Body temperature can be an indicator of thyroid function
Our healthy body temperature is around 36.6 degrees Celsius or 97.88 Fahrenheit. It cannot deviate from that number too much and for too long. The human molecules and enzymes inside of the cells are designed to function around this magic temperature or otherwise they get irreversibly damaged.
We need adequate and regulated energy production to maintain our health. The whole body is involved in the regulation of our body temperature. However, the thyroid hormones play a major role in the energy production and temperature regulation. Thyroid gland is the first endocrine gland to develop in a fetus at four weeks of gestation as it drives the whole development of the embryo. The growing fetus uses maternal thyroid hormones also. Every baby is tested soon after birth for thyroid hormone levels to detect possible hypothyroidism. The treatment for hypothyroidism needs to be started as soon as it is detected. The baby who was born without a thyroid gland can only live for few weeks.
Without a thyroid hormone we would eventually stop moving, our muscles (including the heart muscle) would cease to work. There are some thyroid hormones analogues produced outside of the thyroid, like in the heart or the stomach but we primary need the thyroid hormones from the thyroid to keep us alive. In someone who had their thyroid removed, taking thyroid hormones is necessary. How long a person would survive without taking thyroid hormones after thyroid removal is dependent on the individual and the stress in their life. Thyroid hormones are stored in fat cells and will get used up over time, which may take about 6 weeks or slightly longer. After that the life will cease. A partially removed thyroid does not regenerate as the cell turn over in the thyroid is very slow.
Thyroid hormone T3 starts the process of energy production in the energy houses of our cells, mitochondria. T3 needs potassium mineral to initiate the production of the energy and life giving molecule, ATP. Other nutrients, especially vitamins B are also very important.
Adrenal hormones produced by small glands above your kidneys also play an important role in regulation of body temperature and generation of energy. Impaired adrenal function may result in body temperature changes. Individuals who are chronically stressed over a period of time tend to have some degree of adrenal exhaustion and produce lower levels of cortisol which can result in temperature fluctuations and lower body temperature. High levels of cortisol due to severe stress can raise body temperature temporarily.
The conversion of T4 into T3 is dependent on the availability of thyroid hormone nuclear receptors for binding of thyroid hormones, which in turn is mediated by the levels of cortisol (also called stress hormone). Adequate levels of cortisol and T3 hormone are important for maintaining a normal body temperature. Unfortunately, hypothyroidism may cause adrenal dysfunction. Nothing works well with low thyroid.
Hypothyroidism affects the body temperature more greatly than cortisol in general. A body temperature can be an indicator of a thyroid function, however blood tests are the accurate measure of thyroid hormonal levels. Body temperature it is not considered accurate test for determining thyroid function due to the fact that other factors can play a role in changing of the body temperature, such as certain illnesses, a reduced adrenal activity (and some degree of adrenal exhaustion) and even low blood sugar. Adrenals help to stabilize the body temperature and with a poor adrenal function, body temperature might be unstable. A slight increase of temperature also occurs in the middle of cycle, at ovulation time (around day 14) in women.
Anyway, it is good to be aware of your temperature and you can take your readings to your doctor. I had a lowered body temperature when I suffered with borderline low T3 hormonal levels while on a levothyroxine only hormonal replacement after my thyroid surgery.
Woman should measure their temperature from day 5 of the menstrual period and for three consecutive days. Non menstruating women and men can do this test at any time. You can only do the reading once at the time and do not repeat.
How to measure your basal temperature:
Measure your temperature as soon as you wake up while still in bed. Try not to move too much. Stay in bed for 10 minutes and record the temperature.
Digital thermometer is best for measuring underarm temperature. Oral thermometers are also considered to be very effective; you put them deep under the tongue. Mercury thermometers should not be used due to a danger of mercury toxicity. Ear thermometers are thought to be the least accurate for this purpose.
The normal underarm temperature is between 36.6 and 36.8 degrees C.
Anything below 36.6 degrees C (or below 97 F) might indicate hypothyroidism.
Anything above 36.8 degrees C (or 98.2 F) might indicate hyperthyroidism.
Oral readings are slightly higher, temperature of 37.0 degrees C (98.6 F) is considered normal.
Consider drinking this juice if you have Graves’ disease.
One of the helpful hints in my book: ’Thyroid and Graves ’disease unmasked’ is a recipe for a raw vegetable/fruit juice. This juice might help you feel better when you have Grave’s disease.
1/2 a bunch of parsley
1/2 of organic lemon (with skin)
1 small raw beetroot
1/2 of organic broccoli or if you cannot tolerate broccoli, substitute with 1 cup of raw kale
2 organic carrots
1 organic apple
1 small stick of celery
1 tea spoon of freshly ground flax-seeds
Wash very well, chop up and make juice in a juicer.
You can blend them all as well in a blender with addition of some spring water.
Here is why this juice might be helpful:
Parsley: rich in vitamins and minerals such as iron (often depleted in thyroid autoimmunity), it also contain Pyrroloquinoline quinone (PQQ), a molecule which helps with the repair of mitochondria, energy factories of cells. Mitochondrial dysfunction is connected to autoimmunity. Generally, eating any long, green leafy vegetables, in any form would increase methylated folate in the body, which reduces inflammation.
Lemon: Provides vitamin C and pectin- vitamin C supports adrenal function (adrenals often show some degree of exhaustion with autoimmunity), repairs iodine transporter in the thyroid gland (which can be dysfunctional), neutralizes excessive free radicals (problem connected with autoimmunity), important for collagen building. It is also vital for a proper synthesis of carnitine, which is essential for transport of fatty acids into the mitochondria to make energy (often depleted in Graves’ disease). It provides pectin (in the skin) for removal of toxins and excessive hormones.
Beetroot: it detoxifies liver, 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.
Broccoli is a star vegetable for Graves’ disease. Broccoli and kale are highly goitrogenic foods which slow down thyroid gland, great vegetables for detoxification of excessive hormones. Broccoli is rich in chromium mineral, important for sugar control. It contains uridine diphosphate, a molecule important in balancing of the immune system.
Carrots: Contain Beta carotene, which inhibits Bcl-2 gene, switched on in thyroid cells in Graves’ disease and thus balance the immune system, beta carotene is a precursors of vitamin A, often depleted in Graves’ disease.
Apple: provides some sweetness, minerals and vitamins and quercentin (in skin) which balances the immune system.
Celery: source of vitamins and minerals (especially vitamin K, which can be depleted in Grave’s disease), lowers inflammation and removes excessive estrogens from the body (common in Grave’s disease)
Flax seeds: provides essential omega fatty acids and can reduce inflammation and excessive action of thyroid hormone at the nuclear level.
Raw juices are great but it is best to start slow with raw juices, and not on an empty stomach. This juice is not suitable for young babies. Some people with previous problems (such as diverticulitis) or after bowel surgery need to be careful with raw juices, especially on empty stomach.
Healthy skin care for your thyroid
Some skin care products contain toxic ingredients and it is best to avoid them. One of the toxic antimicrobial chemicals present in some skin care products is triclosan (TSC) and triclocarban (TCC) which are toxic to thyroid. Others include parabens which disrupt hormonal balance. Oxybenzone (benzophenone) addidative (UV filter) can disrupt thyroid hormone receptor. Triethanolamine (TEA) also inhibits thyroid. Many skin care products have toxic fragrances.
Some manufactures are becoming more aware and are removing these toxic ingredients from skin care products. It is more common these days to find parabens, triclosan and triethanolamine (TEA) free products. Triclosan has been recently banned from antibacterial washes and soaps.
These harmful chemicals are absorbed through skin and can travel to other body tissues and damage vulnerable cells.
Therefore, it is best to strive for a more natural skin care and check the labels. You can also use simple healthy products and it does not have to be hard. Here are some ideas for you:
- Use oils in skin care such as rose hip oil, emu oil or grape seed oil with few drops of fragrant essential oils, argan oil or coconut oil. Cosmetic argan oil is great for skin care; it contains carotenes, sterols, antioxidants and omega 3 essential fatty acids as well as caffeic acid which were found to lower antithyroid antibodies.
- Buy more natural skin care products, free of harmful chemicals. Aloe Vera based creams are great.
- Make your own products. Below is one of my personal favorites with coconut oil and Aloe Vera. If you do not have a fresh Aloe Vera leaf, you can use a good quality gel (not juice) for this purpose. It can be easily purchased from a chemist. I use a leaf from my own Aloe Vera plant. This cream is absorbed fast and leaves skin beautifully soft, smooth, nourished and non- greasy.
My simplest, cheapest and healthiest skin care cream.
1 fresh Aloe Vera leaf
5-6 table spoons coconut oil
Few drops of essential oils of your choice (my favorite is rose geranium, lavender or lemon).
