america’s thyroid epidemic

Prepare to be doubly shocked.  It is estimated that fully 90% of America’s 30 million Hypothyroidism sufferers (some experts put the number at twice that), have hypothyroidism due to something called Hashimoto’s Thyroiditis.  That’s right.  Almost 10% of America’s adult population is known to be suffering from an autoimmune thyroid disease called Hashimoto’s Disease.  The term “AUTOIMMUNITY” means that their thyroid is being attacked and destroyed by their own Immune System.  Not good!  But uncommon?  Unfortunately, not.  An amazing one in five Americans has an autoimmune disease of some sort, with Hashimoto’s being one of the more common (HERE is a list of common Autoimmune Diseases).  Now prepare to be really really shocked.

Even though doctors can test for Hashimoto’s Disease, this rarely happens in today’s medical community.  Why not?  Because they treat Hashimoto’s the exact same way that they treat Primary Hypothyroidism.  They simply prescribe T4, the inactive form of Thyroid Hormone, in the form of drugs with names like Synthroid, Armour Thyroid, Cytomel, etc (some of these have some T3 as well).  Unfortunately, this is often times not the best solution. Why not?   Because it fails to address the Immune System dysfunction. 

It is critical to remember that Thyroid Autoimmunity is not so much a thyroid problem as it is an immune system problem.  This is why so many people do OK with hormone replacement therapy —– for a short time; and then start to have the same problems again.  Bottom line, proper management of Hashimoto’s must consist of recognizing the underlying Immune System dysfunction and addressing it.  What typically triggers the body to start attacking itself — especially the thyroid gland?

There are all sorts things that trigger Hashimoto’s Disease.  Although the majority of the medical community is not asking this question any more, they used to be.  Since the early mid 1900’s it has been known that Chronic Infections play a huge role in autoimmunity.  These include various forms of Dysbiosis, BACTERIAL INFECTIONS, viral infections, DENTAL INFECTIONS, as well as yeast, mold, and fungi overgrowths.  Oh, and just because we live in “clean” America, we cannot forget an exceedingly common cause of Hashimoto’s; PARASITES. 

Other causes of Hashimoto’s include Adrenal Fatigue, Fibromyalgia, Food Sensitivities (particularly GLUTEN), environmental toxicity (MERCURY, ALUMINUM, and thousands of others), Female Issues (particularly POLYCYSTIC OVARIAN SYNDROME which to some degree is said to affect as many as 50% of America’s menstruating women), and numerous others.  All of these problems lead to out-of-control SYSTEMIC INFLAMMATION.  But the number one trigger is probably Blood Sugar Regulation Problems (DIABETES, INSULIN RESISTANCE, HYPOGLYCEMIA, METABOLIC SYNDROME, etc). Not only are these problems exceedingly common in America, not 1 in 100 doctors is talking about this relationship — even though the research is coming from the medical field.  It’s the reason we have a canyon here in America much bigger than the Grand Canyon (HERE).

Why is it so important to recognize Hashimoto’s and not simply manage it simply as “Hypothyroidism”?  Namely because it is the most common major autoimmune disease in a country where at least 20% of the population is dealing with an Autoimmune Disease.  Autoimmunity usually follows a progression. When you find it attacking one area, it is likely to be attacking others as well.  And with any Autoimmune Disease, the problem does not lie with the tissue being attacked, it lies with the immune system.  When the immune system fails, where does it typically fail first?  Because of our poor diets (“crappy” would be more descriptive) the first place that Immune System function fails is in The Gut —- the place where 80% of it lives.

Instead, it is a problem with the immune system itself.   Why is this so important to understand? Because once the EPIGENETIC FACTORS turn on the genes for autoimmunity, it can never be turned off again. However, it is possible for autoimmune responses to be turned down (HERE is an example). But in order to do this, we have to know which part of your immune system is being ramped up, and / or which part of your immune response is being suppressed (HERE). 

