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