It is best to check your skin sensitivity first to any ingredients, especially the essential oils you are going to use prior to making the cream.
Cut the long edges off the Aloe leaf and remove the top green covering to reveal the gel inside and scoop it with a spoon into a small blender like a magic bullet. Blend well and add the coconut oil (do not heat it, as is from a jar) and blend together very well. You can use an electric hand blender or a bullet blender. Add 4-6 drops of essential oil (you can mix few different ones) and mix well. I like rose geranium and lavender. Scoop into a clean glass container. Ready to use as body lotion. Lasts for few weeks. Enjoy.
Autoimmune Thyroid Disease and gluten. Is there a connection?
Our digestive system is like a plants’ root system. If a plant is grown in a barren soil deprived of soil bacteria and nutrients, it will not be healthy.
A ‘leaky gut’ allows to filter out undigested larger food molecules instead of just simple fatty acids, amino acids, minerals and vitamins, the building blocks and simple molecules our body needs to function. These simple molecules go through the cell of the intestinal lining into the outside fluid and bloodstream.
However when a person has a leaky gut, unwelcome components can pass through spaces between the intestinal cells to the outside. The junctions between the cells of intestinal lining supposed to be tight and nothing should get through between the cells. However in leaky gut some of the junctions are not closed enough. These components can be undigested molecules, toxins and pathogens. About ¾ of our immune system is associated with our gut. This relationship is extremely important as digestive system is the main contributor to the health of our immune system. Leaky gut is associated with autoimmunity problems but not all leaky gut problems cause autoimmune disorders. Genetic components are also important. Gluten sensitivity is linked to a leaky gut and vice versa, a leaky gut can make a person more sensitive to gluten.
There are many reasons why a person may have an unhealthy gut. They include: poor nutrition (too much sugar, not enough vegetables, too much processed food), lack of fiber in diet, infections, food poisonings, frequent use of antibiotics, illness (including thyroid autoimmunity and thyroid problems, pancreatic insufficiency, etc.), certain medications such as NSAIDS (non-steroidal anti-inflammatory drugs such as aspirin or ibuprofen), stress, toxins (such as food chemicals, pesticides, other additives), food allergies and sensitivities such as sensitivity to gluten. A low stomach acid may play a role in how well gluten is digested and the health of the gut.
Gluten is a protein, a large molecule composed of amino acids. ‘Gluten’ comes from a Latin language and it means glue. It is what gives dough its elasticity. It is found in gluten containing grains. The proteins in gluten are: prolamines and glutelins, folded and coiled and connected by disulphide bridges. Wheat contains prolamine – gliadin and glutelin- glutenin. The prolamine of rye is secalin, prolamine of barley is hordein and oats is avenin. Allergy to gluten is usually strongest to gliadin (in wheat).
Gluten containing food include: wheat bran, wheat, rye, barley (both whole grains and flours) and oats. Wheat flour white bread, cakes, pastries and pasta contain high amounts of gliadin. It is also found as a filler in many products. Modern wheat is different to the wheat our ancestors ate. It has been hybridized and selected for higher yields. The modern farming technology involves using pesticides and fertilizers and bleaching the flour. The flour our ancestors ate was organic, grind whole and unbleached. There are questions regarding the effects of modern wheat on our health which are still awaiting clear answers. Nevertheless, some people are sensitive to gluten containing products.
Good gluten free grains are: brown/white rice, buckwheat, quinoa and amaranth. Quinoa contains lots of iron and methylated folate, which is beneficial.
Gluten is a complex molecule, which is difficult to digest as some of the bonds between amino acids in gluten are uncommonly seen in other proteins. Some sections of undigested gluten can have immuno-modulatory activities in individual people.
Some people are able to dispose of the undigested parts of gluten through their gut easier than others. They can also digest it better. There are individuals in which their overall health is strongly impacted by their gastrointestinal system and it is the key for their well being.
There is an enzyme in human cells called transglutaminase. It is important for linking proteins to collagen in extracellular matrix (outside of cells). Gliadin molecule in gluten looks similar to transglutaminase enzyme and can confuse the immune system in genetically predisposed people. This may result in Coeliac Disease where antibodies to transglutaminase and components of collagen (what holds cells together) are generated.
Gluten, especially gliadin part also shares similarity to thyroid molecules. Therefore, when leaky gut is present, the immune system of genetically predisposed individual can get confused and generate faulty antibodies to thyroid tissues. Also, the auto-antibodies directed against transglutaminase (anti-TGase II antibodies) bind to thyroid cells and the collagen components outside of the thyroid cells and thus could be implicated directly in thyroid autoimmunity which can explain an increased correlation of Coeliac Disease and thyroid autoimmunity.
Gluten sensitivity is associated with Hashimoto’s thyroiditis and Graves’ Disease and other autoimmune disorders. Gluten sensitivity seems to be more strongly associated with Hashimoto’s thyroiditis than Graves’ Disease. Apart from possible gluten sensitivity, casein in cow’ milk products may be a problem for people with thyroid autoimmunity. It seem to be more strongly connected to Grave’s Disease.
Coeliac disease (CD) is an autoimmune disorder, severe allergy to gluten with auto- antibodies to tissue components which can damage intestinal finger-like projections (villi) which absorb nutrients from food. It can co-occur with thyroid autoimmunity. Coeliac disease may sometimes precede thyroid autoimmunity. The links between autoimmune thyroid disease and Coeliac Disease were shown in many scientific research studies (1, 2, 3, and 4). The immune system in people with autoimmunity in general shares common genetic components and can get confused easier. The presence of Coeliac Disease in patients with Autoimmune Thyroid Disorder ranged from 3.3% – 5.5%. There were also few cases of laboratory diagnosis of Coeliac Disease in Autoimmune Thyroid Patients who did not have symptoms of Coeliac Disease (4).
The presence of Autoimmune Thyroid Disease was also 11.8% higher in coeliac patients when compared to controls in a study (4). It is worth mentioning that the diagnosis of Coeliac Disease requires more tests than blood anti-gliadin antibody test. This test is not 100%. Stool analysis is one more sensitive method to detect antibodies produced in the digestive tract rather than blood. Dr. Kenneth Fine at the Intestinal Health Institute had shown that a high percentage of his patients had IgA anti-gliadin antibodies in stool samples and not in blood, 60% and 75% positive versus 11% in the blood (7). Some asymptomatic people have these antibodies. Tissue biopsy and antibody testing to tissue components such as anti-endomysial antibodies or EMA and transglutaminase autoantibodies (TGAA) confirms CD diagnosis. Patients need to be on a gluten containing diet at the time of testing.
It may be beneficial to get tested for Coeliac Disease if you experience a lot of gastrointestinal issues. Coeliac Disease affects 1 in 70 Australians but many others may be not be diagnosed because many symptoms can be unrecognized and some people may be asymptomatic as mentioned before, perhaps in early stages of an illness. Genetic screening for the HLA DQ2/8 gene (present in a half of population) can also be a useful test especially with a family history of an illness. People not carrying this gene are very unlikely to have Coeliac disease. People with Coeliac Disease cannot have any gluten in their food. They need to have gluten-free grains like rice or quinoa, otherwise they get very sick and have symptoms such as bloating, irritable bowel, diarrhea, constipation, gas, abdominal pain, nausea, joint and muscle pain, headaches, skin rashes, tiredness, brain fog, sleep disturbances, anxiety, depression, iron deficiency and emotional issues. In Coeliac Disease secretory IgA antibody binds gliadin and transports it on the outside of the intestinal cell. The immune system generates antibodies to gliadin (in gluten) and the connective tissue in the gut (endomysium), specifically tissue transglutaminase or tTg (also abbreviated as TG2 or TG).
However one does not need to have Coeliac Disease, antibodies and classical changes in gut villi to be sensitive to gluten. Negative coeliac panel tests do not necessary mean that a person is not sensitive to gluten. People with autoimmune thyroid illness may not have Coeliac Disease (as it only co –occurs in about 3-5% of people with thyroid autoimmunity), they may just be sensitive to gluten. Allergic and autoimmune reactions are not present in gluten sensitivity. A study reported that about 6.8% of population were diagnosed in Non-Coeliac Gluten Sensitivity –NCGS (15). More specifically, patients have negative serological tests for Coeliac Disease (endomysial and/or tissue transglutaminase antibodies) but antigliadin antibodies may be present. They may have other antibodies to various wheat and tissue components (15, 17). This was demonstrated in a patient with Crohn’s Disease (17) who also had NCGS. The immune system mechanisms of gluten sensitivity are not clearly understood. People with gluten sensitivity may also have symptoms triggered by other molecules present in rye or barley. This sensitivity may possibly be connected to stress, toxins, low stomach acid, hormonal imbalances and other factors. People who are sensitive to gluten might have symptoms similar to Irritable Bowel Syndrome. They might experience discomfort, gas and burping after they eat gluten containing food. A research study showed that heartburn, stomach ulcers, GERD may be linked to gluten sensitivity. Complete stool diagnostic test can determine the health of the digestive system.
