The Thyroid-Gut Connection

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This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.

Hippocrates said: “All disease begins in the gut.” 2,500 years later we’re just beginning to understand how right he was. And, as I’ll explain in this article, hypothyroidism is no exception. Poor gut health can suppress thyroid function and trigger Hashimoto’s disease, and low thyroid function can lead to an inflamed and leaky gut – as illustrated in the following diagram:

thyroidgut

The gut-thyroid-immune connection

Have you ever considered the fact that the contents of the gut are outside the body? The gut is a hollow tube that passes from the mouth to the anus. Anything that goes in the mouth and isn’t digested will pass right out the other end. This is, in fact, one of the most important functions of the gut: to prevent foreign substances from entering the body.

Another important function of the gut is to host 70% of the immune tissue in the body. This portion of the immune system is collectively referred to as GALT, or gut-associated lymphoid tissue. The GALT comprises several types of lymphoid tissues that store immune cells, such as T & B lymphocytes, that carry out attacks and produce antibodies against antigens, molecules recognized by the immune system as potential threats.

Problems occur when either of these protective functions of the gut are compromised. When the intestinal barrier becomes permeable (i.e. “leaky gut syndrome”), large protein molecules escape into the bloodstream. Since these proteins don’t belong outside of the gut, the body mounts an immune response and attacks them. Studies show that these attacks play a role in the development of autoimmune diseases like Hashimoto’s.

We also know that thyroid hormones strongly influence the tight junctions in the stomach and small intestine. These tight junctions are closely associated areas of two cells whose membranes join together to form the impermeable barrier of the gut. T3 and T4 have been shown to protect gut mucosal lining from stress induced ulcer formation. In another study, endoscopic examination of gastric ulcers found low T3, low T4 and abnormal levels of reverse T3.

Likewise, thyrotropin releasing hormone (TRH) and thyroid stimulating hormone (TSH) both influence the development of the GALT. T4 prevents over-expression of intestinal intraepithelial lymphocytes (IEL), which in turn causes inflammation in the gut.

The gut-bacteria-thyroid connection

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.

Inflammation in the gut also reduces T3 by raising cortisol. Cortisol decreases active T3 levels while increasing levels of inactive T3. 1

Studies have also shown that cell walls of intestinal bacteria, called lipopolysaccharides (LPS), negatively effect thyroid metabolism in several ways. LPS:

  • reduce thyroid hormone levels;
  • dull thyroid hormone receptor sites;
  • increase amounts of inactive T3;
  • decrease TSH; and
  • promote autoimmune thyroid disease (AITD).

Other gut-thyroid connections

Hypochlorhydria, or low stomach acid, increases intestinal permeability, inflammation and infection (for more on this, see my series on acid reflux & GERD). Studies have shown a strong association between atrophic body gastritis, a condition related to hypochlorhydria, and autoimmune thyroid disease.

Constipation can impair hormone clearance and cause elevations in estrogen, which in turn raises thyroid-binding globulin (TBG) levels and decreases the amount of free thyroid hormones available to the body. On the other hand, low thyroid function slows transit time, causing constipation and increasing inflammation, infections and malabsorption.

Finally, a sluggish gall bladder interferes with proper liver detoxification and prevents hormones from being cleared from the body, and hypothyroidism impairs GB function by reducing bile flow.

Healing the gut-thyroid axis

All of these connections make it clear that you can’t have a healthy gut without a healthy thyroid, and you can’t have a healthy thyroid without a healthy gut. To restore proper function of the gut-thyroid axis, both must be addressed simultaneously.

Healing the gut is a huge topic that can’t be covered adequately in a few short sentences. But I will say this: the first step is always to figure out what’s causing the gut dysfunction. As we’ve reviewed in this article, low thyroid is one possible cause, but often hypochlorhydria, infections, dysbiosis, food intolerances (especially gluten), stress and other factors play an even more significant role. The second step is to address these factors and remove any potential triggers. The third step is to restore the integrity of the gut barrier. My preferred approach for this last step is the GAPS diet.

The influence of thyroid hormones on the gut is one of many reasons why I recommend that people with persistently high TSH and low T4 and T3 take replacement hormones. Low thyroid hormones make it difficult to heal the gut, and an inflamed and leaky gut contributes to just about every disease there is, including hypothyroidism. Fixing the gut is often the first – and most important – step I take with my patients.

