic acid may also help to remove mercury.

Infrared sauna may help with Hg removal through sweat.

Medical treatments for mercury toxicity involve the use of metal chelating drugs such as DMSA (used in children), DMPS, DPCN, or BAL compounds. 

You might consider removal of mercury amalgam teeth fillings. However, it might be more dangerous than having undisturbed fillings. It needs to be done by highly competent and experienced dentist (such as Biological dentist) as vapors created during removal might make things worse. Avoid eating large fish and choose smaller varieties. Eating smaller varieties of fish two times a week should not be a problem.

Speak to your doctor if you have concerns regarding mercury.

References:

    1. Somers EC, Ganser MA, Warren JS, Basu N, Wang L, Zick SM, Park SK. Mercury Exposure and Antinuclear Antibodies among Females of Reproductive Age in the United States: NHANES. Environ Health Perspect. 2015 Aug; 123(8):792-8.
    2. Sterzl I, Prochazkova J, Hrda P, Matucha P, Bartova J, Stejskal V. Removal of dental amalgam decreases anti-TPO and anti-Tg autoantibodies in patients with autoimmune thyroiditis. Neuro Endocrinol Lett. 2006 Dec; 27 Suppl 1:25-30.
    3. Yorita Christensen KL. Metals in blood and urine, and thyroid function among adults in the United States 2007-2008. Int J Hyg Environ Health. 2013 Nov; 216(6):624-32.
    4. Monika Rathore, Archana Singh and Vandana A. Pant. The Dental Amalgam Toxicity Fear: A Myth or Actuality. Toxicol Int. 2012 May-Aug; 19(2): 81–88.
    5. Mortazavi SM, Neghab M, Anoosheh SM, Bahaeddini N, Mortazavi G, Neghab P, Rajaeifard AHigh-field MRI and mercury release from dental amalgam fillings. Int J Occup Environ Med. 2014 Apr; 5(2):101-5.

 

 

Effects of Cadmium on thyroid gland

Effects of Cadmium on thyroid gland

What is the connection between cadmium metal and thyroid?

Cadmium (Cd) is a silvery metal sitting next to zinc on a periodic table. The metals often appear together in nature. Unfortunately, unlike zinc, cadmium is a toxic and carcinogenic. Even though cadmium release into environment is closely controlled by government legislation, cadmium is impossible to avoid. More and more people are getting closer to reaching toxic levels, especially with increased age and those who had occupations exposing them to cadmium or exposed to cigarette smoke. Cadmium accumulates in the body and is difficult to excrete. Cadmium is found in soils (especially those industrially polluted), artists’ paints (orange, yellow and red), pigments, bake ware, nickel cadmium batteries, phosphorous fertilizers, plastics stabilizers, corrosion-resistant metal plating, metal alloys, brake lining of cars, pollution from power plants, mining and smelting and from production of some foods like margarine. Cd may be present in some plants (especially grown on soils contaminated with industrial pollution, green leafy plants tend to uptake it more easily), some organ meats (liver and kidneys), molluscs and other shellfish in some areas (as they tend to accumulate it) and large ocean fish. Some plants such as tobacco, marijuana and rice tend to uptake Cd more readily. Coffee and black tea may also contain some cadmium. Cigarettes are a significant source of cadmium exposure as lungs take up cadmium more readily than the digestive system. It is considered a substantial source of cadmium toxicity in humans. It generally doubles the cadmium intake. We also have to remember that cigarette smoke also contains other substances including thiocyanate that inhibits iodine uptake by the thyroid gland. Nicotine in cigarettes increases the synthesis of T3 from T4 in the brain, which might explain the difficulty in quitting smoking as higher T3 levels correspond to higher serotonin (feel good chemical) levels in the brain. However since cadmium is such a toxic metal, its influence on thyroid cannot be overlooked. Thyroid is one of organs that tends to accumulate cadmium.

What is the relationship between cadmium, thyroid and autoimmunity?

Cadmium and other toxins present in cigarettes interfere with thyroid gland function and thyroid hormone T4 to T3 conversion; they may cause damage to the thyroid resulting in the generation of autoantibodies. Cadmium exposure is associated with thyroid autoimmunity (both Graves’ disease and Hashimoto’s thyroiditis) in genetically predisposed people. A study of 132 pairs of twins showed that cigarette smoke exposure was connected with thyroid autoimmunity with higher rates (about 2.5X higher) for Graves’ disease than Hashimoto’s thyroiditis. It was also less significantly associated with non-autoimmune thyroid diseases (simple goiter and nodular toxic goiter) (17).