Dr. Alessio Fasano, a leading expert in Celiac Research and Gastroenterology has done a lot of research into non-celiac gluten sensitivity. It was noted by Dr Fasano and other health practitioners that people with IBS (Irritable Bowel Syndrome) like symptoms such as bloating, abdominal pain, constipation and diarrhea and no Coeliac Disease improved their gastrointestinal symptoms on a gluten free diet. Some people report feeling generally better and happier as gluten sensitivity may affect brain and other tissues.
People, sensitive to gluten, have an immune response to undigested parts of gluten molecules, which causes inflammation although exact mechanism are yet to be understood. The nervous system influences the permeability of tight junctions to macromolecules, thus modifying mucosal barrier of the digestive system through neuropeptides. Thus stress plays a big role in the gastrointestinal health. It is important to have a balanced but flora. The beneficial bacteria in our gut ‘educate’ the immune system how to function properly. A healthy gut flora reduces the over-activity to some food antigens and prevents allergies.
Gluten intolerance can cause low levels of diamine oxidase (DAO) in the digestive system, which breaks down histamine. Histamine is an immune system modulating molecule, which causes an immediate inflammatory response. The intestinal lining can become more permeable to certain toxic molecules, which leak through it and enter the blood system. Inflammatory molecules can be released as a reaction to gluten sensitivity, opening passages between the cells of gastrointestinal tract, allowing toxic molecules to leak through these passages. Dr. Alessio Fasano and his team of researchers had discovered a molecule called zonulin (10), a protein that can be triggered by gluten and other molecules, which is expressed in all autoimmune conditions and is associated with leaky gut. Dr. Fasano’s and his research team are working on a new medication which inhibits zonulin.
Gluten sensitivity may play a big part in some people. As mentioned previously, the gut is closely connected to the immune system and as gluten can mimic some molecules of the thyroid, subsequent attack on thyroid attack is possible.
Personally, I do not have Coeliac Disease. I was tested for blood anti-gliadin antibodies when I had experienced a lot of IBS like symptoms while on sub optimal thyroid hormonal treatment after my thyroid removal. This is not surprising as the luck of T3 hormone creates lots of negative effects on the gastrointestinal system. Without adequate T3 a person suffers from a low stomach acid and poor digestion of proteins such as gluten. People with a low stomach acid can have vitamin B12 or iron deficiency. My issues subsided with the introduction of Natural desiccated thyroid to my levothyroxine hormonal replacement. I was skeptical in regards to gluten for years until my integrative doctor suggested to try to lower my inflammation levels by avoidance of gluten. I thought that it is possible that I may have gluten sensitivity and a gluten free trial would help me determine that. I had gone on a complete gluten free diet for six months and I did see improvements in my well- being, less bloating, better digestion and feeling better. The markers of my inflammation had decreased (anti-nuclear antibodies- ANA). When people lower their inflammation, T3 hormone works better in their body. However I am not sure if the markers of inflammation went down specifically due to gluten as I had made some other positive changes. I personally feel that I am more sensitive to cow’s milk products than wheat. These days, I am still limiting gluten products and a light gluten exposure works for me. I feel better when I limit gluten and will continue to do so.
However, every situation is unique and the power of your personal observation is important. Gluten free diet may benefit people with autoimmunity problems. We know that there is a connection between thyroid autoimmunity and Coeliac Disease. We also know that some people with autoimmunity have Non Coeliac Gluten Sensitivity. A Case Report in Non-Coeliac Gluten Sensitivity and Autoimmunity (18) says that: “Non-coeliac gluten sensitivity can be associated with autoimmune manifestations and, more importantly, that the finding and treatment of non-coeliac gluten sensitivity can be critical for the management of an otherwise refractory patient.”
One of the important observation derived diet tips for Hashimoto’s thyroiditis and Graves’ disease suggested in literature is the avoidance of gluten. It was found in a study (12) that gluten withdrawal may in distinct cases, reverse thyroid abnormality.
Apart from thyroid autoimmunity, some people who have coeliac disease may also suffer from sub clinical non-immune hypothyroidism which may be due to malabsorption of nutrients.
Bone broths, foods containing gelatin, organic food which includes lots of vegetables, apple cider vinegar, fermented vegetables and stress reduction may also improve the health of gastrointestinal system. It is also important to avoid any other food your body reacts negatively to.
Speak to your doctor if you have any digestive issues.
This blog is for educational purposes only.
- Pekka Collin, Jorma Salmi, Olavi Hällström, Timo Reunala and Amos Pasternack. Autoimmune thyroid disorders and coeliac disease. Eur J Endocrinol 1994; 130:137–40.
- Akçay MN, Akçay G. Hepatogastroenterology. The presence of the antigliadin antibodies in autoimmune thyroid diseases. 2003 Dec; 50 Suppl 2.
- Chin Lye Ch’ng, MRCPI, M. Keston Jones, MD, FRCP, and Jeremy G. C. Kingham, MD, FRCP. Celiac Disease and Autoimmune Thyroid Disease. Clin Med Res. 2007 Oct; 5(3): 184–192.
- Sategna-Guidetti C, Bruno M, Mazza E, Carlino A, Predebon S, Tagliabue M, Brossa C. Autoimmune thyroid diseases and coeliac disease. Eur J Gastroenterol Hepatol. 1998 Nov; 10(11):927-31.
- Hakanen M, Luotola K, Salmi J, Laippala P, Kaukinen K, Collin P. Clinical and subclinical autoimmune thyroid disease in adult celiac disease. Dig Dis Sci. 2001 Dec; 46(12):2631-5.
- Ruuskanen A, Kaukinen K, Collin P, Huhtala H, Valve R, Mäki M, Luostarinen L. Positive serum antigliadin antibodies without celiac disease in the elderly population: does it matter? Scand J Gastroenterol.2010 Oct; 45(10):1197-202.
- Carlo Catassi and Alessio Fasano. Tempters and Gluten- Free Diet. Nutrients. 2016 Dec; 8(12): 786.
- Chin Lye Ch’ng, MRCPI, M. Keston Jones, MD, FRCP, and Jeremy G. C. Kingham, MD, FRCP. Celiac Disease and Autoimmune Thyroid Disease. Clin Med Res. 2007 Oct; 5(3): 184–192.
- Fasano A. Leaky Gut and autoimmune disease. Clin Rev Allergy Immunol. 2012 Feb; 42(1):71-8.
- Fasano A. Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer. Physiol Rev. Vol 91. Jan 2011. 151-175.
- Naiyer AJ, Shah J, Hernandez L, Kim SY, Ciaccio EJ, Cheng J, Manavalan S, Bhagat G, Green PH. Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction. Thyroid. 2008 Nov; 18(11):1171-8.
- Sategna-Guidetti C, Volta U, Ciacci C, Usai P, Carlino A, De Franceschi L, Camera A, Pelli A, Brossa C. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. The American Journal of Gastroenterology. 2001; 96(3): 751–757.
- Carlo Catassi, Julio C. Bai, Bruno Bonaz, Gerd Bouma, Antonio Calabrò, Antonio Carroccio, Gemma Castillejo, Carolina Ciacci, Fernanda Cristofori, Jernej Dolinsek, Ruggiero Francavilla, Luca Elli, Peter Green, Wolfgang Holtmeier, Peter Koehler, Sibylle Koletzko, Christof Meinhold, David Sanders, Michael Schumann, Detlef Schuppan, Reiner Ullrich, Andreas Vécsei, Umberto Volta, Victor Zevallos, Anna Sapone, and Alessio Fasano. Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders. Nutrients. 2013 Oct; 5(10): 3839–3853.
- Geoffrey Holmes. Non coeliac gluten sensitivity. Gastroenterol Hepatol Bed Bench. 2013 Summer; 6(3): 115–119.
- Capannolo A, Viscido A, Barkad MA, Valerii G, Ciccone F, Melideo D, Frieri G, Latella G. Non-Celiac Gluten Sensitivity among Patients Perceiving Gluten-Related Symptoms. Digestion. 2015; 92(1):8-13.
- Imran Aziz and David S. Sanders (2012). Emerging concepts: from coeliac disease to non-coeliac gluten sensitivity. Proceedings of the Nutrition Society, 71, pp 576-580.
