069 [Ask Inna] More Answers to Your Hashimoto’s Questions (Part 2)

07/23/20 • 29 min

Thyroid Mystery Solved: Hashimoto's and Hypothyroidism Revealed

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Last week I shared some of the questions you wanted answered about Hashimoto’s. I covered topics like the relationship between heavy metals and Hashimoto’s, the role the adrenals play in Hashimoto’s, the relationship between Epstein-Barr Virus (EBV) and Hashimoto’s and how to reduce the risk for kids of people with Hashimoto’s. All of them were very important questions that have a lot to do with the triggers of Hashimoto’s. If you missed it, here is a link to episode 068.

In this episode, I answer more of your questions about Hashimoto’s.

Question #1: With Hashimoto’s, is TSH a reliable indicator of the body’s thyroid hormone needs? If not, what else can we use to know what the body needs?

This can be very confusing for anyone with Hashimoto’s. The short answer is, no. TSH is not a reliable indicator. The ranges for TSH are very broad (typically between about 4.5 - 5 depending on where you live. This range is not really optimal. The optimal range for TSH is between 1.8-3 (if you’re on thyroid medication this shifts a bit).

But, TSH is only one indicator and you need to look at the big picture including your total T4, free T4, total T3, free T3, and reverse T3. This is because TSH is not actually created in the thyroid - it's the thyroid stimulating hormone created in the pituitary gland. So, only looking at TSH doesn’t tell us which hormones the thyroid is producing and at which ratio. And, it doesn’t tell us how well the body (primarily the liver and the gut) are converting these hormones or how the hormones are actually utilized. Essentially, TSH shows a very very small part of a much bigger picture and that is why its not nearly complete. With Hashimoto’s you also want to track your antibody levels so that you can determine which triggers (listen to episode 068 for more on the four triggers) are affecting you and your levels.

I’ve listed the various tests I recommend to get the whole picture of your thyroid functionality and optimal levels for each in the show notes for episode 027. If you are looking for a lab to do these tests, here is a link to a helpful resource and lab.

I’m in the process of creating my thyroid course which is going to get way more in depth about this and how you can figure out your pattern and exactly what to do about it. The course will launch this fall. Add your name to the wait list if you’d like to be personally invited to join.

Question #2: Why does someone with Hashimoto's feel tired all day long? How can we help this and what can we do to wake up feeling refreshed and have more energy throughout the day?

While Hashimoto’s is an issue, we need to look at the root cause of the fatigue. It’s true that Hashimoto’s causes the immune system to attack the thyroid and often causes hypothyroidism which has a common symptom of fatigue. So, the first step is to make sure that you are supporting thyroid function optimally with what your body needs (foods, supplements or if necessary thyroid medication that is dosed appropriately) and you are also by avoiding Hashimoto triggers (noted in last week’s episode).

If you are doing these things and continue to feel tired, then you may want to consider the role your adrenal glands may be playing in your fatigue. The adrenals and the thyroid are very interrelated. Stress is a key trigger for Hashimoto’s and it can also impact adrenal function.

Clean eating is also recommended but if you continue to feel tired, you may be having some issues with absorption which could be caused by a gut issue. This could be the real cause of the fatigue as well

And finally, check that you are not deficient in nutrients that help us feel more energized like iron, B12 and other B vitamins. As you can see, feeling tired is quite multi faceted so we have to look at it from all angles.

Question #3: My diagnosis of Hashimoto's only came after being on thyroid medication for years. Can this medication be contributing to Hashimoto's?

In my opinion, I don’t think it did. What often happens is that the Hashimoto’s is undiagnosed for many years. Conventional doctors will often stop looking for answers once they dia...

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In this episode, I answer more of your questions about Hashimoto’s.

Question #1: With Hashimoto’s, is TSH a reliable indicator of the body’s thyroid hormone needs? If not, what else can we use to know what the body needs?

Question #2: Why does someone with Hashimoto's feel tired all day long? How can we help this and what can we do to wake up feeling refreshed and have more energy throughout the day?

Question #3: My diagnosis of Hashimoto's only came after being on thyroid medication for years. Can this medication be contributing to Hashimoto's?

