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Adrenal function, stress and thyroid autoimmunity connection

Adrenals and thyroid problems

Adrenal function, stress and thyroid autoimmunity connection

Adrenals are endocrine glands which sit on top of kidneys. They produce many hormones and are involved in stress management. Cortisol hormone is made by adrenals and it is involved in managing stress and balancing of the immune system. It is produced continually in small quantities but spikes when a person is experiencing stress.

Adrenals and thyroid glands work together in stress management. They need each other to work properly. Optimal (not too high or too low) levels of cortisol are required for thyroid hormone to work well at its nuclear receptor. This in turn affects the conversion of thyroid hormone T4 into active T3 hormone. Thyroid hormones do not work optimally with chronic levels of high or low cortisol.

Imagine a tug of rope game with adrenal glands on one side and thyroid gland on the other. When both glands work optimally and pull with the same strength on each end, the health is maintained and everything is balanced. Stress adds weight onto the rope and makes the endocrine glands work harder.

When a person is experiencing high degree of intense stress (physical or emotional), the adrenals pump out high levels of cortisol in order to release nutrients around the body necessary to deal with stress. This depletes these essential nutrients. Cortisol increases heart rate and changes utilization of certain nutrients like copper by making it more available for the immune system. High levels of thyroid stimulating hormone are connected to high cortisol level and stress.

If stress is chronic, adrenals get exhausted eventually. This process occurs in stages. The balance in the tug rope game is lost. Thyroid gland is left with the job of overcompensating for a poor adrenal status and keeping the ‘rope’ tight (as it is seen in Graves’ disease). Some degree of adrenal exhaustion (from mild to severe) can be seen with autoimmune disorders. Cortisol is an anti-inflammatory hormone and stops the immune system from over reacting. When adrenals are exhausted due to a chronic stress, the production of cortisol is lowered. No wonder, people are given Prednisone (cortisol like steroid) to lower the autoimmunity and restore the balance of the immune system.

Some people tend to be more prone to adrenal exhaustion. I suppose it relates to personality traits and life experiences. For example, children separated from their mother at an early age or infancy (length of separation did not play a role) showed positive association with higher cortisol levels upon wakening and a flatter pattern of cortisol levels during the day for the rest of their life in a study (1). It is evident in many studies that stress is a strong factor in the development of autoimmune disorder.

How can you tell if you have some degree of adrenal exhaustion? Here are some questions to consider. Are you sleeping well? Is it usually difficult to get up from bed in the morning? Are you getting frequent colds and allergies? Do you experience high level of stress? Did you experience a significant stressful event like a loss of a loved one? Do you feel tired /wired often? Do you suffer from autoimmunity problems? If answer is yes to one or more, the adrenals may need some support.

Getting adrenals to work optimally can reduce autoimmunity problems, restore energy levels and lower stress.

How can it be done in the following conditions?

  1. Autoimmunity

Lower your stress levels (changing thought patterns, prayer, rest/work balance), eating better, reducing sugar in the diet, nutritional support, resting, sleeping enough, limiting over exertion, deep breathing exercises, meditation, tapping technique, acupressure, adrenal support herbs, vitamins and minerals (Magnesium is important). Important vitamins for adrenal support are these from B group, vitamin C (natural like from Camu Camu root powder) and D (get adequate sun exposure). Lemon balm (Melissa officinalis) tea is very calming and helpful for Graves’ disease.

I refer you to my book: ’Thyroid and Graves’ disease unmasked’ for a more detailed list.

  1. For people living without the thyroid gland (after treatment such as surgery or radioactive iodine treatment) a good adrenal support containing vitamins, minerals (especially Magnesium) and herbs (such as Rhodiola Root extract) may be of a benefit.

I have had my thyroid removed due to Graves’ disease and have to say my favorite adrenal support is Adrenal day formula by Dr Berg or Rhodiola relax by Nature’s Sunshine.

A very important point for people living without a thyroid gland is to have an optimal hormonal replacement. It is important to look at the levels of both T4 and T3 hormones. Without adequate levels of T3 hormone, adrenals get exhausted, they are unable to work properly. More about that in my book.

 

Please speak to your doctor before any herbs, supplements, dietary modifications and other changes are undertaken.

 

References

  1. M. Kumari, J. Head, M Bartley, S. Stansfeld, M. Kivimaki. “Maternal separation in childhood and diurnal cortisol patterns in mid-life: findings from the Whitehall II study”. Psychological Medicine. 2013 March; 43 (3): 633–643.
  2. 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
  3. Kimberly N Walter, Elizabeth J Corwin, Jan Ulbrecht, Laurence M Demers, Jeanette M Bennett, Courtney A Whetzel, and Laura Cousino Klein. Elevated thyroid stimulating hormone is associated with elevated cortisol in healthy young men and women. Thyroid Res. 2012; 5(1):13.
  4. James L. Wilson. Adrenal fatigue. The 21st Century Stress Syndrome. Smart Publications. USA. 2003.

 

 

 

Autoimmune illness, why me?

Immune system and autoimmunity

Autoimmune illness, why me?

Why do people get autoimmune disorders? Genetics? Environmental factors?

The answer is it is both. However, environmental factors need to be there for an autoimmune illness to develop.

Autoimmunity arises when the immune system gets confused and produces antibodies to its own body components.

Our body has immune cells called T lymphocytes which are the detectives and defense soldiers of our body. They must recognize our own body molecules from foreign ones. They give a signal to other immune cells to launch an attack and to dispose of foreign invaders.

These immature T cells arrive from bone marrow and go to school to learn their skills. This school is called thymus gland. In this school, they are presented with different body molecules and they learn how to recognize them from other foreign ones. Now imagine that some students are genetically predisposed to problems with the recognition of these molecules. A dyslexic student might have a problem in recognizing letter d from letter b, etc. A good school have the capabilities to help the student recognize these differences. Now imagine that a dyslexic student is taught how to recognize d from b by tracing, visualizing and repetition, however he was not taught to recognize p from q. The material necessary to distinguish p from q was not presented.

I will use Graves’ disease or Hashimoto’s thyroiditis (autoimmunity to thyroid) as an example. If thyroid molecules are not presented well to T cells in the thymus gland, they do not learn properly. When these T cells mature and escape the thymus to do their job in the body, they have problems with recognizing self- thyroid molecules from foreign molecules (‘letters p from q’). Many molecules are similar to thyroid molecules like some bacterial or viral components, parts of gluten molecules, parts of other foods or some  pollen molecules.

The reasons for a poor recognition of thyroid components in the thymus may be due to viral infection or stress (emotional or physical) in childhood. Thymus gland is located above the heart and is active until puberty after which it starts to shrink. The mechanism needed to express thyroid molecules in thymus of people predisposed to Graves’ disease is genetically sensitive to a low cortisol level and a low progesterone level. These levels can be seen in some degree of adrenal exhaustion. Adrenals do not produce sufficient cortisol after a chronic and prolonged exposure to stress (physical or emotional). Thymus gland is also sensitive to stress, toxins and radiation. When cortisol is low, the thyroid molecules may be expressed poorly in the thymus and students (T-lymphocytes) do not have a good exposure to thyroid molecules and therefore cannot learn properly.

A mature T –lymphocyte is send into ‘the world’ but it still has a problem with distinguishing self -thyroid molecules from similar foreign molecules. It is like a seed from which autoimmunity can arise.

Imagine a person has a stressed thyroid gland. The thyroid gland can become stressed due to many factors. These factors may be chronic stress (emotional and physical), viral or bacterial components, nutritional deficiencies, hormonal imbalances, toxins, radiation and others. There is a pressure on thyroid to work harder. Stressed thyroid cells look foreign to the immune system. There might be some damage to the thyroid with some self- molecules being released in the process.

Some people may also have digestive health issues and become sensitive to components of food which look similar to thyroid molecules. A person may be more sensitive to air born allergens with similarities to thyroid molecules.

The T cells responsible for recognizing thyroid molecules get overwhelmed. Since they always had some problems recognizing p from q (thyroid molecules from foreign similar ones), now they are even more confused as many outside forces steer them to launching an attack on the thyroid gland. They mistakenly present thyroid self-molecules to B lymphocytes, which then produce thyroid specific antibodies, launching an autoimmune attack on the thyroid. Other coexisting genetic predispositions can also make it easier for T lymphocytes to steer the immune system in the wrong direction.

The autoimmunity can wax and wane. When some of the environmental triggers are removed and immune system balances, the antibody production can be reduced back to its normal levels and the illness can go into a remission. This can be done by reducing stress, detoxification, nutritional balancing, hormone balancing and avoidance of food and allergens one is sensitive to. Medications, specific herbs and supplements can help to re-balance a defective reaction of the immune system.

 

Reference:

Stefan M, Wei C, Lombardi A, Li CW, Concepcion ES, Inabnet WB 3rd, Owen R, Zhang W, Tomer Y. Genetic-epigenetic dysregulation of thymic TSH receptor gene expression triggers thyroid autoimmunity. Proc nati. Acad. Sci USA. 2014 Aug 26; 111(34):12562-7.

