How to Give Yourself Hashimoto's Thyroiditis: 101

25. January 2009 William Davis (18)
I borrowed this from the enormously clever Dr. BG at The Animal Pharm Blog.


How to Give Yourself Hashimoto's Thyroiditis: 101

--lack of sunlight/vitamin D/indoor habitation
--mental stress
--more mental stress
--sleep deprivation... (excessive mochas/lattes at Berkeley cafes)
--excessive 'social' calendar
--inherent family history of autoimmune disorders (who doesn't??)
--wheat, wheat, and more wheat ingestion ('comfort foods' craved in times of high cortisol/stress, right? how did I know the carbs were killing me?)
--lack of nutritious food containing EPA DHA, vitamin A, sat fats, minerals, iodine, etc
--lack of play, exercise, movement (or ?overtraining perhaps for Oprah's case)
--weight gain -- which begins an endless self-perpetuating vicous cycle of all the above (Is it stressful to balloon out for no apparent reason? YES)


If you haven't done so already, take a look at Animal Pharm you will get a real kick out of Dr. BG's quick-witted take on things.


We are systematically looking for low thyroid (hypothyroidism) in everyone and findings oodles of it, far more than I ever expected.

Much of the low thyroid phenomena is due to active or previous Hashimoto's thyroiditis, the inflammatory process that exerts destructive effects on the delicate thyroid gland. It is presently unclear how much is due to iodine deficiency in this area, though iodine supplementation by itself (i.e., without thyroid hormone replacement) has not been yielding improved thyroid measures.

I find this bothersome: Is low thyroid function the consequence of direct thyroid toxins (flame retardants like polybrominated diphenyl ethers, pesticide residues in vegetables and fruits, bisphenol A from polycarbonate plastics) or indirect toxins such as wheat via an autoimmune process (similar to that seen in celiac disease)?

I don't know, but we've got to deal with the thyroid-destructive aftermath: Look for thyroid dysfunction, even in those without symptoms, and correct it. This has become a basic tenet of the Track Your Plaque approach for intensive reduction of coronary risk.
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Comments (18) -

  • Bad_CRC

    1/25/2009 7:07:00 PM |

    Hmm, really?  So if I eat wheat (or was it 'carbs' generally?) and not enough animal fat, drink coffee, don't sleep enough, etc., Hashimoto's autoantibodies will start showing up in my blood?  And when I reverse the above, the antibodies will disappear and TSH, etc., will revert to normal?

    Any support for this in the literature?

  • dubyaemgee

    1/25/2009 8:12:00 PM |

    I suspect there needs to be some reeducation as to what is considered "normal" within the medical community as a whole. My TSH was last measured at 4.32, and is considered well within the range of normal, even though I've been complaining of hypothyroidism for a while now. Seems like we have to go into the doctor's office with steely determination to have these problems addressed.

  • mike V

    1/26/2009 2:03:00 AM |

    Drs Davis and BG:
    I think you are both on target with the attention you pay to hypothyroidism in relation to heart disease, and other related diseases such as obesity, diabetes, kidney and other hormone related problems.

    Question please:
    In your opinions:
    1 Is the high incidence of hypothyroidism in the population throwing 'off' the lab  norms for TSH, FT3, FT4 or can we assume the numbers used by most labs are based on world wide or historical values?

    2 Is 'Subclinical Hypothyroidism' real, or could it simply be a function of #1, or inadequate vitamin D3/iodine etc. I understand that 60% of the US population may be in that category.

    Thank you
    Mike V

  • Anne

    1/26/2009 2:26:00 PM |

    You mention the connection between wheat and thyroid. If you want to read more about that, go to The Gluten File. www.theglutenfile.com There you will find a section on thyroid disease.

    It is known that about 4-6% of those with Hashimoto's have celiac disease. I am sure that percentage would go even higher if one included those with non-celiac gluten sensitivity. There has been at least one study showing that thyroid antibodies disappear with the use of a gluten free diet.

