Previous research showed that taking an acidic substance (like hydrochloric acid) at the same time as the levothyroxine improved the drug absorption to the bloodstream. That inspired the latest research to investigate the effect of ascorbic acid on decomposition and absorption of the levothyroxine.

It was found that vitamin C improves the oral absorption of the levothyroxine (ref). The results showed that the presence of vitamin C improves the drug absorption. In consequence, the serum concentration of T4 and T3 improves and the serum TSH decreases and normalizes.

However, the patience who participated in this study did not have a celiac disease. Meaning, the damage to the intestines at celiacs (especially in the beginning of the gluten free diet when the intestine is not yet healed) is expected to play a role in malabsorption of the levothyroxine.

The treatment of Hashimoto’s should actually be focused on treating the immune system. Such an overactive immune system that attacks the body’s cells needs to be calmed down. This is important. Some try to improve their health by using ‘superfoods’ but it seems that not everybody understands that ‘superfoods’ are highly functional ingredients. They can stimulate human organism and be beneficial to health but they can also be harmful when used incorrectly, especially for those who already developed some disease(s). Before using ‘superfoods’ it is good to research if the particular ingredient benefits our individual condition.

Literature shows that if the treatment of Hashimoto’s doesn’t direct the immune system but instead only suppresses the symptoms of Hashimoto’s, the immune system will attack other body tissues. The immune system is programmed to protect us. When it sees a threat it attacks. What triggers the imbalanced reaction of the immune system (and an auto attack) is still not fully understood. Recent studies suggest that the ‘leaky gut’ can be one of the reasons. It seems that once such an auto-attack is activated it cannot be stopped. It can however be reduced.

How to soothe the autoimmune reaction

Our immune system has two main arms: Th1 and Th2.
Th1 is responsible for the production of NK cells (natural killer) and T cells (lymphocytes = white blood cells), which are responsible for ‘killing the intruders’, whereas Th2 is responsible for the production of B lymphocytes, which point out the cell that must be destroyed.

Usually, one of the arms is more active than another and a suitable treatment should be adjusted accordingly. To define this, usually the level of cytokines is tested. Cytokines are small proteins used in cells communication, also in communication between the lymphocytes Th (helpers) and the immune system.
Cytokines are a bit like hormones. Too high level of cytokines Th1 or Th2 blocks thyroid receptors and does not allow hormones to enter the cells. This blockage leads to hypothyroidism.

How do we know which cytokines dominate (Th1 or Th2)

Cytokines of Th1:

• IL-2
• IL-12
• TNF alpha
• Interferon

Cytokines of Th2:

• IL-4
• IL-10
• IL-13

Balancing Th1 and Th2

Balance between Th1 and Th2 is essential to improve functioning of thyroid in Hashimoto’s patients. It requires adaptation of a new diet and lifestyle, aimed at calming the immune system.

It is necessary to support and balance the lymphocytes T (regulatory). What helps:

• Vitamine D (the highest safe level)
• EPA/DHA (Omega3)
• Glutathione (ref)

Besides, the weaker arm of the immune system should be stimulated.

Stymulation of Th1 (when Th2 dominates)

• Astragalus
• Echinacea
• Mushrooms’s Beta-glucan
• Mashroom Maitake
• Liquorice
• Melissa

Stymulation of Th2 (when Th1 dominates)

• Caffeine
• Green tea
• Grape seed extract
• Pine bark extract
• Willow bark extract
• Lycopene
• Resveratrol
• Pycnogenol

Modulation of Th1 and Th2

• Probiotics
• Vitamine A
• Vitamine E
• Colostrum

Lowering IL-1*, activation of Th1 and Th2

• Boswellia
• Pancreas enzymes
• Turmeric (Kurkuma)

*IL-1 = cytokines, which play a central role in the regulation of immune and inflammatory responses.

It sounds straightforward. But it seems that it is not that easy to test which arm of the immune system is weaker. Perhaps this is also a reason why it is not commonly practiced (it sounds pricey too). This is why, paying an attention to the body responses is very important. For example, how a person reacts to the stimulants associated with the particular arm, Th1 or Th2.

Also, it seems that in some cases, both arms Th1 and Th2 are equally dominant but the level of the lymphocytes T is low. That means that some antigen is stimulating the immune system. An antigen can be a fungus, virus, heavy metal, pesticides or gluten.

Figures 1-5

[See image gallery at glutenfreelady.nl]

Source: Tluste Zycie (Highly recommended if you can read Polish)

Literature shows that although Hashimoto’s is the most common form of hypothyroidism, it is still often misdiagnosed. The doctors conclude hypothyroidism based on increased level of the hormone TSH in blood and subscribe synthetic thyroid hormone T4. Often, they don’t bother to test the TPO and TG antibodies. Even if they do test the antibodies, the treatment doesn’t change. The cause of our condition is never investigated by the conventional doctors.

But a gland does not just stop functioning properly without any reason. It is a secondary condition. A human body consists of many organs that cooperate and communicate together. Each organ relies on other organs and their performance.  These are strongly affected by our diet, lifestyle, stress level etc.

What causes the low performance of the thyroid?

• A diet of too little calories
• Too intense training
• Not enough of carbohydrates in a diet
• Weaker performance of hypothalamus
• High level of estrogen
• High level of prolactin
• Low level of progesterone
• High level of testosterone at women
• Malnutrition
• Problems with digestion
• Chronic infections
• Diet rich in foods that cause inflammation like gluten, sugar, dairy, alcohol, coffee
• Stress
• High level of homocysteine
• Toxins
• Anemia
• Lack of Hydrochloric acid
• Instable glucose level in blood

The factors listed above influence the thyroid health directly or indirectly. Using a synthetic hormone to fix it might reduce some of the symptoms temporarily but after a couple of weeks the symptoms come back. Inhibition of one symptom does not solve the cause of the problem. In contrary, it leads to further imbalances like:

• If you already have high testosterone, and you start using the synthetic T4 hormone and the contraceptive pill, it results in too high level of estrogen.
• If you have a problem with digestion and thyroid, and you start using the synthetic T4 hormone, you are not improving the absorption of the nutrients nor the intestinal bacterial flora risking impaired conversion of T4 to T3.