L- carnitine and its effect on Graves’ disease

Nutrition for Graves' Disease

L-carnitine is an amino acid that is very important for energy production and fat metabolism and it is often depleted in hyperthyroidism. It helps to carry fatty acids into mitochondria, the energy houses of cells.

L-carnitine, known as acetyl-L-carnitine or carnitine, is synthesised in the liver, kidney and brain and then transported to other areas of the body. It is also present in some foods like red meat and avocado. 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. It is possible that vitamin B3 may be depleted in people with leaky gut problems and digestive problems (common with autoimmunity) as vitamin B3 and amino acid- tryptophan are not well absorbed. Tryptophan is used for vitamin B3 and serotonin production (the happy hormone) in the body.  In fact Graves’ disease may be triggered by diets low in tryptophan, as was shown in animal studies (2). People with Graves’ disease need to have adequate protein (as proteins are made up of amino acids) and fats in their diet. L tryptophan is an essential amino acid, present in high protein foods such as nuts, seeds, egg whites, cheese, red meat, chicken, turkey, fish, oats, beans and lentils. Therefore, indirectly, leaky gut, digestive issues and a low protein (and low tryptophan) diet may be related to a low L-carnitine level.

L- carnitine may help with Graves’ disease. A scientific trial involving fifty women found carnitine to be effective in reversing and preventing the symptoms of hyperthyroidism (1). Its action seems to be similar to antithyroid drugs. Carnitine may inhibit the passage of thyroid hormone into the nucleus or it can interfere with the action of excessive T3 at the nuclear receptor. It seemed to be a very important nutrient in the methylation processes of the body. There is indication that an aberrant methylation process may play a role in the development of GD.

The usual dose of L-carnitine is 500-2,000mg/day. It is available in tablet or liquid form and can be easily obtained as a supplement without a medical prescription.

Some people take L-carnitine with their antithyroid medications but it is best done under a medical supervision as lower doses of antithyroid medication may be needed when taking L-carnitine.

Consult your doctor before using L- carnitine as it needs to be used with caution when taking anticoagulants (blood thinners), beta-blockers, or calcium channel blockers as well as in certain medical conditions. Avoid if pregnant or breastfeeding and with a known allergy or hypersensitivity to carnitine.

References

  1. Benvenga S, Ruggeri RM, Russo A, Lapa D, Campenni A, Trimarchi F. Usefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trial. J Clin Endocrinol Metab. 2001 Aug. 86(8):3579-94.
  2. Carew, L.B. Jr, Alster, FA, Foss, DC and Scanes CG. Effect of tryptophan deficiency on thyroid gland, growth hormone and testicular functions in chickens. J. Nutr. 1983 Sep; 113(9):1756-65.

Minerals and thyroid problems

Our body is mainly made up from carbon, hydrogen, nitrogen and oxygen. Other elements present in larger amounts are: calcium, potassium, sulphur, phosphorous, chlorine, sodium and magnesium.

We also need essential trace minerals. They are required in only small amounts and these are selenium, iodine, vanadium, manganese, iron, cobalt, nickel, copper, zinc, molybdenum, chromium, boron, silicon and arsenic.

Our bodies also need few other minerals in much lesser amounts, such as lithium. The total number of chemical elements that are absolutely needed is not known for any organism.

The main minerals thyroid needs to make hormones are:  iodine, selenium, manganese, iron, phosphorus, calcium, magnesium, chromium, potassium, sulphur, zinc and copper. Potassium is needed for conversion of T4 into the active form, T3. The production is also dependent on the abundance of tyrosine amino acid, vitamin B complex, A and C.

I would like to focus on the conditions of Graves’ disease (main cause of hyperthyroidism) and hypothyroidism.

Two main minerals thyroid needs to make hormones are iodine and selenium. Iodine is needed for making of thyroid hormones and selenium for protection of thyroid against oxidative damage that may occur as iodine is processed in the thyroid. Selenium is a part of enzymes which convert T4 hormone into T3 (the main bio-active) thyroid hormone in the thyroid gland and other tissues.

Therefore the balance of these two minerals is important, if you have too much iodine and not enough selenium, then you can damage thyroid cells, generating thyroid molecules. This can confuse the immune system of a genetically predisposed individual resulting in thyroid autoimmune disorder. Therefore people with thyroid autoimmune disorders (Graves’ disease and Hashimoto’s thyroiditis) might benefit from adequate selenium levels.

It might be beneficial to test selenium levels (urine test) and iodine (iodine loading test) in people with autoimmunity and thyroid problems as well as for people suffering from under active thyroid issues.

Graves’ disease

Iodine

As mentioned previously, excessive iodine can be a problem for people low in selenium and genetically predisposed to Graves’ disease. In fact excessive iodine can trigger Grave’s disease. It has been reported that extremes of iodine consumption may trigger Graves’ disease (both lack and excess of it). Hyperthyroidism may be triggered by amounts greater than 150mcg/day in some sensitive people. It may be triggered by excessive ingestion of iodine containing food (seafood, sea vegetables and iodised salt), supplements containing iodine (such as kelp), some medications (like Amiodarone) and exposure to medical contrast dyes and surgical iodine. Also is someone is deficient in iodine and takes high dose of iodine, induced hyperthyroidism may develop.

No matter what got you there, once you are diagnosed with Graves’ disease, most literature recommends limiting iodine (not avoidance). Generally, it is regarded as pouring fuel on a fire. A minimum of 60 mcg of elemental iodine per day is required to make thyroid hormone. Recommended Daily Intake for adults is 150mcg and for children 90-120mcg. The general recommendation in the literature is not to exceed these amounts when a person has Graves’ disease. Iodine is an essential and important nutrient. It is used by the whole of endocrine system. Iodine seems to be very important for breast and reproductive system health. You need enough iodine but not too much. The exact mechanism of how iodine might trigger Graves’ is not known. Possibilities might include defects in iodine processing and selenium deficiency resulting in free radicals and cellular damage.

Some iodine deficient people with Graves’ disease respond well to iodine supplements (depending on their iodine level, selenium levels and individuality) when they have GD.  Iodine deficient people may need to supplement with iodine but it needs to be done in a very careful and slow manner as indicated by a medical professional. However, I believe that selenium status needs to be checked and corrected first before iodine supplementation. If someone is deficient in Iodine, there is more possibility of damage to the thyroid by environmental pollutants and toxins (especially with low selenium intake). However, there is some debate whether it is the low selenium level, low magnesium and zinc and copper imbalances and not high iodine level that predispose people to GD.

Iodine in the diet usually comes in the form of a compound such as sodium iodide or potassium iodide (iodized salt often contains these forms of inorganic iodide). However, the main source of iodine is seafood. Sea food contains iodine, mostly in its molecular form, I2. Both I-(iodide) and I2 (iodine) forms are important for the body. Iodine is water soluble when Potassium iodide is present.

The effects of Iodine intake and GD process may be connected with coexisting selenium status as selenium seemed to play a protective role against iodine toxicity. People, who had low iodine diets in the past, might be more sensitive to an excess of iodine intake. Many areas in the world are iodine depleted, however Australia is not too bad in that respect. However, children and pregnant women are more vulnerable to iodine deficiency.

High iodine content foods would not be recommended in GD. Sufficient selenium in the diet is also important. One teaspoon of iodized salt contains around 150 mcg of iodine and therefore I do recommend being aware of how much iodized salt you are having when you have GD. According to Dr Sandra Cabot and Margaret Jasinska in their book: ‘Your thyroid problems solved, holistic solutions to improve your thyroid’, if you eat fish three times a week, (smaller varieties are lower in mercury) you are most likely getting enough of iodine. Meat, poultry and eggs also contain some iodine. Oysters are very high in iodine, best avoided.

It is important to know your iodine/selenium status. It is difficult to assess how much iodine one is ingesting. The best way to tell is by having the levels of iodine tested. Iodine loading test assesses iodine body levels. There is an increase of iodine excretion in urine during pregnancy.

Selenium

24hr urine test can determine selenium deficiency. Selenium deficiency is common in people with Grave’s disease and Hashimoto’s thyroiditis.  It is important mineral for the formation of glutathione peroxidase, which detoxifies excess hydrogen peroxide in thyroid gland. Hydrogen peroxide is needed to oxidize iodine in order to make thyroid hormone. Excessive hydrogen peroxide may be a problem when not enough selenium (as it cannot be neutralized) and can damage healthy thyroid cells. Selenium intake can lower thyroid specific antibodies. Selenium has been used in Graves’ disease therapy. There are some studies indicating that it helps with eye problems connected to GD.

Selenium is important for detoxification of toxic molecules and is body’s best antioxidant. People with mercury toxicity (connected to Grave’s disease in some individuals) may be deficient in selenium. Selenium is also a major component of enzymes that convert T4 into the main bio-active T3 thyroid hormone and also convert T3 into T2 in the peripheral tissues. Selenium is important for DNA methylation and its deficiency may possibly trigger GD.

You can find selenium in Brazil nuts (2 Brazil nuts/day provide the recommended daily intake) as well as in organ meats, beef, mushrooms and sunflower seeds. People with thyroid autoimmunity and selenium deficiency might benefit from supplements as indicated by a medical professional. Usual dose is 70mcg/day. It works with vitamin E.

