lesson thirty-five thyroid dysfunction...thyroid dysfunction •in the previous lesson i briefly...

Hompes MethodPractitioner Training Level II

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Lesson Thirty-Five –

Thyroid Dysfunction

Thyroid Dysfunction

• In the previous lesson I briefly introduced some of the reasons why thyroid function can become imbalanced. In this lesson, we’ll go into much more detail about thyroid dysfunction.

Thyroid Dysfunction

“An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of these people are unaware of their condition. One in eight women will

develop a thyroid disorder during her lifetime.”

Chris Kresser – Thyroid Disorders e-book.

Thyroid Dysfunction

“Broda Barnes, more than 60 years ago, summed up the major effects of hypothyroidism on health very

neatly when he pointed out that if hypothyroid people don't die young from infectious diseases, such as

tuberculosis, they die a little later from cancer or heart

disease.”

http://raypeat.com/articles/articles/thyroid.shtml

http://raypeat.com/articles/articles/thyroid.shtml

Thyroid Dysfunction - Resources

• Even in the hour or so we have on this topic, we can’t do it justice. So please make sure you make yourself familiar with the content I’ve recommended in your resources list. The key resources include:

– Ray Peat’s referenced articles.

– Dr. Kharrazian’s book.

– Chris Kresser’s free PDF e-book.

– 2x Thyroid Summits.

Thyroid & Stress

• As you already know, the HPT and HPA axes are inexorably linked. It’s virtually impossible to have a dysfunctional HPA axis and have a normally functioning HPT axis due to the interactions between the two.

Thyroid & Stress

Thyroid & Stress

• As CRH, ACTH and cortisol go up in response to stress, the following thyroid markers are affected:

– Reduced TSH

– Reduced T4 > T3 conversion

– Increased rT3

– The hypothalamus and pituitary themselves may become “damaged”, or weakened by a constant onslaught of stress.

Thyroid & Stress

• What causes stress?– Too much bad stuff – foods, bugs, toxins

– Not enough good stuff – foods, bugs, nutrients

– Blood sugar problems (a big problem)

– Structural and mechanical problems

– EMF / EMR

– Mental, emotional and spiritual problems

– So ultimately, these factors can all be considered as possible thyroid-unfriendly factors!

Thyroid & Stress

• Thus, you don’t have a cat in hell’s chance of rehabilitating a client/patient’s thyroid function without addressing the stressors – it’s simply not possible unless there’s a healing modality somewhere that I don’t know about!

Thyroid & Bad Foods

• A number of foods are believed to have the ability to adversely impact the thyroid:

– Gluten

– Polyunsaturated oils (overconsumption)

– Soy and soy-based foods

– Excessive intake of processed sugar, soda, HFCS

– Possibly raw greens (Ray Peat discusses this in some detail)

Thyroid & Bad Bugs

• H. Pylori and Yersinia have both been directly associated with thyroid dysfunction via the production of thyroid autoantibodies. The research is not conclusive, but it would make perfect sense that an immune reaction against these bugs “gone bad” could lead to the production of antibodies against the thyroid.

Thyroid & Bad Toxins

• An eloquent discussion of specific toxins and thyroid health is provided in Part One Dr. Crinnion’s article. See pages 56, 60 and 61. Toxins can directly affect hormone metabolism and can cause autoimmunity.

Thyroid and Good Bugs

• As mentioned the good bugs are responsible for converting a modest amount of T4 > T3, as long as they’re present in adequate amounts and in the optimal balance. As you know, the microbiome can easily become imbalanced due to stress, poor food choices, toxins and opportunistic infections.


“One little known role of the gut bacteria is to assist in converting inactive T4 into the active form of thyroid

hormone, T3. About 20 percent of T4 is converted to T3 in the GI tract, in the forms of T3 sulfate (T3S) and

triidothyroacetic acid (T3AC). The conversion of T3S and T3AC into active T3 requires an enzyme called intestinal

sulfatase.”


“Where does intestinal sulfatase come from? You guessed it: healthy gut bacteria. Intestinal dysbiosis, an imbalance between pathogenic and beneficial bacteria in the gut, significantly reduces the conversion of T3S and T3AC to T3. This is one reason why people with poor gut function may have thyroid symptoms but

normal lab results.”

