Dr. Davis:
doctors including most in your specialty use statins as their first line of defense in treating heart disease. Perhaps because it is easy; perhaps because of the drug company sponsored tests.  In any event, it may be that it makes sense in some cases, only we the public do not know when they should be prescribed.  Perhaps you can enlighten us on when and for what reasons you would prescribe statins, if at all.
Excellent post.

Why didn't you tell her that it's now been proven that no woman should ever be on statins (and very few men should be.)

My mom now has to walk with a cane after six months on statins, at her idiot doctor's insistence.

At least I'm sure her doc enjoyed his free lunches (paid for by hot, nubile drug reps, just a year or two out of the sorority.)

Sometimes this country makes me want to VOMIT!

Dr. Eades keeps repeating it's never been proven that statins do any good to women of any age - what do you think about it, maybe that patient should just stop taking statins and increase fish oil?

http://www.lipidworld.com/content/pdf/1476-511x-7-37.pdf
In this paper Das proposes that a rational combination of -3 and -6 fatty acids and the co-factors that are necessary for their appropriate action/metabolism is as beneficial as that of the combined use of a statin, thiazide,a  blocker, and an angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin.
Furthermore, appropriate  combination of -3 and -6 fatty acids may even show additional
benefits in the form of protection from depression, schizophrenia, Alzheimer’s disease, and enhances cognitive function; and serve as endogenous anti-inflammatory molecules; and could be administered from childhood for life long.

But I suspect that such an approach would not be as profitable as the use of a polypill.

RCT's have demonstrated that Omega 3 fatty acid supplements can reduce
cardiac events like death,non fatal MI and non fatal stroke.

I like Omega3 fatty acid supplement from Neurovi.It has many benefits related with Heart disease.Check out the website of Neurovi.

www.neurovi.com

There's a relatively new (rat) study on krill oil.

If you're interested, you can access the abstract here:

http://www.ncbi.nlm.nih.gov/pubmed/18755044?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Is this true? If someone takes a statin drug, like Crestor, Lipitor, Zocor (simvastatin), pravachol, or lovastatin, they don't need to take anything else because the statin drug is so powerful that it eliminates risk?

We must first gather some informations bbelieving that when we take statin, we should not take any other like fish oil.

We must first gather some informations before believing that when we take statin, we should not take any other like fish oil.

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?

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.

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

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.

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?

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

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

Hello,

The question of gluten/wheat and autoimmune diseases including Hashimoto's is unquestionable and pretty in-disputable.

We just currently do not have the technology to fully detect this relationship.

(wait until we're a couple light years ahead...like Star Trek years/eons away)

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.

Markers of potential coeliac disease in patients with Hashimoto's thyroiditis. Eur J Endocrinol. 2002 Apr;146(4):479-83.

OBJECTIVE: Coeliac disease (CD) is associated with autoimmune thyroid disease. Gluten sensitivity represents a spectrum, with at one end cases with severe gluten-dependent enteropathy, and at the other subjects with minor signs of deranged mucosal immune response. The aim of this paper was to look for signs of minor small bowel injury and immunohistochemical markers of gluten sensitivity in a group of patients with Hashimoto's disease. S
UBJECTS AND METHODS: Fourteen patients with Hashimoto's thyroiditis without serological evidence of CD underwent immunohistochemical analysis of jejunal biopsies.
RESULTS: In 6/14 cases (43%) an increased density of gammadelta T cell receptor bearing intra-epithelial lymphocytes was found. In 6/14 (43%) signs of mucosal T cell activation (presence of interleukin 2 (IL2) receptor (CD25) on lamina propria T cells and/or expression of human lymphocyte antigen (HLA)-DR molecules on crypt epithelial cells) were noted. In 4 out of 6 such cases (WOWO 80% of cases!!), HLA haplotypes were described in association with CD.
CONCLUSION: A significant proportion of patients with Hashimoto's thyroiditis present signs of 'potential' CD and of activated mucosal T cell immunity. The gluten dependence of such findings remains to be ascertained.  PMID: 11916614

Celiac disease and autoimmune thyroid disease.

Coeliac disease in patients with type 1 diabetes mellitus and auto-immune thyroid disorders.

Celiac disease-associated autoimmune endocrinopathies.

Endocrinological disorders and celiac disease.

Clinical review: Type 1 diabetes-associated autoimmunity: natural history, genetic associations, and screening.

Celiac disease and its link to type 1 diabetes mellitus.

Celiac disease in patients with an affected member, type 1 diabetes, iron-deficiency, or osteoporosis?

Gluten-sensitive enteropathy (celiac disease): more common than you think.




PROLACTIN:

There is HHEEEYYuge link betw man-boobs ('moobs' as know by 'experts' *ah* who have cup sizes that EXCEED mine). Prolactin grows mammary glands/breasts -- and this is induced by wheat, wheat, wheat/gluten, high carbs high carbs high carbs (lack of EPA DHA/vit D/vit A/etc).

Prolactin and autoimmunity.

Hyperprolactinemia and autoimmune diseases.

Prolactin in autoimmune diseases.

Prolactin in human systemic lupus erythematosus.

Prolactin and autoimmunity.

[Prolactin in the immunological system: synthesis and biological effects]

[Prolactin, a link between the neuroendocrine and immune systems. Role in the pathogenesis of rheumatic diseases]

Endocrine, paracrine and autocrine actions of prolactin on immune cells.


Hope that helps... so much understanding... but so little medical science... sometimes.