  1. Stockigt, JR and Baverman LE. Update on the Sick Euthyroid Syndrome. Diseases of the Thyroid. Humana Press, Totowa, NJ, 1997, pp.49-68

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Comments Join the Conversation

  1. Hap says

    While having no familiarity with thyroid issues, I’d still be interested to hear your (possibly relevant) take on the health of the “second brain,” something my tai chi teacher wrote about and which “Scientific American” and the NYT has covered. Many believe that traditional fermented foods are smart choices for promoting healthy intestinal flora, e.g. “the Activia Challenge.”
     
    http://www.scientificamerican.com/article.cfm?id=gut-second-brain

  2. says

    Superb post Chris!
    What do you think about the possible effect of eating charred meat on serum AGEs, and on health in general, in people with a health GI tract.
    Here is the reason for my question. I had a few exchanges with a commenter under the post below. I looked into some refs the commenter provided.
    http://healthcorrelator.blogspot.com/2010/05/oven-roasted-meat-pork-tenderloin.html
    It seems that, in the absence of gut problems, ingested AGEs (e.g., Maillard) may not be a big deal. But I’m not sure.

    • Chris Kresser says

      Ned, you’ve looked into the AGE issue in much more depth than I have. The conclusion I reached after the little bit of research I did was similar to your own: that the potential damage caused by AGEs – even when someone has a leaky gut – pales in comparison to the harm caused by refined carbs and industrial seed oils. Based on the evidence I’ve seen, I don’t find cause to strictly avoid roasted or BBQ’d meat, but at the same time I wouldn’t eat it every day. For me this is a quality of life issue as well. I am interested in health, of course, but I’m also interested in living well. The pleasure that eating a particular food and the real physiological benefit that pleasure brings is always a part of the equation.

  3. Charlotta (Sweden) says

    Another higly interesting post and yet I feel slightly more confused by every post I read, it’s a lot to take in and I guess the language barrier doesn’t help. I don’t know if I’ve got it all right and if I’ve missed something but I can’t understand that cortisol would decrease active T3. I’ve been recommended to support my adrenal glands by taking cortisone or a natural supplement with adrenal gland extract. I chose the latter and it’s helped me a lot, I feel much better. Now with what you’re saying about T3 it seems like it should’ve had the opposite effect? And what is your take on adrenal gland fatigue? The more I read (not only here) the more I think that my thyroid problems actually are adrenal glands problems. And finally, you haven’t really said anything about hypo2, I presume you’re familiar with Dr Mark Starrs theories. How do they fit in with your take on it all?

    • Chris Kresser says

      Charlotta,

      Many of your questions will be answered in my next article on adrenal stress and the thyroid, which I will publish either today or tomorrow. I’ve read about Type 2 hypothyroidism. I have been talking about it, but not under that name. Whenever I say “thyroid hormone resistance” or “thyroid receptor site downregulation”, that’s what I’m talking about. Cortisol depresses thyroid functions by several different mechanisms, which I’ll outline in the next article. Taking cortisone is not the way to support your adrenal glands. Taking compounds that regulate the cortisol rhythm is.

  4. Charlotta (Sweden) says

    Thanks, that clears up a lot and I’m looking forward to your next post! You say that the way to go is with a compound that regulates the cortisol rhythm, is adrenal gland tablets (in Sweden called Adrekomp and containing extract from natural adrenal glands from pigs along with vitamins A, C, B1, B5 and B6, minerals P, K, Zn and Betain HCl) such a compound?

  5. Chris Kresser says

    I’m not a big fan of the gland supplements.  A more sophisticated approach is to use adaptogenic botanicals like Panax ginseng, Siberian ginseng, Ashwagandha, etc. that elevate or reduce cortisol as necessary.  The most important thing is regulating the cortisol rhythm. You can have normal levels of cortisol, but if the rhythm is off, you’ll have symptoms.

  6. Charlotta (Sweden) says

    Still a little confused over here. Do you consider thyroid hormone resistance to be an autoimmune condition? Can’t seem to find it in your previous articles.

  7. Chris Kresser says

    It can be a genetic condition, but as I’ve written in my articles it can also be caused by inflammation, stress and high homocysteine levels.  See #5 in this article, and reason #2 in this article.

  8. Lg says

    Along with the GAPS diet for gut heaing we need to include colon cleanses either with thereputic enemas or colonic hydrotherapy sessions.
    Blessed Herbs has a complete herb cleansing kit.
    Also Kristina Amelong’s book, Ten Days to Optimal Health gives great advice on cleansing, detox, gut healing, colonics, etc.  She also has a website to purchase at home enema kits and detox supplements (cheaper then Blessed Herbs): OptimalHealthNetwork.com. She recommends bone broths and raw milk while cleansing, whereas Blessed Herbs recommends fresh pressed juices like apple juice (not possible for those with blood sugar problems).
    Their colon cleanse supplements are basically the same: bentonite clay, pysillum husk, apple pectin.
    If you have blood suagr problems, it may make cleansing more difficult.  I used True Balance supplement as suggested by Julia Ross in the Diet Cure to help and followed the raw milk and bone broth plan.  Amelong also recommends flax oil and coconut oil while cleansing.
    I find this approach to work and is so much easier to do than GAPS alone (the extra fiber is filling) with faster results.  I believe The GAPS diet also reccomends enemas and/or colonics, but only briefly and does not go into great detail about it.
    It is recommend that a person does 3-4 intense cleanses a year for one to two years if in poor health.
     