FIXING THE LEAKS
No one likes a leaky faucet, except maybe your plumber.  The same is true of the Immune System.  But unlike a leaky faucet that is easy to see and usually easy to fix, the body can spring leaks which you cannot see, even with standard medical testing.   If you have read much of my work, you already know where this is heading.  Chronic Inflammation can cause things like “Leaky Gut Syndrome“, “Leaky Lung Syndrome“, “Leaky Brain Syndrome“, or any (or all) of several other “LEAKIES“.  But in order to understand why various organs spring leaks, we must first understand Inflammation.

INFLAMMATION is the collective name given to a group of naturally occurring chemicals that the Immune System makes in response to tissue damage of various sorts.  These chemicals have strange sounding names like prostaglandins, histamines, kinins, cytokines, ecosonoids, Substance P, and numerous others (see link).  It is not that these chemicals are bad in and of themselves.  In fact, they are vital to your body’s ability to heal whatever is thrown at it.  However, when inflammation driven out of control by the things we talked about several paragraphs ago, they promote a whole cascade of health problems including

• Skin Conditions such as Eczema, Psoriasis, & Contact Dermatitis (HERE)

• Heart Disease / Stroke

• Fibromyalgia / Adrenal Fatigue / Chronic Fatigue Syndrome

• Obesity

• Diabetes

• Irritable Bowel Syndrome

• Arthritis

• CANCER (HERE)
• Numerous Others

In fact, research is showing us that the number one reason that people have Thyroid Dysfunction / Autoimmunity (remember, most thyroid problems are actually autoimmune diseases) is a diet high in refined carbohydrates, sugar, and highly processed GRAIN-BASED foods (HERE).  The latest statistics are suggesting that every man, woman, and child in America is eating just under 200 lbs of sugar (or HIGH FRUCTOSE CORN SYRUP) per year.  Stop.  Re-read this paragraph again and let it sink in (HERE).  We are destroying our own thyroids and those of our children because of our addiction to simple carbohydrates and sugar (NUMEROUS POSTS on this ugly fact, as well as information on breaking said addiction). 

Low thyroid function is almost always secondary to another condition —- frequently an endocrine problem.  Although we have already learned that problems with regulating blood sugar is probably the number one cause of hypothyroidism, Adrenal Fatigue (called “Fibromyalgia” here in America once the symptoms manifest visibly) probably runs a close second.

STRESS & THYROID FUNCTION
If you have been on my BRAIN-BASED THERAPY, MISSOURI, website, you already realize that many (if not most) endocrine problems are related to the Sympathetic Nervous System (“Fight or Flight”) run amok (HERE).  This is particularly true of the Adrenal Glands.  In the field of FUNCTIONAL MEDICINE, there is probably no more commonly seen problem than Adrenal Gland Imbalances.  Why?  In a word, stress.

Stress (dietary stress — overloading with sugar and simple carbs), immune system stress, emotional stress, physical stress, food sensitivities, parasites, dysbiosis, mold, candida, etc, etc, etc, turns on the body’s Sympathetic Nervous System causing SYMPATHETIC DOMINANCE, and the body responds by performing a whole host of functions related to fighting these stressors or fleeing from them.  What does this do to the body?  Let’s take a look:

• Affects Communication Between Brain and Endo System:    The HYPOTHALAMUS and Pituitary Gland directly control the Endocrine System (thyroid included).  Adrenal Stress weakens both of these parts of the brain —- subsequently, diminishing neurological control of the thyroid.

• Increases Thyroid Binding Activity:  When more thyroid hormone is in a bound state (as opposed to free) it cannot get into the cells like it should —- even though your blood test might very well appear normal.

• Decreased Conversion Rate:  Like poor Gut Function, Adrenal Stress slows the conversion of T4 (inactive) to T3 (active). What does this do?  It slows your metabolism.

• Hinders Metabolic Detox Pathways:  This is big.  When your body cannot get rid of excess hormones (HERE’S HOW IT’S DONE), your body reads this as having plenty (or even too much) hormone in your body.  In a properly functioning negative feedback loop, the body will begin to shut down production of said hormones — exactly what it is supposed to do.  This causes a condition of “Thyroid Resistance” that is quite similar to the way people develop “Insulin Resistance”.  And, just like we see in Insulin Resistance, where cells lose their sensitivity to insulin, we see the same thing with the thyroid.  Even though there may be lots of thyroid hormone circulating in the body, it is not able to do its job because the body has lost its sensitivity to it — sort of the same way a drunk tends to lose their sensitivity to booze over time.  In other words, in a ‘Resistant” individual it takes increasing amounts of chemical (booze, Thyroid Hormones, whatever) to get the same reaction in the body.

