The Thyroid Adrenal Pancreas Axis

09/18/16 • 26 min

The thyroid-adrenal-pancreas axis is one of the most important connections in understanding and healing your thyroid. In addition to gastrointestinal and blood sugar disorders, adrenal gland dysfunction is one of the most commonly seen imbalance in today’s society. Adrenal gland imbalances are also one of the major factors that cause thyroid hormone imbalance. Stress from work, relationships, electronics, poor diet choices such as consumption of refined carbohydrates and trans fats, infections, and environmental toxins all contribute to adrenal disorders. Let's discuss the thyroid-adrenal-pancreas axis in detail so you can understand this complex connection The Adrenal Glands The adrenal glands are about the size of a walnut and lie on top of the kidneys. The outer adrenal cortex comprises eighty percent of the gland and produces many hormones including cortisol and DHEA from cholesterol. Ninety percent of the cholesterol in the body is made by the liver and only ten percent comes from the diet. Cholesterol converts into the hormone pregnenolone in the adrenal cortex which then converts to cortisol, the stress hormone, or DHEA, the sex hormone source, immune enhancer and anabolic. Cortisol is our “fight or flight” stress hormone. Cortisol slows down digestion, suppresses immune function and raises blood sugar as a survival mechanism when we are under stress. The problem arises when this becomes chronic and over time, elevated cortisol will tear down your body. Cortisol is secreted on a circadian rhythm with highest production in the morning that slowly tapers off as the day progresses. Sleep is when our bodies repair and rejuvenate but high cortisol during sleep will prevent this from happening. Hormones Secreted by the Adrenal Glands DHEA DHEA (dehydroepiandrosterone) is a precursor to estrogens, progesterone and testosterone. DHEA is extremely important for immune system function and anabolic (building up) processes in the body. DHEA levels begin to decline after age thirty-five but cortisol can remain elevated during continuing periods of stress. Low DHEA levels are also found in diseases such as multiple sclerosis, cancer, fibromyalgia, lupus, rheumatoid arthritis, Crohn’s, ulcerative colitis and of course, thyroid disorders. The inner medulla produces adrenalin and noradrenalin also known as norepinephrine and epinephrine. The cortex is under the control of hormones produced in the brain and the medulla is under the control of the nervous system. Healthy adrenal glands are vital for women who are peri- and post-menopausal. The adrenal glands are responsible for producing the majority of sex hormones in a menopausal woman once the ovaries stop functioning. If the adrenal glands are fatigued and not ready for menopause, there will be an exaggeration of menopausal symptoms such as hot flashes, weight gain, sleep problems, bone loss, mood swings, depression, anxiety, loss of sex drive and vaginal dryness. Healthy adrenals ensure an easy transition into menopause and beyond. A vast majority of the women I see in practice approach menopause with adrenal imbalances leading to severe menopausal symptoms and hormone dysfunction. Aldosterone Aldosterone is produced by the cortex and causes sodium absorption and potassium excretion. Low salt diets and high water intake put a major stress on the adrenal glands to retain as much salt as possible as the blood becomes more diluted from the extra water intake. One of the easiest ways to maintain healthy adrenals is to consume a half- teaspoon of unrefined celtic sea salt every morning with a few glasses of water. It’s important to consume half of your bodyweight in ounces of water every day but it must be balanced with salt to remove stress from the adrenal glands. Cortisol Cortisol is also produced by the cortex which increases blood sugar when it is low or if the body is under stress. Cortisol will cause glucose production in the liver or...

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Gluten and Hashimoto’s Disease