There is some suggestions in literature that Hashimoto’s thyroiditis may be triggered by cadmium especially when iodine and selenium levels are low. People with Graves’ disease may have adequate iodine levels (although not always) but are also usually low in selenium.

Graves’ disease is strongly connected to cadmium toxicity. It is especially connected to Graves’ disease with TED (eye involvement). Smoking has been connected with higher incidence of GD in females (26). It is believed that cigarette smoke may increase the risk of GD as much as two fold. Acropachy association with TED tends to represent the most severe form of autoimmune thyroid disease, with patients having very high levels of thyroid stimulating antibody. Cigarette smoking rates were found to be high in these individuals. Cd disrupts the ratio of copper and zinc which are vital for thyroid function. It contributes to copper deficiency, condition which accelerates thyroid function. Copper deficiency can occur when the body uses copper very fast (perhaps when children and teens get Graves’ disease) or when it cannot use copper efficiently and stores it in unusable form. Cadmium also interferes with zinc metabolism and competes with copper and zinc for binding on a transport protein called metallothionein. Also, in the cause of adrenal exhaustion, due to chronic stress for example, metallothonein is not produced in sufficient quantities. When this happens, copper is not metabolized properly. Copper deficiency affects the immune system and can also result in hyperactivity, high blood pressure and overuse of the sympathetic nervous system. According to Dr. Willson (9) cadmium toxicity may contribute to violent human behavior. Cd exposure may cause GABA imbalances (calming molecule in the brain). Cd also interferes with metabolism of vitamin D which is important for the balance of the immune system. It also decreases magnesium levels (common deficiency with autoimmune thyroid conditions). Cadmium can also induce iron deficiency anaemia. Cadmium damages mitochondria, organelles where energy is produced. Dysfunctional mitochondria are connected to autoimmunity. Cd toxicity has also been connected to rheumatoid arthritis and Multiple sclerosis. Cadmium may also bind to glutathione making it ineffective. Glutathione is a free radical scavenger, important for the health of the thyroid gland.

Reducing Cadmium levels may be important for some people in achieving a remission from thyroid autoimmunity.

Do some people absorb Cd more easily?

This predisposition to accumulate those specific metals might be connected to individual’s genetics. It is also relates to a poor stress management. Females tend to absorb Cd more easily due to higher levels of oestrogen hormone (necessary for ovulation and pregnancy). Oestrogen may act as an accelerator of mineral uptake into the body; it may act to enhance cadmium absorption. Women who have insufficient levels of progesterone to balance oestrogen may accumulate Cd more easily. People with low iron stores are especially vulnerable to the adverse effects of cadmium. As cadmium tends to accumulate with age (it is difficult to get rid of), it causes lowered levels of zinc which is needed for thyroid hormonal binding to their receptors. This may explain higher risks of hypothyroidism in older people, especially women. Also, older cells have a reduced capacity to produce Metallothioneins (MTs) which is are protective against Cd toxicity and proper levels of zinc and copper. Adrenals glands need to strong for sufficient production of this molecule.

Stress and cigarette smoke exposure can induce Graves’ disease as it lowers production of metallothioneins and increased Cd exposure. This trigger might be especially powerful in younger people as they tend to use copper fast. Copper deficiency accelerates thyroid function and damages the energy producing mitochondria. It was found to interfere with Coenzyme A, which helps to transport free fatty acids to mitochondria for energy production.

What Cadmium does in the body?

Cadmium tends to accumulate in the thyroid gland and therefore may cause thyroid damage due to its toxicity. It is one of the triggers for thyroid autoimmunity in individuals who are genetically predisposed to autoimmunity. In significant levels, it depletes selenium mineral which is extremely important for the health of the thyroid gland as it important for the glutathione peroxidase system which removes free radicals from the thyroid gland. In the thyroid gland, free radicals are produced continuously due to oxidation of iodine by hydrogen peroxide for the production of thyroid hormones. If free radicals are not properly controlled by glutathione peroxidase in the thyroid, they damage the thyroid cells and the lipid membranes. Cadmium toxicity increases free radicals in the body overall. Cd was shown to inhibit superoxide dismutase (copper, zinc based), two antioxidant enzymes. Cd toxicity may therefore play a role in other autoimmune disorders.

Cd was found to decrease T4 levels and increase T3 levels in a Japanese study comparing residents of the Cd-polluted Kakehashi River basin with residents of a nonpolluted area (1). Therefore Cd can induce T3 thyrotoxicosis and hyperthyroidism which was also demonstrated in animal studies (5). In people predisposed to autoimmunity, it can cause thyroid autoimmunity. High levels of cadmium exposure were associated with changes to thyroid hormonal levels. A large human study (29) showed that blood Cd was positively associated with FT3 and urinary Cd was positively associated with FT4.

