Archive | December, 2014

Hidden Cause #20 Why You STILL Have Low Thyroid Symptoms–Cytokines & Receptors

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill thyroid expert, explains how cytokines affect thyroid hormone receptors and cause Low Thyroid symptoms.

Hidden Cause #20 why you still have low thyroid symptoms even though your lab tests look normal and even though you may be taking medication is…

Elevated inflammatory cytokines blocking &blunting thyroid hormone receptor sites 

Let’s review for a second.

You can take thyroid hormones, but that doesn’t guarantee that you will get any benefits of the hormone. Why?

The hormone has to bind/dock on the receptor…AND…the receptor has to then RESPOND to the docking.

T3 comes along and docks on the receptor—and then the receptor makes the machine inside the cell do what it’s programmed to do.  This system depends on a receptor that is unblocked, unblunted and responsive.  

Cytokines can block, blunt and make the thyroid hormone receptors un-responsive. This causes low thyroid symptoms.

Cytokines are immune system messengers (example: interleukin 2, interferon gamma). We all have cytokines in our body, but people with inflammation, inflammatory conditions or autoimmune conditions have A LOT of cytokines.

If you have a condition such as

  • Hashimoto’s
  • Vitiligo
  • Rheumatoid arthritis
  • Psoriasis
  • IBS
  • PCOS
  • Endometriosis

….chances are you have a large amount of cytokines. And that can affect your thyroid hormone receptors and cause low thyroid symptoms (even if you’re taking medications like Synthroid®, Armour® or Cytomel®)

What causes high levels of inflammatory cytokines?

Here’s a partial list:

  • Psychological stress
  • Food sensitivities
  • Infections: viral, bacterial
  • Autoimmune conditions
  • Chemical sensitivities

Cytokines can shut down the receptors for T3, making you FEEL hypothyroid and actually FUNCTION as hypothyroid–even though your TSH, T4 and T3 lab numbers are “normal” and within the lab range.

You WILL have low thyroid symptoms like these:

  • Hair loss (scalp, eyebrows, body hair)
  • Weight gain — even though you’re eating a low calorie diet, even though you may be exercising like crazy
  • Brain fog–slow thinking, memory problems, can’t think of words
  • Sleeping excessively in order to feel like you’re even normal
  • Constipation
  • Dry skin, dry hair, nail problems. 
  • Infertility
  • High cholesterol

High cytokines can make have any or all of those low thyroid symptoms.

This is a hidden cause mainly because the lab numbers really are “normal.” This can confuse your well-meaning doctor.

If your TSH and T4 are clearly abnormal, the answer is easy: prescribe thyroid hormones.

But if your labs are normal and you have low thyroid symptoms….what does your doctor do? Usually, he/she says you’re depressed and recommends an anti-depressant.

What if you’re already diagnosed hypothyroid AND taking thyroid medication BUT you still have low thyroid symptoms?

The thyroid medication can make your T4 levels look normal–but if you’ve got something that’s suppressing the receptors, you will NOT get the benefit of all that T4 floating around in your blood. 

I hope that makes sense. 

You can have a ton of  Synthroid® circulating, but it’s all for nothing if cytokines are blocking or blunting your receptors.

You will feel like you’re NOT taking any medication because you will still suffer low thyroid symptoms.  And this chain of events will really confuse most doctors because they just don’t know about cytokines and how they affect hormone receptors.

There’s another possibility with cytokines and receptors…you never even get diagnosed hypothyroid because your numbers look normal. The receptors are the problem.

Unfortunately there are NO lab tests that can tell us what’s going on with the receptors.

Women that suffer high cytokines and screwed up receptors but normal lab tests…these women wander in the medical wasteland forever. 

 They’ll see chiropractors, MDs, DOs, acupuncturists, Functional Medicine practitioners…and they’ll get prescribed everything from serotonin to Armor to iodine…but none of it works because that’s not the problem. 

The problem is cytokines and receptors.

Typically, she’ll see 10 or more practitioners before she finally finds someone who understands this point:

“Look, none of these other approaches have worked.  All these other mechanisms are not what’s going on with you.  Maybe it’s inflammation, cytokines and recptors.”

In my practice, I see this EXACT scenario in about 25%  of my new thyroid patients.