Too much supplemented selenium can toxic especially for pregnant women.

Other important minerals for people with Grave’s disease are: magnesium, calcium, copper (only in deficiency) and possibly others such as boron, lithium and iron. Calcium and Magnesium work together and should be in the right balance. Calcium needs to be added in supplement or diet when magnesium becomes effective.

 

Under active thyroid (not related to autoimmunity)

Iodine

People with under active thyroid may be low in iodine as it is the necessary ingredient for the production of thyroid hormones. This can be due to diets low in iodine, toxins from the environment (such as perchlorate), some medications with bromine, bromine in food and excessive fluoride.

Selenium

Selenium is essential for our body to convert T4 into T3, the most active form of thyroid hormone. It is also required for the health of the thyroid gland.

 Zinc

Zinc is required for the conversion of T4 to T3 and proper functioning of thyroid hormones at DNA level. Adequate levels of copper, iron and zinc are important for the thyroid gland and a person deficient in zinc will have imbalance in copper and iron. Vitamin A works with zinc so adequate levels of vitamin A are also needed. Zinc is plentiful in seafood (oysters, sardines) and meats. Split peas, whole grains and sunflower seeds are also good vegetarian sources.

Most people diagnosed with low thyroid may need to discuss possible supplement of these minerals with their doctor. Most underactive thyroid patients are prescribed thyroid hormone T4 (levothyroxine), however getting optimal levels of minerals and vitamins is also important. Adequate stomach acid is also important to absorb minerals and vitamins.

Reasons for an under active thyroid problems might be many. Low iodine and selenium are only tips of an iceberg.

T4 hormone can be made into T3 (active hormone) and Reverse T3 (inactive hormone) in the peripheral tissues. Some people may have increased production of Reverse T3 instead of free T3. Reverse T3 can block thyroid hormone receptors. The blood test result would show the right levels of free T4 and free T3 but a person may have many hypothyroid symptoms as free T3 (the active hormone) would not work because its receptors within cells are blocked by reverse T3.

The reason for problems with a proper T4 into T3 conversion can be many.  They can be: inflammation, illness and autoimmune antibodies, such as TPO antibodies (seen in autoimmune thyroid disorders), low growth hormone, other hormonal imbalances, poor nutrition low in vitamins A, D, B, C, chromium, iodine, selenium, zinc and others, high sugar intake, low stomach acid, excessive soy intake, some medication (such as beta-blockers), heavy metals(especially mercury), birth control pills, environmental estrogen, obesity, toxins, certain pollutants, high stress, low protein intake, severe diet, liver problems and adrenal insufficiency.

Some of the possible solution (depending on a problem) may include: stress reduction, nutrition rich food, correcting stomach acid, adrenal support and detoxification.

Bibliography

  1. Dr Sandra Cabot, Margaret Jasinska ND; Your thyroid problems solved, holistic solutions to improve your thyroid, WHAS Pty Ltd, Australia, 2006
  2. Eric M. Osansky, D.C. Natural treatment solutions for Hyperthyroidism and Graves’ disease, Natural Endocrine Solutions, USA, 2011.
  3. Thyroid disease and its healing by Lawrence Wilson. URL: http://www.drlwilson.com/articles/thyroid.htm
  4. Kucharzewski M, Braziewicz J, Majewska U, Gozdz S: Concentration of selenium in the whole blood and the thyroid tissue of patients with various thyroid diseases. Biol Trace Elem Res 2002, 88:25-30.
  5. Roland Gärtner, Barbara C. H. Gasnier, Johannes W. Dietrich, Bjarne Krebs, and Matthias W. A. Angstwurm. Selenium Supplementation in Patients with Autoimmune Thyroiditis Decreases Thyroid Peroxidase Antibodies Concentrations. J Clin Endocrinol Metab. 2002 April; 87(4):1687-91.
  6. Roberto Negro. Selenium and thyroid autoimmunity. Biologics. 2008 Jun; 2(2): 265–273.

Published online 2008 Jun.

  1. Elaine Moore with Lisa Moore, “Graves’ Disease a practical guide”; McFarland & Company, Inc., Publishers, USA 2001.
  2. Ridha Arem, MD. The Thyroid solution, Rodale Inc, USA, 2008
  3. Mary Shomon, Living well with Graves’ disease and hyperthyroidism, what your doctor doesn’t tell you that you need to know. Harper Collins Publishers, New York, 2005
  4. Malic and H.Hodgson. The relationship between the thyroid gland and the liver journals. An International Journal of Medicine Oxford Journals, QJM. 2002; 95 (9): 559-569. URL: http://qjmed.oxfordjournals.org/content/95/9/559.long
  5. Edith C.H. Friesema, Jurgen Jansen, Carmelina Milici, Theo J. Visser Transporter defects – A novel mechanism of thyroid hormone resistance with dramatic consequences. Vitamins and hormones. 2005; 70:137-167.

 

Vitamin deficiencies and their connection to thyroid and autoimmunity

Vitamins

Vitamin deficiencies and their connection to thyroid and autoimmunity

The production of thyroid hormones is dependent of the abundance of vitamin B complex, A and C. The thyroid hormones would not work properly without vitamins A and D. Also vitamins do not work properly without thyroid hormones. For example, thyroid hormones are important for the production of vitamin K dependant proteins, which are important for healthy blood vessels.

Nutritional profile of B1, B6, B12/folate and vitamin D can be requested by a doctor and it is beneficial for patients with thyroid problems.

The most common vitamin deficiencies seen in hypothyroidism are: Vitamins C, B1, B2, B9, B12, A, E and D but other B complex vitamins may also be depleted. Vitamin C helps to displace toxic halogens (bromine and fluoride) from the body with iodine which is a vital molecule for the production of thyroid hormones. Vitamin C binds iodide effectively and improves functioning of iodine symporter which pumps iodine into the thyroid and absorption of iodine from the gut. As all vitamins B work together, other vitamin B deficiencies (especially B5, B6 and B9) are common in hypothyroidism. Others, like B7 deficiency may cause hair loss and weak nails. This is due to a poorly functioning digestive system. People with hypothyroidism have lowered stomach acid levels which are important for absorption of vitamins and minerals. They often have other digestive system problems. Hypothyroidism due to autoimmunity (Hashimoto’s thyroiditis) presents with itself a higher requirement for antioxidant vitamins such as C and E. The levels of vitamin B12 might also be low due to autoimmunity problems and low stomach acid. Thyroid hormone needs vitamins A and D to work at the cellular level. Vitamin D is vital for people with autoimmunity problems as it rebalances the immune system. The level of this vitamin needs to be optimal. Hypothyroid people do not absorb vitamin A well and they also do not convert beta-carotene (from vegetables and fruit) to vitamin A efficiently. They might need to include direct sources of vitamin A from cod liver oil and generally work at improving the functioning of their digestive system. Achieving optimal thyroid hormonal levels is essential.

The most common vitamin deficiencies seen in hyperthyroidism are: Vitamin C (natural, food based only), D, E, and B complex. Vitamin B12 is especially important for people with Graves’ disease (the most common cause of hyperthyroidism due to autoimmunity) as many people with Graves’ disease people have anti-parietal cell antibodies which block the absorption of vitamin B12). People with thyroid autoimmune disorders have a confused immune system generally and often have some other non-thyroid related antibodies like ant-parietal ones. They may also have other autoimmune disorders. They tend to have low stomach acid levels. People with anti-parietal antibodies may need to relay on vitamin B12 injections or sublingual vitamin B12. Graves’ disease patients also have a higher requirement for antioxidant vitamins C and E. They remove excessive damaging free radicals and vitamin C supports the function of adrenal glands. Some people may also be deficient in vitamin A. Vitamin deficiencies in hyperthyroidism are due to a poorly functioning digestive system and a rapid nutrient depletion due to a higher metabolic rate.

Vitamins are biological complexes. They work with minerals in the body but more on minerals in a future blog. Most cannot be made in the body. The difference between natural and synthetic vitamins is that synthetic vitamins work more like medications. They have their uses in some cases, especially with specific deficiencies and illnesses. For example ascorbic acid, an antioxidant which is a part of vitamin C complex, can help greatly with many health conditions but high doses may not be suitable in the case of copper deficiency (which is common in hyperthyroidism). This is because the body will need to draw on its own stores of copper and other components so that the whole vitamin may be present. The whole vitamin activity takes place when all other conditions and co-factors are present. Therefore the natural vitamins are superior as synthetic vitamins may not prevent deficiencies if other components of a vitamin are missing in the body. I advocate natural vitamins as they are well tolerated and the danger of overdosing is very unlikely unless in severe deficiency (as indicated by your doctor). Synthetic vitamins are often made from petroleum related products like coal tar. Synthetic fat soluble vitamins can come from irradiated vegetable oils which are not ideal.  Also, synthetic vitamins can be toxic when taken in excessive amounts. For example, excessive vitamin A intake by a pregnant mother can cause birth defects in a baby. Excessive vitamin A will deplete vitamins K and D.