Chris Kresser – Thyroid Disorders e-book, page

Thyroid & Good Nutrients

• Just like the rest of the body, optimal thyroid function requires optimal nutrient levels across the board. But specific nutrients that are:

– Tyrosine and iodine as building blocks for thyroid hormones

– Cofactors in T4 and T3 production include selenium, copper, magnesium, B3, B2, B6

– Vitamin A

– EFAs (you’d want to be very careful with these)

Autoimmune Thyroid Disorders

“Studies show that 90% of people with hypothyroidism are producing antibodies to thyroid tissue. This causes the immune system to attack and destroy the thyroid, which over time causes a decline in thyroid hormone

levels.”


“This autoimmune form of hypothyroidism is called Hashimoto’s disease. Hashimoto’s is the most common autoimmune disorder in the U.S., affecting between 7-

8% of the population. While not all people with Hashimoto’s have hypothyroid symptoms, thyroid

antibodies have been found to be a marker for future

thyroid disease.”


“Most doctors know hypothyroidism is an autoimmune disease. But most patients don’t. The reason doctors

don’t tell their patients is simple: it doesn’t affect their

treatment plan.”

Chris Kresser – Thyroid Disorders e-book.


“Conventional medicine doesn’t have effective treatments for autoimmune disease. They use steroids and other medications to suppress the immune system in certain conditions with more potentially damaging

effects, such as multiple sclerosis, rheumatoid arthritis and Crohn’s disease. But in the case of Hashimoto’s, the consequences – i.e. side effects and complications – of

using immunosuppressive drugs are believed to

outweigh the potential benefits.”


• If these statistics are accurate, you’d be forgiven for thinking that thyroid disorders aren’t actually thyroid disorders at all: they’re immune dysfunction disorders that just happen to have the thyroid gland as the target! I’ll say that again: many thyroid disorders aren’t thyroid disorders at all – they’re immune disorders.

• So is Chris Kresser correct in his assertion that most thyroid disorders are due to autoimmunity?


“Most cases of underactive thyroid happen when the immune system, which normally fights infection,

attacks the thyroid gland. This damages the thyroid, which means it is not able to make enough of the

hormone thyroxine, and leads to the symptoms of an

underactive thyroid.”


“A condition called Hashimoto's disease is the most common type of autoimmune reaction that causes an

underactive thyroid. It is not clear what causes Hashimoto’s disease, but the condition runs in families.

It is also common in people with another disorder related to the immune system, such as type 1 diabetes

and vitiligo.”


“An underactive thyroid can also occur as a side effect or complication of previous treatment to the thyroid

gland, such as surgery or a treatment called radioactive iodine therapy. These treatments are sometimes used

for overactive thyroid (where the thyroid

gland produces too much hormone) or thyroid cancer.”

http://www.nhs.uk/Conditions/Thyroid-under-active/Pages/Causes.aspx

http://www.nhs.uk/Conditions/Thyroid-under-active/Pages/Causes.aspx


• So, incredibly, the NHS clearly states that most thyroid disorders are due to a faulty immune system. I haven’t worked with a single client who was aware of this information in anywhere near the level of detail you’d expect given the information on the NHS site. So it looks like Chris Kresser is right!


• What could trigger an autoimmune response against the thyroid? According to Kharrazian:– “Stress”

– Gluten intolerance / coeliac disease

– Chronic inflammation

• Infections

• Viruses

– Compromised mucosal barrier system

– Oestrogen fluctuations

– Insulin resistance and PCOS

– Vitamin D deficiency

– Excess iodine

Autoimmune Thyroid Disorder Progression

http://1-in-10.org/hashimotos-pcos-the-autoimmune-link

http://1-in-10.org/hashimotos-pcos-the-autoimmune-link


Chris Kresser – Thyroid Disorders e-book, page 19.


• Kharrazian’s book, as well as an article on his blog that I’ve added to your resources section helps to explain the complexity of autoimmune disorders –they’re not easy to understand for either patients or clinicians.


“Autoimmune disease is not only extremely complex, but also highly individualized. Hashimoto’s in one person is not the same as Hashimoto’s in the next

person. In one person, Hashimoto’s could present as a Th1-dominant condition. In another, it may present as Th2 dominant. In still another, both the Th1 and Th2

systems might be overactive, or underactive. And each of these cases requires a different approach.”