- Aristo Vojdani and David Perlmutter. Differentiation between Celiac Disease, Nonceliac Gluten Sensitivity, and Their Overlapping with Crohn’s Disease: A Case Series. Case Reports in Immunology.Volume 2013 (2013), Article ID 248482, 9 pages. URL: https://www.hindawi.com/journals/crii/2013/248482/
- Carlos Isasia, Isabel Colmenerob, Fernando Cascoc, Eva Tejerinad, Natalia Fernandez-Pugae. Non-Coeliac Gluten Sensitivity and Autoimmunity: A Case Report. URL: http://ejcrim.com/index.php/EJCRIM/article/view/156/206
- Grain brain David Perlmutter, MD. Little, Brown and Company. Hachette Book Group. 2013 New York.
- Diagnosing coeliac disease – the key facts URL: http://www.coeliac.org.au/uploads/65701/ufiles/Fact_sheets/DiagnosingCoeliacDisease.pdf
- An Interview with Dr. Kenneth Fine of EnteroLab.com and the Intestinal Health InstituteCeliac.com. URL: https://www.celiac.com/articles/23428/1/An-Interview-with-Dr-Kenneth-Fine-of-EnteroLabcom-and-the-Intestinal-Health-Institute/Page1.html.)
- Sarah Wilson. URL:http://www.sarahwilson.com/2015/11/should-i-be-eating-gluten-if-i-have-hashimotos-i-mean-really/
- Chris Kresser. The gluten thyroid connection. URL:https://chriskresser.com/the-gluten-thyroid-connection
- MTHFR support. Australia. URL:https://www.mthfrsupport.com.au/dao-deficiency-and-histamine-the-unlikely-connection/URL:
- Gluten Free Society. URL:https://www.glutenfreesociety.org/gluten-sensitivity-induces-acid-reflux/#QbsgUG90I4WtrY5g.99
Coenzyme Q10 and thyroid dysfunction
Coenzyme Q10 (CoQ10) is a fat soluble molecule which is made by our body (primary in the liver) and is essential for energy production. I had talked previously about another important molecule, L-carnitine which is also needed to make energy in cells. Coenzyme Q10 is just as important. It is especially concentrated in the heart and brain. CoQ10 has two forms: oxidized Coenzyme Q10 (ubiquinone) and reduced form (ubiquinol). Ubiquinone is converted into ubiquinol in the body so that it can utilised. Ubiquinol is a powerful antioxidant. It protects cell membranes, proteins, DNA and mitochondria from free radicals. CoQ10 works well with vitamin E and C.
A blood test can determine total CoQ10 levels.
Thyroid hormone ignite the energy production process in mitochondria in every cell of our body. Coenzyme Q10 is needed in the chain of that process in order to generate ATP, energy and life giving molecule. Thyroid cells, just like every single cell in the body, need Coenzyme Q10 to function.
In Graves’ disease, the body uses up more CoQ10 due to the accelerated energy production. It is a common deficiency coexisting with hyperthyroidism. A scientific study (3) has shown that the values of CoQ10 in hyperthyroid patients are among the lowest reported in different human diseases. The heart works forcefully and beats faster in Graves’ disease putting a strain on the heart muscle and increasing the demand for Coenzyme Q10. Basically, in Graves’ disease, the body uses more CoQ10 than it can produce. A scientific studies (2, 3 and 5) had demonstrated that people with hyperthyroidism have significantly lowered Coenzyme Q10 levels when compared to patients with normal thyroid function. In the study (5) on cardiac performance and Coenzyme Q10 in thyroid disorders, it was shown that heart performance was improved in patients when 120mg of Coenzyme Q10 was given daily for one week to 12 hyperthyroid patients. ”It appears, therefore, that the Coenzyme Q10 dose actually has a therapeutic value for congestive heart failure induced by severe thyrotoxicosis.”
On top of that, excessive thyroid hormones may deplete other necessary mitochondrial nutrients faster such as vitamins B, L-carnitine, potassium, selenium and magnesium. The imbalance of thyroid hormones, essential nutrients and antioxidants, such as CoQ10 may lead to mitochondrial dysfunction which can be connected to autoimmunity. Study (4) had shown that Coenzyme Q10 deficiency is associated with selenium deficiency.
Deficiency of CoQ10 may lead to muscle and joint pain as well as muscle damage and mental and physical fatigue. Mood swings, inability to handle stress and memory lapses can be a sign of a low CoQ10.
Coenzyme Q10 levels decline with age and lowered levels are connected with certain other health conditions (such as diabetes, heart disease, depression, migraines). Other condition in which Co Q10 can be reduced are: underactivity of the adrenal glands (hypoadrenalism) and underactivity of the testes and ovaries (hypogonadism). Smoking and obesity also depletes Q10. Cholesterol lowering medications (statins) may result in decreased levels of CoQ10 and other oil-soluble nutrients in the body (6). These medications interfere with an enzyme which produces both cholesterol and Coenzyme Q10. You might consider supplementing with Q10 if you are taking cholesterol lowering medications.
Many medications used to treat blood pressure, such as propranolol were shown to lower CoQ10 levels (1). Also, people with essential hypertension (even those not treated with hypertensive medications) were shown to be deficient in CoQ10 (1). This study by Kishi H, Kishi T and Folkers K concludes that:” A pre-existing deficiency of coenzyme Q10 in the myocardium of hypertensive patients could be augmented by subsequent treatment with propranolol, possibly to the “life-threatening” state described by others.” This means that if you have Graves’ disease and take propranolol to lower your blood pressure, your CoQ10 levels need to adequate. Blood pressure medications such as propranolol are commonly prescribed for patients diagnosed with Graves’ disease.
Let’s look at the opposite condition of thyroid dysfunction- hypothyroidism. Low levels of energy may be due to low thyroid hormone levels and/or low levels of certain minerals, vitamins and other nutrients. Studies show that CoQ10 levels seem to have an inverse relationship with free T3 hormone which means people with hypothyroidism are less likely to have low coenzyme Q10 levels than people with hyperthyroidism. Scientific studies showed that the CoQ10 levels did not show any significant difference in hypothyroid people vs normal healthy patients (2).
People suffering from Fibromyalgia have high levels of inflammation (sore and painful muscles as often seen in hypothyroidism) may possibly have lowered Coenzyme Q10 levels. Blood test would be useful to determine individual CoQ10 levels, especially for someone with an autoimmune disorder. If you are diagnosed with CoQ10 deficiency and are taking thyroid hormones such as Synthroid, CoQ10 should be taking 2hour apart from the thyroid hormone.
Coenzyme Q10 is made in the body from tyrosine amino acids which our body can manufacture. Tyrosine is also a building block of thyroid hormones. It also requires C vitamin, some B vitamins and trace minerals to be made in the body. According to Dr Sarah Myhill (11) the synthesis of this molecule can be inhibited by chronic illness and toxins. CoQ10 can also be supplied in food. It is present among others in beef, organs such as heart and liver, fish (herring and rainbow trout), olive, canola and grape seed oils, parsley, avocado, broccoli, cauliflower, orange, strawberries, roasted peanuts, sesame seeds, pistachio nuts and eggs.
Supplements may help with allergies, migraines, strengthening of the heart muscle and with TED. CoQ10 supplements are widely available without a prescription. They are considered safe at the recommended doses and without major adverse effects. Usual dose is 30mg/day. There are two types of CoQ10 used in supplements: ubiquinone and ubiquinol. The most common is ubiquinone, in powder form or dispersed in oil. Oil form increases its bioavailability. The natural source of ubiquinone (made from fermentation process) might be a preferred choice. Ubiquinol form of Coenzyme Q10 is believed to be better for older people as it is better absorbed and the ability to convert ubiquinone to ubiquinol decreases with age. It was shown in a study to raise CoQ10 levels faster (9). Co-supplementation with vitamin E might be beneficial. People who are deficient in CoQ10 might need to check their selenium levels as these two deficiencies commonly co-exist. Adequate magnesium levels are also important for heart health.
Coenzyme Q10 is a blood thinner so care needs to be taken in individuals with certain medical conditions (such as diabetes as it lowers blood sugar)and those taking warfarin, aspirin or other blood thinners. It is best to stop taking Coenzyme Q10 before surgery. It should be avoided if pregnant or breastfeeding (as controlled studies are not available). Therefore, it is advisable to consult your doctor before supplementing with Coenzyme Q10.
This blog is for educational purposes only.
- Kishi H, Kishi T, Folkers K. Bioenergetics in clinical medicine. III. Inhibition of coenzyme Q10-enzymes by clinically used anti-hypertensive drugs. Res Commun Chem Pathol Pharmacol. 1975 Nov; 12(3):533-40.
- Ogura F, Morii H, Ohno M, Ueno T, Kitabatake S, Hamada N, Ito K. Serum coenzyme Q10 levels in thyroid disorders. Horm Metab Res. 1980 Oct; 12(10):537-40.