    • Chris Kresser says

      I’m not a fan of colon cleansing. Colonics can be harsh and depleting, and I don’t think they’re necessary – especially on a repeated basis. I can see a role for enemas over a short period, as Natasha suggests for people following GAPS, but I don’t recommend either colonics or enemas over an extended period. This is particularly true for people who are debilitated and have sensitive guts.

  9. Phoenix says

    Chris, with your recommendation of ginseng for supporting the cortisol rhythm, does it matter whether one is TH1 or TH2 dominatant. In reading Dr. K’s book that was the thing that was the most confusing. Without access to the tests or practictioners I wouldn’t want to treat the wrong one.

    Given that it is a rhytmic thing, should the ginseng be taken at certain times of day?
    Thanks

  10. Connie says

    So, I have been on a thyroid medicine since 1992, I would love to change my diet and not take the medicine anymore, what do you suggest. I think you are right with it being gut related, burt I have no idea how to start dissecting the issue.

    • Steinalder says

      I have been on thyroid medicine for more than 15 years. After going Paleo in March last year I had to reduce quite quickly and stopped all medication after 2 months (I got overdose symptoms). When I started medication I had “normal” blood work but had a low FT3. The medication did not do much for me, and I believe that the gluten and casein intlerance I discovered last year is much to blame for all my “low thyroid symptoms” these years. I had constantly gut problems and my diet was low in protein and veggies and fruits and I always had digestive problems. I switched to a Paleo diet over night (no grains, no dairy, no fruits, no soy, no sugar). However, I suddenly experienced a lot of heart burn! It was so bad I thought I had a heart attack! It is possible to get off the medication, it just takes a lot of hard work and strong will. I had strong withdrawal symptoms for 3 months and at first I thought I was going to die (!); I had a hard time breathing, I was dizzy and even got ME symptoms for a few weeks (could not read, watch TV, etc). I guess my body was exhausted from being fed the wrong food for such a long time (decades). After 8 months into the new diet I found out I had a bacteria infection and yeast. I also had iodine deficiancy, as well as zink, magnesium and iron deficiancy. It takes time to heal, but if you change your diet it will affect your medication quite fast, maybe after a couple of weeks. So listen to what your body tells you, but at the same time be prepared there will be withdrawal symptoms. I have been without medication for 8 months now, and I no longer have all those symptoms I had when I was taking medication for low thyroid and my FT3 has never been better than now. My recommendation is that you take it very slowly, step by step. It is possible!

    • steinalder says

      Connie, my suggestions would be that you get tested for food intolerances (IgG a good place to start) – preferably before you get off grains and dairy. If you change your diet to grains and dairy free, be sure you will get withdrawal symptomes… I had tem for 3 months. And please be aware that your medication will probably have to be reduced as you go along. I had to start reducing Levaxin after 2 weeks on the new diet. You can of course also take a week by week approach, and sort of adapt to a new diet over some time, and eliminate dairy first and grains afterward.
      A stool test is the best thing I have ever done for myself – as it turned out I had bad bacteria and yeast (I took one called CDSA 2.0, one of the best there is, I think). The Lab is Genova Diagnostics (Asheville, NC). You need good bacteria for your gut anyway, and these capsules can be bought wthout prescription. I use them every day. Try also digestive enzymes to your meals (lipase, amylase, protease) and see if that helps on digestion. They are also without prescription (at least here in Norway). I would also take omega 3, 2 table spoons olive a day oil and start cooking with coconut oil. All other oils should be banned. Coconut oil is good for the thyroid. I would also do a 24-hr urin test to make sure you have enough iodine. You also need to check your mineral and vitamins, especially vit D, magnesium, zink and selenium. If you have a leaky gut you probably have deficiencies in these minerals and vitamins (I did). Start with 1000 mg C every day (make sure they are without grain/soy based ingredients).
      Listen to your body, but reaslize that there is no quick fix to a gut/health that has been compromised for many years. I am still not “there”, after 10 months, and one problem I still have is eating fruit. My stomach starts WW3 everytime I try a banana or a handful of berries. If anyone out there has expereinced the same, I would appreciate hearing from you!
      Don’t care about friends and family caling you a nut case because you stop eating grains..or dairy! Good luck from Norway!