• What are Th1 and Th2 systems? To understand this means taking a look at the way in which the immune system is set up, and it’s not too easy to explain, as you can see from the next diagram…


http://livingwellnessblog.wordpress.com/2012/10/12/am-i-th1-or-th2-or-th17/



• Immune response trigger

– Macrophages, or “Big Eaters” scavenge and envelop intruders

– This creates an antigen-presenting cell (APC)

– The APC is like a burglar alarm and summons other immune cells

– T-helper cells respond first and summon natural killer cells and cytotoxic T-cells to destroy the intruder


– T-regulator cells monitor the scene to make sure there are enough T-helpers and also T-suppressors that stop the immune response once the intruder is dealt with.

– The immune system takes no chances on another attack

– T-helpers fetch B-cell antibodies, which attach to the intruder and download his information into a memory bank

– This improves the efficiency of the response if it happens again in the future


• The autoimmune crime scene:

– If any of these “players” deviate from their jobs, you can quickly have a problem

– Some people don’t make enough T-suppressor cells and the ongoing immune response can begin to attack the body’s own tissues

– Some people make too much IL-2, which can lead to too many NK cells and cytotoxic T-cells

– Some people make too much IL-4, leading to an overabundance of B-cells that may “mark” their own tissues as intruders


– Poor blood sugar control can stimulate the overproduction of B-cells

– Parasites and food intolerances may drive up IL-4, causing over production of B-cells

– Chronic viral infections may drive up IL-2, causing over production of natural killer cells and cytotoxic T-cells

– The net result of these suppressed or enhanced responses can be a “friendly fire” effect.


• When considering autoimmune disorders, it’s very important to understand which arm, or side of the immune system is most active.

– Is it the side that deploys NK cells and cytotoxic T-cells (Th1)

– Is it the side the deploys B-cell antibodies (Th2)


“If you are dominant in one or the other, your immune system is out of balance and autoimmune disease is

either highly likely or already under way.”

Dr. Kharrazian – Why Do I Still Have Thyroid Symptoms? Page. 48.


• Remember that T-helper cells orchestrate an immune attack – they send messages to NK, cytotoxic T-cells and B-cells to the “crime scene”. In order to do this, they send hormone-like messengers called cytokines. They can drive Hashimoto’s disease and block thyroid hormone receptors.


• It’s possible to measure cytokine levels in order to determine whether they are Th1 or Th2 dominant. This is incredibly important when it comes to helping clients/patients deal with an autoimmune issue.


• Th1 Cytokines:

– Interleukin 2 (IL-2)

– Interferon gamma (IF-y)

– Tumour necrosis factor alpha (TNF-a)

• Th2 Cytokines:

– Interleukin-4 (IL-4)

– IL-5

– IL-6

– IL-10

– IL-13


• Dr. Kharrazian states that 90% of his Hashimoto’s patients are Th1 dominant, meaning they have overactive NK cells and cytotoxic T-cells attacking and destroying thyroid tissue.


http://flipper.diff.org/app/items/605

http://flipper.diff.org/app/items/605


• See these resources:

– Kharrazian article:

• http://drknews.com/hashimotos-hypothyroidism-immune-basics/

– General cytokine article at BMJ:

• http://www.bmj.com/content/321/7258/424.1

– Th17:

• http://www.ncbi.nlm.nih.gov/pubmed/19132915



http://drknews.com/hashimotos-hypothyroidism-immune-basics/

http://www.bmj.com/content/321/7258/424.1

http://www.ncbi.nlm.nih.gov/pubmed/19132915




• A concept I’m developing throughout this lesson is that thyroid issues are nearly always secondary to something else. Hopefully this lesson has reinforced the concept. The Hashimoto’s thyroiditis explanation of thyroid disorders is the one proposed by most functional and integrative medical doctors, but its not the only angle.


• Ray Peat, PhD, looks at thyroid health in a different way in the sense that he doesn’t feel standard lab tests are appropriate, and he doesn’t “treat” autoimmunity, so to speak. We’ll explore more of his opinions in the next lesson, which covers thyroid testing.

Thyroid Basics - Summary

Thank You!

• As always, thanks a million for tuning in and consuming this info. It’s been my pleasure sharing this wisdom with you. In the next lesson we’ll move into more detail about why thyroid issues develop, exploring the theories of eminent practitioners such as Dr. Peat and Dr. Kharrazian.

lesson thirty-five thyroid dysfunction...thyroid dysfunction •in the previous lesson i briefly...

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