How do you deal with high cytokines and blocked/blunted receptors? 

You’ve got to find out what’s causing the inflammation. 

For example, is Hashimoto’s the cause of your high cytokines and blocked/blunted receptors? Hashimoto’s is an inflammatory autoimmune condition featuring high levels of cytokines.  You CAN have both of these mechanims happening at the same time. 

There’s no rule that says you can only have one thing wrong.  You could have Hashimoto’s and the cytokine/receptor problem. I see it all the time.

  • Is it the fact that you’ve got some other autoimmune condition? 
  • Do you have a leaky gut or GI dysbiosis–a gut infection that’s causing inflammation throughout your entire body?
  • Do you have a food sensitivity? Chemical sensitivity?

You’ve got to have somebody that knows how to look for all these factors AND understand that cytokines can block/blunt receptors…AND know what to do correctly address the cytokine problem.  

If you don’t find a doctor who knows these concepts, chances are you’ll go to doctors 16, 17 and 18, and they’ll just offer you slight variations on what all the other doctors tried that didn’t work.

Your doctor has to think outside of that “normal box” and consider that cytokines are shutting down the receptor—even though the lab tests may look normal—even though you might be taking thyroid medication already—but you can STILL have this problem.

© 2014 David Clark. All Rights Reserved.

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

Hidden Cause #19 Why You STILL Have Low Thyroid Symptoms-High Testosterone & Resistance

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill thyroid expert, explains another way that high Testosterone causes Low Thyroid symptoms.

TriangleThyroidDoctor.com

Hidden Cause #19 why you still have low thyroid symptoms even though you may be taking thyroid medication and even though your lab tests look normal is…

Elevated Testosterone causing low thyroxine binding globulins and too much T4 and T3 leading to resistance.

Let’s pause and take a breath…

The basic problem in this hidden cause is you’ve got too much testosterone…and it’s lowering the amount thyroxine binding gloubins (aka TBG).  TBGs are like little taxicabs that carry T4 and T3 around your body.  You’ve got to have them. 

When there’s too many taxi cabs (TBGs), then the hormones can’t get out of the taxicabs and get into a free-form state. “Free” hormones get into the cells.  If the thyroid hormones aren’t free, you can’t use them.

In this hidden cause you have too few taxicabs… you’ve got tons of “free” hormones floating around…and they cause resistance, which leads to MORE low thyroid symptoms.

Think of Resistance like this… you’re growing a plant. The plant likes to have a little bit of water, but it doesn’t like to have a floord of water because you’ll drown it.  You’ll kill it. 

Well, thyroid hormone receptors  are like that.  They like to have enough thyroid hormones in order to dock and make them work. 

But if you bombard them with lots of thyroid hormones, they shut down and become resistant…

….which means you can have all the T4 and T3 in the world floating around,  trying to get onto this receptor, but it can’t. 

Or… alternately, the hormones can dock on the receptor, but the response to the docking is blunted.

For comparison, another example of “resistance” is women who take Cytomel® T3 and then become more hypothyroid. You’re bombarding the receptors.  There’s too much there and they shut down.

Here’s what high testosterone causing low binding globulins leading to resistance looks like….

A women has totally normal thyroid lab numbers (except maybe her T3 Uptake is >38) but, has these low thyroid symptoms:

  • hair loss
  • weight gain
  • constipation
  • brain fog
  • fatigue
  • needing to sleep an excessive amount of hours just to function
  • infertility
  • miscarriage. 
  • high cholesterol

Those are all low thyroid symptoms that can be caused by thyroid hormone resistance–even though your lab numbers look okay.
 
Of course, this assumes that your doctor is actually running all the numbers you need to look at.  If they just run a TSH and T4, they’ll never pick up this problem.  It will never show up. 

If your doctor also funs free T4, free T3 and T3 uptake, then this might show up. 

Your T3 uptake might  be outside the lab range…this would mean your binding globulins (taxi cabs) are low, and your “free” hormones are probably high.

High Testosterone is the main cause of low binding globulins (and high “free” hormones leading to resistance)

How would a woman get too much testosterone? 

The most common reason is from high blood sugar levels and insulin resistance.  Women that have chronically high blood sugar get surges of insulin in an attempt to get rid of that blood sugar. 

