Dr. Doni explores the relationship between Graves’ Disease and Leaky Gut, and offers advice on addressing auto-immune hyperthyroidism.

Part 11 of Dr. Doni’s Series on Leaky Gut

In this series, we are looking in detail at Leaky Gut, a condition that is very common, yet poorly understood. We have examined what it is, how to find out if you have it, and how to treat it—as well as how it relates to other common conditions such as IBS, depression, and heartburn.

Today we are going to continue the discussion about Leaky Gut and autoimmunity that affects the thyroid gland. Instead of causing low thyroid function, as we discussed last week, let’s discuss what happens when autoimmunity causes high thyroid function. Hyperthyroid function caused by auto-antibodies is referred to as Graves’ Disease. It can cause quite a disruption in your daily life and though it can be treated medically, as I will explain, conventional medical treatments can result in an underactive thyroid, which is an incurable condition with severe lifelong symptoms. I want to help you understand it so that you’ll know your options for addressing it naturally and without the long-term implications for your health.

What is Graves’ Disease and How Does it Feel In Your Body?

As with Hashimotos disease, the auto-antibodies involved with Graves’ disease attack the thyroid gland cells, causing them to behave abnormally. With Hashimoto’s, they cause the thyroid to make less thyroid hormone (resulting in under-activity). But with Graves’, the thyroid makes more thyroid hormone, causing over-activity. This increase in thyroid hormone causes over-stimulation within the body on every level. This over-stimulation creates a feeling that could be described as pedaling a bicycle downhill without brakes. Some of the most common symptoms are:

• Anxiety
• Irritability
• A tremor in your hands
• Feeling hot and/or clammy
• Unexpected weight loss
• A change in menstrual cycle – spotting or skipping a period
• More frequent bowel movements
• Heart racing and/or palpitations
• Insomnia
• Bulging eyes (eyes appear enlarged)
• A visibly enlarged thyroid gland (or goiter)

At the same time as feeling over-stimulated, many people with Graves’ actually feel very tired. Imagine being over-stimulated all day—of course it would wear you out.

Graves’ disease is much more common in women than it is in men and is likely to occur between the ages of 30 and 60. A family history of Graves’ increases the risk of experiencing it, as does having another autoimmune condition, such as type 1 diabetes, vitiligo, and rheumatoid arthritis.^1,2 You can read more about other autoimmune conditions here.

How We Can Tell If Your Thyroid Is Over-Active

There are two kinds of thyroid hormone, inactive (T4) and active (T3). The thyroid gland produces inactive T4 which is then converted into the active T3. The thyroid knows how much T4 to produce from the levels of another hormone (Thyroid Stimulating Hormone, or TSH) in your blood. TSH is produced by the pituitary gland in the brain in response to the amount of thyroid hormone being produced—too much thyroid hormone and the brain will produce less TSH, too little and it produces more. Endocrinology journals indicate that TSH levels in blood work should optimally be between 0.5 and 2.5 (when taking thyroid hormone, it should be between 0.5 and 1.5), and a lower number indicates higher thyroid function³. A blood test to determine the levels of TSH is one of the key ways of telling if you have Graves’ disease.

A further blood test measuring the amount of available (or “free”) T4 and T3 will give a better, more detailed understanding of the state of your thyroid activity.

Another indication of thyroid problems is the presence of certain auto-antibodies that can also be tested in the blood. Thyroid Peroxidase Antibody (TPO) and Thyroid Stimulating Antibody (TSI) can trigger Graves’.

NB: TPO Antibodies can also cause Hashimotos disease so other indicators will also be taken into account when making a diagnosis.

If your blood work indicates Graves’ disease, then an imaging test of your thyroid gland will be recommended for confirmation. This test (known as a radioactive iodine thyroid test) involves swallowing radioactive iodine before taking an x-ray of the neck (where the thyroid gland is located). A normal thyroid absorbs iodine, one with Graves’ will pull in more and the x-ray will be able to see this because of the radioactivity.

Another possible test is referred to as a “thyroid scan” which shows more precisely where the iodine is going in the thyroid gland – all over or just to certain areas or nodules within the gland. With Graves’, iodine will be found throughout the gland.

How is Graves’ Treated?

There are several treatment options for Graves’:

• Methimazole – a medication that inhibits the thyroid gland. This medication has potential side effects, including risks to your baby if you are pregnant.
• Thyroidectomy – where the thyroid gland is removed so that there is nothing for the auto-antibodies to stimulate.
• Radioactive iodine – this destroys the thyroid gland without harming other cells in the body (as far as we know).

With a thyroidectomy or radioactive iodine, once the thyroid gland is either removed or destroyed, you will have hypothyroidism and will be reliant on thyroid hormone treatment for the rest of your life.

What causes Graves’ Disease? The Link with Leaky Gut

In the past two articles, we’ve explored how Leaky Gut is linked to auto-immunity and specifically auto-immunity in the thyroid gland.⁴ This information is not often addressed by your endocrinologist, so I want to re-emphasize it here.

When the cells lining the intestinal walls are not as healthy as they could or should be, they allow undigested food and toxins from unhealthy bacteria to cross into your body. Once inside, they trigger a response from your immune system, as it attempts to protect you from them. Over time however, your immune system may get confused about what it should be protecting your from (especially if you are genetically prone to having that happen) and begin to attack your own healthy cells as if they are foreign. This is the beginning of auto-immunity and, contrary to popular belief, it can be reversed.

However, to fully understand the cause of Graves’ disease, we need to look beyond Leaky Gut to what caused the Leaky Gut in the first place. It could be different for you than it is for the next person or it could be a whole combination of things.