      • Eva Lagodmos says

        Hello there;-)) What an accomplishment to gradually wean off Levaxin. I also live in Norway and would love to hear how you are doing today. I would appreciate an Email from you if possible: evalagos@gmail.com.
        Thanks, Eva

  11. Lisa truity says

    I too have been able to reduce/eliminate natural desicated thyroid by improving gut health, eradicating infections. I have had ibs colitis for decades. As a child I had the constipation kind which switched to diarrhea and inflammation. I did the scd/gaps low carb type diets for a few years and coyld avoid the diarrhea, but had gradually developed worsening hypot symptoms as an adult in spite of normal thyroid labs. I had to stay strict with diet or diarrhea would return. I also take zinc, manganese, selenium, chromium, molybdenum, and eat chicken liver pate for iron. This helped energy and libido and caused a slight improvement in thyroid function resulting in a need for less meds on some days. The thing that has really caused me to turn a corner however is berberine and berberine containing barberry root. I started using these alternating about a month ago and they have enabled me to eat normally. Starch and dissacharides no longer give me diarrhea, I have had to drastically cut back on thyroid meds and can envision that I will probably be completely off soon. My mood and energy have increased significantly. Even in the dark dreary winter here in kentucky, I am not feeling depressed. I got the idea to give berberine another try from zhao lipings work on gut infections as a cause for obesity. He mentioned berberine as showing very impressive results in their lab for decreasing bad microbes and increasing beneficial strains in their study subjects. I had some berberine previously but would get bad headaches after taking just one capsule for three days. It seemed like such a small amount I figured I must be having an allergic response. I decided to try again with 1/2 capsule a day and slowly work up. This worked. I guess it was actually die off that caused me to feel bad and berberine is so powerful just one capsule was too much.

  12. steinalder says

    Hi from Norway! Lisa truity, I am glad Im not the only one who has experienced that gut health is everything when it comes to thyroid problems (and other health issues). What surprises me is that this approach is not a option when people are diagnosed with low thyroid (at least here). I was given medication (Levaxin) without any further check ups, for example minerals and vitamins, food intolerances or anything else. I live in Norway, and here it is still a “fact” that low thyroid is a life long diagnose and cannot be cured! After reading Dr Peter Osborne’s website (Houston) and his articles on gluten and the connection between leaky gut (which I have obviously had for MANY years), and thyroid problems, I am convinced that this was my problem in the first place, leading to hypothyroidism and fibromyalgi. I discovered I had an iodine deficiency too (had to struggle a bit to get that test done!), and that is also a very important test to do. I have had so many improvments to my health the last 10 months by just eating the right food for me. However, when I tell people (including doctors) that I have cured myself of hypothyrodism, they don’t believe me….. Fibromyalgia is also one of those diagnosis that is “impossible” to cure. Food is everything, and i truely believe that grains are bad for everyone. And the A1 milk we drink here is not a health food either. The “cleaner” my body becomes, the more I react if I without knowing it eat something with grains in it (for example Ester-C vitamins – they contain corn, although it says gluten free on the package). The definition of gluten is not updated in decades. There is gluten in ALL GRAINS, only different types, and I react to all of them, including rice.
    I haven’t heard about berberin – will check it out. You seem to have a lot of choice when it comes to different supplements in the USA. Unfortunately we are not allowed to order supplements from the US, only from other European countries within the EU, though with certain restrictions to how much. We have a very strict law when it comes to medication/supplements here, and the Norwegian equivalent to the FDA thinks that we don’t need supplements as long as we eat a “healty and varied” diet (based on grains and milk!!).

    • Karen says

      Would love to know more about the diet you say cured your Fibromyalgia and Hypothyroidism. I have both and my dr. Just gives me meds and basically says deal with it, there is nothing you can do about it.

  13. abhishek says

    Hi,
    My symptoms are
    Pain in left side of abdomen,heavy head,constant fatigue,frequent constipation (with occasional blood in stool),rashes after having nonveg,pain in eye,muscle cramps and irritable behaviour

    Tests
    Thyroid T3 2.87 T4 0.94 TSH 20.96 ANTI TPO 1300
    AEC 2.08

    Two years ago my stool test showed E Histolytica
    Endocrinologist has suggested thyroid medicine 75mg for life with vitiman supplements

    My questions
    1Could bacteria cause high TSH and allergic symptoms aswell?
    2If not do i have to get AEC and high TSH treated seperately?

  14. Ladonna says

    Chris, this question is about the GAPS diet, hypothyroidism and all the Cruciferous vegetables the GAPS diet has you eating. Arent these vegetables supposed to be avoided when you have hypothyrodism?