That surge of insulin causes them to make more testosterone…and that testosterone is what causes these binding globulins to drop, leading to excess amounts of “free” hormones—>Resistance—>Low thyroid symptoms.

If the doctor doesn’t run all the tests, or get a complete history, he/she may not see the problem. 

The doctor would need to actually run the T3 Uptake (and it’s low) and Free T4 and Free T3 (and they’re high)…then understand what it means if those numbers are abnormal (or at least functionally abnormal).  

What causes irregular blood sugar?

What you’re eating is a HUGE factor. 

If you’re overeating simple carbs (breads, pastas, grains)….

…or you’re eating “crap” food (from a drive-thru or out of a box or bag)

…or drinking sugary drinks (sodas, coffee drinks)

There’s a good chance you’ll end up insulin resistant and have high blood sugar.

Inflammation–from any source– can also make you insulin resistant.  

This could be a bacterial infection (like H. Pylori in the stomach)…Small Intestinal Bowel Overgrowth…food sensitivities…anything that’s inflaming you can lead to this testosterone problem. 

If a woman has Low thyroid symptoms + labs look “normal” + she has insulin resistance symtpoms = must consider high testosterone causing low binding globulins leading to resistance.

The Classic insulin resistance symptoms is getting tired/sleepy 15 to 30 minutes after you eat. 

Other symptoms of insulin receptor resistance include:

  • Crave sweets after you eat. 
  • Hard time going to sleep 
  • Wake up in the morning feeling completely beat up as if you didn’t sleep at all. 

Those are all pretty good signs of insulin resistance.

If you’re getting sleepy after you eat PLUS you’ve got those low thyroid symptoms, THEN insulin resistance might be the issue here…and testosterone could be causing you to have not enough binding globulins, causing too many “free” hormones, which leads to resistance, which causes low thyroid symptoms. 

I know that’s a lot of steps, so it’s really important you find a doctor who knows what I’m talking about.  It’s not as simple as running only a  TSH and T4, or saying “everybody’s got Hashimoto’s” or “all thyroid patients are iodine deficient!

To make this even a little more complicated…

You could really have Hashimoto’s AND this testosterone scenario. Why?

There’s no rule that says you can only have one thing wrong. You have whatever you have…however complicated…howeve simple…

…and you may have Hidden Cause #19: too much testosterone causing too many “free” hormones and resistance.

© 2014 David Clark. All Rights Reserved.Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

Hidden Cause #18 Why You STILL Have Low Thyroid Symptoms-High Testosterone & Overconversion

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill thyroid expert, explains how high Testosterone causes Low Thyroid symptoms.

Hidden Cause #18 Why you STILL have low thyroid symptoms, even though you may be taking thyroid medication and even though your lab tests are normal is…

Elevated Testosterone causing Over-conversion of T4 into T3 leading to Resistance. 

Okay, that’s a mouthful.  There’s a couple of different concepts we have to understand so let’s first talk about “Over-conversion.

A lot of times you’ll hear me talk about “under-conversion”…under-conversion of T4 to T3 that leads to low levels of T3.

Well, now we’re talking about something being too high.  If you remember the thyroid story…

…97% of what your thyroid gland makes is T4.  T4 is basically inactive. It must be converted into T3.  T3 is the active form of your thyroid hormones.

Conversion primarily happens in the liver, primarily through an enzyme called 5-deiodinase.  

Here, we’re talking about Over-conversion–something is speeding up the conversion of T4 to T3 leading to something called “resistance.” 

Think of Resistance like this… you’re growing a plant. The plant likes to have a little bit of water, but it doesn’t like to have a floord of water because you’ll drown it.  You’ll kill it. 

Well, thyroid hormone receptors (for T3) are like that.  They like to have enough T3 in order to dock and make them work. 

But if you bombard them with lots of T3, they shut down and become resistant…

….which means you can have all the T3 in the world floating around,  trying to get onto this receptor, but it can’t. 

Or… alternately, the hormone can dock on the receptor, but the response to the docking is blunted.

For comparison, another example of “resistance” is women who take Cytomel® T3 and then become more hypothyroid. You’re bombarding the receptors.  There’s too much there and they shut down.

Here’s what high testosterone causing over-conversion leading to resistance looks like….