- Antonio Mancini, Roberto Festa, Sebastiano Raimondo, Alfredo Pontecorvi and Gian Paolo Littarru. Hormonal Influence on Coenzyme Q10 Levels in Blood Plasma. Int J Mol Sci. 2011; 12(12): 9216–9225
- Vadhanavikit, H.E. Ganther. Selenium deficiency and decreased coenzyme Q levels. Mol. Aspects Med., 15 (Suppl.) (1994), pp. s103-s107.
- Suzuki H, Naitoh T, Kuniyoshi S, Banba N, Kuroda H, Suzuki Y, Hiraiwa M, Yamazaki N, Ishikawa M, Hashigami Y, et al. Cardiac performance and coenzyme Q10 in thyroid disorders. Endocrinol Jpn. 1984 Dec; 31(6):755-61.
- Littarru GP, Langsjoen P. Coenzyme Q10 and statins: biochemical and clinical implications. Mitochondrion. 2007 Jun; 7 Suppl: S168-74. Epub 2007 Mar 27.
- Mancini, A.; de Marinis, L.; Calabrò, F.; Sciuto, R.; Oradei, A.; Lippa, S.; Sandric, S. Littarru, G.P.; Barbarino, A. Evaluation of metabolic status in amiodarone-induced thyroid disorders: Plasma coenzyme Q10 determination. J. Endocrinol. Invest. 1989, 12, 511–516.
- Alehagen U, Johansson P, Bjornstedt M, et al. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among elderly Swedish citizens. Int J Cardiol. 2013; 167(5):1860-6.
- Langsjoen PH, Langsjoen AM. Comparison study of plasma coenzyme Q10 levels in healthy subjects supplemented with ubiquinol versus ubiquinone. Clin Pharmacol Drug Dev. 2014; 3(1):13-7.
- Cordero MD, Cotan D, del-Pozo-Martin Y, et al. Oral coenzyme Q10 supplementation improves clinical symptoms and recovers pathologic alterations in blood mononuclear cells in a fibromyalgia patient. Nutrition. 2012; 28(11-12):1200-3.
- Sarah Myhill on Coenzyme Q10 in Chronic Fatigue Syndrome (ME/CFS). URL: http://www.prohealth.com/library/showarticle.cfm?libid=16337
Lemon balm (Melissa officinalis) and Graves’ disease- overview
Lemon Balm is one of herbs which may be useful for Grave’s disease. I had talked about many other herbs in my book: ’Thyroid and Graves’ disease unmasked’. Lemon balm is a relaxing, gentle, anxiety reducing herb from the mint family.
It has been approved by the German Commission E for sleep disturbance and nervousness. It has been used in the past to treat baby’s colic and viral infections. Many people use it as a calming remedy in times of stress and to help them sleep better. Fresh leaves are often put into salads.
There are no clinical human studies of Lemon balm effectiveness in relation to Graves’ disease. However laboratory studies have shown that freeze dried extracts of lemon balm had decreased the binding of Graves’ disease thyroid stimulating antibody to the receptors on thyroid cells in a dose dependent manner (1). Lemon balm also blocks the stimulation of thyroid by thyroid stimulating hormone (3). Therefore the herb may reduce the symptoms of hyperthyroidism. A study in rats has shown that lemon balm extract had inhibited the generation of T3 hormone (2). Another study had demonstrated a reduction of cardiac rate in isolated rat hearts with extracts of lemon balm. A human clinical study showed that lemon balm had reduced heart palpitations and anxiety in patients (6). Therefore, it is possible that lemon balm may improve the symptoms and thyroid hormone levels in Graves’ disease.
There was a human trial showing lemon balm effectiveness for better sleep. Lemon balm was also shown to increase mood and significantly increase calmness. A scientific study has shown that it was effective in treating laboratory induced stress (4).
Lemon balm has anti-oxidant properties. The active ingredients in lemon balm include caffeic acid, protocatechuic acid (also found in green tea, acai berries and onion skin), luteolin-7-glucoside (also found in dandelion, coffee and artichoke) and rhamnazin rosmarinic acid (also present in rosemary, sage and mint).
No serious adverse effects have been reported with the use of this herb. Overall it is considered safe when used as a leaf, fresh or dried. No interaction with other drugs is known. However due to its sedative effects, take care if you are also taking sedatives or barbiturates. Lemon balm has been used safely for thousands of years, however it is not recommended for pregnant/breastfeeding women unless under doctors consultation. It has a prolactin depressing effect. As with any new herbal remedies, it is important to watch out for any side effects. Consult with your physician before using Lemon balm.
I grow it in my garden and hang branches in a cool place or dry some leaves on towel paper for few weeks and store it in a glass container for use. It has a nice citrus, aromatic taste. The lemon balm is usually not used alone to treat hyperthyroidism.
The recommended dose, suggested by German Commission E monographs is 1.5-4.5g /day prepared as tea (or 0.5 g-1.5g/3times daily). It is sold in a tea bag form in many continental shops.
- Auf’mkolk M, Ingbar JC, Kubota K, Amir SM, Ingbar SH. Extracts and auto-oxidized constituents of certain plants inhibit the receptor-binding and the biological activity of Graves’ immunoglobulins. Endocrinology. 1985 May;116 (5):1687-93.
- Auf’mkolk, M., Kohrle, J., Gumbinger, H., Winterhoff, H., and Hesch, R. D. Antihormonal effects of plant extracts: iodothyronine deiodinase of rat liver is inhibited by extracts and secondary metabolites of plants. Horm Metab Res 1984;16(4):188-192.
- Auf’mkolk, M., Ingbar, J. C., Amir, S. M., Winterhoff, H., Sourgens, H., Hesch, R. D., and Ingbar, S. H. Inhibition by certain plant extracts of the binding and adenylate cyclase stimulatory effect of bovine thyrotropin in human thyroid membranes. Endocrinology 1984; 115(2):527-534.
- Kennedy DO, LittleW, Schley AB. Attenuation of laboratory-induced stress in humans after acute administration of Melissa officinalis (Lemon Balm). Psychosom Med. 2004 Jul-Aug; 66(4):607-13.
- Zahra Akhondali, Mahin Dianat and Maryam Radan. Negative Chronotropic and Antidysrhythmic Effects of Hydroalcoholic Extract of Lemon Balm (Melissa Officinalis L.) on CaCl2-Induced Arrhythmias in Rats. Electron Physician. 2015 Jan-Mar; 7(1): 971–976.
- Alijaniha F, Naseri M, Afsharypuor S, Fallahi F, Noorbala A, Mosaddegh M, Faghihzadeh S, Sadrai S. Heart palpitation relief with Melissa officinalis leaf extract: double blind, randomized, placebo controlled trial of efficacy and safety. J Ethnopharmacol. 2015 Apr 22;164:378-84
- Inhibition of Endocrine Function by Botanical Agents, Review Article; Journal of Naturopathic Medicine; Francis Brinker, N.D.URL: http://webhome.idirect.com/~wolfnowl/thyroid3.htm
Aspartame and thyroid autoimmunity
Aspartame is an artificial sweetener used since 1980s. It was made accidently in 1965 by James M. Schlatter while doing a research in a laboratory. It is therefore not a naturally occurring substance. It is commonly known as NutraSweet, Equal, NatraTaste Blue or number E951. There are many other artificial sweeteners but I will focus on aspartame in this blog. Aspartame is about 200 times sweeter than sugar so very little is needed to achieve the same sweetness as sugar. It is approved for human consumption by FDA and is present in thousands of products including common diet soft drinks, chewing gums, vitamins, some medications (even sugar free cough lozenges) and many other foods ( jellies, confectionary, desserts, yoghurts).
While we all know that high sugar diet is bad for us but what about aspartame?
There is a controversy about the safety of aspartame and the efficacy of aspartame studies. Aspartame breaks down to toxic products in the body. The products are phenylalanine, aspartic acid, methanol (which is then metabolised to a neurotoxin formaldehyde and formic acid). The amounts generally consumed by people are believed to be acceptable and safe. However, as a scientist who worked on DNA, I can tell you that methanol and formaldehyde are still mutagenic substances. Aspartame contains aspartic acid and amino acid phenylalanine, which our body can convert to tyrosine, a building block or thyroid hormone and other hormones. Aspartic acid is a nerve cell stimulant. Even though aspartic acid and phenylalanine occur naturally in protein food, they do not occur by themselves but are balanced with other amino acids. There is a observational study linking consumption of diet soda daily was associated with significantly greater risks of select incident metabolic syndrome components and type 2 diabetes (1). Another scientific study linked consumption of artificial sweeteners with obesity (3). There are many other diseases possibly linked to aspartame consumption (6, 7).
The article published in The American Journal of Industrial medicine in 2014 urges for urgent need for regulatory evaluation of Aspartame and raises serious questions about its safety for human consumption and possible link to cancer development. “On the basis of the evidence of the potential carcinogenic effects of APM herein reported, a re-evaluation of the current position of international regulatory agencies must be considered an urgent matter of public health.”