• It Causes Leaky Immune System Barriers:  There are Immune System barriers in the body for good reason.  The chief of these are found in the gut (MUCOSAL LAYER OF THE MICROVILLI), the brain (the blood-brain barrier), and even in the lungs.  Due to weakened Adrenal Glands (often brought on by chronic inflammation), the protective barriers are weakened. What is the affected person left with?  A bad case of the “Leakies” — Leaky Gut Syndrome, Leaky Brain Syndrome, and Leaky Lung Syndrome.  Although the medical community will deny that this is happening, there are any number of simple and inexpensive tests for it — some of which you can order by mail (HERE).

Estrogen is the chief female hormone. It is the hormone that essentially makes a woman look like a woman. Part of the function of estrogen is to make sure that women have more body fat than men —– about 8-10 percent more on average. A woman needs to carry at least 15 percent body fat in order to be able to produce enough estrogen to conceive and carry a baby to term. 

On average, women carry about 20-23% body fat.  Much of a woman’s estrogen is produced in her ovaries. However, unbeknownst to most of the female population, a significant percentage of estrogen is produced by their fat cells. If a woman is not carrying enough body fat (cross country runners for instance), she is not going to have menstrual periods (amenorrhea). Unfortunately, if she carries too much body fat, it automatically cranks up her estrogen-producing ability.

Think about this one for a moment. For any number of reasons, a woman gains some extra weight as fat. Fat cells do what they are supposed to be doing and make estrogen. Increased estrogen causes women to put on more weight —- as fat. Fat cells produce estrogen. Estrogen causes women to gain more weight —- as fat.  Repeat ad infinitum.  And the real bite is that excess estrogen is actually stored in fat cells.  It is a vicious cycle that must be broken in order to get to a healthy weight, as well as being an important part of turning a low functioning thyroid turned back on.

When a person is saturated in excess estrogenic hormones (estrogen and synthetics, xeno-estrogens, phyto-estrogens), the body looses its own feedback loop.  Unfortunately, this is true of most Endocrine System hormones, and is called “Resistance”.  We see this most commonly in the case of Insulin. When there is too much insulin circulating in the blood, the cells actually become resistant to it, and need ever-increasing amounts of the hormone to do their jobs.

Be warned:  When your doctor tests you for levels of female hormones, the test might actually show that you are low in Estrogen.  Why do you think so many women end up on HRT (Hormone Replacement Therapy)?  It is because most of these hormones are artificial or synthetic, or they come from animals (Premarin, for instance —- which stands for “Pregnant Mare’s Urine” — the source of the hormone).  It also has to do with the fact that Estrogen Dominance simply means you do not have enough Progesterone for the amount of Estrogen you have.

Although it is true that your nerve system carries electrical messages, these messages are moved from place to place via chemicals called “neurotransmitters”.  Neurotransmitters, chiefly Dopamine & Serotonin are affected (as is the brain itself) by high levels of Inflammation.  And in the same way that high levels of Systemic (whole body) Inflammation causes a very serious health problem called Leaky Gut Syndrome, Systemic Inflammation causes both a deficiency of neurotransmitters as well as something called Leaky Brain Syndrome.

The individual cells that make up the brain’s blood vessels, form very tight junctions that only allow very small molecules and substances through.  You have heard of this before — it is known as the Blood Brain Barrier or BBB.  Due to Chronic Systemic Inflammation, the cells that make up the “tight junctions” become loose.   Substances normally kept out of the brain are able to breech the membranes of the vessels and enter the brain.