A women has totally normal thyroid lab numbers but, has these low thyroid symptoms:

  • hair loss
  • weight gain
  • constipation
  • brain fog
  • fatigue
  • needing to sleep an excessive amount of hours just to function
  • infertility
  • miscarriage. 
  • high cholesterol

Those are all low thyroid symptoms that can be caused by resistance–thyroid hormone resistance.

I’ll  back up and explain it again (there’s a lot of moving parts). 

T4 has got to get converted to T3.  When you over-convert, you get lots of T3…and T3 can bombard the receptor and shut it down…making you have more low thyroid symptoms.

Now, I said “testosterone causing overconversion leading to resistance.”  Where does this testosterone come from?

In a woman, the #1 cause for abnormally elevated testosterone is blood sugar instability–insulin resistance. 

These are women who have chronically high blood sugar.  The classic symptom of “insulin receptor resistance” is getting sleepy/drowsy within 15 to 30 minutes after you eat. (Not 2 hours later). Other symptoms of insulin receptor resistance include:

  • Crave sweets after you eat. 
  • Hard time going to sleep 
  • Wake up in the morning feeling completely beat up as if you didn’t sleep at all. 

Those are all pretty good signs of insulin resistance.

In insulin resistance you get surges of insulin when you eat…this surge up-regulates an enzyme that makes women make more testosterone. 

Testosterone can cause this Over-conversion that bombards the receptor that leads to resistance and low thyroid symptoms. 

…I know that’s kind of a long story, but that’s what happens.

Women with insulin resistance are often diagnosed with Polycystic Ovarian Syndrome.  The insulin resistance leads to elevated testosterone. 

So, blood sugar instability is often the underlying cause of this high testosterone that we’ve been talking about.  What you eat, when you eat and inflammation are ALL factors that can cause insulin resistance.

We’ve got a lot of pieces on the chessboard…pieces that a good, effective doctor must looking at and thinking about all at one time.

Now, another way that you can develop elevated testosterone is simply if you are using it…or if your husband or your boyfriend is using topical testosterone.  Testosterone gel easily rubs off on you and will can cause this Over-conversion. 

Your doctor’s got to be able to evaluate all of those different possibilities.

Treatment depends on what the actual mechanism is for each individual patient.  If it’s insulin resistance, chances are you’ll have to change your what you’re eating and when.  You have to look for food sensitivities…inflammation (from all possible sources). 

For successful treatment, you’ve got to do ALL the above simultaneously. 

I see a ton of PCOS and Insulin resistance caused by diet and inflammation.

Now, back to the thyroid to wrap it up….

The reason high testosterone causing Over-conversion leading to resistance and more low thyroid symptoms is a hidden cause is because there’s so many links in the chain.

Your doctor needs to have the skills, experience and determination to find these links.

© 2014 David Clark. All Rights Reserved.

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

Hidden Cause #17 Why You Still Have Low Thyroid Symptoms – Peripheral Dopamine Deficiency

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill Thyroid expert, explains how low dopamine can cause low thyroid symptoms

Hidden Cause #17 Why You STILL Have Low Thyroid Symptoms even though you may be taking thyroid medication, even though your lab tests look normal is…

A peripheral deficiency in the neurotransmitter Dopamine

What would that look like? Well, there’s really not a lot of peripheral signs of dopamine deficiency.

Most of dopamine deficiency signs happen because of it’s effect on your central nervous system and how your brain is working….and those are typically things that look like ADHD: so we’re talking about

  • distractibility
  • impulsivity
  • can’t focus
  • can’t stay on task

But there’s also some sort of, you know, emotional symptoms that go along with that.

Let’s clarify “deficiency.” In most people, absolute low quantities of dopamine are not the problem. In most people the problem is low activity of the neurotransmitter.

Deficiency implicates that you’ve got absolute low levels, but it could be that your levels are fine…and it’s just that the receptors for the dopamine are not doing their job.

So with that in mind, what are some of the emotional signs that go along with dopamine being low activity or deficient?

  • Preferring to isolate oneself
  • Anger under stress

My favorite example of this last one is my own personal example. It was about 16 years ago….

I was in the kitchen cutting up an apple, and the apple fell in the sink and I yelled a 30 second stream of expletives.

