Thyroid Mystery Solved: Hashimoto's and Hypothyroidism Revealed

I asked what you wanted to know about Hashimoto’s and the questions came flying in! In this episode, I’m going to tackle half of them and tune in next week as well because I’ll answer the rest there!

Hashimoto’s disease is an autoimmune disease that affects the thyroid. Like other autoimmune diseases, what happens is that the immune system gets confused and starts to see the thyroid as a threat. In other autoimmune diseases, the system attacks a different part of the body (the myelin sheath with MS, joints with rheumatoid arthritis, connective tissue with lupus). Under this attack, the thyroid can’t perform optimally and the result is often hypothyroidism.

Conventional medicine treats Hashimoto’s by only addressing the hypothyroidism if present or waiting for hypothyroidism to begin or suppressing the immune system with medication. The functional medicine approach is to find the root cause of the Hashimoto’s and fix it. I support the functional medicine approach and it starts by understanding what’s going on first. Which is why, I’m so happy to answer your questions!

Autoimmune Triggers

There are four main triggers that can get the immune system in a tizzy. Here are the key triggers for autoimmune diseases:

• Food

Individuals may have food sensitivities, or lack the proper enzymes or stomach bile to properly digest food. If the food we eat doesn't work for our body its a huge trigger for autoimmunity.

• Infection

There are a variety of infections that can become chronic causing the immune system to malfunction.

• Toxins

Environmental toxins (like those found in some cleaning products and beauty products) as well as heavy metals can serve as a trigger.

• Stress

The immune system handles stress by shutting down other non-essential systems. Over time (especially if it’s chronic), this can be a trigger for autoimmune disease.

Question #1: What is the relationship between heavy metals and the root cause of Hashimoto's?

Heavy metals are things like aluminum, mercury, arsenic, lead and they can really do a number on our system. Our bodies can handle a little bit of heavy metals but when they build up, they become a toxin (which is one of the triggers). Even copper can become a toxin if it gets out of control (usually due to a zinc deficiency). Mercury has an affinity for the thyroid, so this heavy metal (in particular) should be monitored to ensure it hasn’t reached toxic levels in the body.

There are lab tests that will determine if heavy metals might be the root cause for you. A standard hair analysis is one test but it doesn’t show both types of mercury. My go-to tests for heavy metal are the Quicksilver Scientific Tests because it includes a full heavy metal panel and looks for mercury levels in the blood, urine, and hair.

If heavy metal is a problem, then a detox using binders and herbs like Milk Thistle are often used. However, you’d want to consult with a functional medicine practitioner to make sure you’re doing the right kind of cleanse.

Question #2: What is the connection between Hashimoto’s and the adrenal glands?

Stress is one of the four triggers. The adrenal glands deal with stress by producing the hormone cortisol. When too much is produced, the immune system takes that to mean that it’s an emergency putting things like thyroid production on the backburner.

Cortisol also has a relationship with TSH. When cortisol is off, TSH can be off as well and directly affect thyroid function. There is one other potential connection. The symptoms of hypothyroidism are very similar to the symptoms of adrenal fatigue (weight gain, fatigue, depression, hair loss) and so the symptoms may be misinterpreted.

Question #3: What is the true connection to EBV (Epstein-Barr Virus)?

This question sparked a secondary question involving the Medical Medium and the things he’s said about EBV being connected to everything, including attacking the thyroid before causing Hashimoto’s.

I get asked about this a lot but remember the four triggers - one of them is infection which is exactly what EBV is. There is some research that EBV can get into the thyroid gland (as well as other organs) but I wouldn’t say it’s conclusively linked. However, it is an infection which is a trigger. It’s worth noting that once someone gets EBV it’s always in the system and it can flare up due to stress, toxins, and other infections - it has the same triggers as autoimmune.

Question #4: Can you Address Food Sensitivities with Hashimoto’s?

Another listener also asked about her experiences with cutting out gluten and dairy and subsequently developed other food sensit...

Have you noticed more wrinkles, and your skin looking dryer and perhaps even thinner along your thyroid journey?

What if I told you that expensive lotions are not the root answer and that there is something else you can do from the inside out that is super simple?

Meet Alicia, my latest case. She, like many of us, has been dealing with frustrating Hashimoto’s symptoms - fatigue, bloating, and also a lot of skin issues (dry, irritated, saggy, and wrinkly skin).