Even though I will focus on thyroid autoimmunity in this blog, it is important to mention the questions raised about aspartame as our body works as a whole system and to focus on thyroid alone would be irrational.
In my opinion, the research on thyroid autoimmunity and aspartame is insufficient to properly establish a definite link between thyroid autoimmunity and aspartame. Larger population studies would be needed and beneficial. The link between aspartame and GD is not proven as such so far. However Dr. H. J. Roberts described cases of aspartame-related Graves’ disease in four weight-conscious women with hyperthyroidism who had experienced dramatic remissions within several weeks to 3 months of avoiding aspartame. He also had noticed that four other women who had been treated previously for Graves’ disease developed symptoms after beginning aspartame consumption and their symptoms subsided after cessation (4, 5). The power of observation is important and it is great that Dr Roberts is putting those issues into a light and raising questions. Artificial sweeteners were also tentatively linked to Hashimoto’s thyroiditis (8). Dr Janet Starr Hull, managed to cure herself of Graves’ disease by detoxifying from aspartame (10). Those correlations have been noticed by nutritionists as well. It is therefore best to avoid aspartame for people with thyroid autoimmunity. Having regular food and drinks containing aspartame may contribute to thyroid autoimmune illness.
Some individuals may be more sensitive to aspartame damage and may include pregnant women, growing foetus, children and older people who might not tolerate it well. For people with the disease phenylketonuria, ingesting aspartame may cause damage to their brain.
How do you then satisfy your sweet tooth and stay healthy? Limiting sugar is important, especially the white and refined sugar.
I can only talk about my personal choices only. I am not a dietician but I do not like including anything artificial in my food. I made my personal choices in regards to sugar and its artificial substitutes. I avoid foods containing high fructose corn syrup. I do not have any diet or sugar free foods with artificial sweeteners. I try hard to limit sugar. In my belief, sugar is inflammatory (especially refined, white) for someone with autoimmunity problems. It should be limited definitely. I stopped using sugar to sweeten my drinks in my twenties. Over time, I got used to that and never looked back. I do not use stevia (plant derived sweetener) as personally, I do not tolerate it well. I bake cakes or biscuits for special occasions and use brown unrefined sugar, coconut sugar in baking but only with less than a third of the recommended amount and limit the amount I eat. Unrefined brown sugar comes from natural sources like sugar beets and cane and not from a laboratory so I believe it is still better in small amounts than artificial sweeteners. I sometimes use small amount of honey, blackstrap molasses or maple syrup in baking also. Blackstrap molasses is a thick, brown liquid which also contains B vitamins, iron, chromium and other minerals. The presence of chromium in blackstrap molasses is very beneficial as chromium deficiency is connected to increased sugar cravings. Maple syrup also contains minerals. Aspartame may deplete chromium nutrient, which is important for hormonal balance and it may make you crave sugar more. Both blackstrap molasses and maple syrup are believed to have some antioxidant and anti-inflammatory qualities. They have a lower glycaemic index than plain sugar. Raw honey is high in sugar but also has antimicrobial and other beneficial properties so it is a better alternative to plain white sugar when used in small amounts.
I had noticed that some tricks can reduce my sugar cravings, which I usually have after dinner. Good adrenal support day formula works well for me if I notice experiencing lots of sugar cravings. Eating something fatty (few nuts or small piece of feta cheese) or sour (pickled or fermented vegetables) after a main meal has helped me personally. The trick for me is to be strong and wait 10-15 minutes after that and the craving go away. A teaspoon of apple cider vinegar in some water before a meal also lowers my blood sugar and helps. Including foods containing chromium and B vitamins in your diet such as some Brewer’s yeast helps with sugar cravings. Also, having lots of green, organic salads every day help with sugar cravings as they provide plenty of minerals such as potassium and magnesium which support adrenal glands. Finally, a small piece of dark 70-80% chocolate with unsweetened coffee helps me if everything else fails. Naturally decaffeinated, organic coffee would be better for people with Graves’ disease. Dealing with sugar cravings and emotions may help some. Emotional freedom technique (tapping on some acupuncture points) is a gentle technique that may be useful.
Please note my blogs are for educational purposes only.
- Jennifer A. Nettleton, PHD, Pamela L. Lutsey, PHD, Youfa Wang, MD, PHD, João A. Lima, PHD, Erin D. Michos, MD and David R. Jacobs, Jr., PHD. Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care 2009 Apr; 32(4): 688-694.
- Morando Soffritti, MD, Michela Padovani, MPH, Eva Tibaldi, PhD, Laura Falcioni, DMV, Fabiana Manservisi, PhD and Fiorella Belpoggi, PhD. The carcinogenic effects of aspartame: The urgent need for regulatory re-evaluation. American Journal of Industrial Medicine. 2014: 57(4):383-397.
- Endocrine Society. Low-calorie sweeteners promote fat accumulation in human fat. April 03, 2017. URL: https://www.endocrine.org/news-room/current-press-releases/low-calorie-sweeteners-promote-fat-accumulation-in-human-fat
- J. Roberts, MD, FACP, FCCP. Aspartame Disease. A Possible Cause for Concomitant Graves’ Disease and Pulmonary Hypertension. Tex Heart Inst J. 2004; 31(1): 105
- Roberts HJ. Aspartame and hyperthyroidism: a presidential affliction reconsidered. Townsend Letter for Doctors & Patients 1997; May: 86–8.
- 22nd Annual Scientific & Clinical Congress of the American Association of Clinical Endocrinologists: Hashimoto’s Hypothyroidism Induced by Artificial Sweeteners. https://www.endocrineweb.com/professional/meetings/hashimotos-hypothyroidism-induced-artificial-sweeteners
- Janet Starr Hull. Sweet Poison. New Horizon Press. 1999. USA.
Imprint of stress on thyroid – Angel’s wing
You might wonder about a strange photo I included in my blog. I call it “Angel’s wing”. I took this picture myself after I had noticed an imprint of bird’s wing on my window. The bird must have hit my window very hard to leave such an imprint. However it must have recovered and flew away as it was nowhere to be seen. I thought this picture would be a great metaphor for my blog. Sometimes life presents us with unexpected stresses we were not prepared for or stresses which are chronic, origin of which can be difficult to define. The stresses leave imprints on our health like the wings of unknown bird on my window.
Genetics (this includes personality traits), together with specific epigenetics factors (factors originating from outside of the body) such as toxins, radiations, nutrition, infections, hormonal imbalances, emotions and stress can cause autoimmunity. I will focus on stress specifically in this blog. It is one of the triggers of autoimmunity in genetically predisposed people. Stress can affect many functions in the body and may be connected to chronic infections, food intolerance and allergies. From scientific research, we know that even identical twins do not both necessary get Grave’s disease (GD) and so the environmental factors are at play. If you lose yourself in stress, then your immune system will lose itself too, it will stop distinguishing self from non self. The most difficult stressful events are the sudden loss of a loved one. However stresses can be chronic. Those cannot be easily solved sometimes due to particular circumstances of life. Stress itself is not the only culprit; it is important how stress is handled. If an emotionally sensitive person is constantly exposed to GD triggers and cannot effectively react to them, autoimmune thyroid illness may start. Our genes direct our personality. People predisposed to Graves’ disease may be more vulnerable to negative emotions. It has nothing to with being weak or emotional but just being more genetically sensitive to stress.
I had always been interested in psychology of an illness and understanding my own personal journey. Today, I believe that specific stresses are connected to specific body symptoms. Different people are sensitive to different stresses and experiences.
I would like to share the things I had learned about stress and thyroid autoimmunity relationship. The knowledge is not my own vague hypothesis. It comes from observations of medical practitioners, researchers and psychologists who collected data from their patients.
Medical doctors in their descriptions of Graves’ disease in past decades attributed it to stress. It was noted that there were more cases of GD during war times. The correlation of GD and stress was noticed by Doctor Parry, who originally described the illness. Large population studies indicated that negative life events, their increased number and impact can definitely be a factor in GD (1, 2, 3, and 4). Despite the fact that stressful life events often correlate with GD and there seems to be plenty of data to support it, the link still remains controversial. It is difficult to measure stress or an individual reaction to it. We should be careful tough of dismissing the power of observation. Emotions, such intense fear, has been connected to GD as early as 1825 by doctor Caleb Perry, who described case of a young woman developing GD after falling from her wheelchair while coming down the hill too fast. GD used to be called ‘Shock-Basedow’.