It may also lower levels of both T4 and T3 (perhaps if iodine and selenium are low) which was shown in animal studies. Obviously as Cd levels accumulate, eventually T3 levels will be decreased due to lowered levels of T4 and selenium resulting in hypothyroidism. A study in children demonstrated that Cd increases TSH levels and decreases thyroid hormone T4 (15).

People who had a thyroidectomy might be more vulnerable to lung damage by exposure to Cd (11). Smoking would not be recommended.

Other thyroid changes and thyroid cancer (22) may also be seen with cadmium toxicity. Cancer may also be more advanced with cadmium toxicity.

“The accumulation of cadmium in thyroid tissue may be one of important etiologic factors for the thyroid cancer progression and aggravation in Korean women.”(21)

“Colloid cystic goiter, adenomatoid follicular hyperplasia with low-grade dysplasia and thyroglobulin hypo- and asecretion, and parafollicular cell diffuse and nodular hyperplasia and hypertrophy are often found in chronic cadmium toxicity.” (20)

Test for Cadmium:

Comprehensive Urine Profile (better for detection of long time Cd exposure), serum Cadmium and mineral hair analysis

How to reduce Cadmium in the body:

The medical system uses chelators such as DMPA for cadmium removal from the body in case of detected toxicity.

However, there are ways to decrease Cd uptake and increase removal in the body and they are:

  • Consider stopping smoking, avoid secondary cigarette smoke
  • Limit occupational/environmental exposure
  • Support glutathione production in the body (glutathione requires selenium and precursors such as glycine, glutamine, cysteine).
  • Support glutathione conjugation in liver which detoxifies body from heavy metals. The nutrients required for this step are methionine, amino acids cysteine and taurine, glycine, vitamin C and vitamin B6. Brassica vegetables, such as cabbage, cauliflower, kale, and broccoli and allium vegetables, such as onions, garlic, shallots also help. Vitamin E, N-acetyl cysteine (NAC), bioflavonoids supplementation and fermented vegetables may also be helpful to improve glutathione conjugation. Brewers’ yeast has glutathione building nutrients. One of the best ways is to consume fermented vegetables with liver cleansing herbs. Dandelion root, milk thistle, coriander herb, horseradish and wasabi may also be helpful. Probiotics may also help.
  • Avoid environmental exposure in food (organic diet, increasing fibre, detoxifying vegetables, herbs, avoiding refined food). Fibre removes toxins by binding to them.
  • Chlorella, sea algae may help but since it is high in iodine, it can aggravate Graves’ disease but may help people with low iodine. Selenium levels needs to be adequate. MetalAway is one of the products a holistic doctor may prescribe in case of metal toxicity.
  • Hormone balancing (for example, insufficiency of thyroid hormones compromises liver function and detoxification).
  • Adrenal support, stress reduction and better stress management may help.
  • Coenzyme Q10 may play a positive role as an agent for treatment of CD poisoning (6)
  • Carotenoids were found to increase Cd excretion from the body in study in rats (7), (present in red and orange vegetables, if you use carrots for carotenoids source, use organic carrots and peel them before use)
  • Diet which includes selenium and glutathione producing nutrients.
  • Vitamin C (28)
  • Vitamin D
  • Correcting iron deficiency
  • Checking zinc and copper levels
  • Reducing alcohol consumption as alcohol can increase cadmium uptake
  • Alpha-lipoic acid
  • Fruit pectin (soluble fibre), psyllium
  • Olive leaf supplement
  • Willson recommends near infrared sauna for cadmium removal
  • Milk consumption may increase Cd uptake (as it is rich in hormones), especially with iron deficiency.

 

This post is for educational purposes only. Consult your doctor in regards to cadmium and before taking any supplements and dietary changes.

References:

  1. Nishijo M, Nakagawa H, Morikawa Y, Tabata M, Senma M, Miura K, Tsuritani I, Honda R, Kido T, Teranishi H. A study of thyroid hormone levels of inhabitants of the cadmium-polluted Kakehashi River basin]. Nihon Eiseigaku Zasshi. 1994 Jun; 49(2):598-605.
  2. Hammouda F, Messaoudi I, El Hani J, Baati T, Saïd K, Kerkeni A. Reversal of cadmium-induced thyroid dysfunction by selenium, zinc, or their combination in rat. Biol Trace Elem Res. 2008; 126(1-3):194-203.
  3. S Salminen, et al. Probiotic bacteria as potential detoxification tools: assessing their heavy metal binding isotherms. Can J Microbiol. 2006 Sep; 52(9):877-85.
  4. JN Bhakta, et al. Characterization of lactic acid bacteria-based probiotics as potential heavy metal sorbents. J Appl Microbiol. 2012 Jun; 112(6):1193-206.
  5. Ghosh N; Bhattacharya S. Thyrotoxicity of the chlorides of cadmium and mercury in rabbit. Department of Zoology, Visva-Bharati University, Santiniketan, India. Biomed Environ Sci, 1992 Sep; (3):236-40.
  6. Patrick J. Kennedy, Ajay A. Vashisht, Kwang-Lae Hoe, Dong-Uk Kim, Han-Oh Park, Jacqueline Hayles, and Paul Russell6. A Genome-Wide Screen of Genes Involved in Cadmium Tolerance in Schizosaccharomyces pombe Toxicol Sci. 2008 Nov; 106(1): 124–139
  7. El-Missiry, M.A. and F. Shalaby, 2000. Role of β-carotene in ameliorating the cadmium-induced oxidative stress in rat brain and testis. J. Biochem. Mol. Toxicol., 14: 238-243.
  8. A. Bashandy and I. M. Alhazza. The Hepatoprotective Effect of β-Carotene against Cadmium Toxicity in Rats. Science Alert. URL: http://scialert.net/fulltext/?doi=jpt.2008.457.463&org=10
  9. http://drlwilson.com/Articles/CADMIUM.htm
  10. Sharma G; Sandhir R; Nath R; Gill K. Effect of ethanol on cadmium uptake and metabolism of zinc and copper in rats exposed to cadmium. Department of Biochemistry, Postgraduate Institute, Medical Education and Research, Chandigarh, India. 1991 Jan; J Nutr. 121(1):87-91
  11. Palmer KC; Mari F; Malian MS. Cadmium-induced acute lung injury: compromised repair response following thyroidectomy. 1986 Dec Environ Res, 41(2):568-84
  12. Nishiyama S; Onosaka S; Taguchi T; Konishi Y; Tanaka K; Kinebuchi H Stimulation of cadmium uptake by estradiol in the kidney of male rats treated with cadmium. Department of Environmental and Occupational Health, Kochi Medical School, Japan. 1988 Aug 15. Biochem Pharmacol, 37(16):3091-6.
  13. Fiala J; Hrub´a D; R´ezl P. Cadmium and zinc concentrations in human placentas. Institute of Preventive Medicine, Faculty of Medicine, Masaryk University, Brno, Czech Republic. Cent Eur J Public Health, 1998 Aug; (3):241-8.
  14. Soldatovi´c D; Matovi´c V; Vujanovi´c D; Stojanovi´c Z. Contribution to interaction between magnesium and toxic metals: the effect of prolonged cadmium intoxication on magnesium metabolism in rabbits. Department of Toxicological Chemistry, Faculty of Pharmacy, University of Belgrade, Yugoslavia. Magnes Res, 1998 Dec.11(4):283-8
  15. Osius N, Karmaus W, Kruse H, Witten J. Exposure to polychlorinated biphenyls and levels of thyroid hormones in children. Environ Health Perspect 1999 Oct; 107(10):843-9.
  16. Sumathi R, Baskaran G, Varalakshmi P. Relationship between glutathione and DL alpha-lipoic acid against cadmium-induced hepatotoxicity. Jpn J Med Sci Biol 1996 Apr; 49(2):39-48.
  17. Thomas Heiberg Brix, MD; Pia Skov Hansen, MD; Kirsten Ohm Kyvik, MD, PhD; Laszlo Hegedüs, MD Cigarette Smoking and Risk of Clinically Overt Thyroid Disease. A Population-Based Twin Case-Control Study. Arch Intern Med. 2000 Mar 13; 160(5):661-6.
  18. Z Ernahrungswiss The toxicological estimation of the heavy metal content (Cd, Hg, Pb) in food for infants and small children 1990 Mar;29(1):54-73.
  19. Stohs SJ, Bagchi D, Hassoun E, Bagchi M. Oxidative mechanisms in the toxicity of chromium and cadmium ions. J Environ Pathol Toxicol Oncol. 2000; 19(3):201-13.
  20. Jancic SA, Stosic BZ. Cadmium effects on the thyroid gland. Vitam Horm. 2014; 94:391-425.
  21. Chung HK, Nam JS, Ahn CW, Lee YS, Kim KR. Some Elements in Thyroid Tissue are Associated with More Advanced Stage of Thyroid Cancer in Korean Women. Biol Trace Elem Res. 2016 May;171(1):54-62
  22. John Kovach, Maisie Shindo, Sharon Liang, Jingxuan Liu, Joy Roelfs, John Chen, David Bellis and Patrick Parsons. Environmental cadmium as a potential risk factor for thyroid cancer. Cancer research. URL: http://cancerres.aacrjournals.org/content/68/9_Supplement/5593
  23. Yangho Kim, MD and Sangkyu Park, MD. Iron deficiency increases blood concentrations of neurotoxic metals in children. Korean J Pediatr. 2014 Aug; 57(8): 345–350
  24. Ithyroid.com Cadmium. URL: http://www.ithyroid.com/cadmium.htm
  25. Oualid Hamdaoui. Removal of cadmium from aqueous medium under ultrasound assistance using olive leaves as sorbent. Chemical Engineering and processing: process intensification. Volume 48, Issue 6, June 2009, Pages 1157-1166.
  26. Yoshiuchi K, Kumano H, Nomura S, Yoshimura H, Ito K, Kanaji Y, Ohashi Y, Kuboki T, Suematsu H. Stressful life events and smoking were associated with Graves’ disease in women, but not in men. Psychosom Med. 1998 Mar-Apr; 60(2):182-5.
  27. Hegedus, T.H. Brix and P. Vestergaard. Relathionship between cigarette smoking and Graves’ ophthalmopathy. J. Endocrinol. Invest. 2004. 27:265-271.
  28. Gupta P, Kar A. Role of ascorbic acid in cadmium-induced thyroid dysfunction and lipid peroxidation. J Appl Toxicol. 1998; 18:317–20.
  29. Aimin Chen, Stephani S. Kim, Ethan Chung, and Kim N. Dietrich. Thyroid Hormones in Relation to Lead, Mercury, and Cadmium Exposure in the National Health and Nutrition Examination Survey, 2007–2008. 2013. Volume 121. Issue 2. URL: https://ehp.niehs.nih.gov/1205239/