In my opinion, I don’t think it did. What often happens is that the Hashimoto’s is undiagnosed for many years. Conventional doctors will often stop looking for answers once they dia...

Previous Episode

068 [Ask Inna] Answers to All Your Hashimoto’s Questions

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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...

Next Episode

070 The Case of Mercury Fillings w/ Dr. Kourosh Maddahi

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The Case:

Emily is 45 dealing with fatigue, brain fog and digestive issues as well as dry mouth and bad breath.
Her doctor’s diagnosed her with Crohn’s Disease and Hashimoto’s but that alone didn’t help her symptoms.
She tried changing her diet, took supplements and brushed her teeth after every meal.

The Investigation

My investigation started by looking into Emily’s dry mouth and bad breath. Her oral health was quite poor despite frequent brushing and I noted that she’d had several root canals and many silver fillings. I know this was going to be a key piece in solving her health mystery because even though these may not seem related, everything in the body is connected.

“Silver fillings” or Amalgam fillings are actually about 54% elemental mercury and mercury can cause all kinds of health issues. On top of that, our oral health can seriously impact our overall health, even when we think we are practicing good oral hygiene.

Dr. Kourosh Maddahi is a dentist to the stars, the author of 'Anti-Aging Dentistry' and the founder of the research-based Lumineux Oral Essentials. He joins me in this episode to shed some light on what might be going on with Emily.

Your Mouth is a Gateway to Your Body

The mouth is the first entry point for the digestive system with regards to disease or infection. The mouth is the most vascular area which means that it is easy for bad bacteria and viruses to be transmitted through the mouth vascularly as well as by swallowing.

We know that chronic inflammation is a key component in many diseases and the mouth is also susceptible to inflammation. Gingivitis, for example, is chronic inflammation of the gums. This inflammation can increase the chances of transmitting disease because swollen gums are more likely to have tiny cuts (and bleed) which removes the barrier between bad bacteria or viruses and the bloodstream.

Signs of Inflammation in the Mouth

The first and most common sign of acute or chronic inflammation is bleeding during or after teeth-brushing. A second sign is if there is discomfort when eating, especially if there is pain when biting or chewing. Pain during eating can be a sign that there is an infection under the tooth, in the gums, or in the bone. Dentists can do X-rays and probe the gums to confirm chronic inflammation and/or a suspected infection.

Causes of Inflammation in the Mouth & How to Avoid It

Inflammation can happen quickly. For example, Dr. Maddahi says that a build up of hardened plaque causes inflammation and plaque can harden on your teeth within 24 hours. That’s why brushing frequently is so important. He says the simplest way to avoid inflammation is to remove plaque before it can harden - in other words, floss and brush regularly and see your dentist to remove hardened plaque every 6-months.

Health Risks from Silver Fillings (Amalgam Fillings)

Silver fillings contain mercury which is known to cause health issues. Mercury exists in three forms: solid, liquid, and vapor. The vapor form is the greatest concern in the mouth because it can leach out when we are chewing or drinking hot liquids and enter various tissues and organs. Of particular concern is that mercury vapor can break the blood-brain barrier and the half-life of mercury in the brain is 20-years. As mercury accumulates in organs, it can reach toxic levels. Mercury toxicity can impact the nervous, digestive and immune systems. It can also negatively affect the development of children in utero and in early life.

Testing for Mercury Toxicity

Common practice is to test your hair and urine to determine mercury levels in the body. However, Dr. Maddahi says this is not a true indication because the mercury could be absorbed in the tissues and organs. Instead, he suggests doing a challenge test.

Should You Remove Mercury Fillings?

This is a controversial question for a lot of dentists and health experts. While it may seem like an obvious solution, given the leaching of mercury vapors into our system, the drilling and removal of silver amalgam fillings can cause a significant release of vapors - as much as 100 times more than the you might experience by not removing them - during a very short time period. If the patient is healthy and doing the removal as a precaution, then Dr. Maddahi suggests only doing one quadrant at a time.

Safety During the Removal of Mercury Fillings

Anyone choosing to remove mercury fillings should select a dentist who will take the greatest precautions to reduce the potential exposure to mercury vapors. For example, the patient sh...