The significance of Hippocrates’, the founder of medicine, suggest “All disease originates in the gut,” is likely best appreciated when the relationship of the gut to thyroid function is examined.
The reason for this is that without a healthy gut, the ability to create active thyroid hormone is hampered, and low active thyroid hormone (free T3) cellular response negatively affects every cell in the body, contributing to any health difficulty if it is not functioning optimally. TSH and T4 blood levels are the most often measured and treated medically related to thyroid function.
Unfortunately, these markers do not fully account for your body’s response to active thyroid hormone ( free T3). To put it another way, having aberrant thyroid function is COMMON, even if lab tests are “normal” with or without thyroid medication! What causes thyroid hormone dysfunction? Here’s a rundown:
What is the thyroid gland, and what does it produce?
The thyroid is a tiny butterfly-shaped gland located near the base of the trachea. When the thyroid gland receives the signal to make thyroid hormone from the pituitary hormone TSH, it produces two hormones: T4 (93 percent) and T3 (7 percent ).
Remember that only T3 is active to the cells, and that only 7% of the thyroid hormone produced by the thyroid gland is in its active form.
In addition, the thyroid gland generates the hormone calcitonin, which is necessary for calcium absorption in the bones. The remaining 93 percent of the relatively inactive T4 is allowed to proceed to the liver and intestines to be activated.
T4 is converted in the liver into either active T3 or reverse T3 (rT3). Under normal circumstances, 60% of T4 is converted to T3, 20% to rT3, and the remaining 20% is activated in the small intestine. Many functional thyroid diseases are caused by this conversion mechanism.
Functional thyroid problems differ from diseases in which TSH and T4 levels rise to pathological (disease state) levels, necessitating medical intervention. Rather, functional thyroid diseases encompass all dysfunctions of thyroid production and cellular response, whether or not TSH or T4 blood levels reach pathological levels.
What about thyroid drugs?
Synthetic forms of T4 are used in the most regularly prescribed thyroid treatments (Synthroid, Levothyroxine, or Levoxyl). These treatments rely on correct conversion in the gut, which, as you’ll see below, does not occur efficiently for many people who are on or off medication. When evaluating the success of these medications, the doctor is primarily concerned with the lab values of TSH and T4, rather than whether or not active thyroid hormone is being created and successfully entering the cells of the body.
Natural thyroid hormones, such as Armour Thyroid or Nature-Throid, are glandular thyroid hormone formulations that contain T4, T3, and calcitonin. These natural versions appear to perform better for some people, but because certain people have problems with over-conversion from T4 to rT3 for the reasons stated below, these medications may also be unsuccessful.
The following are five ways that changes in the stomach might lead to aberrant thyroid hormone function. (Because the liver performs numerous tasks, one of which is bile production, it is listed as a component of the gut.)
Symptoms
- Brain Fog
- High Cholesterol
- Heart Disease
- Constipation
- Dry Skin
- Frequently Feeling Cold
- Hair Loss
- Low Libido
- Depression
- Irregular Menstrual Cycle
- Muscle Aches/Fibromyalgia
- Joint Pain
- Poor Immunity
- Weight Gain
- Inability to Lose Weight Even With Exercise
Hashimoto’s disease
Hashimoto’s disease is the name given to autoimmune disease of the thyroid gland, where the immune system attacks cells of the thyroid gland.
Hashimoto’s disease is estimated to be the most prevalent autoimmune disorder in the US. Hashimoto’s has been found to be the mechanism for hypothyroidism in 90% of the cases in the US.
One of the primary mechanisms for auto-immune disorders is “leaky gut”, where the gut lining becomes damaged and allows material (pathogens, undigested food, etc.) to cross the gut barrier and into the blood that was not supposed to cross.
If “leaky gut” contributes to autoimmune disease in general, and it’s recognized that most cases of hypothyroidism are the result of an autoimmune condition, it’s reasonable to assume that the gut may be involved in most cases of hypothyroidis.
Gluten Sensitivity
If you’re experiencing thyroid problems, it’s important to rule out gluten sensitivity. Gluten is a protein found in certain grains, like wheat, barley, rye and oats, and can cause inflammation in the body. This inflammation can lead to problems with the thyroid gland.
This could be grouped in with Hashimoto’s since it’s typically associated with autoimmune disorders, but is separate because gluten is a unique agent in autoimmune hypothyroidism. Gluten is a protein found in the grains – wheat, barley, rye, and oats. It is believed that the gluten molecule appears similar to the cells of the thyroid, so if the body identifies gluten as a problem it may identify the thyroid as a problem as well.