Mike V....TOTALLLY, I agree, in utero exposure determines our gene expression and is involved with epigenetics -- the genes in fact our future F1 F2 generations carry.  Epigenetics is supposed to enhance survival of our kind and adaptability... Personally, I think we are just de-evolving as the homo sapien race. Forget about the rain forests...look at us and our kids?

We are killing our future generations with the current low fat/whole grains food paradigm, lack of nutrient dense foods and high carb/high wheat/vit D deficiency/low fat guidelines in pregnant women.

Look at the rampant rate of death, mortality, chronic pain syndromes, heart disease, diabetes (OMG -- in CHILDREN), fatty liver (O-M-G.... in young YOUNG children), and the explosive degree of Hashimoto's and ALL autoimmune disorders (including AUTISM).  Some babies are even BORN with Hashimoto's thyroiditis.

What is going on?

For the first time in human history, our generation has high mortality/morbidity before their respective parents. (at least our parents had ample sunshine, their moms during gestation had saturated fats, EPA DHA, vitamin D and AEK, good nutrient dense food --though they might've poor; no air/water/land pollution, etc).


IMHO...That is just nuts... like our current world.
-G

Hello,

The question of gluten/wheat and autoimmune diseases including Hashimoto's is unquestionable and pretty in-disputable.

We just currently do not have the technology to fully detect this relationship.

(wait until we're a couple light years ahead...like Star Trek years/eons away)

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.

Markers of potential coeliac disease in patients with Hashimoto's thyroiditis. Eur J Endocrinol. 2002 Apr;146(4):479-83.

OBJECTIVE: Coeliac disease (CD) is associated with autoimmune thyroid disease. Gluten sensitivity represents a spectrum, with at one end cases with severe gluten-dependent enteropathy, and at the other subjects with minor signs of deranged mucosal immune response. The aim of this paper was to look for signs of minor small bowel injury and immunohistochemical markers of gluten sensitivity in a group of patients with Hashimoto's disease. S
UBJECTS AND METHODS: Fourteen patients with Hashimoto's thyroiditis without serological evidence of CD underwent immunohistochemical analysis of jejunal biopsies.
RESULTS: In 6/14 cases (43%) an increased density of gammadelta T cell receptor bearing intra-epithelial lymphocytes was found. In 6/14 (43%) signs of mucosal T cell activation (presence of interleukin 2 (IL2) receptor (CD25) on lamina propria T cells and/or expression of human lymphocyte antigen (HLA)-DR molecules on crypt epithelial cells) were noted. In 4 out of 6 such cases (WOWO 80% of cases!!), HLA haplotypes were described in association with CD.
CONCLUSION: A significant proportion of patients with Hashimoto's thyroiditis present signs of 'potential' CD and of activated mucosal T cell immunity. The gluten dependence of such findings remains to be ascertained.  PMID: 11916614

Celiac disease and autoimmune thyroid disease.

Coeliac disease in patients with type 1 diabetes mellitus and auto-immune thyroid disorders.

Celiac disease-associated autoimmune endocrinopathies.

Endocrinological disorders and celiac disease.

Clinical review: Type 1 diabetes-associated autoimmunity: natural history, genetic associations, and screening.

Celiac disease and its link to type 1 diabetes mellitus.

Celiac disease in patients with an affected member, type 1 diabetes, iron-deficiency, or osteoporosis?

Gluten-sensitive enteropathy (celiac disease): more common than you think.




PROLACTIN:

There is HHEEEYYuge link betw man-boobs ('moobs' as know by 'experts' *ah* who have cup sizes that EXCEED mine). Prolactin grows mammary glands/breasts -- and this is induced by wheat, wheat, wheat/gluten, high carbs high carbs high carbs (lack of EPA DHA/vit D/vit A/etc).

Prolactin and autoimmunity.

Hyperprolactinemia and autoimmune diseases.

Prolactin in autoimmune diseases.

Prolactin in human systemic lupus erythematosus.

Prolactin and autoimmunity.

[Prolactin in the immunological system: synthesis and biological effects]

[Prolactin, a link between the neuroendocrine and immune systems. Role in the pathogenesis of rheumatic diseases]

Endocrine, paracrine and autocrine actions of prolactin on immune cells.


Hope that helps... so much understanding... but so little medical science... sometimes.



Mike V....TOTALLLY, I agree, in utero exposure determines our gene expression and is involved with epigenetics -- the genes in fact our future F1 F2 generations carry.  Epigenetics is supposed to enhance survival of our kind and adaptability... Personally, I think we are just de-evolving as the homo sapien race. Forget about the rain forests...look at us and our kids?

We are killing our future generations with the current low fat/whole grains food paradigm, lack of nutrient dense foods and high carb/high wheat/vit D deficiency/low fat guidelines in pregnant women.

Look at the rampant rate of death, mortality, chronic pain syndromes, heart disease, diabetes (OMG -- in CHILDREN), fatty liver (O-M-G.... in young YOUNG children), and the explosive degree of Hashimoto's and ALL autoimmune disorders (including AUTISM).  Some babies are even BORN with Hashimoto's thyroiditis.

What is going on?

For the first time in human history, our generation has high mortality/morbidity before their respective parents. (at least our parents had ample sunshine, their moms during gestation had saturated fats, EPA DHA, vitamin D and AEK, good nutrient dense food --though they might've poor; no air/water/land pollution, etc).


IMHO...That is just nuts... like our current world.
-G

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.

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'. )

MikeV

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

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?

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.

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.

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.

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.

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.