    • Chris Kresser says

      Steaming or boiling eliminates a substantial portion of the goitrogens in cruciferous veggies. You don’t need to avoid them, but may want to moderate intake.

        • Tim says

          Fermenting the vegetables makes the goitrogens more potent in my experience.

          It didn’t make me feel sleepy like you would expect but gave me a mild dose of caffeine effect.

  15. Connie says

    I just came across this post, which I realize was written a while ago, so no idea if you will see this post or not. But I thought I’d post just in case. Something you wrote captured my attention:

    “Hypochlorhydria, or low stomach acid, increases intestinal permeability, inflammation and infection (for more on this, see my series on acid reflux & GERD). Studies have shown a strong association between atrophic body gastritis, a condition related to hypochlorhydria, and autoimmune thyroid disease.”

    A little history about myself. In 2009, I lost 60 lbs with a low calorie diet. I gained about 15 pounds back last year and this year I have been trying to lose weight. But am having no success. I found if I even eat the amount of calories I should to maintain my weight, I still will end up gaining weight. This led me to wonder about my metabolism.

    My doctor mentioned my thyroid could be the problem and so she had the lab run tests. I have not heard back any results and it’s been about a week. I am assuming a letter will be in the mail saying everything is normal. But I’ve been reading about low thyroid since then and found I have at least a couple of the other symptoms – cold intolerance (I used to be hot all the time and now am always cold) and heavier menstrual cycles. I’ve also read how often tests can come back normal but there is still a problem.

    I also have been having issues with what I assume is either acid reflux/GERD. I spoke with my doctor about this but since it wasn’t happening frequently, she did not find the need for any medication. I was fine with this since I currently take medication for kidney stone prevention and migraine prevention. My husband has been dealing with acid reflux for about 2 years and takes both prescribed prilosec and zantac.

    I actually found your other articles on acid reflux, as well as this article on thyroid. I am interested in learning more about the possible connection of these two things. And any other helpful information/advice you’d be willing to share. Thank you so much!

    • Connie says

      Just wanted to add that I received the letter about my TSH level. It is listed as .73 (with normal range of .4 to 4.5).

  16. Carolyn says

    I’ve been drinking George’s Aloe Vera water for years and recently was dignosed with Hashimoto’s (antibodies in the 1800′s). Wouldn’t Aloe have any healing affect on any immflamation in the gut?

  17. Naveen says

    Hi Chris,
    I am 33 years old, until last 6 months I was fit and healthy.. Suddenly I had a fatigue attack all blood tests revealed normal numbers. Doctors told me may be my low weight is reason and I put on almost 5 kilos in last 6 months or so. I weight around 55 kilograms for height of 5’5″.
    I was running well and had cut down on eating Junk food.
    Residing in India our staple food is Rice, Ragi, Wheat which we cook and have with a curry of vegetables, dal. I am a pure vegeterian no egg or meat in my diet.
    After 3 months I gained some confidence changed diet to add additional small meals to get things going. I felt better started running but with lesser intensity. Past 1month or so I again face similar symptoms of fatigue, sleepiness/tiredness/fatigue through days inspite of eating well and nutritious. So I read about this gut health associated cause related to these symptoms also leading to anxiety/depression. What is best way to come out of it, being in India does GAP diet workout for me since most of nutrition suggestions may be best for Western countries i.e. Eurpope and America? So do you include diet for other countries like India?

  18. says

    please tell me where to find the complete list of footnote references for this article — only one footnote appears — very interesting article that applies to me totally & I would guess many others — thank you very much!

  19. Sabra Zay says

    Hi and thank you for these wonderful posts. I wish I would have known about them years ago. I had hashimotos and had the raidioactive iodine in 1996, had my gallbladder removed a couple of years after that… I have had severe joint problems, rosacea, exzema, depression and anxiety… and labs have shown B12 deficiency. I also have fibromyalgia with some bad brainfog. I round the GAPS diet and I have been shocked and amazed at how fast I am seeing improvements. I have only been doing this 2 and a half weeks but my skin is much more clear, my memory seems better. My energy level isnt really great yet but my depression is lessening a lot and while I dont have much energy, I am having enthusiasm and at least want to do things now. My question for you is this… I have read multiple things saying that I shouldnt have gone gluten free without a diagnosis first. How important it actually having a diagnosis? I am 50 and supposed to have a colonoscopy as part of a routine checkup and my doctor said that they can test for celiac disease with that. Have i had time to heal up enough and that test wouldnt be accurate? Should I add wheat back into my diet and then do the test. I really hate to do that especially when I read in your article that it can take up to 6 months for this to clear up. While I have only been doing the GAPS diet for a couple of weeks… over a period of months to a year… I have been moving to a diet that had a lot less carbs-which included a lot less wheat. I am fairly convinced that the gluten is what is the issue with me-especially after reading your article and I have so many of these issues but I suppose that there could be something else that I have changed that might account for my improvement. Bone broth or something. I know you cant give individual advice but can you make a general comment on how important or not important actually having the celiac disease diagnosis is… and if people in general should add wheat back into their diet to get a confirming diagnosis or if we should not worry about that and just continue on with what seems to be working.
    Thank you, Sabra