The problem with getting adequate vitamins is that our food is commonly depleted in them due to soil and mineral depletion, pesticides, air pollution and erosion. Minerals are also depleted which is a problem as vitamins and minerals work together, often as complexes. Therefore we need to aim for organic produce and meat from grass fed animals. Adding trace minerals may also help. Our body takes what is needed from our food. It is able to store some nutrients, like the fatty vitamins (A, K, E and D). Others need to be taken up continually as they get depleted faster, such as the water soluble vitamins (B, C) which need to be replenished daily. Vitamins B complex reduce inflammation. All B vitamins work together. For example isolated vitamin B6 deficiency is uncommon.

Nutrition packed quality food/ good digestion/good assimilation/ moderate exercise/ stress reduction/ genetics = health

How do you assess the health of the digestive system?

Simple truth is that if you have thyroid hormonal imbalances you will most likely have digestive system problems.

Low thyroid = poor digestion= poor absorption of essential nutrients

Hypothyroidism can be due to deficiency of specific nutrients. It is also a problem in people on sub-optimal hormonal therapy as can be seen in some people on T4 levothyroxine therapy only, insufficient replacement (too low doses of levothyroxine or Natural Desiccated Thyroid) and in people who have adrenal exhaustion as they do produce sufficient cortisol which activates thyroid hormones (common co-existing problem with hypothyroidism).

Look at symptoms like indigestion (probably low stomach acid, stress, thyroid hormonal imbalance), acid reflux (poor stomach acid, bacterial infection), bloating, gas (pancreatic insufficiency, low thyroid, food intolerances, bacterial gut imbalance), pain on the right hand site of your rib cage after eating fatty food (gallbladder problems, poor bile salt production, hormonal imbalances(oestrogen dominance, low thyroid ), constipation (luck of fibre, bacterial imbalance, hormonal imbalance, low thyroid) and others.

Consult your doctor if you have digestive issues who might request some tests to diagnose your problem. Comprehensive stool analysis looks at how you digest your food, gut bacteria, parasites and blood in stools. It is usually requested by integrative medical doctors. Your doctor might help you depending on your problem. Poor stomach acid can be treated with betaine HCl. You might be helped with some digestive enzymes. Digestion of fats and absorption of fat soluble vitamins (A, D, K) can be helped with bile salts. Bacterial gut imbalance can be helped with apple cider vinegar, probiotics and diet changes. Having a table spoon of apple cider vinegar (like Braggs) in some water before meals can increase stomach acid naturally. It is important to avoid food you are sensitive to. Coeliac disease (gluten allergy) can coexist with thyroid autoimmunity problems in some individuals. Avoidance of gluten might be beneficial for some people with thyroid autoimmunity problems as gluten is a large molecule and have components similar to thyroid molecules. Other foods some people with autoimmunity might be sensitive to are: gluten, soy and sugar as well as some food additives.

Let’s get to know some of the vitamins which might be low in with thyroid problems:

Vitamin C

I am vitamin C

I am a complex

Bound to food

As any natural vitamin would

Ascorbic acid and tyrosine with copper in my outer shell

Protects all my parts very well

As without rutin, bioflavonoids, Factors J, K and P

It just would not be me

It is quite evident

I work as an antioxidant

I keep your blood vessels healthy

It is quite a fact

I will protect you from a heart attack

I help to make collagen magic

Without me your skin and gums would look tragic

It is very true

I protect you from allergies, colds and flu

I am great in times of stress

When your adrenals are a mess

Capsicum, citrus fruits, coriander, parsley, onions and kale you find me there

What it does?

Vitamin C is vital to our health and it is necessary to include it in our diet as we do not make it. In terms of thyroid health, vitamin C is needed for proper workings of iodine symporter in the thyroid, which pumps iodine into the thyroid cells for the production of thyroid hormone. Toxic halogens (bromine and fluoride) in excessive amounts can displace iodine from the body disrupting a proper functioning of hormones. Vitamin C helps to displace them in the favour of iodine. Also, vitamin C (from food) is a vital molecule for people with autoimmunity problems with its strong antioxidant properties. Autoimmune disorders are characterised by a higher ratio of free radicals, oxidants vs. antioxidants which damage healthy cells. Vitamin C improves adrenal function. Often, adrenals have some degree of exhaustion with autoimmune disorders. Adrenal function needs to be optimal for thyroid hormones to work well on a cellular level. The former American president John F. Kennedy was prescribed a daily dose of vitamin C for his autoimmune problems. It is also a powerful antihistamine, antiviral and antitoxin. It stabilizes blood vessels, makes them strong, cleans them, relaxes them and helps the heart work better. Vitamin C deficiency is a risk factor for heart disease. It may also help to improve diabetes. It also helps with weight loss. Vitamins C and E also help to prevent osteoporosis. It increases the production of collagen, elastin and so it also great not only for blood vessels but all connective tissue and our skin. Vitamin C is a number one anti-aging molecule. Vitamin C is also needed for iron absorption.

One important fact for underactive thyroid patients taking thyroid hormones is that vitamin C helps with thyroid hormone delivery into cells. I take my hormones with a glass of water and some lemon juice.

Vitamin C deficiency symptoms: weakened immune system, increased susceptibility to cancer, heart disease, impaired wound healing, gum disease, damage to nerves, eyes and vascular system and easy bruising.

How much do we need?

RDI for adult is 45 mg/day (to prevent scurvy)

However 300mg- 1000mg daily might have beneficial effects on health

Equivalency in food:

1 cup of acerola berries/ 1,600mg

1tsp acerola cherries powder/ about 1,000mg

Coriander seed powder 3tsp/ about 400mg

1 large yellow bell pepper/ 341mg

1 guava/125mg

1 orange/ 80mg

Kale 1cup/80mg

Broccoli 1cup/81mg

What lowers vitamin C?

  • Stress
  • Not sufficient dietary intake (not enough vegetables, herbs, fruit)
  • Processed food diet
  • Illness (such as autoimmunity)
  • Some medications (Barbiturates, Tetracycline, Salicylates)
  • Oestrogen/oral contraceptives

Conditions with the possibility of lowered vitamin C: thyroid conditions (hyper and hypothyroidism), autoimmunity, cancer, stress, smoking, requirement increasing during lactation and pregnancy

Vitamin B1

I am thiamine, vitamin B1

I am a part of B vitamin complex

Bound to food

As any natural vitamin would

I help your heart

And that’s just a start

I am very eager

To control your sugar

And so you know I help you grow

I help to digest your food

Like a good vitamin B should

I am your charm

I keep you calm

Yeast extracts, whole grains, nuts, seeds, lean pork and wheat germ

That is where I am

What it does:

It helps with learning and growth, healthy metabolism, stomach acid production, blood formation, energy, circulation, sugar metabolism, helps with gastrointestinal, neurological and heart muscle tone problems. In a scientific study vitamin B1 supplementation helped with symptoms of fibromyalgia (sore, tender and tired muscles, often seen in hypothyroidism). Another study showed that administration of thiamine helped three Hashimoto’s patients with regression of their fatigue levels (10). It also improves cognitive functioning and mood.

Symptoms of deficiency: weakness, fatigue, headache, nausea, irritability, depression, abdominal discomfort, blood sugar problems, heart complications, psychosis, and nerve damage.

Severe deficiency is rare but mild deficiencies are possible as Vitamin B1 gets depleted fast from the body. Beriberi is the disease resulting from severe thiamine deficiency.

How much do we need?

RDI of adults is 1.2 mg/day for men and 1.1 mg/day for women

Food equivalencies:

Brewer’s yeast- 2tsp/1.0mg

Nutritional yeast- 2tsp- 9.6mg

Asparagus- 1cup/0.19mg

Sunflower seeds-1/4 cup 0.17mg

Green peas- 1cup/0.386mg

Flaxseeds 1 tsp. ground/ 0.115mg

What lowers vitamin B1?

–           Refined and processed food diet (refined rice and grains)

–           Digestive absorption problems (Leaky gut, poor stomach acid)

–           Crohn’s disease

–            Anorexia

–           Adrenal weakness

–           Copper toxicity

–           Anxiety and stress

–            Alcoholism

–            Cancer

–           Gastric bypass surgery

–           People on kidney dialysis and elderly more vulnerable

Conditions with the possibility of lowered vitamin B1: Chronic fatigue, fibromyalgia, gut issues, blood sugar problems, neurological problems, mood and cognitive functioning problems, autoimmune disorders, hyperthyroidism, Graves’ disease, hypothyroidism, Hashimoto’s thyroiditis.

Vitamin B2

I am riboflavin, vitamin B2

I am a part of B vitamin complex

Bound to food

As any natural vitamin would

With other B vitamins in alliance

I give your body a balance

I keep the immune system strong

Help to produce antibodies where they belong

I work around the clock

To make your enzymes work

I help to metabolise your food

Like a good vitamin B2 should

And so you know

I help your cells grow

My sources are nutritional yeast, liver, milk, eggs, leaf vegetables, kidneys, legumes, mushrooms, almonds and cheese

So have some please.