 

 

 

 

 

Gut and autoimmunity connection

Gut and autoimmunity connection

The health of digestive system is very important for people with autoimmunity problems. Our immune system is closely connected with our gut. The intestines can be compared to the roots of plants that absorb nutrients for them to grow. If the soil is poor and roots weak, the plant will be struggling to survive. Unhealthy gut has been connected to autoimmunity.

There are few factors which can benefit the health of our digestive system. These are: healthy diet, lots of vegetables (including some cruciferous ones like broccoli, cabbage, horseradish, wasabi), herbs, fiber, fermented food, limiting processed food, avoiding foods one is sensitive too (like gluten) and avoiding stress. Frequent use of antibiotics and some other medications (like steroids, NSAIDs- aspirin, ibuprofen and others ) can also affect the balance of bacteria in our gut and promote imbalances with a loss of beneficial bacteria. Antibiotics and some other medications can damage the lining of our intestines. Frequent infections may also have a negative effect. Hormonal balance is also very important for gut health. Imbalance of thyroid hormones for example may lower the stomach acid, digestive enzymes and bile and change the time food travels through the digestive system, ultimately causing an imbalance in gut bacteria, nutrient deficiencies and health issues.

The gut flora consists of over 500 species of bacteria (Firmicutes/Bacteroidetes most common), fungi and viruses. Beneficial bacteria help to digest food, absorb and make vitamins (B and K2), help to metabolize hormones and other chemicals (such as short-chain fatty acids used for energy by our body) that keep our body healthy and our immune system balanced. They help to remove toxic heavy metals (6, 7). Lactobacillus strains were found to be able to absorb and remove cadmium from culture mediums in a study (8). Cadmium toxicity has been implicated in thyroid autoimmunity.

We live in a symbiotic relationship with our gut microflora as it interacts with the cells of the intestines. The live microorganisms in our gut interact with our nervous system and our immune system as well, they can induce a production of certain immune-regulatory molecules which are also absorbed by our intestines. Balanced gut flora can help the immune system not to over-react. Most of our immune system is associated with our gut. Serotonin, happy molecule is produced predominantly by our gut. Beneficial microorganisms in our gut protect our body from bad, pathogenic organisms. If there is imbalance of gut flora and ‘bad’ inhabitants predominate over ‘beneficial’ inhabitants, the nervous system and the immune system of an individual will be affected. Some bacteria can influence our mood for the better, there is a saying healthy gut, happy person. It was found in animal study (2) that Lactobacillus rhamnosus (beneficial bacteria) in our gut can reduce anxiety by producing molecules which directly interact with our brain. Interestingly, Lactobacillus species can be depleted by overgrowth of Candida yeast. Even though having some Candida in the gut is normal, overgrowth can be a problem. Many people with autoimmunity may have imbalances in their gut microbiota (dysbiosis). An example of that is the lack of Lactobacillus or Bifidobacterium species in the gut. As mentioned before, lack of Lactobacillus can make a person more anxious. Different bacteria can have a specific effect on our body, for example Styreptococcus thermophiles may improve lactose intolerance.