  20. Christine says

    I have graves and had my thyroid removed two years ago. I’m trying to address my thyroid related food issues now, but am unsure how to maintain proper nutrition while respecting my food sensitivities (beef, eggs, lamb, tree nuts, dairy and gluten) while breastfeeding. My 9 week old son is very fussy and I’m wondering if I eliminate my food sensitivities would this help him? Also since I feel pretty limited on hat I can even eat how do I ensure my dietary changes don’t affect my milk supply? Lastly, since I no longer have a thyroid am I will considered a Graves’ disease patient or do I now have something else? Thanks!!

  21. Chris says

    Hi Chris, very interesting and informative site, thanks! I hope you’ll take a minute to answer a couple of questions. I’m 49, male w/hashi’s (since age 33) , taking 75syn and 90 armour/daily. On a lower dose, my labs come out perfect but I feel awful and have all the problems you list, including major fatigue, near constant low blood sugar, significant intestinal blockage, rock hard bloated belly and major joint pain. On the higher dose listed above, I feel well enough and those problems fade nearly completely. I’m on a strict low carb diet (by necessity) and not diabetic. I also am an avid bicyclist and ride about 100 miles per week. My 2 questions are: First ( #1) when I work outside in the sun and modest heat, in short order I get very low blood sugar, below 70, regardless of type or quantity of food intake, candy does not help. Only time fixes it. Second ( #2) I now have tingling feet and hands, which I am now understanding can be a symptom of hashi’s. Is there anything I can do to improve these conditions?

  22. PennyRobinson says

    So, what does a person who has no thyroid do? Mine was removed 7 yrs ago due to thyroid cancer. I take thyroid meds but still feel yuky and have constipation and digestive issues…all the time.

    • Tim says

      Stop the thyroid madness has a website and book

      Or Adrenal fatigue 21st century has a book

      If you have these two and your asking this question then couldn’t help you however if you don’t they are well worthy investments

  23. says

    Very fascinating! I developed hypothyroidism several years ago, when I made the mistake of going on birth control. I have gotten smarter since, came off it, changed my diet, reversed hypothyroidism, but always wondered what damage I might have done long-term to my gut flora. I recently spoke with a specialist who suggested doing a probiotic treatment (a month for every year of birth control use) to restore balance. As I am getting ready to do it ASAP. Meanwhile it made me wonder if thyroid issues and gut health have a lot in common–glad I found your article to confirm my hunch.

  24. Toni Coleman says

    My daughter is GF but not dairy free. We do not worry about cross-contamination, so I can see where we could improve our concerns there. Anyway…she has AIT, but the hyperthyroid type. She is only 8 and so far no palpably enlarged thyroid nor eye involvement. Because she is young, we are not interested in “killing” her thyroid and putting her on thyroid meds the rest of her life. We have been doing biomedical treatments since 2010 so we have been on and off probiotics with no known “visual” benefits, but being that she is 8, I am not sure I would notice (she has never been one to complain of body pain)

    Well, my question is, is there a probiotic you would recommend for her, specific to AIT/hyperthyroid/Graves? I am not exactly looking to improve t4 to t3 conversion LOL unless there is a specific probie that will prevent reverse t3.

    Her other existing issues are: recovering from ASD, anxiety, sound sensitivity, positive thru DD labs for C. Diff and GPL labs indicating dysbiosis (treated on and off with high dose probies, like VSL#3 and Custom Probiotics)

    Thank you for any suggestions. :-)

  25. Marie-Eve says

    Hi,

    It is important for me to thank you for this very interesting site. It gave me explanation to the mystery of my healt problems I am searching for so long! When I was around 16, I started to loose lots of hair and feel cold all the time. At 18, on one extremely ordinary morning, I started to feel extremely cold, anxious, depressed and I started to fall asleep almost anywhere. I always told the doctors that those symptoms were all related but as my thyroid gland exam seemed normal, they just insisted to give me medication for every symptoms (ritalin (for narcolepsy), Paxil, psychologist referral to find imaginary traumas, anti acid for the stomach -nexium…). Everything just went worst and I am 37 now and decided to make my own research and saw the Gapsme site (have lots of digestion problems since childhood) and then I saw your site. I have started a anti candida (have lots of symptoms for that as well!) diet. I red that thyroid problem can often be undetected with the classical test. Because of the normal result exam, doctors refuse to give me the thyroid classical medication and I am now followed by a nathuropath for the bad gut condition. I have always been convinced that there was something wrong with my thyroïd even though doctors are almost laughing at me and deny any relation in my symptoms. Is there natural substances that I can take to help my body produce the thyroid hormones? Is there any substances that does not need a doctors prescription that would help?