So, if 90% of the cases of hypothyroidism are from an autoimmune condition, and gluten sensitivity is linked to a high degree of autoimmune thyroid disorders- avoiding gluten is important for a number of reasons, but especially important for anyone with a suspected thyroid disorder.
Here are a few studies linking the connection between gluten and thyroid dysfunction: (1), (2), (3), (4). Keep in mind, that even if you tested negative for celiac disease there’s still a good chance you have a problem with gluten!
While autoimmune conditions are the most common cause of hypothyroidism, gluten sensitivity can also be a factor.
Studies have shown that people with gluten sensitivity are more likely to have autoimmune thyroid disorders.
If you think you may be sensitive to gluten, There are a number of different tests that can be used, including blood tests and biopsies of the small intestine.
If it is determined that you are gluten sensitive, there are a number of steps you can take to manage the condition.
Gut Flora Imbalance
Microbes in and on our bodies can either promote or detract from health.
As many as 20% of the T4 released by the thyroid is converted into the active T3 hormone in the small intestine. This conversion requires the presence of hydrochloric acid in the stomach and beneficial bacteria in the small intestine. If any of these are lacking, it can impair the production of intestinal sulfatase – a necessary ingredient to active thyroid hormone production.
This is just one example of how gut flora can play a role in thyroid health. Maintaining a healthy balance of gut flora is essential for overall wellness, and should be a priority for anyone with thyroid issues.
Microbial Toxins
One of the ways in which gut microbes can sabotage thyroid function is by producing toxins that interfere with the conversion of T4 to active T3 in the liver. This results in a build-up of the inactive form of thyroxine, known as reverse T3 (rT3).
Too much rT3 relative to free T3 can have a number of negative consequences, including:
– Increased weight gain
– Difficulty losing weight
– Feeling cold all the time
– Dry skin
– Constipation
– Moody or depressed moods
If you are experiencing any of these symptoms, it’s important to speak to a TCM doctor or a holistic doctor to determine if they could be related to an imbalance in your gut flora. A TCM doctor will be able to help you restore balance and improve your overall health.
Food Allergies
Food allergies are a serious issue, and they can have a significant impact on your health. While gluten sensitivity may certainly qualify as a food allergy, there is a distinction made here for any food that creates an inflammatory response in the body.
There are certain immune system-based chemicals that are produced upon exposure to certain foods that are particularly disruptive to thyroid function. These inflammatory chemicals are called “cytokines”. While many, if not most, food allergies are undoubtedly the result of a “leaky gut”.
There are certain immune system based chemicals that are produced upon exposure to certain foods that are particularly disruptive to thyroid function. The bottom line here is that if there are food allergies, there are cytokines, and if there are cytokines there is going to be functional thyroid impairment. The impairment may again come from over producing rT3 relative to free T3, or it may occur elsewhere within the synthesis of thyroid hormone production.
If you’re looking for a TCM (traditional Chinese medicine) doctor or holistic doctor who can help you with food allergies, there are a few things to keep in mind. First, it’s important to understand that blood tests are not always the most accurate way to diagnose thyroid hormone problems. Some researchers believe that body temperature is a more important value for assessing thyroid function. Additionally, the free T3 relative to rT3 ratio is often considered the most important value for assessing thyroid function, as high amounts of rT3 can block the activity of free T3 at the receptor site. With this in mind, TCM doctors and holistic doctors who are experienced in treating food allergies may be your best bet for getting accurate and effective treatment. Food allergies are a serious issue, and they can have a significant impact on your health. While gluten sensitivity may certainly qualify as a food allergy, there is a distinction made here for any food that creates an inflammatory response in the body.
My focus is to deepen my understanding of the way in which I relate to myself with others and the world. My exploration as an entrepreneur, community builder, traveler, and the lifelong student has helped me cultivate my skills as a practitioner.
Using the art of Chinese Medicine as my tool, I gently guide, nudge, and aid one’s body and mind to find its own balance. From there the intelligence of the body knows what to do next. This is what the healing process has taught me. I see myself as the tuning fork for my clients.
I am here to hold space. My role is to aid you in your return to inner harmony, emotionally, physically and spiritually well-being, in tune with our true nature so that we can realize our life’s passion without limitations.
Dr. Antonika Chanel LA.c DACM is a board-certified NCCAOM Chinese medicine physician. Since 2016 Antonika has traveled the world treating patients on world-class cruise ships and is considered a top-tier practitioner. Her practice, ChiC Wellness offers health consulting and telemedicine support utilizing all modalities of Chinese Medicine.
Antonika is also a yoga and Medical Qigong practitioner.