Low stomach acid may play a havoc with the balance of bacteria in the digestive and immune system. Low stomach acid may be seen with thyroid hormonal imbalance and stress. Low stomach acid may allow harmful bacteria like H. pylori to survive (this bacteria may cause stomach ulcers). Low stomach acid is connected to a poor absorption of minerals and vitamins. This then causes loss of essential nutrients. Eating processed packaged food and food with preservatives (after all, preservatives do not allow bacteria to reproduce) will affect our gut flora. Diet high in sugar, high carbohydrate diet, predominantly wheat flour based products, fatty food, low in vegetables, fiber and low in fermented food and essential fatty acids can lead to an unhealthy gut. One more reason for imbalanced gut flora is stress. Stress activates the sympathetic nervous system in place of parasympathetic nervous system which is responsible for proper digestion of food. We cannot also forget about vitamin D which is absolutely vital for people with autoimmunity as it activates pathways to make antibacterial molecules which are designed to kill harmful bacteria in our gut and generally in the body. Vitamin D balances the immune system. Frequent use of some medications like the anti-inflammatory NSAIDs, steroids and antibiotics negatively alters the gut microbiota. High consumption of alcohol also alters the balance of bacteria in the gut.

Complete stool analysis test can determine the health of the digestive system, digestion and gut health. This test is generally requested by the integrative medical doctors so that the specific problems can be rectified. If you have bacterial gut imbalance (or parasites), you might be given specific probiotics or herbal remedies by your holistic doctor (such as those containing oregano, thyme, licorice, slippery elm, marshmallow root, olive leaf, garlic and other herbs) to correct the problem. If you have digestive problems, HCl-betaine (for a low stomach acid) or enzymes may be prescribed.

Gas, burping, bloating, heartburn, constipation, diarrhea, indigestion would be the obvious signs that there is something wrong with your digestion. However other signs can be allergies, itching and anxiety. Therefore, signs of gut microbiota imbalance can be difficult to recognize. Obviously if you suffer from thyroid problems, have imbalanced of deficient hormones, the digestive system will not work well. It is common problem with hypothyroidism. I had poor digestion and stomach ulcers as a direct consequence of being on sub-optimal thyroid hormonal treatment. Personally, I saw a great improvement in my gut health by adding NDT to my levothyroxine hormonal replacement, making sure my hormonal balance was the best I could achieve. My integrative medical doctor put me on a quality probiotic for a month.

Fermented food can help to balance gut bacteria (such as sauerkraut, other fermented vegetables). Eating organic, non- processed and non-preserved food can help. Soluble fiber was found to benefit intestines (found in oats, beans, lentils, peas, flax seeds, other seeds and some fruits and some vegetables). Supporting your adrenals, good sleep, rest and relaxation can help with stress and limiting frequent infections requiring antibiotics. Some people find colostrum beneficial for balancing their gut flora. Apple cider vinegar also helps to re-balance the gut. Hormonal balance is also very important. The health of the gut can be achieved back through a healthy diet, fermented foods, probiotics, herbal remedies, improving digestion with specific supplements (glutamine), avoiding food one is sensitive to, balancing hormones and limiting stress. Glutamine is great for a leaky gut but some people should avoid it, especially if they get more nervous after taking glutamine and in specific conditions) so consult your doctor regarding glutamine. I personally took glutamine supplement for a month (1 tsp) per day to improve my gut. The positive steps you will take in the direction of your gut health, can greatly benefit your overall health and help with autoimmunity problems.

This post in for educational purposes only. Consult your doctor/ health practitioner if you experience any digestive and gut issues and regarding any supplements and remedies.

References:

  1. Eamonn M. M. Quigley, MD, FRCP, FACP, FACG, FRCPI. Gut Bacteria in Health and Disease. Gastroenterol Hepatol (N Y). 2013 Sep; 9(9): 560–569.
  2. Javier A. Bravo, Paul Forsythe, Marianne V. Chew, Emily Escaravage, Hélène M. Savignac, Timothy G. Dinan, John Bienenstock and John F. Cryana. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci U S A. 2011 Sep 20; 108(38): 16050–16055.
  3. Candida and Gut Dysbiosis. URL:http://www.ei-resource.org/illness-information/environmental-illnesses/candida-and-gut-dysbiosis/
  4. Geraldine O. Canny and Beth A. McCormick. Bacteria in the Intestine, Helpful Residents or Enemies from Within? Infect Immun. 2008 Aug; 76(8): 3360–3373.
  5. Françoise Rul, Leila Ben-Yahia, Fatima Chegdani, Laura Wrzosek, Stéphane Thomas, Marie-Louise Noordine, Christophe Gitton, Claire Cherbuy, Philippe Langella, and Muriel Thomas. Impact of the Metabolic Activity of Streptococcus thermophilus on the Colon Epithelium of Gnotobiotic Rats. J Biol Chem. 2011 Mar 25; 286(12): 10288–10296.
  6. S Salminen, et al. Probiotic bacteria as potential detoxification tools: assessing their heavy metal binding isotherms. Can J Microbiol. 2006 Sep; 52(9):877-85.
  7. JN Bhakta, et al. Characterization of lactic acid bacteria-based probiotics as potential heavy metal sorbents. J Appl Microbiol. 2012 Jun; 112(6):1193-206.
  8. Anna V. Kirillova, Anna A. Danilushkina, Denis S. Irisov, Nataliya L. Bruslik, Rawil F. Fakhrullin, Yuri A. Zakharov, Vladimir S. Bukhmin, and Dina R. Yarullina. Assessment of Resistance and Bioremediation Ability of Lactobacillus Strains to Lead and Cadmium. International Journal of Microbiology. 2017. URL: https://www.hindawi.com/journals/ijmicro/2017/9869145/

Olive leaf may help with symptoms of hypothyroidism

Olive leaf extract may help with symptoms of hypothyroidism

Olive leaf extract was found to enhance thyroid function as it helps with the conversion of T4 into its active form T3. Therefore, it boosts the levels of T3. It was found to stimulate the thyroid gland in animal study (1) in a dose depended manner.

Olive leaf extract contains many health beneficial molecules including oleuropein and hydroxytyrosol and flavonoids (rutin), polyphenols (apigenin, luteolin) among others.

The molecule hydroxytyrosol in olive leaf was shown to inhibit pro-inflammatory molecules such as IL6 and TNF- alpha in mice studies (8) and in human studies (9, 10). It also reduces many other inflammatory molecules.

IL6 levels were found to be high in post- menopausal women with Hashimoto’s thyroiditis (5). Also, a study in animals (6) showed that autoimmune thyroiditis could be prevented by blockade of IL6.  One of the problems in Hashimoto’s thyroiditis is the high level of inflammation which interferes with the conversion and action of thyroid hormones. Patients with Hashimoto’s thyroiditis are often on high doses of thyroid hormonal replacement. One of the reasons for that is to counteract the effects of inflammation in their bodies. Olive leaf extract may help to reduce these thyroid blocking molecules.

A study of Hashimoto’s patients (4) stated that: “These results are possibly attributable to the inhibitory effect of IL6 on deiodination of T3 and imply a role for IL6 in determining thyroxine replacement dose among these patients.”

Hydroxytyrosol in olive leaf is a powerful free radical scavenger, protecting the energy houses in cells called mitochondria. It is believed to be protective for the central nervous system. Other positive effects of olive leaf extract (among many others) are reported to be: reduction of blood pressure, anti-microbial and anti- bacterial, anti-fungal activities, anti-parasitic activities, anti-carcinogenic effects, lowering blood sugar and cholesterol, powerful anti-oxidant activities (believed to be more powerful than vitamin E), beneficial for cardiovascular system, eye health, helping with allergies, asthma, colds, protecting against UVB radiation, benefits for people with osteoporosis, benefits for some autoimmune disorders, anti-aging, helps to remove heavy metals such as lead from the body and energy increasing properties.

Olive leaf extracts are regarded to be quite safe. Effective dose of powdered leaf extract is likely to be 500-2,000 mg daily. It is available in capsules.

This post is for educational purposes only.

References:

  1. Al-Qarawi AA, Al-Damegh MA, ElMougy SA. Effect of freeze dried extract of Olea europaea on the pituitary-thyroid axis in rats. Phytother Res. 2002 May; 16(3):286-7.
  2. Olive leaf. Alternative Medicine Review. 2009. Vol 14 (1):62-66. Monograph. URL: http://www.altmedrev.com/publications/14/1/62.pdf
  3. Hao J, et al. Hydroxytyrosol promotes mitochondrial biogenesis and mitochondrial function in 3T3-L1 adipocytes. J Nutr Biochem. 2010 Jul; 21(7):634-44.
  4. Papanas N., Papazoglou D., Papatheodorou K., Antonoglou C., Kotsiou S., Maltezos E. Thyroxine replacement dose in patients with Hashimoto disease: A potential role for interleukin-6: Cytokine. 2006:35(3-4): 166-170.
  5. Lucyna Siemińska, Celina Wojciechowska,, Beata Kos-Kudła,, Bogdan Marek, Dariusz Kajdaniuk, Mariusz Nowak, Joanna Głogowska-Szeląg, Wanda Foltyn, Janusz Strzelczyk. Serum concentrations of leptin, adiponectin, and interleukin-6 in postmenopausal women with Hashimoto’s thyroiditis. Endokrynologia Polska/Polish Journal of Endocrinology; Jan-Feb 2010:61(1):112-116.
  6. Kouki Mori, Katsumi Yoshida, Masahiko Mihara, Yoshiyuki Ohsugi, Yoshinori Nakagawa, Saeko Hoshikawa. Effects of interleukin-6 blockade on the development of autoimmune thyroiditis in nonobese diabetic mice. Autoimmunity Volume 42, 2009 – Issue 3: 228-234. |
  7. Julien Peyrol, Catherine Riva and Marie Josèphe Amiot. Hydroxytyrosol in the Prevention of the Metabolic Syndrome and Related Disorders. Nutrients. URL: file:///C:/Users/jkrywult/Downloads/nutrients-09-00306%20(3).pdf
  8. Cao, K.; Xu, J.; Zou ,X. ;Li, Y. ;Chen, C.; Zheng, A.; Li, H.; Szeto, I. M. -Y. Hydroxytyrosol prevents diet-induced metabolic syndrome and attenuates mitochondrial abnormalities in obese mice. Free Radic. Biol. Med. 2014, 67, 396-407.
  9. Tzoulaki I, Murray GD, Lee AJ, Rumley A, Lowe GDO, Fowkes FGR. C-reactive protein, interleukin-6, and soluble adhesion molecules as predictors of progressive peripheral atherosclerosis in the general population. Circulation (2005) 112:976–83.
  10. Richard N, Arnold S, Hoeller U, Kilpert C, Wertz K, Schwager J. Hydroxytyrosol is the major anti-inflammatory compound in aqueous olive extracts and impairs cytokine and chemokine production in macrophages. Planta Med (2011) 77(17):1890–7.
  11. ProHealth. The Most Powerful Natural Antioxidant Discovered to Date – Hydroxytyrosol. URL: http://www.prohealth.com/library/showarticle.cfm?libid=17054

 

 

 

 

Bugleweed- primary herb for hyperthyroidism

Bugleweed- primary herb for hyperthyroidism

Bugleweed (Lycopus virginicus or Lycopus europaeus-gypsywort)

It is a primary herb for Graves’ disease and a member of the mint family. It might help in mild forms of hyperthyroidism. Bugleweed has been approved by German Commission E for use in mild hyperthyroidism. It is used in Europe for a mildly overactive thyroid, usually in the early stages and often with combination of Melissa. The herb is considered safe for long term administration. It is traditionally used to stop iodine conversion in the thyroid gland.  Bugleweed also inhibits the conversion of T4 into T3 in peripheral tissues. It might also inhibit the action of thyroid-stimulating antibodies. Bugleweed is helpful for symptoms such as palpitations and convulsions; it can lower heart rate and help with insomnia. It helps with relaxation. There has been a human study of Bugleweed for use in hyperthyroidism. The study involved 62 patients and its findings confirmed positive effects of Bugleweed (Lycopus europaeus) in mild forms of hyperthyroidism (1) without adverse reactions. German Bugleweed europaeus preparation is called Thyreogutt mono tablets or drops. Scientific studies of this preparation showed statistically significant improvements for mild hyperthyroidism for over 300 patients without side effects. Best results were seen in people receiving more than a 4 week course of preparation (2). Other German preparation is Mutellon (Lycopus Europaeus, Motherwort and Valerian).

Aqueous extracts of Bugleweed are also commonly used as well as alcohol extracts (prescribed by naturopathic professionals). Tea can be prepared by infusing 2-3 teaspoons of air-dried herb in a cup of hot water drank three times daily.

Talk to your doctor before using Bugleweed. It is not indicated with iodine supplements or iodine I-125 (used for Iodine Uptake Test) and with certain medical conditions. Bugleweed should not be taken in condition of osteoporosis. It is not advisable in pregnancy or lactation.

This post is for educational purposes only.

References:

  1. Beer AM, Wiebelitz KR, Schmidt-Gayk H. Lycopus europaeus (Gypsywort): effects on the thyroidal parameters and symptoms associated with thyroid function. Phytomedicine 2008 Jan; 15(1-2):16-22.
  2. Eiling R, Wieland V, Niestroj M. Improvement of symptoms in mild hyperthyroidism with an extract of Lycopus europaeus (Thyreogutt® mono). [Article in German]. Wien Med Wochenschr. 2013 Feb; 163(3-4):95-101.