Vitamin deficiencies and their connection to thyroid and autoimmunity

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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