  • Nameless

    1/26/2009 8:46:00 PM |

    Are there any studies showing wheat, vitamin D, etc. causing Hashimoto's? I suspect there isn't, but if population studies are looked into, perhaps you could find a correlation? Look at populations that generally don't consume much wheat, and see what their rates of Hashimoto's are. Or populations at upper latitudes vs those near the equator, and their rates of Hashimoto's.

    However, if wheat, lack of sleep, poor diet, etc. does cause Hashimoto's, wouldn't it alter the male/female ratio of who gets the disease? Why would women still be more likely to contract Hashimoto's, if the cause is diet?

    And in my case, several years ago I went to a low carb diet, restricted wheat, desserts consist of fruits/berries only, corrected my vitamin D levels, took fish oil, etc. I also tested negative for Celiac. Before these changes my thyroid tested normal (TSH in the low 1s). I was never overweight and exercised regularly too.

    And this past month I was  diagnosed with Hashimoto's (high antibodies, TSH in the 3s, thyroid scan all lumpy). So... if there is a correlation, shouldn't my thyroid have improved, not gotten worse?

  • G

    1/26/2009 10:00:00 PM |

    Bad_CRC,

    I think you need to have the genetic susceptibility. On the animal pharm blog, I've listed a few that scientists have already correlated to Hashimoto's
    --VDR polymorphs
    --HLA polymorphs

    I'm certain there will only be dozens others b/c these things (autoimmunity) don't happen alone.

    Add'l, perhaps these things are also just signals for 'hibernation'...??  Perhaps we are only inducing ancient signals that are meant to protect and increase survival (low melatonin, high carbs, wheat/stress, fructose (from the Italian sodas I forgot to mention!), gaining weight, slowing down to Eat-Eat-Eat/stress, etc).

    Any thoughts?

    There are a few links in the literature regarding higher TSH, lower T3/T4 during winter months and lower vitamin D in the serum. Of course!

    -G

  • mike V

    1/27/2009 2:32:00 AM |

    G
    I have no personal doubt that how well you choose your parents is of primary importance.
    My late mother, and two brothers and sisters have all been  hypothyroid.
    As in most diseases, I think other immune factors can be involved, some in the womb, some exposures in early childhood, while the immune system is still being 'programmed', others from bacterial or viral exposures.
    It is said that vitamin D is quite important in a balanced immune system, but it starts very low in typical breast milk, and in very young children, and can remain low throughout life in much of the population.
    Iodine deficiency was a critical factor in people not living near the coasts, until iodized salt was introduced in the early 20th century.
    Lack of timely exposure to bright light is well known to "mess" with our biological clock, moods, and immunity.
    I did not become aware that I was hypothyroid until my forties, and since have not found nutrition a major factor, until perhaps vitamin D.
    With the exception of vitamin D, I have not personally been aware that other nutrition has affected my treatment.
    Is there any co-relation between Hasimoto's, and other auto-immune conditions?

    MikeV

  • Dr. William Davis

    1/27/2009 11:53:00 AM |

    Mike V--

    The newest data, e.g., the HUNT Study, are analyses of events based on TSH. It therefore factors out the effect of population distributions.

    You are correct, however, in pointing out that previous analyses were flawed precisely for this reason.

  • mike V

    1/27/2009 5:13:00 PM |

    As usual thanks to all for the education, and for all you do to penetrate the blood brain barrier between the specialties, Big Medica, and us (the great 'unwashed'. Smile)

    MikeV

  • Pat Elliott ND

    1/27/2009 5:44:00 PM |

    Hi Doc,
    We are seeing a very high % of our patients with zinc deficiency - similar to the whole vitamin D thing. Just wanted to share this with you since zinc is also correlated to blood sugar and cholesterol problems. Would love to see what you find in your patients with regard to this nutrient as well.
    Regards,
    Pat Elliott ND
    www.elliotthealthcare.com

  • Anonymous

    1/28/2009 3:51:00 AM |

    Pat Elliott  --

    How do you define a zinc deficiency? I've read that serum zinc is pretty inaccurate (as is copper or magnesium serum testing).

    Looking at other biomarkers, or a zinc taste test?