What it does:

Vitamin B2 (Riboflavin): involved in the metabolism of carbohydrates, fats and proteins, cell growth, balance of the immune system and production of antibodies, metabolism of vitamins B6, B9, B3 and iron.

Vitamin B2 deficiency is rare in developed countries. However suboptimal levels are possible. Vitamin B2 deficiency occurs with other vitamin B deficiencies usually. Vitamin B2 is required for metabolising vitamin B9. Vitamin B1 is required for adequate vitamin B2.

The conversion of vitamin B2 into its active enzyme form- flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN) is impaired in hypothyroidism and adrenal insufficiency. This then affects the recycling of glutathione, the main body detoxifier. It may result in the damage to the thyroid gland. Deficiency of vitamin B2 lowers the absorption of iron (common problem with thyroid disorders).

People with low thyroid and low vitamin B2 levels we found to be more predisposed to depression and mental health problems in a scientific study(14).

Symptoms of vitamin B2 deficiency: low iron, other vitamin B deficiencies, anxiety, depression, sore throat, redness of throat, migraines, moist, scaly skin, cracks of lips on the outside, red eyes, tired eyes, formation of blood vessels in the clear covering of the eye, cataracts, sores and cracks in corners of the mouth and decreased red blood cell count.

How much do we need?

RDI for adults is 1.3 mg for men and 1.1 mg for women

Food equivalencies:

Best source: Nutritional yeast 2tsp/ 9.7 mg

Brewer’s yeast 2tsp /1.5mg

Liver 100g/17.5mg

Almonds 100g/1.1mg

Egg 1/0.26mg

Beef and lamb lean steak 100g/0.86mg

What lowers vitamin B2?

–           Adrenal insufficiency

–           Poor diet low in vitamin B2

–            Malnutrition

–            Malabsorption

–           Medication, such as some antidepressants

–           More susceptible to deficiency are vegetarians, vegans, athletes, physical workers,     pregnant and breastfeeding women.

Conditions with the possibility of lowered vitamin B2: Genetic conditions, autoimmunity, hypothyroidism, malignancy and coeliac disease.

Vitamin B9

I am vitamin B9, Folic Acid, Folate

I repair DNA and methylate

And without a question

I am essential for red blood cells formation

It is not a joke

I can prevent a stroke

One of my many DNA effects

Is to protect from neural tube birth defects

And so you know

I help you grow

Folate comes from Latin word folium

Meaning Leaf

No wonder green leafy vegetables that where I mainly live.

What it does?

Folate is often called the natural form of vitamin B9. Folic acid is the synthetic version. It is important for folate and folic acid to be methylated in order to became active.  This might be a problem with hypothyroidism. Grave’s disease may also result from aberrant methylation. It is believed that most fresh green plant sources contain some methylated folate so eating lots of them would help. Gut bacteria helps with methylation of folic acid and folate so improving the health of the intestines would also help (apple cider, probiotics, avoiding foods one is sensitive to). The active and methylated folate is also a vital nutrient for methylation processes of other molecules.  Methylation is an important chemical reaction in the body needed for switching genes on and off, detoxification of molecules and many others. Hypothyroidism relates to methylation problems as the main methylating enzyme MTHFR does not work well with low thyroid hormones.

Problems with proper methylation may lead to a disease (autoimmunity, cancer of bowel and cervix) and others. Methylated folate is needed for DNA and RNA synthesis. Lowered levels may lead to a higher level of homocysteine, a marker for heart and vascular health. It is needed for neurotransmitter production and is essential for brain health. Vitamin B12 is essential for proper functioning of methylated folate. It is also important for red blood cell production. Vitamin C keeps the methylated folate stable.

Vitamin B9 can reduce homocysteine levels (a risk factor for heart and vascular disease) in patients with hypothyroidism. It can help with depression.

Symptoms of deficiency: sore muscles and aches, weakness and tiredness, getting sick frequently, insomnia, shortness of breath, irritability, memory loss, anxiety, nausea, headaches and migraines, depression, heart palpitations, birth defects, infertility, mouth sores, swollen tongue, loss of appetite, diarrhoea, constipation, bloating, IBS, poor digestion, premature grey hair, skin acne and rashes. Long term deficiency may lead to anaemia, cancer and an increased risk of osteoporosis.

Conditions with lowered vitamin B9: genetic problems with methylation, hypothyroidism, depression, type 1 and 2 diabetes, colon cancer, folic acid deficiency anaemia, sickle cell disease, liver or kidney disease, Age-related macular degeneration (AMD) and age related hearing loss.

What lowers vitamin B9?

  • Genetic defects
  • Malnutrition
  • Malabsorption (conditions like coeliac disease, inflammatory bowel disease (IBD)
  • Poor diet (high in overcooked and processed foods and low in green vegetables)
  • Deficiency of B12
  • Alcoholism or heavy alcohol drinking
  • Smoking
  • Certain medical conditions
  • Some medications (long term medications for diabetes- metformin, methotrexate, frequent use of laxatives and diuretics, antacids, H2 blockers, anti-seizure medications, some antibiotics like Trimethoprim for urinary tract infections, oestrogen/oral contraceptives and others)
  • Needs increase during pregnancy and lactation
  • Kidney dialysis patients more vulnerable

How much do we need?

400 micrograms daily

Tests to detect folic acid deficiency are: a complete blood count and red blood cells folate level.

This vitamin needs to be provided every day and deficiency is common.

Brewer’s yeast 2tsp 60mcg

Nutritional yeast 2tsp 240mcg

2cups of spinach/daily requirement (about 500mcg)

Liver (Chicken) 100g/ 578msg

Asparagus 8- 178mcg

Broccoli 1cup/104mcg

1 orange 29mcg

Others: lentils, sprouting legumes, berries, cruciferous vegetables, chickpeas, roman lettuce and fermented foods

Vitamin B12

I am Vitamin B12, Hydroxycobalomin

I am a part of B vitamin complex

Bound to food

As any natural vitamin would

I help you digest and metabolise food

Like a good vitamin B12 should

For me, it is a norm

To help your red blood cells form

My main destination

Is your DNA and methylation

I work without a strain

To protect your nerves and brain

I lower your risk of cardiovascular disease

So have some of me please

I am hard to beat and my main source is fish, shellfish, eggs, milk, chlorella and meat

What it does?

It helps the nerves work properly, improves the mood and protects the brain. It helps with energy production and lowers the risk of cardiovascular disease. It helps with DNA replication and damage. Some people with thyroid autoimmunity problems (in around 25%) (22, 23) may also have antibodies against the intrinsic factor, which lowers B12 absorption from the stomach. People with hyperthyroidism have an increased need for vitamin B12 due to sympathetic system dominance.

Symptoms of vitamin B12 deficiency: heart palpitations, numbness and tingling of the hands and feet, difficulty walking, memory loss, depression, lethargy, fatigue, disturbed sleep pattern, memory impairment, disorientation, dementia, gastrointestinal symptoms, tongue soreness, appetite loss and constipation.

What lowers B12?

–  Genetic disorders

–  Chronic stomach inflammation

–  Gastric bypass and stomach surgery

–  Pernicious anaemia (autoimmune disorder)

–  Autoimmunity

–  Some medications (like Metformin)

–  Malabsorption (due to problems with proper functioning of stomach, pancreas, and small intestine)

– Colon cancer

– Elderly individuals and vegans are more vulnerable

Conditions with coexisting and possible vitamin B12 deficiency: pernicious anaemia, autoimmunity, atrophic gastritis, hypothyroidism, hyperthyroidism, colon cancer

Vitamin B12 deficiency can make hypothyroidism and hyperthyroidism worse. It is a relatively common deficiency with hypothyroidism and thyroid autoimmunity problems. It is one of the vitamins which need to be supplemented when deficient as obtaining it from a diet might not be sufficient.

It is better to aim for upper quarter of reference range for vitamin B12 as suggested by Janie A. Bowthorpe on the ‘Stop the thyroid madness’ website. Some doctors believe that the range for vitamin B12 is too low.

Methylated form of vitamin B12 (methylcobalamin) may be helpful for many deficient people as many hypothyroid patients may have problems methylating vitamin B12. There are sublingual (under the tongue) methylated B12 drops which might be beneficial for people with deficiencies. Some people with severe deficiencies and Pernicious anaemia may need to relay on vitamin B12 injections.

How much do we need?

RDI is 2.4 mcg for adult men and women

Food equivalency:

Shellfish 100g/ 99mcg

Liver beef 100g/ 83mcg

Fish (marcel) 100g/19mcg

Cereals (All Bran) 100g/20mcg

Red meat 100g/ 6mcg

Vitamin B5

I am Vitamin B5 (Pantothenic Acid)

It is my strategy

To make energy

I am a busy bee

Fatty acid, cholesterol and acetylcholine

Would not be synthesized without me

I keep your adrenal strong

With me you cannot go wrong

I am abundant in meat, mushrooms, wholegrain cereals, broccoli and avocado

When you eat these I say bravo!

What it does?