My wife ran into the kitchen, struck with terror…“Oh my God, what happened? Are you hurt?”

I screamed back:  “This APPLE FELL in the sink!”

Well, you understand that’s completely out of proportion, right? I had a little bit of stress and I got very angry. That’s a good sign of a dopamine issue.

How would dopamine and thyroid symptoms show up in someone that has that problem?

Well, first thing they could have are low thyroid symptoms:

  • hair loss
  • brain fog
  • fatigue
  • high cholesterol
  • gain weight easily
  • infertility
  • constipation.

Those are those low thyroid symptoms.

Now, if you had those PLUS dopamine sypmptoms, the two could be directly related because what dopamine seems to do to thyroid hormones.

Research seems to say that Dopamine controls the rate of conversion of T4 into T3.

That’s a very big deal because T4 is inactive. T3 is the active thyroid hormone. 97% of what your thyroid gland makes is T4– and so a lot of that has got to get converted to T3 in order for you to have enough T3 for your body to work correctly.

That process is  conversion. And dopamine seems to influence how well you can convert T4 into T3. When you don’t have enough dopamine peripherally (outside the central nervous system) you may not convert very well…

You may develop those low thyroid symptoms. The problem is when you walk into a doctor’s office in saying, “Hey, I can’t focus. I’m distractible. I can’t follow through on things.” Bonk! You’re going to get labeled ADHD and offered a prescription.

But the dopamine medication is going to work mainly CENTRALLY and not work peripherally. You might have an improvement of some of your distractibility and your focus problems, but your low thyroid symptoms may stay exactly the same.

The key is finding a doctor that understands that dopamine has an impact on how thyroid works.

You could be taking thyroid medication. You could have lab tests that look totally normal because when this situation happens your T4 and your T3 don’t really necessarily change a lot to be outside of the lab range, but they can change enough to affect how you feel.

And it becomes very difficult for most doctors to do because they want to treat the labs.

I think a really good doctor/good clinician  doesn’t treat the lab. They treat YOU.

They use the lab for guidance.

So if you have dopamine symptoms plus low thyroid symptoms, then your doctor really should have that on the radar and think: what could cause dopamine deficiencies?

The two things that cause low dopamine activity/deficiency: blood sugar irregularity and iron deficiencies.

And that makes you go down another rabbit hole because…

…”why would you be iron deficient?”

…Do you have a parasite?

Do you have an H. pylori infection?

What’s up with your blood sugar? Are you eating? Are you not eating?

There’s a ton of factors to start investigating and thinking about….

And that’s another thing that a lot of doctors just don’t want to do. They just don’t want to think. They’d much rather you come in with your ADHD signs, give you medication for that and hope everything works out.

And when you come back six months later and it’s not working out… it’s YOUR fault, the patient.

Find someone that understands the complexity of that situation and understands that dopamine can be a hidden cause of why you still have low thyroid symptoms.

© 2014 David Clark. All Rights Reserved.

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

Hidden Cause #16 Why You STILL Have Low Thyroid Symptoms-Peripheral Serotonin Deficiency

Dr. David Clark, DC – Raleigh-Durham-Chapel Hill Thyroid expert, explains how Serotonin can cause Low Thyroid Symptoms.

Hidden Cause #16 why you STILL have low thyroid symptoms even though you may be taking medication and even though your lab tests look normal is…

 A peripheral deficiency in the neurotransmitter Serotonin. 

When I say ‘peripheral’, I’m trying to contrast that to “central,” meaning inside your nervous system, and peripheral, meaning in the nervous system in the rest of your body. 

You have a ton of serotonin outside of your brain. Your GI tract has a huge amount of serotonin. 

In fact, we like to call the GI tract “the second brain” because it really has more neurotransmitters than your brain. 

What would a serotonin deficiency look like? 

  • Intestinal Pain
  • Constipation
  • Diarrhea
  • Bloating

Essentially, any type of GI symptom could be related to peripheral serotonin deficiency.  I realize that’s not  super-specific but it’s the truth.

As for Central Nervous System symptoms of serotonin deficiency….

Classically, the big symptom is “depression.” But what does “depression” look like? 

….losing interest in things that were previously pleasurable

…being sad or down for no reason

…overwhelmed with ideas, can’t manage them

….feelings of inner range and anger

….feelings of unprovoked anger

Those are really what we mean by depression.