  • Lou

    4/1/2009 11:54:00 PM |

    I'm guessing that when "Nameless" took up the low-carb eating plan, they may have also increased eating soy.  Soy can really mess up the hormones.  I think we can blame soy for all this thyroid trouble and fibromyalgia and fatigue related troubles.  Add to that inadequate fish oils, butter, after years of telling us to avoid fats and sunlight (vitamin D) and you get a nice picture of what has happened to far too many of us.

  • scall0way

    11/10/2009 8:35:12 PM |

    I know this is an old post but I'm just going through all the thyroid-related posts. My TSH got flagged at a 9 when I went for a physical a couple weeks ago, and further tests came back with a Hashimoto's diagnosis.

    I just don't know. I follow a gluten-free diet, in fact I avoid all grains. I avoid all sugars, I don't consume any high-PUFA vegetables oils. I have not eaten any sort of soy (except for rare splashes of fermented soy sauce here or there) in a dozen years. I always cook any veggies I might eat  that call into the goitrogenic category. I supplement with 5000 IU of D3 in gelcap format daily. I consume most of my fats as sat fats/animal fats. I take fish oil, cod liver oil. I love to eat sardines.

    Yet my thyroid apparently has slowly been getting worse over the last couple years. My TSH is definitely higher than it was in 2007, and that was higher than it was in 2006 - slowly been climbing over the last few years until finally the doctor red-flagged it.

  • Anonymous

    7/29/2010 10:42:48 AM |

    I have Hashimotos. Was diagnosed at 15. Had it long before then. I am convinced it is genetic when I look at other family members (although no-one else has been diagnosed). I am on 'correct' dosage of thyroid hormones but many of the symptoms still exist and I would LOVE to blame my GP but the fact is that they are overworked and are doing the best with what they have - like the rest of the population. Recently diagnosed with anxiety by a psychologist. Does this cover the hashimotos symptoms completely or partially? Who knows? All I know is that I am drunk now as I am bone tired from trying and failing from everything from relationships to work - alcohol seems to be the only way out...although my psychologist has told me it isn't - just being tired and weak I guess. I'm sure you will delete this post as soon as you see it blog owner, but before you do, I hope a few Hashimotos/anxiety sufferers see one person struggling to be better despite the messy interference of life. Having a temporary failure right now but will be back on the horse again tomorrow like every other day.

    Love you all.

    XXX.

  • buy jeans

    11/3/2010 6:58:15 PM |

    JMC at the blog animal pharm has linked some fantastic resources from Loren Cordain and how the Paleo diet reverses autoimmune diseases (incl JMC's own rheumatoid arthritis). Wheat is not the ONLY culprit. Legumes, Dairy/casein, nutr'l deficiencies, excessive fruit/HFCS, lack of exercise, lectins, etc are part of the equation for autoimmunity disorders as well.

  • PureAlan

    1/24/2011 10:46:15 AM |

    What a brilliant idea! Thanks for sharing this information. I have hypothyroidism for almost 4 years and it was terrible. I am currently taking porcine thyroid .  Now I'm gaining back my normal life.

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Do stents kill?

Do stents kill?

6. February 2007 William Davis (5)
There's apparently a lively conversation going on at the HeartHawk Blog (www.hearthawk.blogspot.com). Among the hot topics raised was just how bad it is to have a stent.

I think that my comments some time back may have started this controversy. I've lately noticed that having a stent screws up your heart scan scoring in the vicinity of the stent. I was referring to the fact that I've now seen several people in the Track Your Plaque program do everything right and then show what I call "regional reversal": unstented arteries show dramatic drops in score of 18-30%, but the artery with a stent shows significant increase in score.

This is consistent with what we observe in the world outside Track Your Plaque when stents are inserted. Someone will get a stent, for instance, in the left anterior descending artery. A year later, there will be a "new" plaque at the mouth of the stent or just beyond the far end. This is generally treated by inserting another stent. Use of a drug-coated stent seems to have no effect on this issue.

Now, my smart friends in the Track Your Plaque program would immediately ask, "Does this mean you continually end up chasing these plaques that arise as a result of stents? Do you create an endless loop of procedures?"