WHAT CAUSES LEAKY BRAIN SYNDROME?
What causes Leaky Brain Syndrome?  The same blasted thing that causes Leaky Gut Syndrome, “Inflammation” — Chronic Systemic (Whole Body) Inflammation.  In fact, if you suffer from Leaky Gut Syndrome, it is almost guaranteed that you have at least a degree of Leaky Brain as well.  But what causes this Inflammation?  The same list of things that we have spent lots of time on already.  Once the blood brain barrier has been breached, the floodgates are opened to neuro-toxic substances such as heavy metals, bacteria, viruses, chemical toxins, parasites as well as numerous others, which always leads to other neurological conditions: Things like Depression, ADD / ADHD, SEIZURES, AUTISM SPECTRUM DISORDERS, CHRONIC PAIN, and all sorts of mental illnesses.

NEUROTRANSMITTERS:
Although your body has numerous neurotransmitters, we will confine our discussion to the most important; Dopamine and Serotonin.  Like most other Endocrine System Problems, the most common cause of deficiency of either is Blood Sugar Regulation Problems. 

DOPAMINE:
Dopamine is a “feel-good” neurotransmitter.  Most addictions have their roots in people’s attempts at trying to increase Dopamine levels.  These include CIGARETTES & CHEWING TOBACCO (nicotine), SUGAR / JUNK CARBS, chocolate, coffee & soda (caffeine), as well as ALL SORTS OF DRUGS including PRESCRIPTION PAIN PILLS.  Although these things initially boost Dopamine levels, the boost does not last long.  The “low” after the “high” becomes the norm, as baseline levels of Dopamine continue to decrease. 

This is a huge problem as far as the thyroid is concerned, because dopamine stimulates the Hypothalamus to produce TSH, and aids in the production of T4 (inactive thyroid hormone) as well as its conversion to T3 (active thyroid hormone).  On the other side of this equation, thyroid hormones stimulate the production of Dopamine. Are you beginning to see the makings of a vicious cycle? Diminished thyroid function causes decreased levels of Dopamine, and decreased levels of Dopamine leads to diminished thyroid function.  Dopamine deficiency results in the following symptoms:

• Feelings of Worthlessness

• Feelings of Hopelessness

• Self Destructive Thoughts

• Inability to Deal with Stress

• Anger & Aggression — Especially Under Stress

• Desire for Isolation

• Lack of Concern for Others — Particularly Family and Friends

• Easily Distracted

• Trouble Finishing Tasks

• Need for Caffeine or others from the “Addiction” List Above

• Diminished Sex Drive

To top it all off, people that have long-standing hypothyroidism are at a greater risk of being diagnosed with PARKINSON’S DISEASE, a health problem characterized by tremor-like actions and gait abnormalities.  The cause of Parkinson’s — an absolute loss of Dopamine.

SEROTONIN:
Like Dopamine, SEROTONIN is also responsible for communicating with the thyroid gland and specifically helping convert T4 (inactive thyroid hormone) to T3 (active thyroid hormone).  Serotonin helps to regulate mood, appetite, and sleep. It also plays an important role in memory and learning. Eighty to ninety percent of the neurotransmitter serotonin is made from the amino acid tryptophan by the body’s “Second Brain” (The Gut).  The remainder is made by the brain itself.   Like Dopamine, it is also a “feel-good” chemical that is typically associated with happiness and well being.  Because it is so similar to Dopamine, the symptoms of decreased levels are similar as well.  These include:

• Loss of Enjoyment from Hobbies

• Loss of Enjoyment from Favorite Foods

• Loss of Enjoyment of Relationships

• Loss of Artistic Appreciation

• Sleeplessness / Insomnia

• Feeling Overwhelmed

• Unable to Manage Problems

• Rage

• Paranoia

• Depression

• Chronic Pain

SSRI’s
As you just saw, both of these neurotransmitters are powerfully related to thyroid function.  Is it any wonder that one of the most common classes of drugs to prescribe people who are suffering with symptoms of low thyroid is Antidepressants? 

Because diminished levels of neurotransmitters (particularly Serotonin) leads to Chronic Pain, a common treatment is to give sufferers Antidepressants in the form of SSRI’s (Selective Serotonin Reuptake Inhibitors).  While I can understand their reasoning for doing this (doctors like to tell patients that Chronic Pain is caused by DEPRESSION), the research has shown that just the opposite is far more likely to be true.  People get depressed because they have CHRONIC PAIN!