This vitamin is believed to be reduced in copper deficient people (common in Grave’s disease). It is a good vitamin for the support of adrenal function which might be important in thyroid conditions, both hyperthyroidism and hypothyroidism and may help to promote proper thyroid function and reduce stress. It is vital for energy production as a component of coenzyme A. It is vital for the production of red blood cells, as well as other hormones in the adrenal glands. It plays a role in the health of the digestive tract and supports proper cholesterol metabolism. B5 also helps the body utilise other vitamins, particularly B2. It boosts glutathione levels (main body detoxifying molecule, levels of which are low with chronic illnesses).

Symptoms of Vitamin B5 deficiency: headaches, listlessness, fatigue, insomnia, intestinal disturbances, indigestion, nausea, numbness and tingling of hands and feet, elevated cholesterol, burning and pain in the arms and legs, fainting, hair loss, premature greying of hair, dermatitis, elevated heart rate and susceptibility to infection.

What lowers B5?

–           Gluten sensitivity

–            Imbalanced gut flora (B5 can be made in the gut by bacteria, balancing gut flora with good probiotics, apple cider vinegar, healthy diet and avoidance of gluten in gluten sensitive individuals might help)

–           Poor stomach acid

–           Depression

–           Some medications, such as those for high blood pressure medications and acid reflux

–           Too much coffee and caffeine

Conditions associated with possible vitamin B5 deficiency: Celiac disease, adrenal disease, adrenal fatigue, Chronic Fatigue syndrome, fibromyalgia, autoimmunity, hyperthyroidism hypothyroidism

How much do we need?

RDI for adult men is 6 mg and women 4 mg

Food equivalency:

Liver (chicken) 100g/8.32mg

Mushrooms shiitake 100g/3.59mg

Bran (rice) 100g/ 7.39mcg

Sunflower seeds 100g/7.06mcg

Cheese (gjetost) 100g/3.35mg

Fish oily 100g/ 2.24mg

Lean pork 100g/1.65mg

Avocado 1.4mg/100g

Nutritional yeast 2tsp/ 1.0mg

1egg /0.77mg

Vitamin B6

I am Pyridoxine Vitamin 6

I help with the mess

Of a premenstrual stress

I help to make serotonin for a start

I make you happy; protect your nerves and heart

You should pay me attention

When you have fluid retention

As a part of vitamin B6 treaty

I help with your immunity

I am found in chicken, turkey, tuna, salmon, liver, lentils, brown rice, bananas, sunflower seed, milk and cheese

So have some please

What it does: Your body needs B6 in order to absorb vitamin B12 and to make red blood cells and the cells of the immune system. It is needed for thyroid hormone production and metabolism. Premenstrual swelling and tension can be relieved with zinc and vitamin B6. This problem is often seen in hypothyroid women. Vitamin B6 in coenzyme forms is involved in many enzyme functions mainly in protein metabolism. It is also important for sugar metabolism and production of hormones and neurotransmitters.

Symptoms of vitamin B6 deficiency: fatigue, muscle weakness, carpal tunnel syndrome, water retention, irritability, nervousness, depression, difficulty concentrating, short-term memory loss, increased premenstrual stress, nausea and vomiting during pregnancy (morning sickness)  allergies, asthma, weakened immune system and heart disease.

How much do we need?

Mild deficiency of vitamin B6 is common. However I recommend natural vitamin B6 as supplements are not well tolerated by some people with hypothyroidism. It would depend on levels of vitamin B6 and personal tolerance factor.

On a personal note, it is one of the vitamins I supplement with occasionally. My favourite is Zinc plus (contains zinc and B6) by Cenovis.

Recommended Dietary Allowances for adults is 1.3mg for males 19-50 yrs.  and 1.3mg/day for women 19-50 yrs. old

Food equivalency:

Beef liver 100g/ 0.9mg

1 potato with skin/0.7mg

Chickpeas 1cup/ 1.1mg

What lowers Vitamin B6?

  • Some medical conditions (kidney. liver and heart problems, thyroid problems)
  • Some medications
  • Alcoholism
  • Malabsorption (due to celiac disease, Crohn’s disease, and ulcerative colitis)
  • Low levels of magnesium, vitamin B2 and C
  • Children, the elderly and smokers are more vulnerable to deficiency

Conditions associated with possible vitamin B6 deficiency: – people with asthma, Age-related macular degeneration (AMD), hyper or hypothyroidism, autoimmune disorders, colorectal cancer, depression and PMS.

Vitamin A

I am Vitamin A

A complex of retinol, retinal, retinoic acid and several carotenoids

I help your adrenals produce steroids

I help thyroid and other steroid hormones function

I am involved in cell growth and replication

I help your wounds heal

Keeping your immune system strong is my deal

I am fat soluble and stored mainly in the liver

Healthy eyes, skin I deliver

You find lots of me in cod liver oil, butter any animal liver

Your body can convert carotenes in yellow, orange, red vegetables and fruit

To vitamin A as it should

What it does?

It supports a proper copper metabolism which is important for people with thyroid autoimmunity. Vitamin A is necessary for thyroid hormones to work properly. The thyroid shrinks and does not work properly with chronic vitamin A deficiency. It has a beneficial effect on the balance of the immune system. When a person is deficient in zinc, the body cannot absorb vitamin A. Vitamin A deficiency can coexist with iron deficiency despite good iron intake and an improvement in vitamin status increases iron utilization (35). Deficiency can be seen in both hyperthyroidism and hypothyroidism. In hyperthyroidism it is due to the completion of thyroid hormones and vitamin A with transthyretin, a proteins that carries these molecules in blood. In hypothyroidism, as mentioned before, there are problems with conversion of beta-carotene to active vitamin A.

Symptoms of deficiency:

Sinus, allergies, skin and acne problems, poor wound healing, night blindness and other eye problems, impaired bone and teeth formation and accelerated aging

What lowers Vitamin A?

  • Problems with gallbladder and low bile salt production (common with hypothyroidism) causing malabsorption
  • Diet low in animal sources of pre-formed vitamin (no butter, no fish oil, liver, eggs)- hypothyroid people do not convert beta carotene from vegetables to vitamin A properly
  • Pancreatic insufficiency
  • Iron deficiency
  • Excess alcohol
  • Infections (such as measles)
  • Celiac disease
  • Liver cirrhosis

Conditions associated with a possible vitamin A deficiency: cirrhosis, cystic fibrosis, celiac disease, duodenal bypass, bile duct obstruction and problems, hyperthyroidism and hypothyroidism.

How much do we need?

RDA 700 mcg/day or 2,300 IU for adult women

900mcg/day or 3,000 UI for adult men

Natural is the best as synthetic vitamin A megadoses can cause vitamin K deficiency

Food equivalency:

Best source: cod liver oil and animal livers

Cod liver oil 100g/ 100,000 IU

Liver 100g/ 18,000 IU

1 Sweet potato 961mcg/ 21, 909 IU

1 Carrot 835 mcg/ 7,835 IU

Vitamin D

I am Vitamin D

Not a vitamin alone

I am also a fat soluble hormone

To get me sun skin exposure is your goal

I am produced by sun rays in your skin from cholesterol

Or if you wish

You also find me in butter and fatty fish

I work to make your bones and teeth strong

I help your body absorb calcium all day long

I am a real gem

For the work of your immune system

I help to prevent diabetes, cancer, autoimmunity and illness

So have some reasonable sun exposure, no stress!

What it does?

Vitamin D is important for a proper balance of the immune system and deficiency can be a trigger for autoimmunity; it is essential for proper calcium metabolism and gene expression. It is essential for proper functioning of thyroid hormones on a cellular level.

Symptoms of deficiency: Bone loss (osteoporosis), low blood calcium, pain in ribs, spine, pelvis, legs, muscle weakness, brittle bones, retarded growth, impaired tooth development and rickets in children

Why deficient in vitamin D?

  • Genetics (can predispose to lower levels of vitamin D)
  • Stress
  • Low sun exposure (not enough outdoor time, low skin exposure, use of sun blocks, covering up)
  • Low in food intake (no oily fish, fortified milk products)
  • Problems with gallbladder (low bile salts production)
  • Leaky gut, celiac disease, gluten intolerance
  • Some medications (like Corticosteroids)
  • Hypothyroidism
  • Autoimmune thyroiditis
  • Polycystic ovary syndrome

Conditions of low vitamin D3: autoimmunity, illness, hypothyroidism and autoimmune thyroiditis (Grave’s disease and Hashimoto’s thyroiditis), celiac disease

How much do we need?

RDI= 600IU/day for adults

RDI 5.0mcg/day for men and women 19-50 years old and 10mcg/day for 51-70 and 15mcg for 70+

About 10min full sun body exposure = daily vitamin D requirement

Vitamin D is most likely needed to be supplemented in patients with thyroid problems.