Thankfully, the majority of times you do not. Rarely, this does happen and can lead to need for bypass surgery to circumvent the response. But it is unusual. The tissue that grows above and below stents does seem to be unusually impervious to the preventive efforts we institute.

Perhaps there's some new supplement, medication, or other strategy that will address this curious new brand of plaque growth. Until then, you and I can only take advantage of what is known. If it's any consolation, the plaque that seems to grow because of a previously inserted stent seems to lack the plaque "rupture" capacity of "naturally-occuring" plaque. It is, indeed, somehow different. It is more benign, less likely to cause heart attack. It's always been my feeling that this tissue behaves more like the "scar" tissue that grows within stents, causing "re-stenosis", a more benign, less rupture-prone kind of tissue.
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Comments (5) -

  • madcook

    2/6/2007 5:17:00 AM |

    "If it's any consolation, the plaque that seems to grow because of a previously inserted stent seems to lack the plaque "rupture" capacity of "naturally-occuring" plaque. It is, indeed, somehow different. It is more benign, less likely to cause heart attack."

    Dr. Davis:

    You'll pardon my obvious question:  Has anybody actually looked at this phenomenon both in structure and composition at (pardon the word) autopsy?  I would wonder if it's a hyper-reaction to a foreign object, a kind of 'normal' scarring, as you mentioned, or something else.  Obviously there is calcium in this plaque, else it wouldn't be visible on scan. Very curious...

    madcook

  • Dr. Davis

    2/6/2007 8:46:00 PM |

    Madcook--
    The phenomenon is known as "edge restenosis". When examined at autopsy, or in years past when plaque was actually extracted by procedures like directional atherectomy, the material is the same as that occuring within the stent, known as "neointimal hyperplasia."

    The million dollar question is: Can anything modify neointimal hyperplasia? This is the whole dilemma of stent restenosis, the growth of tissue into stents. Of course, the procedural answer tends to involve drug coated stents. However, I know of no specific preventive strategy that has demonstrated substantial impact on the edge restenosis phemenonon. I've tried several agents, including cilostazol, which holds modest promise.

  • madcook

    2/6/2007 11:14:00 PM |

    Thank you for that information... I look forward to hearing more about the use of these agents as time goes by.

    "Of course, the procedural answer tends to involve drug coated stents."

    I just wonder how many people, who 'flunk' a treadmill test, or having an 'equivocal' result, end up in the cath lab and emerge with stent(s)... Are they _really_ aware beforehand that a lot of stent use is "off label" and they just might end up with a year or two (or a lifetime) on Plavix and aspirin?

    I lasted a week on Plavix before I refused anymore... after nearly bleeding to death in the kitchen from a cut (where else would a madcook hang out?).  But then I was very lucky, too as I escaped the cath lab without needing stenting.  A rare event I understand... and aspirin will always be my daily friend (along with most of the other TYP recommendations).

    Regards and thank you for the Heart Scan Blog.  It is a tremendous resource and very informative.

    madcook

  • John Townsend

    2/7/2007 9:15:00 PM |

    RE: "A year later, there will be a "new" plaque at the mouth of the stent or just beyond the far end."

    I'm curious whether or not this is a regular or typical occurrence and if there are symptoms one should be sensitive to that indicate such a development. Also does the size of the stent have a baring on the condition? Does vigorous exercise exasperate the condition?

    I appreciate your blog. It's very informative and helpful.

  • Dr. Davis

    2/7/2007 9:42:00 PM |

    John--
    It is, unfortunately, a very common occurrence, though the majority of times it does not result in any specific symptom or clinical consequence. Among the 30% or so of people who do re-develop chest pain, breathlessness, or have a new abnormality on a stress test, most of the time another stent is implanted at the area of tissue growth.

    Though this is really outside the realm of the Track Your Plaque program, it is yielding confusing results for people who engage in the program yet have a stent or two. It's my believe that the stent modifies the process of scoring in the stented artery. That's why we can see score reduction in arteries without stents, while the artery with a stent shows substantial increase in score.

    The larger the artery, the less likely this occurs. Large means 3.5 mm or greater in diameter.

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