    Thanks again for your website, it is extremely useful- a revelation for me! Marie-Eve

  26. Summer says

    I have Been dealing with thyroid issues all f my life. I am 26 and have within the last year figured out sometbing is really wrong with the way I feel. What should be my first step in fixing my thyroid issues. Should I get a blood panel test to see where my levels are and how it’s affecting my hormones or should I go straight to gaps diet? I am big on traditional gods and have started takin fermented cod liver oil, gelatin, coconu oil, grass fed butter and prescript assist probiotics. Also have been brewing kombucha for my gut health. I still feel my blood sugar levels dropping and I get really sick and weak. I feel so miserable like I am dying! I hate it and I’ve had enough!! Please let me know what I should do first.

  27. Linda Shamba says

    I started having problems about 7 years ago, right after my mother passed away and I started pre-menopause. I had such heavy bleeding that it caused anemia. My gyn at the time tried me on several heavy pills that caused my whole body to go out of whack. Long story short…I felt like I was having thyroid & hormonal issues. As for the thyroid, no one would put me on any thyroid meds (until now…too late in my book!) I developed 3 nodules. They continued to grow. I had just about every symptom of hypothyroidism..some sevearly. I developed MS. I went to a neurologist and described all of my symptoms and he sent me to an endochrinologist. This dr. finally put me on synthroid. It was like a miracle. All the things that I had been complaining about went away. For about 6 months that is! I got a sinus infection and had to go on antibiotics. For some reason the antibiotics also had potassium in them, for which I cannot take (IC), so I stopped them about 2 days shy of the dose. A few days later I began having terrible digestion issues. I have had slight IBS before in my life, but nothing like this. Severe bloating, gas, pelvic pain, distension, weight gain (23 lbs in 3 months), water retention. Burping even when drinking water. My endo switched me to Armour, but reduced my dose. My nodules were still growing, so he recommended I have my R side removed, which I did 2 months ago. They would not raise my armour and said my TSH is slightly high. I am still having terrible digestion problems, weight gain, etc. My other levels are all normal, except for my cholesterol is high. I am at my whits end!!!!! Now they say to take estrogen. I do have a history of thyroid disorder (mother). I read not to take estrogen, so now I don’t know what to do. I am now on gluten free diet, whole/clean foods, but only a slight change. I take probiotics and Keifer daily. I really don’t know where to go from here. No one will give me more armour to see if it helps.

    • chris says

      Linda,

      I posted the above question to Chris (I’m a different Chris) .

      I’ve been through much of what you describe. And, I have a suggestion or two. First, I use both Armour/Synthroid. I’m truly useless without the T3 from Armour. The only way my body functions properly is if my TSH is driven down into the 0.0something range, Period! Higher and I have all the classic hypo symptoms.

      Second. I was having a horrible prob with bloated belly, constipation, and so on. Even with regular exercise and strict diet. It was inflammation. What worked was a water fast for 10 days. Then months of fat free, low cal Atkins to get myself (as fast as possible) to my ideal weight. Then lifting weights at the gym 4x/week.

      Is it a cure? Nope. Did it fix my symptoms? Yes! It might not be what you wanted to hear. But inflammation is a monster and left uncontrolled, it ruins your life. I had to take drastic action. And, am I glad I did!

      I now know that I cannot eat anything man made (short of zero carb whey protein after a workout) And, I mean nothing. No man made salad dressing, no bread, crackers, pasta, no cooked veggies, no processed anything. Just smoked fish (in my electric smoker) chix, a touch of lean beef and turkey. Plus dried meats. The reason for this is clear. My body attacks carbs of any sort. Driving insulin levels up, storing it as fat and causing inflammation. There is a clear relationship between stored fat and inflammation. Get rid of it, period! There is a clear relationship between inflammation and all these symptoms. I’d much rather have fewer symptoms, wouldn’t you?

  28. Victor says

    Hi, I’ve been suffering from the following symptoms: chronic constipation, cold intolerance, and a very low immune system making me very susceptible to infections. My magnesium levels are in range but consistently over the past year my lymphocytes and immune system is in the lower borderline( 850-3900). MY TSH and T3 levels are also low, especially my TSH which is significantly low. Please advise me how I can treat this ? I always eat very healthy ( no gluten, no dairy,) and exercise and try to minimize stress.

