Treating Thyroid Disease by Fixing the Gut: The Thyroid-Gut Connection
In a June 2020 study published in the journal Nutrition (see Thyroid-Gut-Axis: How Does the Microbiota Influence Thyroid Function?), researchers concluded that a healthy microbiota has “beneficial effects not only on the activity of the immune system but also on thyroid function.” Are you considering thyroid hormone therapy?
Also included are Hashimoto’s thyroiditis and Grave’s disease, as well as thyroid carcinoma (cancerous tumor).
They also point out that the composition of gut microbiota influences the availability of micronutrients required for thyroid health and function, including iodine, iron, copper, selenium, zinc, vitamins A and D, B vitamins, and tyrosine. (Gut microbiota is a term used to describe the community of microorganisms living in the digestive tract.)
Supplementation with the right probiotics (beneficial bacteria) tends to both improve the availability of these micronutrients and restore thyroid health and function, providing further proof of the existence of the thyroid-gut axis.
Identifying the Root Cause of Thyroid Dysfunction
As explained in the study, the problem begins with dysbiosis (an imbalance in the microbiota), which damages the intestinal lining — a single layer of cells that allows nutrients to pass into the bloodstream while preventing antigens from passing through(an antigen is anything that triggers an immune response).
Damage to the intestinal lining results in increased intestinal permeability (leaky gut), allowing antigens to pass through more easily, thereby triggering an immune reaction. If the antigen has a molecular structure, like that of thyroid cells (molecular mimicry), the immune system also attacks the thyroid.
Compounding the problem is the fact that the thyroid influences motility (the movement of food through the digestive tract by muscle contractions). As the movement of food and waste products through the digestive tract slows, susceptibility to small intestinal bacterial overgrowth (SIBO) and small intestinal fungal overgrowth (SIFO) increases.
The result is a vicious cycle driving a continuous and worsening thyroid, gut, and immune function disruption. While conventional medicine often focuses solely on treating the thyroid, the solution is in the gut — restoring a healthy gut microbiota and repairing any damage to the intestinal lining while at the same time supporting thyroid health and function.
Recognizing the Symptoms
Illnesses related to gut-thyroid axis dysfunction, such as Hashimoto’s thyroiditis or hypothyroidism, are typically associated with symptoms such as hormone imbalances, weight gain, fatigue, anxiety, hair loss, and infertility, but several gastrointestinal symptoms can also be a sign of thyroid dysfunction, including the following:
- Bloating
- Constipation
- Gastroesophageal reflux disease (GERD), also known as acid reflux
- Indigestion
- Irritable bowel syndrome (IBS)
Testing for Gut-Thyroid Axis Health Issues
Here at BioDesign Wellness Center, we follow the Functional Medicine credo — “Test, don’t guess.” Before recommending any treatments, we want to know specifically what’s going on with our patients. When we suspect an issue with the gut-thyroid axis, we order lab tests, which often include the following:
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A full thyroid panel, including TSH, free T4, free T3, reverse T3, Thyroglobulin (TG), and Thyroid Peroxidase (TPO) antibodies.
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Complete blood count (CBC) and iron panel to check for anemia and iron levels.
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Nutrient testing for iodine, zinc, selenium, vitamins A and D, and some of the B vitamins.
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SIBO breath test, which measures hydrogen or methane gas produced by the overgrowth of bacteria in the small intestines.
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Organic Acids Test (OAT) — a urine test that screens for a variety of factors including nutrient levels and fungal overgrowth.
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GI Map, a stool test that screens for several intestinal pathogens and other markers for intestinal health, such as enzyme function and fat absorption.
Treating the Gut-Thyroid Axis
We often start treatment with a gut healing and microbiome renewal protocol that may include prebiotics, probiotics, butyrate (to feed healthy gut bacteria), and digestive aids for the liver and gallbladder.
We also supplement with nutrients, when necessary, in order to address any deficiencies and support thyroid health and function.
Many of our patients have already tried some of these treatments on their own or under the supervision of other healthcare providers with varying degrees of success. Our approach differs.
We develop a personalized treatment protocol based on each patient’s lab results and clinical history. Then we monitor progress closely and adjust accordingly.
What works for one patient may have little benefit for another. In addition, what a patient needs now usually changes as his or her condition improves.
For more about how we diagnose and treat thyroid conditions, check out our two-part series “Restoring Thyroid Health.”
A Case Study
A 45-year-old female with Hashimoto’s thyroiditis came to our Tampa functional medicine clinic complaining of fatigue, hair loss, and IBS with constipation. (Constipation can be a sign of low thyroid, diet, hormonal birth control, bacterial overgrowth, or other changes in the microbiome.)
She was on medication for her thyroid, but we discovered her thyroid lab tests were normal.
She had been off birth control for 60 days and had started a Whole 30 diet — a restrictive whole foods diet designed to reboot the body. Even with these changes, she did not feel better. She continued to suffer fatigue, constipation, and hair loss.
We ran a stool test and found elevated levels of metabolites that come from the breakdown of estrogen. These metabolites cause severe bloating and can alter bowel habits. A normal microbiome would have helped to break down the extra estrogen, but tests showed dysbiosis and yeast overgrowth.
Based on our consultation with the patient and on her lab results, we knew the following:
- She was experiencing thyroid and digestive problems
- Stool test results showed excess estrogenic metabolites (greater than normally present)
- She was losing hair
- She was experiencing chronic fatigue
In this case, we provided the patient with a gut repair protocol to reduce estrogenic metabolites from circulating in the gut, liver, and gallbladder. Elevated estrogen can block thyroid hormone from circulating freely and therefore cause hypothyroid symptoms — even when thyroid labs appear normal.
The thyroid hormone is blocked by estrogen-binding globulins, thus preventing the passage of thyroid hormone to activate the thyroid receptor on the cell. This resulted in fatigue and hair loss.
Our 45-year-old patient had visited at least five healthcare providers over the course of 10 years, suffering symptoms the entire time. In just three short weeks, she told us had her life back — her hair stopped falling out, she regained her vitality, and her IBS constipation gradually improved.
We cannot stress enough the importance of close doctor-patient consultation, a careful examination of medical and family history, targeted lab tests, and a personalized plan to repair the gut and restore microbiome health.
Stop Suffering Needlessly With Thyroid Hormone Therapy
Unfortunately, case studies like these are not uncommon. People suffer needlessly for years, sometimes decades, because their healthcare providers focus almost exclusively on symptoms. They don’t dig deep enough to identify and treat the underlying causes.
If you’ve been suffering for some time with an unexplained illness, or if you have been receiving treatment that hasn’t made you feel much better, we urge you to try a different approach. Consult with a functional medicine practitioner near you. If you’re in or near Tampa, Florida, contact us to schedule a consultation.
Don’t let a thyroid hormone issue keep you from enjoying all of the things you love about life! Call us at (813) 445-7770, let our Tampa-based hormone specialists help you, and learn how thyroid hormone therapy can change your life for the better!
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Disclaimer: The information in this blog post about treating thyroid disease by fixing the gut is provided for general informational purposes only and may not reflect current medical thinking or practices. No information contained in this post should be construed as medical advice from the medical staff at BioDesign Wellness Center, Inc., nor is this post intended to be a substitute for medical counsel on any subject matter. No reader of this post should act or refrain from acting on the basis of any information included in, or accessible through, this post without seeking the appropriate medical advice on the particular facts and circumstances at issue from a licensed medical professional in the recipient’s state, country or other appropriate licensing jurisdiction.