The thyroid gland is located at the level of the fifth energy centre called the throat chakra in Oriental spiritual books that has to do with expression and creativity. It is believed that when this energy centre does not flow properly, thyroid problems may arise. Dr Christiane Northrup, in her book: ‘The wisdom of menopause’ (6) talks about the connection between emotions and physical anatomy. The energy center of thyroid is connected with communication. It suffers when a person fears expression. The person who is unable to self-express, has an inability to communicate personal needs and express hostility, is treated as insignificant or denied their self- expression might suffer from thyroid issues. Thyroid gland likes free expression of feelings, telling personal truths and it does not like secrets. My personal understanding is that when a person has a problem processing some inner conflict, which is difficult to word or express, that person can metaphorically ‘slow down or speed up time’ by changes to the thyroid function by the immune system, as seen in Graves’ disease or Hashimoto’s thyroiditis. Those two alternating thyroid functions can fluctuate in thyroid autoimmune disease. Hyperthyroidism often proceeds Hashimoto’s disease. Imagine a person saying’ I cannot deal with it and it is hard for me to word what I am missing so ‘I let time pass quickly’ and then realizing ‘I need more time to sort this out’. Nervous energy, never enough time and time is precious and should not be wasted may be emotions of a person with autoimmune thyroid disease.
Austin W. Bennet and Charles Glenn Cambor in a clinical study of hyperthyroidism (7) reference previous studies indicating that hyperthyroid patients tend to bind close to their mothers by caring for them and by winning their love by caring for others. They also struggle against fear, have problems expressing hostility, have care taking behavior, premature self-sufficiency, ambition and exhausting work obligation.
The thyroid autoimmunity stress is also connected with feeling of being unloved, loss of love and security in love. Svetla Bankova, psychologist and a fellow sufferer from GD, who managed to cure herself with lifestyle changes, calls Graves’ disease: ‘a missed call for love’ (9). Childhood is an important time and growing up in a stressful environment of a dysfunctional family where a child has to fight for parental attention or is experiencing some neglect or economic hardship, selective parents focusing on the youngest sibling, premature responsibilities, unresolved trauma and post-traumatic stress disorder may all render the immune system more susceptible to thyroid autoimmunity. One of the factors occurring in a dysfunctional family can relate to child who was unwanted and feels that from the parents even on subconscious level (22) making the child more fearful. An unwanted child’s system may subconsciously try to ‘self-destroy’ because that was what the parents once wanted, which is exactly what autoimmunity is, an immune system trying to destroy its own cells (23). Some studies indicate that the development of a child during pregnancy can be affected by maternal stress hormones. In fact, autoimmunity can arise from stress and poor expression of thyroid molecule in the thymus during a child development as discussed in my previous blog. I came across this information while listening to fascinating and thought provoking Polish presentations by a Magdalena Dembowska who is a consultant in Total Biology.
There is a link between a parent/s with autoimmune BPD and a child/adult with autoimmunity problems. Children brought up by Borderline Personality Disorder (BPD) parents have a higher rate of autoimmune disorders due to invalidating, confusing, controlling and stressful environment they grew up in. This was noted through the observation of a psychologist, while dealing with adult children of BPD parents (10). Interestingly, BPD is also associated with autoimmunity, hypothyroidism and anti-thyroid antibodies (anti-thyroglobulin antibodies) (11, 19 and 20). Stress has been linked to anti thyroid antibodies, autoimmune Borderline Personality Disorder (BPD) and fluctuating mood. Stress can be a factor for both a parent and a child and therefore autoimmunity can possibly be passed through ‘stressful growing up conditions’ to a next generation. Interestingly, when a child develops Graves’ disease, it has been linked to a father’s thyroid autoimmunity and anti TPO antibodies. The imprint of stress on a parent (one example is stressful childhood of the parent) can imprint child’s health too. Not every neglected or stressed child will get BPD and autoimmunity. Of course genetic predisposition plays a role too but we know that triggers has to be there for autoimmunity to develop and stress is one of those triggers. Awareness of this link can help to modify the behavior of a parent and break a chain of suffering for future generations. Childhood stress affects the limbic part of the brain, in which thyroid hormones play a major role. An early negative conditioning (often subconscious) from a parent can create illness in the future if a person is not able to reverse some of the programming.
The loss of a mother or a mother figure in childhood or infancy was a common factor precipitating GD in many studies. Cases of children, who developed GD after a death or separation from the mother figure were described by Morillo and Gardner in a clinical report (8). The onset of Graves’ disease can be followed by a significant life-altering event like death of a loved one (loss of love), separation from a loved one or a divorce. Many studies indicate that these children, who lost their mother figure before teenage years are at a higher risk of behavioral changes and depression in a later life.
An interrupted maternal care during childhood and poor mother-child relationships create dysfunctions in the hypothalamic-pituitary-adrenal (HPA) axis for life. Also, a maternal stress, anxiety, and fatigue have similar consequences on a child. Some children with interrupted maternal care are often diagnosed with ADHD (13). These disruptions can affect cortisol production in a person for life can be a factor in a development of GD. Some children diagnosed with ADHD may be found later to have hyperthyroidism.
It is stipulated that people predisposed to GD might have a poor coordination between the thyroid and adrenal glands. Dr Wilson (15), who studied hair mineral pattern in people with GD, believes that Grave’s disease is linked to an ineffective stress response in which the adrenal glands do not participate much and the thyroid overcompensates and becomes hyperactive. Lowered levels of cortisol are often seen in people with GD and generally in autoimmune disorders as its production is impaired in chronically exhausted adrenal glands.
Forteza states that stress is indeed a factor in development of hyperthyroidism by demonstrating that 65% of his younger patients, who developed the disease, had psychological stress. Physical stress was a factor in older patients (12). Stress (emotional or physical) is also associated with lower vitamin D levels, which affects the immune system negatively. On top of that, stress affects neurotransmitters in the body, detoxification processes and depletes B vitamins, especially B1. Deficiency of that vitamin can express itself as a nervous tension and vivid nightmares. Stress produces real chemical changes in the body. It affects the immune system. Scientific studies found that certain immune system molecules which control autoimmunity were significantly reduced in lymphocytes from stressed animals compared to non-stressed control animals (17). Scientists have looked at the role of B lymphocytes in autoimmune diseases and uncovered that the production of B cell activating factor (BAFF) is related to immune responses affected by stress. When there is too much BAFF, harmful B cells live longer than they can damage healthy tissue (18). Chronic or severe stress alters how minerals in our body are distributed and retained. The first reaction to stress is to excrete zinc and magnesium and accumulate sodium, which is needed to make aldosterone hormone by adrenal glands. Aldosterone prepares body for flight or fight response and increases our blood pressure. Low levels of zinc and magnesium affect the thyroid gland. Some scientists believe that the increased level of thyroid hormone production due to stress may be the culprit to changes of immune system leading to autoimmunity.
I believe that symptoms of illness and autoimmunity, ’angel’s wing’ are the wake up calls to look at unresolved issues. It is our time to act, to become more aware and connect with our outside environment. We should be aware why we feel nervous or fearful sometimes. If we are not in an immediate physical danger, we might need to look into our past experiences for answers. Therefore, resolution is important. However we have to live in here and now, not in the past and not in the future. I believe the resolution of our negative feelings can came through awareness of ourselves. Relaxation, meditations, understanding of our life, lives of others and forgiveness are all important. It is helpful to aim at replacement of anger, pain with peace, forgiveness, gratitude and love. It is also important to remember that our loved ones who had passed would not want us to become sick due their passing. Those are difficult processes but necessary for our health. The best conflict resolutions are practical but they can also be done within us. It is ideal when a conflict resolutions in relationships involve the related parties but that is not always possible. You might consider slowing down, relaxing more, going easy on yourself, expressing your emotions and doing things that make you happier.
It is important to say that nobody should be blamed for your illness, including yourself. Emotions and self- awareness are important for us to grow. We are all learning. Once we are aware of our personal stress triggers and the science behind them, they would be easier for us to handle when encountered again.
Please note this blog is for educational purposes only.
- Harris T, Creed F, Brugha TS. Stressful life events and Graves’ disease. Br. J. Psychiatry. 1992 Oct; 161:535-41.
- Sonino N, Girelli ME, Boscaro M, Fallo F, Busnardo B. Fava GA. Life events in the pathogenesis of Graves’ disease. A controlled study.Acta Endocrinol (Copenh). 1994 Apr; 128(4):293-6.
- Radosavljević VR, Janković SM, Marinković JM. Stressful life events in the pathogenesis of Graves’ disease. Eur J Endocrinol. 1996 Jun; 134(6):699-701.
- Kung AW. Life events, daily stresses and coping in patients with Graves’ disease. Clin. Endocrinol (OXF).1995 Mar; 42(3):303-8.