  29. Andrea says

    Hi There,

    I was wondering if you could recommend good MDs that have an alternative approach or GAPS background who are in the SF Bay area. I am having really bad gallbladder( GB) issues with no relief. Seen docs for the past two years about my GB and they all wanna yank it out. I am not overweight, 34 female and have been on Paleo but yes not diligently which is the problem. If you know of any please let me know… I am searching around myself and appreciate any ideas to start my real healing.

  30. stephanie says

    I’ve been on GAPS for about a year now and only recently have found alot of people saying that they have gotten Thyroid issues from being on GAPS and I’ve done research that says that we need some carbs other then veggies! So is its really harmful to stay off grains and starches? As I feel better staying off them and was going to permanently.

  31. Terry says

    Thanks so much for this! I just found your website. After suffering immensely for the past 15 years with Hashimoto’s, and probably to some extent since my early adolescence, I am finally on GAPS. My daughter, who just turned 15, is starting to suffer from the same symptoms I have had. Now I can help her to break the cycle of disease and live a better life than I have been able to. It is so important that you, and doctors like you, are doing more than just prescribing a pill, and trying to discover the cause of disease. So often I have wondered, “Why me?” Now I begin to have a glimmer of understanding. Thank you!!!

  32. Dave says

    I followed the link to the GAPS diet, and agree with a great deal of the information contained therein. Probiotics, carrot juice, essential fats, etc….

    Can you contrast the diet itself with a vegetarian diet? I am a vegetarian with low thyroid and am on HRT (androgel).

    I avoid gluten, supplement with whey protein, and exercise vigorously 5 days a week. Even with this routine, I still struggle to lose weight.

    Thanks Chris, awesome information you bring!

    (I’m 49)

  33. says

    Chris,

    Thanks for the great website.

    I was diagnosed with Ulcerative Colitis over 12 years ago. Recently I discovered that there may be a real connection to my adrenals. During an appointment with my endocrinologist, he found a large (benign) nodule on my thyroid. So, all the medicine (ASACOL) I’ve been taking for 12 years may not have been addressing the root cause of my condition. I have a good endocrinologist and will be focusing on my adrenals and thyroid once I am tapered off Prednisone.

    Do you have any resources that confirm the connections between UC, the adrenals and thyroid?

    Thanks again. Knowledge is hope.

    Steve
    Scottsdale, AZ

  34. Robin says

    Hi Chris,

    I’m a 40 year old female with a previously active lifestyle. I had a slew of crazy health issues earlier this year– weight gain (25lb in 6 months), fatigue, body aches, GERD, depression, Brian fog, muscle cramps, heavy and horrible periods, PMS, etc. I was convinced that I had hypothyroidism, but all tests looked “normal” except for a lower FT3 and an RT3/FT3 ratio of 18 (pointing to cellular hypo?). I had torn a shoulder muscle the year before and was popping Advil and muscle relaxers all the time. I also had strep throat 6 times that year as well as a UTI and had taken antibiotics each time. I could not catch a break! I ended up going to a integrative MD after the heartburn and stomach pain was beyond what OTC antacids could handle. he ran a stool and blood allergy test. Turns out I had an H. Pylori infection and an unknown parasite– most likely all the Rx’s and Advil created the perfect breeding ground for that to happen. I was given more antibiotics to treat the infection (I wouldn’t if I knew there was an alternative) as well as progesterone cream for estrogen dominance. Things seemed to get better for a short time, but now I have 18 food allergies brought on from leaky gut and I’m still tired and depressed by my lack of energy. I can’t lose the weight no matter what I try– it won’t budge. I’ve cut wheat, whey/casein, eggs (I’m allergic to them all now) and just this last month I’ve cut alcohol completely. Still, no progress! Now I’m doing acupuncture and a series of cleanses. What else should I be trying??? I’m still not convinced that my thyroid is okay, but my dr has kind of thrown up his hands.

  35. Martin Levinson says

    Two days ago i woke up feeling weak and out of it. Took my temperature. It was 93.8. I asked the doctor to take a blood test and my TSH came back at .7. Two months earlier it was 1.0. I’ve been under constant stress for the last three months, not sleeping much, and very agitated. More recently I’ve been very constipated, not peeing much, always hoarse, night sweats, foggy thinking. I suspect with all my agita I may have done a number on my pituitary causing it to stop sending TSH to my thyroid and giving me hypothyroid symptoms. If I am right, is there anything I can do to get my pituitary back to sending proper TSH to the thyroid?

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