If you’re having a few of the above symptoms plus LOW THYROID SYMPTOMS like the following, then Serotonin needs to be on the radar

  • Fatigue
  • Need to sleep excessively just to function
  • Hair loss & hair thinning
  • Dry Skin
  • Constipation
  • Brain Fog
  • Easily Weight Gain
  • Infertility

How does Serotonin affect thyroid hormones?

Research seems to show that Serotonin affects the rate of conversion of T4 into T3. 

And if you remember, T4 needs to be converted into T3 (the active form). 97% of what your thyroid gland makes is T4—so to get T3, you’ve got to “convert” T4 into T3.

Conversion is influenced by how much serotonin activity is going on in the periphery of your body. 

But as I mentioned earlier, we just don’t see a lot of clear signs of peripheral serotonin deficiency other than those that are related to the gastrointestinal system.  So. we have to look more at someone that has central signs of serotonin deficiency (listed above).

What could cause a Central Serotonin Deficiency? 

Since Serotonin is made from the amino acid, L-Tryptophan, you could get into trouble if you weren’t getting enough L-Tryptophan, or absorbing it…

…however, that’s usually NOT the issue.

More often the real problem is LOW Serotonin Activity–in other words, you might be able to make it just fine, but you are NOT making it regularly or consistently…or…your Serotonin RECEPTORS are not responding normally to Serotonin.

Blood sugar regulation and Iron levels are the two critical factors that create Low Serotonin Activity.

If you have low Serotonin symptoms, that doesn’t necessarily mean you need to take L-tryptophan or that you need to take SSRI. 

It DOES mean that the doctor you’re working with has got to put on the detective hat and  figure out what is YOUR problem with Serotonin? 

…Making it (synthesis)

…Using it (receptors)

or both?

This takes some digging.

Im the big picture of Thyroid this hidden cause is pretty darn hidden because it’s  #16 on the list.   Over the last 12 years I haven’t seen that many low thyroid patients with this Serotonin problem–especially compared to the number of women with Hashimoto’s–but they still show up. 

I’ll see a woman who’s been taking thyroid medication because she’s got low thyroid symptoms AND she’s got these serotonin symptoms.

Now, you can guess what happens when she walks into most doctors’ offices.   

She looks depressed. Sounds depressed. So, she gets labeled with “depression.” And is prescribed an anti-depressant–which will not change her thyroid symptoms in the long run.

This is problematic for 2 reasons:

1. If you felt bad for months or years, you might be depressed BECAUSE of that–not the other way around. anyway.

2. A patient can have more than one thing wrong.  This is something that’s very hard to get doctors to understand—doctors of all kinds–that there’s no rule that says a patient can have only one thing.  

You’ll have to look far and wide to find a Doctor that would connect low thyroid symptoms AND low serotonin symptoms to a problem with peripheral Serotonin deficiency.

But the big point is, look, if you’ve got these serotonin symptoms and you feel sad and depressed when there’s no reason for it and you’ve got these low thyroid symptoms, you might need to investigate whether serotonin is an issue for you or not. 

So you’ve got to find someone that would know what to look for and how to help you.  And how to help you is not immediately running out to GNC and buying L-tryptophan.  That’s not necessarily what you need to do.

It’s more complicated than that, and your doctor that you see should know that.

© 2014 David Clark. All Rights Reserved.

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

Hashimoto’s Autoimmune Thyroiditis and Vitamin D Deficiency

Dr. David Clark, DC — Raleigh-Durham-Chapel Hill, NC– helps you understand the critical connection between Vitamin D Deficiency and Hashimoto’s autoimmune hypothyroidism.

I’m going to explain why Vitamin D deficiency is connected to Hashimoto’s hypothyroidism.

Vitamin D is a critical regulator of your immune system and research has already established that Vitamin D deficiency is highly associated with other autoimmune diseases like Multiple Sclerosis and Type I Diabetes.

And Vitamin D deficiency IS associated with Hashimoto’s hypothyroidism–another autoimmune condition.

What is Hashimoto’s? 

Hashimoto’s is an autoimmune attack on the inside of your thyroid gland.  Over time, your immune system destroys the inside of your thyroid gland—so much, that you can’t make enough thyroid hormones and you suffer low thyroid symptoms.