Besides, lab results do not show what is really happening on the cellular level. Your TSH, T4 and T3 levels might be ideal while you still experience all the symptoms of Hashimoto’s.

The key to recovery is a good doctor ‘detective’, who looks into the level of TPO and TG antibodies and does not base the entire treatment on level of the TSH just to prescribe ‘suitable’ dose of levothyroxine.

Main source: Tluste Zycie (Highly recommended in you can read Polish)

In the Netherlands if you have celiac disease and Hashimoto’s you will regularly visit two different doctors. Your Hashimoto’s will be controlled by Internist (in Dutch also ‘Internist’) and the celiac will be under supervision of so called ‘Stomach – Intestine – Liver’ specialist (in Dutch ‘Maag- Darm- Lever’, MDL-arts).

Since a lot of the symptoms of Hashimoto’s and celiac are very similar, it took years before my celiac was diagnosed. It happened by a coincident after my Internist diagnosed me with the iron-deficiency anemia. Surprised by the low level of iron, she decided to screen my blood on celiac disease. First, I thought it was exaggeration; I had no suspicions of having celiac. When the results arrived and I received the phone call with the news, I could not believe and decided to run the test again in Poland (my home country). Well, it was positive for the second time.

Symptoms of Hashimoto’s

Most common

• Fatigue (99%)
• Dry, coarse skin (97%)
• Lethargy (91%)
• Eyelid edema (90%)
• Cold intolerance (89%)
• Decreased sweating (89%)
• Pallor of skin (67%)
• Cognitive changes like memory impairment (66%)
• Constipation (61%)
• Weight gain (59%)
• Loss of hair (57%)
• Peripheral (55%)
• Hoarseness (52%)
• Heavy (menorrhagia) or irregular menstrual periods (32%)

Other

• Muscle pain
• Stiff and tender joints, particularly in the hands, feet and knees
• Dry, thinning hair
• Yellowish skin due to inability to convert  beta carotene into vitamin A
• White discoloration of skin especially on upper arms
• Impaired fertility
• Problems getting pregnant
• Giving birth to a baby with birth defects
• Miscarriage
• Decreased libido
• Slowed heart rate
• High cholesterol
• Heart problems
• Shortness of breath
• Recurrent hypoglycemia
• Fluid retention (oedema)
• Swelling of the legs
• Puffy face
• Decreased sense of taste and smell
• Unnatural sleepiness
• Decreased concentration
• Slow though process
• Sluggish reflexes
• Diminish cognition
• Slow motor function
• Drowsiness
• Irritability
• Moodiness

Why some people have more symptoms than others? Check this video to find out the answer.

The thyroid gland makes two thyroid hormones, triiodothyronine (T3) and thyroxine (T4). A nice video’s explaining the thyroid hormones production (video 1) and common thyroid problems (video 2).

Two brain structures (the pituitary gland (fig 2) and the hypothalamus) regulate the thyroid hormones as follows (video 3):

• The hypothalamus prompts the pituitary gland to make a thyroid-stimulating hormone (TSH).
• The pituitary gland checks the amount of T4 and T3 in the blood and releases TSH. If the T4 and T3 levels need to be increased.
• The thyroid gland secretes the needed T4 and T3. The more TSH the thyroid receives, the more T4 and T3 it secretes.
• The pituitary gland may stimulate the thyroid gland to make T4 and T3 but, in the case of Hashimoto’s disease, the thyroid gland can’t deliver them.
• The immune system creates antibodies that attack thyroid tissue. The thyroid gland becomes inflamed and thyroid cells become permanently damaged (can’t make T4 nor T3).
• In response, the pituitary gland secretes more thyroid-secreting hormone (TSH).
• Then the thyroid may enlarge (goitre).

[See image gallery at glutenfreelady.nl]

Hashimoto’s disease is an autoimmune disorder, meaning the body’s immune system attacks its own healthy tissues. The immune system makes antibodies that attack cells in the thyroid and restrict the ability to produce thyroid hormones. Large numbers of white blood cells called lymphocytes accumulate in the thyroid. Lymphocytes make the antibodies that initiate the autoimmune process. Over time, thyroid damage can cause thyroid hormone levels to be too low. This is called an underactive thyroid or hypothyroidism. An underactive thyroid causes every function of the body to slow down, such as heart rate, brain function, and the rate your body turns food into energy.

Consequences of having Hashimoto’s

• abnormal calcium metabolism
• chronic constipation (risk of infection)
• reduced efficiency of the liver and gall bladder (also kidney)
• reduced production of growth hormone
• reduced metabolism and weight gain
• glucose metabolism disorder (slowly enters the cells having symptoms such as “brain fog” and causing hypoglycemia)
• elevated levels of cholesterol and triglycerides
• problems with correct functioning of the brain (mood swings, depression)
• abnormal metabolism of estrogen (this may lead to breast cancer, ovarian cysts)
• disturbed metabolism of adrenal hormones
• deficiency of progesterone and stopping ovulation
• anemia
• increased levels of homocysteine ​​and heart disease risk
• reduced body detox (thyroid hormones affect the phase II of the detox in the liver)
• reduced production of hydrochloric acid and impaired metabolism of proteins