In this episode we dive deep into Alicia's journey and uncover the surprising root cause behind her struggles—the intricate interplay between her gut, skin, and thyroid health.

I had the pleasure of interviewing Dr. William Davis - if you are not familiar with him, he is the author of the Wheat Belly book series and Super Gut and what an amazing conversation this was! As famous as he is, he is one of the most down to earth, kind and generous people I have connected with recently.
Here's a glimpse into what we uncovered:

• The SIBO connection to common skin conditions like dryness, redness, and even wrinkles
• The power of one very very specific probiotic bacteria (it's not one that is typically in your probiotic blends) that holds the key to skin moisture
• How this specific probiotic bacteria can actually get to the bottom of SIBO without the need for antibiotics
• An innovative approach to combating SIBO and also combatting endotoxemia (endotoxemia is a process where SIBO can create toxicity in your whole body, not just the gut) with a special type of yogurt that you can make at home

We also discuss a product (its NOT a cream) that supports all this. I don’t want to mention it here without explaining it properly as there is a lot to it and it would make this email super long to write it all out so please listen to the episode so you can hear ALL the details, plus there is a discount as well.(Ok ok I will mention it in case you really can’t wait another minute. It’s called Gut To Glow and you can get a 10% discount using code “GLOW”.

But please be sure to listen to the podcast because it will explain much more about what it is, how it works and how you can use it both orally and in yogurt to help with wrinkles, dry skin, eczema, psoriasis and also your gut.

You can read the FULL SHOW NOTES AND SUMMARY HERE to get see ALL the details we discuss in the episode.

The Case:

• Amy is 31 and has been dealing with tons of skin issues for a decade.
• She experiences acne, dry/oily patches, cysts, and generally red, bumpy skin.
• She tried the birth control pill, oral antibiotics, antibacterial soap, and tons of prescription creams.

The Investigation

Many people don’t connect their nutrition to their skin condition but when I met Amy, she told me about digestive issues she was having and I knew this was where we needed to start the investigation into her skin issues.

When it comes to skin and natural health, it felt obvious to turn to Dr. Trevor Cates. She was the first woman licensed as a naturopathic doctor in the state of California. She wrote the Amazon bestselling book Clean Skin From Within. She is known as The Spa Doctor and developed a skin care line under the same name.

Skin Warning Signs

Dr. Cates says that all too often, when we have something out of balance with our skin, the traditional method of treating it is to suppress it with, for example, a steroid cream. They don’t tend to look for the cause. And so, the issue continues to manifest with different (and worsening) symptoms over time that experts may not track back to the initial skin issue. The skin is sending a message that something else is wrong. Erasing the message doesn’t change the fact that something is wrong internally.

Hormonal Issues Presenting with Skin Conditions

There are a number of hormonal concerns that may show up first as skin conditions. Hormonal issues with estrogen, progesterone, thyroid, adrenal hormones and more have symptoms related to the skin. For example, sex hormone changes can cause acne, dull skin and premature aging in skin. Thyroid issues can cause dry skin or oily skin depending on the issue.

Dr. Cates calls inflammation affecting the skin ‘skinflammation’. This is when you have internal inflammation and it shows up on the skin. This might be caused by hormonal imbalances.

Nutritional Deficiencies and Skin Issues

Various nutritional deficiencies show up as skin conditions. In fact, doctors will also look to the skin first to determine if there might be a deficiency or poor nutritional absorption at play. Zinc, essential fatty acids, iron and B vitamin deficiencies all present as skin issues.

Skin Microbiome

Our gut microbiome can also affect the condition of our skin. In addition, the skin itself has its own microbiome. The skin has an organization of microorganisms that live on the skin and keep it healthy and disease free. When it is in balance, we have glowing skin that ages gracefully.

Testing the Skin Microbiome

Unlike testing the gut microbiome balance, there aren’t any true tests for determining the balance of your skin microbiome or microbiota levels. One of the reasons for this is that the state of your skin is affected day to day by your environment. If you have pets in your home, if your space is clean or dirty, if you use antimicrobial agents or cleaning products with certain chemicals - your skin is immediately affected. Researchers focus on testing the pores around the nose, but one of the best ways to determine the health of your skin microbiome is to look at the condition it’s in. If you’ve got dryness, dullness, breakouts, redness or irritation, then the microbiome is likely out of balance.