What low thyroid symptoms does Hashimoto’s hypothyroidism cause? 

Here’s a short list:

  • weight gain
  • constipation
  • hair loss
  • brain fog
  • a need to sleep excessively in order to function
  • high cholesterol
  • infertility
  • joint pain.

Last year a great scientific study looked specifically at Hashimoto’s patients and Vitamin D.
 

The researchers took 161 confirmed Hashimoto’s patients (meaning these people had positive TPO antibodies and/or positive TGB antibodies) and measured their Vitamin D levels. 

The results of their study are downright scary.

92% of the Hashimoto’s patients had Vitamin D deficiency. 

This study defined Vitamin D deficiency as less then 30 ng/dl.

148 out of 161 had Vitamin D deficiency.  Crazy, right?

It gets worse. 

They even broke down the results into three categories of Hashimoto’s patients:

  • Overt Hypothyroidism
  • Subclinical Hypothyroidism
  • Euthyroid

Let me explain what those mean. 

Overt Hypothyroidism Hashimoto’s means:

  1. The person has high TPO and/or TGB antibodies
  2. Their TSH is high
  3. The person has low thyroid symptoms (I see these every day).

Subclinical Hypothyroidism Hashimoto’s means:

  1. The person has high TPO and/or TGB antibodies
  2. Their TSH is high
  3. The person does NOT have low thyroid symptoms ( I don’t see many of these).

Euthyroid Hashimoto’s means:

  1. The person has high TPO and/or TGB antibodies
  2. Their thyroid lab test numbers are “normal.” (I see quite a few of these people in my practice).

Now here’s how they broke it down.

94% of Overt Hypothyroid Hashimoto’s patients had Vitamin D deficiency. 

98% of Subclinical Hypothyroid Hashimoto’s patients had Vitamin D deficiency.

86% of Euthyroid Hashimoto’s pateints had Vitamin D deficiency. 

(The researchers say that it’s not statistically significant in the euthyroid group.  But I’m telling you it is clinically, practically significant.)

Look at those numbers again….see how many of those Hashimoto’s patients had Vitamin D deficiency? Huge.

We know for sure that Vitamin D has something to do with Hashimoto’s. But what exactly does Vitamin D do?

Here’s the short answer… 

Vitamin D is a critical regulator of your immune system. 

Without Vitamin D your immune system can become over-exuberant. Without Vitamin D your immune system easily  can become unbalanced.  Vitamin D deficieny can lead to an expression of an autoimmune attack on a tissue.

So for example in Hashimoto’s….

if you carry the gene for Hashimoto’s and you become Vitamin D deficient your gene can turn on and you can start expressing it and start attacking your thyroid.  Over time you become low thyroid and you develop low thyroid symptoms.

And then…you go see a doctor who probably doesn’t test you to see if you’ve got Hashimoto’s (Medical doctors have nothing to offer but replacement hormones anyway).   They just put you on Synthroid® or Armour®

…but in the long run you end up not feeling much different because the replacement hormones just don’t do much for the underlying autoimmune process.

Sadly, this is exactly what usually happens to a woman with Hashimoto’s. 

Does this mean that you should buy Vitamin D and start supplementing? 

No, it doesn’t. 

Because even though Vitamin D is relatively harmless, you don’t know how much you need.  Plus, there’s a complex situation in which if you take the wrong dosage of Vitamin D— read carefully— if you take the wrong dosage of Vitamin D you can actually make yourself worse. 

Taking the wrong dose of Vitamin D can make you have MORE low thyroid symptoms—even if you really are Vitamin D Deficient.

That scenario nvolves something called 1, 25-dihydroxy vitamin D, and is a little bit beyond what I want to explain here. 

The takeaway message….

Even though there’s a 90% chance that you’re Vitamin D deficient if you have Hashimoto’s— this doesn’t mean you should go out and start supplementing Vitamin D. 

You need to find someone who understands exactly what I’ve been telling you about, someone that understands there’s other things to look at… and that Vitamin D, even though it’s important, is not the magic bullet.

In my practice we see a lot of people that need Vitamin D but some people need more or less than others–and many times it’s the difference between the person feeling good or feeling worse.  A small number people can’t take Vitamin D at all—even though they’re defiicient.