Understanding the importance of gluten and Hashimoto's disease may be the key factor in healing your thyroid. The Link Between Gluten and Hashimoto's Disease Has your doctor talked to you about the link between gluten and Hashimoto's Disease? Hashimoto's Disease is an autoimmune condition that causes 90% of all cases of hypothyroidism. Gluten is a combination of proteins found in grains such as wheat, rye, barley, spelt and many others. Ongoing scientific research indicates that there is a dangerous link between eating foods that contain gluten and Hashimoto's disease. The hard truth is that gluten and Hashimoto's Disease are a destructive combination. If you have been diagnosed with Hashimoto's disease, also known as Hashimoto’s thyroiditis, you need to completely avoid gluten to avoid triggering autoimmune attacks on your thyroid gland. However, you may not have to avoid gluten forever but this depend on a number of factors. What decides if someone must be gluten-free forever? Once my patient's antibody levels are in a healthy range, their thyroid and blood tests look great, and they are feeling great, then we can try a gluten challenge. I always make sure they are eating small quantities from high quality sources such as sourdough bread. Sourdough has much lower concentrations of gluten than normal bread because the leavening process breaks down a lot of the gluten. I'll have a patient eat some high quality sourdough bread a few times a week and see how they feel. Sometimes they will know right away that they must completely avoid gluten. In other cases, they will feel fine and when we test their thyroid antibodies and thyroid numbers, they actually look great and have not changed. These individuals can have gluten in moderation. So as you can see, the answer is not black and white as it is very patient-specific. It would be a tragedy for someone to have to avoid gluten for their entire life unnecessarily. Most people will have to avoid gluten for life but there are always exceptions to this statement. Why should gluten be avoided if you have Hashimoto's Disease? Gluten has been shown in multiple studies to be a contributing factor to not just Hashimoto's disease, but many autoimmune diseases. Gluten can break down the intestinal barrier leading to “Leaky Gut Syndrome” which can lead to autoimmune disease. Gluten can also be an irritant to Hashimoto's disease by creating inflammation in the thyroid gland. The process is known as “molecular mimicry” which basically means that your body’s immune system is attacking the gluten, infection or environmental toxin but also attacking it’s own tissue. Get the Facts on Gluten and Hashimoto's Disease Many physicians do not discuss the connection between gluten and Hashimoto's disease with their patients but instead put them on a regimen of thyroid medications. But medications do not deal with the autoimmune response that damages the thyroid. A functional medicine perspective is that a practitioner must find out what triggers the immune system to attack the thyroid, and work with the patient to develop strategies to avoid those triggers. To get a comprehensive overview of the connection between gluten and Hashimoto's disease, as well as other triggers of autoimmune attacks that lead to hypothyroidism, read The Complete Thyroid Health and Diet Guide by functional medicine practitioner Dr. Nikolas R. Hedberg. The Functional Medicine Approach to Gluten and Hashimoto's Disease A functional medicine practitioner like Dr. Hedberg will discuss gluten and Hashimoto's Disease with you because the functional medicine approach thoroughly investigates underlying causes of dysfunction and targets the unique causes of low thyroid in each person. That means each patient undergoes a comprehensive examination, including health history, environment, diet and nutrition, exercise level, psychological and emotional state, social interactions, hormone levels,

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The Ferritin Level Test

The ferritin test may be the most important blood test you ever get, especially if you have a thyroid problem. When I began my training in the diagnosis and management of internal disorders immediately after graduation, one of the first things we studied heavily was blood chemistry analysis. My teachers always stressed the importance of taking a careful look at iron levels in the blood and a rare test known as the ferritin test. What is ferritin? Ferritin is an iron-containing protein and is the primary form of iron stored inside your cells. Even though there is a small amount of ferritin released into your bloodstream, it is an accurate marker of how much iron is actually stored in your body. Iron is primarily stored in your liver, muscles, spleen and bone marrow but if you have too much it can accumulate in your organs and the brain. You either have too much iron, too little or just the right balance in your body and the ferritin test can give us an excellent picture of how much iron is actually stored in your body. Iron is found in your red blood cells but it also accumulates in your organs and tissues. Iron is important for healthy oxygen transport throughout your body so you can see how vital it really is for your health. Too little iron will result in anemia which basically means that your red blood cells cannot carry enough oxygen to your cells and you start to develop signs of oxygen deficiency. Signs of anemia include: Weakness Dizziness Headaches Pale skin Fatigue Low body temperature Memory loss Hair loss Poor brain function Hypothyroidism Adrenal fatigue Spoon-shaped finger and toenails Smooth tongue Burning sensation in the tongue Sores at the corners of the mouth Dry skin Shortness of breath Ringing in the ears (tinnitus) Leg pains Chest pain Pica (cravings for specific substances, such as licorice, chalk, dirt, or clay) Too much iron can have the opposite effect because iron creates a lot of oxidative stress which is basically too many free radicals that create inflammation. These free radicals eat up your antioxidants like vitamin C and E creating deficiencies. Menstruating females lose a small amount of iron every month during their cycle so they tend not to build up too much iron in their bodies. However, iron levels can get too low when your diet is deficient in iron and you have absorption issues due to things like gluten and gut infections. I tend to see low ferritin levels quite a bit in chronically-ill women who are still cycling but it is also common in postmenopausal women who never restored their iron levels before entering menopause. Since men do not have a menstrual cycle, we are the most at risk for accumulating iron. As iron builds-up in a man’s body he may develop the following symptoms as it accumulates in the brain and other body tissues (most of these also apply to women): Brain fog Fatigue Low sex drive and erectile dysfunction (iron accumulates in the testicles) Mood swings, especially anger Digestive problems as iron builds-up in the gut Anxiety Depression Fatigue after meals (insulin resistance) Memory loss Joint pain Weight loss Abdominal pain Hair loss Congestive heart failure Iron is extremely “heavy” in the bloodstream so it forces the heart to work harder as it pumps this heavy metal through your blood vessels resulting in blood pressure changes and more inflammation in your arteries. This is where the ferritin test is so important because it can tell us if there is too much or too little iron in your body. It’s a simple blood test but rarely ordered during general check-ups and standard blood panels however I believe it is one of the most important and overlooked tests in medicine today. This is why I include it in every patient’s blood panel even if it was normal within the last year.