Blood test for 25(OH) D Vitamin sufficiency > 75nmol/l

Food equivalency:

Cod liver oil 1tsp/500IU

Mushrooms (Portabello exposed to sun) – 1mushroom/954IU

Oily fish 85g/646IU

Vitamin E

α- tocopherol is the most biologically active form of me

I give you good prognosis for atherosclerosis

It is quite evident

I am a powerful antioxidant

It is quite a fact

I keep your cell membranes healthy and intact

I help your gene express

And help your cells with free radicals’ stress

I have skin healing power

You find me in oils such as those of wheat germ oil, sunflower and safflower

What it does? It can help with hypothyroidism and hyperthyroidism as thyroid hormonal imbalances are associated with oxidant stress. The beneficial effects of vitamin E were demonstrated in a scientific study on hypothyroid rats. Vitamin E balances the immune system which is important for autoimmune conditions. It also helps with cognitive functions. It is associated with selenium mineral, which is vital for thyroid hormonal conversion, thyroid health and immune system balance. It reduces inflammation, it is important for heart and vascular health. It keeps the cell membranes healthy and has an important role in cancer prevention.

Symptoms of deficiency: muscle weakness, lethargy, apathy, low concentration, anaemia, decreased sexual performance, damage to retina of the eye, impaired balance and coordination, peripheral neuropathy

Conditions associated with vitamin E deficiency: autoimmunity, impaired immune system, and increased risk of cancer (bladder, colon, breast and others), heart disease, and type 2 diabetes, cataracts, atopic eczema, muscular disorders, neurodegenerative disorders, severe Premenstrual syndrome, dementia, asthma, Parkinson’s disease and Age-related macular degeneration

Why low?

  • Genetic defects
  • Malnutrition
  • Malabsorption disorders
  • Gallbladder problems
  • Pancreatic insufficiency
  • Some medical conditions (Crohn’s disease, Cystic fibrosis)
  • Smoking
  • Low vitamin C levels

How much do we need?

Average requirement 12 mg/day

Maximum 1,000mg (1,500 IU)

Marginal deficiency is common. Excessive vitamin E consumption is associated with the risk of vitamin K deficiency and bleeding problems.

Food equivalencies

Sunflower oil 1tablespoon/ 5.6 mg α-Tocopherol

Safflower oil 1 tablespoon /4.6 mg

Flaxseed oil 1 tablespoons/ 2.4mg

Dark leafy greens 1cup/3.7mg

Almonds 1 cup/ 37.5mg

Other nuts slightly lower than almonds

Sunflower seeds 1cup/49.1mg

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Graves’ disease and Emotional liability

Emotional liability

Thyroid hormonal imbalance affects the brain chemistry. It can be mistakenly diagnosed as bipolar disorder, anxiety disorder or other mental problems. People can be treated with antidepressants, anti-anxiety medications, lithium, Valium, etc.  People with thyroid problems in the past, often ended up in psychiatric hospitals, underwent horrible treatments such as electric shock therapy.

Thyroid hormones are extremely powerful brain chemicals and are neurotransmitters. Overactive thyroid impairs proper brain function. High levels of thyroid hormones change the brain chemistry and levels of neurotransmitters, leading to agitation, nervousness and mood changes. People suffering from Graves’ disease can swing from elevation to exhaustion, have feelings of  anger, depression and confusion. Their thoughts become entangled and coping with simple tasks becomes very difficult. GABA is a brain chemical important in calming anxiety but its levels are reduced in Graves’ disease. Thyroid hormones also stimulate the synthesis of DHEA-S, which is antagonistic to GABA receptors in the brain.

The brain contains more T3 receptors than in other areas of the body. They are found in the highest quantities in the limbic area of the brain, its emotional center. People with Graves’ disease are often governed by an emotional way of thinking.

The excess of thyroid hormones makes the body more receptive to catecholamines (noradrenalin and adrenalin), hormones responsible for the ‘flight or fight’ response. This stimulates the sympathetic nervous system, which is involved in charging and expression, increases blood pressure and heart rate. These hormones are usually released during crisis situations. However in Graves’ disease, due to the excess of thyroid hormones, they exert their effects strongly to prepare a body for a stressful situation, which is not really there. Beta-blockers, given to patients, reduce tremors and anxiety symptoms. They block noradrenalin and adrenalin from binding to their receptors on nerves. When the brain is constantly overstimulated by excessive thyroid hormones, it uses oxygen faster and  produces more free radicals which can damage brain cells. The levels of glutathione, the main free radical scavenger are often reduced in people with autoimmune disorders. The levels of endorphin (‘happy molecules’) are also reduced in people with Graves’ disease.

There is a saying ‘I am not crazy, I have Graves’ disease’. The thyroid hormones are powerful brain chemicals. Emotions define life at the time of illness and are not easy to overcome. It is important to stabilise your hormones and your brain chemistry. Stress is a major trigger for Graves’ and unfortunately, it becomes its symptom. Stress exhausts adrenal glands and thyroid tends to compensate for poorly functioning adrenals. Therefore any stress will make the symptoms of Graves’ worse. Stress exacerbates the illness and is its active partner. Graves’ disease can be caused by the overuse of the sympathetic nervous system. It is important to limit stress  and not to seek it. Rest should be emotional, mental and physical.

“Those who have to do with the care of hyperthyroid patients recognize the value of calm environment and placidity of the emotions in the course of treatment.”

Agnes Conrad, MD. 1934

Hypothyroidism and its consequences

Hypothyroidism

Hypothyroidism and its consequences

Hypothyroidism is a condition in which the body cells are not receiving sufficient amounts of thyroid hormones. It is a common problem these days and is a reflection on stress, some illnesses (such as Hashimoto’s thyroiditis), environmental oestrogens, environmental toxins, obesity, poor diet and deficiencies of trace minerals and vitamins.

People, who have had a radical treatment for Graves’ disease, such as thyroid removal or radioactive iodine treatment may also suffer from hypothyroidism. This occurs when the thyroid hormonal therapy is suboptimal. The common hormonal replacement given to people with hypothyroidism is levothyroxine (T4 hormone). However, this therapy is not sufficient in many cases.

The thyroid gland produces T4, T3, T2, T1, T0 and calcitonin hormones. T3 hormone is the main bioactive hormone responsible for energy and protein production in the body. Thyroid gland supplies a small amount of this hormone but the majority is obtained through the conversion of T4 hormone into T3 in peripheral tissues other than the thyroid gland. Some people have problems with T4 into T3 conversion due to many different issues. Therefore, people who have problems with hormonal conversion (common with thyroid autoimmunity) and do not have a functioning thyroid are very vulnerable to hypothyroidism.

The consequences of suboptimal thyroid hormonal replacement and hypothyroidism are powerful and can create many health problems. They lead to a health disaster as every cell in the body would be affected in a negative way.  After all, we would not be alive without the energy produced in our mitochondria (cell energy factories) and T3 is an integral molecule in the process of energy production.

Suboptimal supplementation with thyroid hormones after thyroid surgery or radioactive iodine treatment may lead to prolonged or severe hypothyroidism becoming worse over time. This may be due to a partial failure of the 5’deiodinase enzyme, impairing the conversion of T4 to T3 as hypothyroidism affects the levels of nutrients required for its function. Thyroid hormone receptors may also become desensitised (if you don’t use it, you lose it) and have problems receiving hormones (due to effects of hypothyroidism, such as adrenal exhaustion, low progesterone and poor sugar control).  An oxidative cell stress can be seen in both hyperthyroidism and hypothyroidism as the optimal thyroid hormone levels are required to prevent generation of excessive free radicals in mitochondria, which damage cells. Mitochondrial dysfunction has been connected to fibromyalgia (sore, weak muscles) and other health problems. It relates to an increase in the acidity of body cells and imbalances of specific nutrients and hormones.  A mitochondrial dysfunction has also been connected to the development of cancer.

Nutritional deficiencies are consequences of hypothyroidism due to a lower production of hydrochloric acid in stomach, bacterial flora imbalance in the gut and an impaired liver function. In the state of hypothyroidism, gastrin levels are usually reduced, which causes low levels of hydrochloric acid in the stomach and a poor digestion. Even mild hypothyroidism leads to a magnification of problems over time as the thyroid hormones are not able to access the cells due to nutritional deficiencies (mainly vitamin B12, vitamin A, zinc, selenium, iron and essential fatty acids). Hypothyroidism reduces not only the absorption of nutrients but also the methylation status of molecules (such as B vitamins). Vitamin B12 needs to be methylated to be used by the body and it is extremely important molecule for a proper body functioning and healthy red blood cells.  Deficiencies of methylating nutrients,  manganese, iron, selenium, chromium, natural vitamin C and other minerals can contribute to a copper accumulation, which is then connected to many health problems. Night blindness may also be a result of hypothyroidism due to low levels of vitamin A. When T3 is not sufficient, the metabolism of cholesterol into bile acids is lowered. Fat is not properly digested. Fat soluble vitamins (A, K, D and E) and the essential fatty acids are not properly absorbed. Poor liver function tests and ‘fatty liver’ (not necessary in an overweight person) are often seen. Higher cholesterol levels may be seen as the liver and gallbladder do not work effectively.  Gallbladder function may also be impaired in hypothyroidism.

Iron deficiency is a common problem in hypothyroidism. Low iron absorption may cause iron deficiency anemia. In people with low thyroid, copper is preferably absorbed to iron in the gut. Vitamin B and C deficiencies and low stomach acid, often seen in hypothyroidism, affect the absorption of iron negatively. 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 and adrenal exhaustion.