Find someone that knows what to do, because Vitamin D deficiency and  Hashimoto’s  are almost the same thing.

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© 2014 David Clark. All Rights Reserved.

 

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.

The Link Between Hashimoto’s Autoimmune Thyroid and Chronic Urticaria

Dr. David Clark, DC – Raleigh-Durham, Chapel Hill, NC- explains why chronic idiopathic urticaria, a skin condition, is forever linked with Hashimoto’s autoimmune hypothyroidism.

Let’s talk about the connection between chronic urticaria and Hashimoto’s autoimmune hypothyroidism. 

Chronic idiopathic urticaria is a condition in which you get itchy wheels on your skin that can vary in size and number.

“Chronic” means that the condition has been going on for a quite a while, versus just a day or two.

“Idiopathic” means that the cause is unknown (or at least not known yet).

Urticaria can be caused by food allergies or medications–but Chronic Idiopathic Urticaria appears NOT to be related to those mechanisms.

Chronic Idiopathic Urticaria (CIU) can be brought on by exercise or stress–and as we’ll see in just a minute, Hashimoto’s autoimmune hypothyroidism.

About 30 years ago there was the first research to see the connection between CIU and autoimmune thyroid disease.  Now, a study released in 2011 picked up that topic again.

What is the connection between Chronic Idiopathic Urticaria and Hashimoto’s? 

The research shows that anywhere between 45% to 55% of people with Chronic Idopathic Urticaria ALREADY have an autoimmune condition...they are making antibodies to IgE (immunoglobulin E) or the IgE receptor. IgE is a part of your immune system.

So, in many CIU patients, their immune system is attacking a part of their immune system! 

If you’re making antibodies to a piece of yourself and you’re attacking it—that is autoimmunity. 

Interestingly, the authors of this 2011 paper didn’t really understand how there could be a connection between CIU and autoimmune thyroid. But, one of the researchers they quote described thyroid autoimmunity and CIU as “parallel autoimmune events.” (I love that description).

In other words, Hashimoto’s and Chronic Idiopathic Urticaria are both autoimmune conditions that can happen at the same time.

I look at that like this…

If you’ve already broken the tolerance to yourself, then you can start attacking anything. 

And if you’ve already developed a situation in which you’re attacking your thyroid… Hashimoto’s, which causes low thyroid symptoms such as depression, constipation, weight gain, hair loss and brain fog…

…if you’ve already got Hashimoto’s it’s not that big of a leap to think that you could develop something like chronic urticaria because it’s another autoimmune condition.

Likewise, if you first develop the skin problem of Chronic Idiopathic Urticaria, and then develop low thyroid symptoms you most likely have Hashimoto’s as an autoimmune cause for your hypothyroidism. 

FYI — Hashimoto’s is the most common cause of hypothyroidism in the U.S.

The 2011 study found that 25% of chronic idiopathic urticaria patients had positive antibodies for Hashimoto’s – 25%!

That is significant. 

I wanted to share this with you because many times a woman will have symptoms and not realize that they’re crucial clues about what’s really causing their problems.

If you’ve ever been diagnosed with chronic idiopathic urticaria and you’ve now developed low thyroid symptoms, there’s a good chance you have Hashimoto’s. 

Likewise, if you’ve already got Hashimoto’s and you develop these short-lasting or even long-lasting itchy wheals that come and go–now you understand they likely are another symptom of your autoimmune condition.

These may be a sign that your autoimmune condition has expanded a little bit into another tissue—not a good sign.  We don’t want the autoimmune process to do that. 

You need to find someone that can help you deal with the total package. Unfortunately, taking Synthroid® or Cytomel® or Armour®or NatureThroid® for Hashimoto’s doesn’t do much to stop the raging fire of he autoimmune condition.

The same thing goes for the urticaria…

You can take steroids for it but that doesn’t really solve the problem, right?  It just temporarily suppresses your immune system.  

Chronic urticaria and Hashimoto’s…”parallel autoimmune events.”

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© 2014 David Clark. All Rights Reserved.

 

Disclaimer: The contents of this site are for educational purposes only. Nothing here should be construed as medical advice. Nothing here is a substitute for actual medical care. Consult a qualified healthcare professional.