Seratonin Re-uptake Inhibitors (Prozac, Zoloft, Paxil, Luvox, Celexa, Lexapro, Sarafem, Fen-Phen, Redux, Meridia, Effexor, Serzone, Wellbutrin, Zyban, etc — some of these have been pulled off the market) do exactly what their name describes.  They inhibit the “re-uptake” of Serotonin once it is in the blood stream.  Instead of the “used” Serotonin being recycled into more Serotonin or other substances, it stays in the blood stream.  If you recall, most of the times that you have a very high level of a hormone or neruotransmitter in the bloodstream, the body tends to “resist” it.  Think of Insulin Resistance here.  Thus, increasing levels of neurotransmitters can have a diminishing return — something seen with those who have had issues with drugs and Depression (think Robin Williams here).

Unfortunately, most of the people who are on SSRI’s (over 10% of the American Population), are not on them for true Clinical Depression.  They are on them because of symptoms of some other problem — usually Endocrine in nature.  On top of that, increased levels of Serotonin are not only neuro-toxic, they are actually associated with things like ALZHEIMER’S DISEASE and AUTISM. High serotonin levels are also responsible for various sorts of psychosis — the very thing that has caused so much controversy over the massively increased levels of suicides while on these drugs — especially children.

But SRRI’s can be dangerous even if you do not happen to kill yourself while on them.  The Prozac label lists dozens upon dozens of side effects, but describes the following as “frequent“.  Chills, Hemorrhage, Hypertension (High Blood Pressure), Nausea, Vomiting, Increased Appetite, Weight Gain, Agitation (easily angered), Amnesia, Confusion, Emotional Liability, Sleep Disorders, Ear Pain, Taste Disruption, and Tinitus (Ringing in the Ears).  I realize that Depression is no fun.  I also realize that there are other ways to deal with it than drugs (HERE). 

Because thyroid troblems are usually a part of a much bigger overall picture of metabolic dysfunction, and because most cases (90%) of hypothyroidism have a major autoimmunity component (Hashimoto’s for incstance), the only way to effectively address thyroid problems is to deal with underlying autoimmune problems.  How is this done?  The first part of effectively managing any problem is to define that problem so that you know exactly what you are up against. 

• Is my Immune System working properly? (Salivary Cortisol Tests)

• Is my Gut functioning properly? (Comprehensive Stool Examination)

• Do I have some sort of underlying Autoimmunity?  (ANA Test — not great but a start)

• Why are my Thyroid tests normal even though I have every symptom of a Thyroid problem? (Complete Thyroid Panel — not just TSH)

• How do can I effectively deal with Fibromyalgia & MIGRAINE HEADACHES?

• What can I do for the Chronic Fatigue?

• The medicine they are giving me is making me worse.  What do I do?

• Why have I been to so many doctors who tell me that nothing is really wrong with me?

• How do I get my life back?

An enzyme called Thyroid Peroxidase (TPO) removes one molecule of iodine from inactive T4, to convert it to active T3.  Unfortunately for the person with Autoimmune Thyroid (Hashimoto’s), supplementing with iodine can in some cases be like trying to put out a fire with gasoline.  Hashimoto’s is often confirmed by the presence of Antibodies (Ab) to TPO. In other words, the enzyme TPO is frequently the aspect of the thyroid that is being attacked.  Iodine increases production of TPO, which can either trigger or magnify an autoimmune attack.  Supplementing with iodine is not actually causing Hashimoto’s, but for some people it can certainly be a trigger or magnifying glass.

Managing thyroid problems, or any other Endocrine Problem for that matter, means taking charge of your health.  Although it certainly may require some testing on your part, I have filed any number of posts that provide you a starting point as far as starting to address this on your own is concerned (HERE is the most comprehensive).  HERE are my other thyroid posts as well.  And for the record, I am not for one moment suggesting you bail on your endocrinologist or the drugs they’ve prescribed; I’m simply giving you some information that will allow you to better deal with potential underlying causes of your thyroid issue as well as any other inflammation-based health issues you might be dealing with.