- Geraldine Falgarone, Hassan M Heshmati, Regis Cohen and Gerard Reach. Role of emotional stress in the pathophysiology of Graves’ disease. European Journal of Endocrinology. 2013; 168 R13–R18
- Wisdom of menopause; the complete guide to women’s health and wellbeing. Christiane Northrup, MD. Piatkus Book. London 2001.
- Austin W. Bennett, M.D.; Charles Glenn Cambor M.D. Clinical Study of Hyperthyroidism. Comparison of Male and Female Characteristics. Arch Gen Psychiatry. 1961; 4 (2):160-165.
- Edgar Morillo, MD and Lytti. Gardner, MD. Clinical report. Bereavement as an Antecedent Factor in Thyrotoxicosis of Childhood: Four Case Studies with Survey of Possible Metabolic Pathways Psychosomatic Medicine. 1979 November; 41(7): 547.
- Svetla Bankova. Life manual for Graves’ disease and hyperthyroidism. Cafepress. USA 2011.
- Kimberlee roth and Freda B. Friedman. Surviving a borderline parent. New Harbinger Publications, Inc. 2003. Oakland, CA.
- Geracioti TD Jr, Kling MA, Post RM, Gold PW. Antithyroid antibody-linked symptoms in borderline personality disorder. Endocrine. 2003 Jul; 21(2):153-8.
- Forteza ME. Precipitating factors in hyperthyroidism. Geriatrics. 1973 Feb; 28(2):123-6.
- Corinne Rees. Childhood attachment. Br. J. Gen Pract. 2007 Nov 1; 57(544): 920–922.
- Lawrence Wilson. Thyroid disease and its healing.URL: http://drlwilson.com/Articles/thyroid.htm
- Falgarone G, Heshmati HM, Cohen R, Reach G. Mechanisms in endocrinology. Role of emotional stress in the pathophysiology of Grave’s disease. Eur J Endocrinol 2012 Dec; 168(1) R13-8. URL: http://www.eje-online.org/content/168/1/R13.full.pdf
- Weiss JM, Sundar SK, Becker KJ, Cierpial MA. Behavioral and neural influences on cellular immune responses: effects of stress and interleukin-1. J Clin Psychiatry; 1989 May; 50:43–55.
- Crupi Rosalia, Cambiaghi Marco, Spatz Linda, Hen Rene, Thorn Mitchell, Friedman Eitan, Vita, Giuseppe, Battaglia Fortunato. Reduced adult neurogenesis and altered emotional behaviors in autoimmune-prone B-cell activating factor transgenic mice” Biological psychiatry; 2010 March 15; 67(6):558-566.
- Geracioti TD Jr, Kling MA, Post RM, Gold PW. Endocrine. Antithyroid antibody-linked symptoms in borderline personality disorder. 2003 Jul; 21(2):153-8.
- M. A. Iddah and B. N. Macharia. Stress and anti TPO antibodies. Autoimmune Thyroid Disorders. Published online 2013 Jun 26. doi: 10.1155/2013/509764. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3710642/
- Seqni M. Pani MA. Pasquino AM. Badenhoop K. Familial clustering of juvenile thyroid autoimmunity: higher risk is conferred by human leukocyte antigen DR3-DQ2 and thyroid peroxidase antibody status in fathers. J. Clin. Endocrinol. Metab.2002 Aug: 87(8):3779-82.
23.Int. J. Prenatal and Perinatal Psychology and Medicine. Moscow2007.Coordinated Congress Summaries. Vol. 20 (2008) No. 1/2, pp. 42–76 http://www.mattes.de/buecher/praenatale_psychologie/PP_PDF/PP_20_1-2_Moscow2007.pdf
What broccoli, thyroid and taste have in common?
Cruciferous vegetables such as broccoli, cabbage, broccolini, mustard greens, cauliflower, kohlrabi, turnip, radish, kale and watercress are great for us. We should include them in our diet. They have many beneficial health effects as they contains plenty of beneficial nutrients, have detoxifying and anti-carcinogenic effects. Cruciferous vegetables are very important for glutathione function (important detoxifying molecule) and removal of many toxins from the body, including heavy metals.
Most cruciferous vegetables are also mild goitrogens. They contain compounds such as isoflavones and isothiocyanates. Those molecules are natural mild thyroid inhibitors with action similar to antithyroid medications used for hyperthyroidism.
Goitrogenic food normally does not hamper the thyroid hormone production in healthy individuals. However, in excessive amounts, believed to be more than two cups a day of raw food, they can slow down the thyroid function. People with a sluggish thyroid may be affected when consuming high amounts of goitrogenic vegetables (especially raw ones) especially if they do not have enough iodine in their diet. Cooking these foods destroys most of the antithyroid chemical. However they would still benefit from having some cruciferous foods, just not in excessive amounts. Those with sluggish thyroid should have adequate iodine levels.
People with Graves’ disease may benefit from eating goitrogenic vegetables. As these vegetables work mildly like antithyroid medications, people who take antithyroid medications might need a lower dose of medication when consuming high amounts (about two cups per day) of raw goitrogenic food. Eating more goitrogens may be used as a remedy to improve symptoms of Graves’ disease. Some goitrogenic food like broccoli induces the enzyme CYP1A, which is involved in metabolising the active vitamin D3 and estrogen, which might benefit someone with GD. CYP1A enzyme might be down regulated in a Graves’ disease process. I came across the comparison of goitrogenic foods in some literature to double edged sword as you might lower the production of thyroid hormones but enlarge the thyroid gland. Therefore over excessive and long term overeating of these foods might backfire. However during periods of hyperthyroidism it may be beneficial to increase consumption of goitrogenic foods.
Speak to your doctor regarding those issues and changes to your diet.
Goitrogenic food competes with thyroid gland with the uptake of iodine from the blood. The compounds in goitrogenic food bind to NIS receptor on thyroid cells and prevent iodine transport into those cells. Iodine is essential for thyroid hormone production. For example, highly goitrogenic food like cassava root and cassava flour, consumed in high amounts in Africa was shown to interfere with the thyroid function.
When goitrogenic foods are chewed, Indole-3-Carbinol, glucose, and thiocyanate ion are generated. Indole-3-carbinol is broken down in the body to Diindolylmethane (DIM), which might help with oestrogen and thyroid hormone metabolism in peripheral tissues by lowering aromatase enzyme activity and thus might help in a relative androgen deficiency and estradiol excess, which is sometimes found in autoimmune disorders. Increased aromatase activity in Graves’ disease may cause Gynecomastia (enlarged breasts) in men and DIM from cruciferous vegetables may help. Other natural aromatase inhibitors are: passionflower tea, chamomile, quercentin, flaxseed oil, lemons, oranges, olive leaf extract and red wine (or red grapes). DIM (Diindolylmethane) is available as supplement. However, there are no scientific studies done on the use of DIM for Graves’ disease and therefore at the present time it’s too early to talk about its benefits vs. risks in regards to this illness.
Other goitrogenic foods include: Brussels sprouts, celery, corn, horseradish, peanuts, almonds, millet, pine nuts, bamboo shoots, sweet potatoes, lima beans, cassava and walnuts. There are cruciferous food powder concentrates on the market, which can be used in drinks or added to shakes and juices. This may make it easier for some people.
Mildly goitrogenic food examples include spinach, strawberries, peaches, apricots, cherries and pears.
It is best to pick cruciferous food you can tolerate as some people may experience bloating or digestive discomfort with some cruciferous foods such as broccoli or cabbage.
PTC (phenylthiocarbamide) is a goitrogenic like substance and PTC- like chemicals are present in goitrogenic foods. It is often used in genetic traits studies at schools in a form of taste paper saturated in PTC. There are PTC taste papers available on the market. Some people taste PTC strongly (very bitter), some mildly (slightly bitter) and others report no taste at all.
The trait of tasters or non-tasters of PTC is genetically inherited and believed to be connected to HLA genes. Those genes are also involved in autoimmunity predisposition.
I found it interesting that there are much more PTC tasters amongst people with Graves’ disease and they can taste lower levels of (PTC) than people with other type of hyperthyroidism (1, 2). On the other hand, people with hypothyroidism tend to be non-tasters. Perhaps, people who can taste bitterness of some goitrogenic compounds have enormous benefits from eating those goitrogenic foods. I can taste PTC. The trait of PTC taster or non-taster may perhaps be some indication of the predisposition to GD.
Our bodies are amazing. Our taste, food preferences, its benefits for our individual health and genetic are all connected.
- F. D. Kitchin, W. Howel-Evans, C. A. Clarke, R. B. McConnell and P. M.Sheppard. P.T.C. Taste response and thyroid disease. Br. Med J. 1959 Apr;1(5129):1069-1074.
- Farid NR, Barnard JM, Bryant DG. HLA and phenylthiocarbamide (PTC) tasting in autoimmune thyroid disease. Tissue Antigens. 1977 Nov;10(5):414-6.