We know that Graves’ has a genetic component and we know that stresses of all types turn on our genetic mutations.⁵ So I suggest you start by looking at your daily life and the things that cause you stress. Are you constantly racing from one place to the next? Do you have trouble sleeping and then, subsequently, an even harder time keeping up with tasks the next day? Are you exposed to toxins from exhaust during a long commute or cigarette smoke or plastics and dry cleaning chemicals? Are you under emotional stress in relationships, or were you when you were a child?

That is what stress looks like. And while I know that it doesn’t necessarily help to look at it – because you may feel stressed just thinking of all your stress—the goal is not to get it to go away nor is the goal to ignore it. The goal is to become more aware of your stress as a way of coming up with strategies that support your body through it. By doing that, you’ll shift how your immune system responds to stress. You heal Leaky Gut and bring your thyroid function back into balance.

5 Steps to Address Graves’ Disease

Here are five steps you can take to begin this shift:

• Step 1: Avoid gluten. Gluten has been linked with the development of thyroid antibodies. Cut it out of your diet and you will reduce the antibodies that are attacking your thyroid. If you’d like help doing this, consider using my guided elimination diet, which I call the Stress Remedy Program (7-day or 21-day version).^6,7

• Step 2: Identify Leaky Gut and start addressing it. As we’ve discussed, Leaky Gut is known to make Graves’ more likely.⁸ For information on how to address Leaky Gut, go back to the 2nd article in this series where I talk about how to test for Leaky Gut and then the 3rd article in the series about how to treat Leaky Gut.

• Step 3: Take Selenium*. 200 to 400 mcg is the dose that has been shown to effectively reduce thyroid antibodies. Be sure to choose a high-quality selenium-methionine such as this product that you can find in my online store.⁹

• Step 4: Take herbs that inhibit thyroid hormone production*. It is important that you do this under the care of a naturopathic doctor (ND) who has graduated from a nationally accredited program and who is licensed in a state that licenses naturopathic doctors. Herbs that your ND may choose for you are: Bugleweed, Lemon Balm, and Rosemary.

• Step 5: Optimize adrenal health. As we’ve discussed in previous articles such as this one, when cortisol levels are higher than they should be due to exposure to stress, they will disrupt your immune system, digestion, as well as your thyroid function. Based on my approach described in my book The Stress Remedy, you can bring your cortisol levels back to optimal which is essential for bringing Graves’ disease to a halt.

It is important to choose a practitioner with extensive training and experience with autoimmunity, Leaky Gut, adrenal stress patterns, and thyroid conditions to help you with these steps. If you would like my help, please consider setting up a comprehensive breakthrough session with me. During this session, I will review your case and we can decide on the best approach for you, whether that’s my specially developed Leaky Gut Package, or my Signature Wellness program. Either way, I encourage you to start taking your health into your own hands and making choices that will benefit your future.

I love to read your comments and questions. If you have anything to say, please use the comments box below. You can also subscribe to this blog to be sure you don’t miss future articles. In my next article I’m going to shift gears and focus on strategies to heal Leaky Gut once and for all.

–Dr Doni
2^nd October 2015

*Please keep in mind that any and all supplements—nutrients, herbs, enzymes, or other—should be used with caution. My recommendation is that you seek the care of a naturopathic doctor (with a doctorate degree from a federally-accredited program) and that you have a primary care physician or practitioner whom you can contact to help you with individual dosing and protocols. If you ever experience negative symptoms after taking a product, stop taking it immediately and contact your doctor right away.

References

1. American Thyroid Association.
2. Dong YH, Fu DG. Autoimmune thyroid disease: mechanism, genetics and current knowledge. Eur Rev Med Pharmacol Sci. 2014;18(23):3611-8.
3. Wartofsky L & Dickey RA. The evidence for a narrower thyrotropin reference range is compelling. Journal of Clinical Endocrinology and Metabolism 2005 90 5483.
4. Fasano A. Leaky gut and autoimmune disease. Clin Rev Allergy Immunol. 2012;42(1):71-78.
5. Carta MG,Loviselli A, Hardoy MC, Massa S, Cadeddu M, Sardu C, Carpiniello B, Dell’Osso L, Mariotti S. The link between thyroid autoimmunity (antithyroid peroxidase auto-antibodiesauto-antibodies) with anxiety and mood disorders in the community: a field of interest for public health in the future. BMC Psychiatry. 2004 Aug 18;4:25.
6. Sategna-Guidetti C,Volta U, Ciacci C, Usai P, Carlino A, De Franceschi L, Camera A, Pelli A, Brossa C. Prevalence of thyroid disorders in untreated adultceliac disease patients and effect of gluten withdrawal: an Italian multicenter study. Am J Gastroenterol.2001 Mar;96(3):751-7
7. Jiskra J1, Límanová Z, Vanícková Z, Kocna P. IgA and IgG antigliadin, IgA anti-tissue transglutaminase and antiendomysial antibodies in patients with autoimmune thyroid diseases and their relationship to thyroidal replacement therapy. Physiol Res. 2003;52(1):79-88.
8. Kyriacou A, McLaughlin J, Syed AA. Thyroid disorders and gastrointestinal and liver dysfunction: A state of the art review. Eur J Intern Med. 2015 Aug 7. pii: S0953-6205(15)00243-5.
9. Gärtner R, Gasnier BC, Dietrich JW, Krebs B, Angstwurm MW. Selenium supplementation in patients with autoimmune thyroiditis decreases thyroid peroxidase antibodies concentrations. J Clin Endocrinol Metab. 2002 Apr;87(4):1687-91.