Protecting the Skin Microbiome

There are things that can definitely interfere with the balance of the skin microbiome. Dr. Cates points to our overly germophobic society as part of the problem. Overuse (or unnecessary use) of hand sanitizers, antimicrobial soaps, antibiotics (internally and externally), antibacterial cleaning products, and other toxic chemicals in our cleaning routine can all negatively impact the microbiome balance. She suggests using them only when necessary.

Probiotics on the Skin

Maintaining a balanced gut microbiome (by ensuring the body is getting enough probiotics) will help the health of skin (a healthy gut leads to healthy skin). Do we also need to apply probiotics to our skin to support a healthy skin microbiome? Dr. Cates says that probiotics in skin products is a bit of a trend right now but our skin doesn’t work like our gut. If people do get good results by using probiotic skin products, it’s more likely to do with the acidic nature of probiotics. The skin has a natural mild acidity to it but many products used on the skin have a very high pH. Soaps, cleansers, even water can strip the skin of natural oils and disrupt the pH balance of the skin.

Ingredients to Avoid in Skincare Products

Dr. Cates has spent many years formulating her skincare line. There are several things she suggests you watch for in your skincare products. The first...

The Case:

• Julie has digestive issues, headaches, lots of skin rashes and irritation, brain fog, and fatigue
• She is also very sensitive to environmental triggers like fragrances, smoke, and chemicals.
• She eats and lives as clean as possible but nothing seems to help.
• She’s seen a dozen doctors who have prescribed a variety of medications but nothing helped.

It’s so common for conventional doctors to focus on treating the symptoms as if they are unrelated instead of considering what the collection of symptoms might mean. Julie knew that her symptoms had to be connected which is when she reached out to me. My feeling was that this was a systemic issue and we got to work investigating the root cause of her problems. The Investigation

With my suspicions of a systemic issue, I knew that Beth O’Hara would be a great source of information. She’s been on Health Mysteries Solved before to speak about Oxalates (episode 67) and Histamines (episode 81). This time, I wanted to dive into the topic of Mast Cells and Mast Cell Activation Syndrome which is Beth’s expertise. What are Mast Cells?

Mast cells are one of the most important types of immune cells in our bodies. They're present at every interface between our bodies and the outside world, and they're also found in every single tissue except for the retina. So, if we think about that, they're in the skin, in the lining of the sinus passages, in the digestive tract from the mouth to the stomach, and they're also found in muscles and bones. They migrate to very important areas like nerve endings and the brain's limbic system.

Mast cells are responsible for a number of functions ranging from the sleep-wake cycle to pregnancy and wound healing. They also help the body monitor for whether or not we're safe from things like toxins, mold, candida, pathogens, parasites, viruses and bacteria. They even monitor for co-infections (like lyme disease). Mast cells are also looking for all types of stressors including psychological stress, physical stress and stress caused by outside factors like electromagnetic fields (EMF) in the environment. How do Mast Cells Work?

Mast cells use what are called receptors - you can think of them like little antennae on the outside of the cell. There are over 200 of these receptors sending out signals using mediators. There are over 1000 different mediators. All of these allow the cells to connect with and monitor the different functions of the body.

When a mast cell detects an issue it will respond, often causing inflammation. It is not the only immune response but it is one of the primary cells responsible for answering a threat to the immune system.

The problem is that our modern world has more threats to the immune system that can cause mast cells to react. These include things like mold, high levels of EMF (wifi, smart homes, etc add to these high levels), environmental chemicals and other toxins. The challenge is that the mast cells are constantly triggered (or in activation) by these things and they don’t have time to rest and reset. This can overwhelm the mast cells and create a chronic issue. The Link Between Autoimmunity and Mast Cell Activation

Mast cells are heavily involved in the development of various autoimmune diseases. The mast cells are involved in both innate and adaptive immunity. Mast cells respond to the initial threat from a pathogen but when that fails, they shift their response and this can be what causes chronic inflammation. This continues as long as there are unresolved root triggers over an extended period of time. Over time, this opens the door for the development of autoimmunity in people who are predisposed for it.

So, if we want to avoid autoimmunity, we need to respond faster to the root trigger so that the mast cell response can be regulated. Regulating the mast cells can also reverse autoimmunity, in some cases, if you identify which mast cells have been activated.