Hypothyroidism effects oestrogen metabolism, lipid metabolism and the sugar balance as the liver is negatively affected and it is a major player in these functions.  Oestrogen is an important hormone, present in higher amounts in women as it is involved in reproduction and immune system functions.

A poor functioning liver cannot detoxify excessive oestrogen or other toxic molecules properly. The amino acid conjugation system in the liver, necessary for a proper detoxification is commonly found to function poorly in hypothyroidism. Glycine and the other amino acids used for conjugation can often become deficient. This then leads to a toxic overload and accumulation of fat soluble toxins in body fat cells. Toxins raise inflammation. Toxic molecules can cause cancer and heart disease. A sluggish liver is not able to produce enough binding proteins for copper, leading to copper accumulation in tissues. Copper toxicity creates problems with the way insulin works in the body. Hypothyroidism can create a state of oestrogen dominance. The increasing oestrogen metabolite can possibly increase the risk of breast cancer and other cancers. Hypothyroid people tend to put on weight due to a slow metabolism and fat cells can produce more oestrogens in the body.

There is a connection between under-active thyroid and gut health. Patients with hypothyroidism have a sluggishness of the gastrointestinal tract and often suffer from constipation, gas, bloating, re-absorption of intestinal toxins and increased intestinal permeability. The abdomen may feel distended with hypothyroidism. They might also have an imbalance of gut flora. The beneficial bacteria in the gut help to convert the inactive T3 into active form for recycling into the body. Some people with hypothyroidism may suffer from chronic gastro- oesophageal reflux.

Low thyroid hormonal levels cause lowered levels of cortisol hormone due to adrenal exhaustion,  leading to body aches and pains, nervousness, irritability, raised testosterone, increased number of allergies, raised inflammation levels in the body, unstable body temperature and frequent upper respiratory tract infections. Hypothyroid people are more predisposed to viruses, colds, influenza and chronic infections because hypothyroidism may cause a reduction in circulating lymphocytes, which fight infections. Infections further deplete adrenal glands. Subsequently, frequent antibiotics and medications disrupt gut health and stress the liver.

People with low T3 levels and autoimmunity problems may have chronic inflammation (due to lowered cortisol levels)and the possibility of other autoimmune disorders. The individual with low T3 may also have low pregnenolone levels, which influence the balance of the immune system and other hormones.

One of the main symptoms of hypothyroidism is depression (brain demands for T3 are not met affecting serotonin levels). Depression may have serious consequences as it threatens the life of sufferer and affects the lives of family and friends. Hypothyroidism significantly lowers the quality of life. Happiness is what we strive for and there is little happiness with insufficient T3. Feeling of being ‘stressed’ is common with low T3. Brain fog, common in hypothyroidism, is most likely due to slowed blood flow to the brain.

Low thyroid hormone levels are associated with a heavy menstrual flow, which leads to anemia and low iron. Hypothyroidism is often associated with low progesterone production. Low progesterone further lowers the absorption of zinc, which is necessary to allow thyroid hormones entry into the cells. Both, T4 into T3 conversion and entry of thyroid hormones into the cells become compromised. Difficulties in achieving and sustaining pregnancy can be connected to hypothyroidism. Lack of T3 hormone in early pregnancy may lead to miscarriage and pre-eclampsia as T3 hormone mediates embryonic and placenta growth. It may also lead to an increased chance of birth defects.

Adrenal aldosterone hormone imbalance is connected to hypothyroidism and may result in a constriction of blood vessels and elevated diastolic (bottom number) blood pressure. High blood pressure can lead to heart problems, inflammation and blockage of blood vessels. Low thyroid hormonal levels result in the inflammation and plasticity loss of blood vessels. This is because thyroid hormones promote the synthesis and action of vasodilators and acts directly on muscles in our arteries. The synthesis of nitric oxide (a powerful chemical, which dilates blood vessels) from L-arginine is stimulated by T3. Imagine your heart trying to pump blood through blood vessels in the body, which cannot effectively dilate and a resulting stress and damage to the cardiovascular system. As adrenal production of aldosterone increases, the production of anti-inflammatory cortisol decreases. Sodium is retained by the body. The person experiences anxiety and body aches. Other symptoms may include water retention and fluctuating blood pressure due to constricted blood vessels and kidney stress. Thyroid hormonal imbalances lead to alterations in the kidney function and structure. Hypothyroidism may lead to kidneys becoming smaller in size. In hypothyroidism, kidneys glomerular filtrations rates fall and elevated serum creatinine is often seen. The consequences of elevated creatinine levels in severe hypothyroidism include dry skin, feeling dehydrated, swelling, nausea, fatigue and shortness of breath. In fact, estimation of creatinine levels may be used to determine thyroid function/adequacy of thyroid hormonal replacement in the future. Kidney stones can occur due to the decreases in renal plasma flow. There are problems in excreting excessive water from the body.

Low thyroid hormone levels are connected to higher homocysteine levels and higher cholesterol, which are then related to an increased risk of heart problems. Hypothyroidism increases the risk of heart attacks and strokes. Generally there are many changes to the way heart works in hypothyroidism and these include: decreased cardiac output, stroke volume, heart rate and pulse pressure. People with hypothyroidism may experience heart palpitations and arrhythmias (free T3 hormone protects the heart from arrhythmias). The worst result of a prolonged hypothyroidism may be congestive heart failure. Changes in low voltage ECG can show prolonged PR interval and flat T wave. There are many studies indicating that sufficiency of thyroid hormones lowers the risk of heart attack. Thyroid hormone are important for the production of vitamin K-dependent proteins. Vitamin K activates these proteins, which keep the blood vessels healthy. Vitamin K does not work well with insufficient amount of thyroid hormone.

Symptoms of low T3 may include lethargy, severe muscle spasms,  muscle and joint pain. Muscles become depleted of glucose and energy with low T3 hormone levels. Fibromyalgia (muscle stiffness) also relates to under methylation of body, which may be a problem in some people with hypothyroidism. When thyroid hormone levels are low, so are methylation processes. In hypothyroidism, the function of MTHFR enzyme is reduced and it is not producing enough FAD or active riboflavin B2, involved in a proper methylation, also raising homocysteine levels. Low levels of vitamin B2 are connected to migraines. Homocysteine elevations have been shown to be an associated risk factor for cardiovascular disease, dementia, neurodegenerative diseases and cervical dysplasia. Methylation processes are extremely important as they are required for the liver detoxification and neurotransmitter production. The production of SAMe (the main methyl group donor) is reduced and its low levels have been linked to depression. High histamine levels are connected to hypomethylation as it is removed by the body by a methylation process. High histamine levels are connected to allergies.

Poor sugar control is a resulting consequence of hypothyroidism. When T3 is not sufficient, it does not activate thyroid hormone receptors properly in the liver, which can lead to a fatty liver and insulin resistance. Low T3 causes poor liver function and impaired glucose metabolism in peripheral tissues, which may lead to diabetes. Under methylation issues has been postulated as a possible mechanisms, which increase insulin resistance. Hypothyroid people store less glucose in the liver as glycogen and are more prone to a low blood sugar. As a consequence, both adrenaline and cortisol start rising at night.  Adrenaline can peak around 2am and a person can wake up with heart palpitations.

In my research, I had come across a saying that “just a few grains of thyroid hormone can make the difference between an idiot and Einstein”.  The slowing of a brain process, clumsiness,  irritability, loss of short term memory, disorientation, depression and melancholia may occur with low levels of T3.  A part of the brain known as the hippocampus, which is responsible for short term memory and special navigation, is strongly affected by not only stress but also hypothyroidism, which slows nerve generation and function in this area of the brain. Thyroid is a major player in this part of brain (hippocampus is very vulnerable region) and brain in general as it modulates glucose metabolism and insulin signalling. Damage to hippocampus has been connected to dementia and Alzheimer’s disease. It may also be connected to the development of type 2 diabetes.

The levels of neurotransmitters are altered in hypothyroidism. T3 hormone is a neurotransmitter. Low thyroid hormone levels cause low dopamine, a neurotransmitter important for motivation and willpower. As methylation process is impaired, the production of SAMe, the main methyl donor is impaired, which affects the balance of neurotransmitters in the brain. When T3 is low, the brain does not work properly and the levels of serotonin go down. Depression is a common symptom of hypothyroidism.

It is easier to put the weight on when metabolism is slow due to hypothyroidism. Hypothyroid people tend to put weight on all over the body. They tend to crave carbohydrates (bread, potatoes, rice, sweets and starchy food) due to the adrenal exhaustion and altered sugar metabolism. When you do not have a proper detoxification in your body, toxins accumulate in the fat cells and make weight loss difficult to achieve. An inflamed body stores excessive water. The levels of glutathione, the main toxin remover, go down. Hypothyroidism is also connected to spikes of cortisol, oestrogen dominance and insulin resistance and thus poor sugar control. All this leads to weight gain.

Hypothyroidism affects many aspects of body functioning and creates multiple health issues. These issues are often looked at separately but are due to one main problem of hypothyroidism. The thyroid hormones are powerful body chemicals and their effects should never be underestimated.