January 13, 2015

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

Hidden Cause #23 Why you STILL have low thyroid symptoms even though you may be taking medication, and even though your lab tests look normal is:

High Homocysteine causing a sluggish response to thyroid hormone 

What is Homocysteine?

Homocysteine is a naturally occurinng chemical floating around in your body.  And it’s essentially an inflammatory chemical.  It can dock and attach onto different types of receptors in the human body. (think of receptors as antennae, or as a lock waiting for a key).

How does this relate to our thyroid story? 

Homocysteine can dock onto a cell and stop that cell from having a normal response to thyroid hormone. This causes low thyroid symptoms such as this partial list:


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

Here’s the kicker… even with these symptoms your thyroid lab tests will look completely NORMAL.

The only thing that might show up on a lab test–if the doctor actually runs the test —is  the homocysteine levels may be elevated. 

What qualifies as “elevated” homocysteine? 

…higher than the lab range (usually 13) is “medically” elevated

….higher than seven is “functionally” elevated. The higher the homocysteine levels are, especially when they’re close to 13 or higher, the more they are relevant to thyroid hormone receptor malfunction.

Remember, T4, T3, T3 Uptake, Reverse T3, Free T4, Free T3….all those may look completely normal. 

This is one of those caught between a rock and hard place situations where you have low thyroid symptoms, but your labs are normal and no one knows what’s causing your symtpoms. 

You can imagine what usually happens.  Your doctor tells you “You’re depressed.  I’ll write you a script for an anti-depressant.” However, she may have high homocysteine causing these symptoms.

What cause high homocysteine levels? 

The big factor is a deficiency of methyl donors (a carbon with three hydrogens).  You don’t have to remember all the chemistry but let me tell you what happens…

The two kinds of people at most risk for methyl donor deficiency—and thus high homocysteine–are women who:

  • take estrogen-based birth control
  • take antacids (of any kind)

Women who take antacids create a situation of low stomach acid. The technical term is hypochlorhydria. The antacids decrease your stomach acid. A low acid environment, over time, can cause low methyl donors (and high homocysteine that messes with your thyroid receptors).

NOTE: Low stomach is not a healthy situation. I know you’re inundated with commercials that demonize stomach….but if  you have low stomach acid you cannot extract minerals (like iron and magnesium) from your food….You cannot appropriately digest your food.  Plus, you can end up with depletion of these methyl donors. 

**Certain mutations in the MTHFR gene (SNPs aka single nucleotide polymorphisms) can definitely cause HIGH homocysteine levels. More on this in another post.

What are the symptoms of low stomach acid (hypochlorhydria)? 

Classic symptoms of hypochlorhydria are:

  • Belching and bloating while you eat
  • A sense of fullness while you eat. 
  • Feeling like your food sits in your belly like a rock and just doesn’t move anywhere. 

Those are good signs of low stomach acid. 

What are the causes of low stomach acid (hypochlorhydria)? 

Now you see what we’re doing here, right?  We’re asking the question why?, why?, why? so that we can get to the root of the cause. 

Here are some common causes of low stomach acid…

Hypoglycemia (low blood sugar)–People that are hypoglycemic have a hard time holding onto their B vitamins.  And B vitamins are some of the co-factors you need  to make stomach acid.  

Hypothyroidism (low thyroid)–low thyroid hormones, or low thyroid hormone receptor response causes decreased digestive secretions. 

H. pylori (helicobacter pylori) infection in the stomach—  This is a bacterial infection that disturbs your stomach acid levels.  The best test to detect it is a Urea Breath Test ( you can also use a test for serum antibodies.)

Almost forgoet to mention gluten sensitivity….

Gluten senstivity can lead to malabsorption of zinc. Zinc is a necessary ingredient to make stomach acid. 

There’s three causes, right? 

These make you have low stomach acid…You can’t get these methyl donors, which means your homocysteine levels rise…

…And homocysteine can slow down the normal response of the cell to thyroid hormone. 

You don’t necessarily have to remember all of that.  Here’s what you need to remember:

If you have low thyroid symptoms…and your labs look normal and people think you’re crazy or depressed…You could have high homocysteine.  

Now, hopefully your doctor would know about this issue and would run a homocysteine to rule this out.  Sadly, not many doctors seem to know this crucial information.  So, you’re going to need to find a doctor who DOES know, and who understands that high homocysteine being high could cause all that stuff I just talked about. 

And then–even MORE importanly–the doctor needs to know what to do about high Homocysteine.

It’s a big job for any doctor to handle. 

Be an advocate for yourself and remember that homocysteine is something that could cause your 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

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