Different mast cells can be triggered (and often triggered together to create a bigger issue). For example, the GI mast cells and the skin mast cells. After determining which mast cells have been activated, you need to understand which receptors are now hyper-sensitive and which mediators are involved. Mast Cell Activation Syndrome Symptoms and Diagnosis

The complexity of what is happening is one of the reasons why it is so hard to diagnose MCAS. Beth says that the average diagnosis takes up to 10 years and the criteria for diagnosis is still being debated. She shared that a population study (pre-COVID) found that up to 17% of the population are dealing with MCAS. That’s hundreds of millions of people with MCAS, the majority of which are ...

The Case:

• Diana is 36 and suffers from irregular bowel movements and stomach upset.
• Endoscopies, colonoscopies and genetic testing for celiac disease provided no answers
• She tried adjusting her diet but nothing has helped and her doctor was stumped.

My first suspicion was that her Celiac test was a false negative or that she had some underlying gluten-sensitivity. Gluten is found in wheat, rye, barley and oats and many people may have the sensitivity. It’s estimated that 30 – 40% of people are genetically positive for gluten-sensitivity. Many go undiagnosed.

Dr. Peter Osborne is world renown in the field of gluten and grain sensitivity. He is the author of the highly acclaimed bestseller, ‘No Grain, No Pain’ and is a Doctor of Chiropractic and board certified in clinical nutrition and pastoral medicine. He is the clinical director of Origins Healthcare in Sugarland, Texas and is also an advisor for Functional Medicine University.

He joins me in the discussion of this case to share his significant expertise in this field.

Confusion Around Gluten Terminology

Many people mislabel conditions relating to gluten and mistakenly use gluten-sensitive, gluten-intolerant, gluten allergy, and celiac interchangeably. So, what is the difference between gluten sensitivity and gluten allergy? What’s the difference between gluten intolerance and celiac disease?

Dr. Osborne explains that gluten sensitivity is a state of genetics which is not a disease. However, this sensitivity can lead to the development of celiac disease which is an autoimmune disease. Gluten intolerance is a reaction to gluten without the genetic disposition. The body cannot digest gluten properly because it is not producing the necessary enzyme. This can result in irritable bowel, gas, bloating and other intestinal discomforts. An allergy to gluten it very rare. Classically, this would show up as an acute response similar to other food allergies which often have symptoms like hives, swollen lips, and throat constriction. It’s potentially life-threatening.

Traditional Testing for Celiac is Insufficient

Most doctors will test two genetic markers for celiac disease but there are 5 antibodies that should be tested. Some people, like Diane, are told they don’t have Celiac disease and can eat gluten when that is not the case. Comprehensive tests that specifically include HLA DQ2 and DQ8 as well as the wheat zoomer (see below for links to these tests) are needed to completely rule out gluten issues. These tests are a simple cheek swab and a blood test.

Gluten Sensitivity due to Genetics is Permanent

While some people may feel better after giving up gluten for a period of time, this does not mean they can return to eating gluten. Dr. Osborne says that it can’t be reversed and his best advice is to stay away from it if they want to maintain their health. Eating gluten (for those that have the gluten genes) is unhealthy for them so if they go back to it, they’ll soon feel the repercussions of their unhealthy ways.

Consider the Quality of Grains

People who do not have the genetic markers for gluten sensitivity, antibodies to gluten, or the presence of autoimmune disease do not need to follow a gluten-free diet. However, it’s important to look at the quality of the food they’re eating. Grains can have mold or mycotoxins (see episode 006). They may also have trace amounts of pesticides that could include glyphosate which has been linked to cancer, neurodegeneration and fertility issues. In addition to that, many grains have been genetically modified.

You Can’t Just Take a Pill

There are enzymes available in supplement form that will help the body digest gluten. While this might seem like a ‘get out of jail free’ card, it’s not. If you have a gluten sensitivity or Celiac disease these are meant only to protect you against unwitting exposure (often through cross contamination in non-gluten-free restaurants or homes). It’s not a magic pill that you can take and then go devour a pizza. Sorry, guys.

Eliminating Health Mysteries

For Diana we were able to get to the real root of the problem and help her regain her health. Could a gluten sensitivity be the missing clue for you or someone in your life? Please share this episode with them so that they can feel better too.

Links:

Resources mentioned

Thanks to my guest Dr. Peter Osborne. You can connect with him through his website: https://drpeterosborne.com/

You can get a copy of his book No Grain, No Pain here:

www.glutenfreesociety.com

Thanks for Listening

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