What Kills A Thyroid Gland?

Today is International Thyroid Awareness Day.

I am celebrating by posting a few thoughts on the current views of Hashimoto's Thyroiditis.

Many people out there will tell you that autoimmune thyroiditis comes from the thyroid gland being attacked by antibodies. People measure those and try to evaluate their degree of thyroid health by them.

My endocrinologist advised me to stop measuring those things. "Once you have them, they're there for life. Genetics plays a big role. At some point, a stress related event may have triggered them and they would exist in your body, once in a while getting to your thyroid, until they destroy it and render it incapable of doing its job". So, according to her, there is no way to go but down and measuring antibodies levels is not constructive or conducive to any worthwhile conclusions. I have to admit, despite my continuing efforts and gluten free diet, the results of my own lab tests indicate she might have a point... Unfortunately...

Dr. Datis Kharazzian, who has a best selling book on Hashimoto's, thinks one can balance the immune system and thus stop the killing of the thyroid. He says Th1 and Th2 cells are out of balance in Hashimoto's and that all the patient has to do is bring them back into the desired equilibrium. He offers combinations of nutrients that would boost either Th1 or Th2.

Dimitry Chistiacov's study, "Immunogenetics of Hashimoto's thyroiditis", published in the "Journal of Autoimmune Diseases" in March, 2005, seems to indicate that it is only the Th1 cells that are to blame for the said destruction. So, if you believe in Dr. Kharazzian's balancing of the immune system you may combine it with the results of this study and go for increasing Th2 right off the bat.

Dr. Alexander Haskell (link to the right) thinks that autoantibodies (Anti-TPO and Anti-TGO) are not the culprits in this scenario. He says they are simply there to clean the thyroid cell debris and that lack of specific nutrients is the culprit for the destruction that does occur at the thyroid gland level. He isolates iodine among those and this has caused some serious rebuttals of his vision (as iodine deficiency is hardly a problem in the US.) If he hadn't emphasize iodine, his theory would have actually sounded a lot more credible - and it is my favorite, still...

Like Dr. Haskell, Ray Peat does not believe in "autoimmune diseases" and the body's feasting on itself via antibodies, like those described above. He thinks that the thyroid does get destroyed (like many other organs) and that this is a process of degeneration, a result of insufficient supply of energy at the cell level. A nutrition blunder, if you will.

His view is consistent with the symptoms I have had after my Paleo time -- and, apparently, more and more people come out of their low carb experiments with damaged thyroid glands.

But let us go back to D. Chistiacov's study mentioned above, from which I have stolen the graphic above (I am giving it back if there are any complaints). His description of how things go wrong in Hashimoto's is representative for the scientific community's viewpoint. Indeed, my own doctor told me about the "strong genetic component" to Hashimoto's, to which environmental triggers are added.

Incorrect nutrition is not considered a factor in this study. However, infection and pregnancy are...

A key phrase in D. Chistiacov's paper remains:

 "The mechanisms, whereby autoreactive T cells escape deletion and anergy, and become activated, remain uncertain. "

This leaves the field still open to many interpretations, in my mind, including that of Dr. Peat and Dr. Haskell -- that the said breakdowns of cells are primarily caused by issues other than our own cells gone crazy and that we can stop or even reverse that destruction through a combination of nutrition, lifestyle and supplementation. I will attempt in full Dr. Haskell's protocol (described in his video series) once I have the necessary ingredients and let you know how it goes.

Perfect 10 Progesterone & Other Curious Findings

I finished reading Dr. Raymond Peat’s book “From PMS to Menopause. Female Hormones In Context” and I am now (re)reading the articles collected in "Nutrition For Women". I will soon write review those. For now, I will just comment on my test results.

In his book, Ray Peat recommends a ratio from five to ten times more progesterone than estrogen in serum levels. He does, on several occasions, mention the possibility of progesterone’s turning into “other hormones”, but he never takes this idea to its full consequence, namely, natural progesterone's possible final transformation into Public Enemy No. 1, estrogen. I think that, sooner or later, he should address this, because it is an important part of the hormonal equation, one that has not received the necessary focus up to now.

Drum rolls, please, as my progesterone levels were exactly TEN TIMES the amount of my estrogen, many weeks after my short Progest-E experiment, when I felt things had returned back to normal. Not five, not six, not seven... Perfect 10 me! 

(So, well, I was right all along, and those who tried to tell me my symptoms stemmed from a potential “liver issue” better learn that their imaginary knowledge of how hormones can affect one would be best not shared out there. Also, if a woman describes previously non-existent symptoms of estrogen and cortisol spikes after taking natural progesterone, you can believe her, although Dr. Peat and other proponents of natural progesterone never explicitly discuss the possibility.)

I also had good levels of DHEAs. I am sorry I didn't check my pregnenolone, I forgot, but I soon will.

Now, for the thyroid part of my labs: despite supplementation of 50 mcg of T4 for almost a month, my levels of T3 and T4 are only slightly changed. That is, T3 decreased a tiny bit, but it was already in mid-range, from 2.55 to 2.43, in a range of 1.71-3.71 pg/ml. T4 went from 13.4 to 13.52 in a range of 12-22 pmol/l, so it’s still lagging towards the lower part of the admissible spectrum, Levothyroxine or no Levothyroxine. TSH was the only one that took a spectacular dive, from 5.21 to 1.90, on range of 0.21 to 4.60 mui/l. This made my GP happy, albeit a bit mistrusting of the Romanian labs, so I will repeat them here in two weeks or so. I wanted to move up to 75 mcg of T4, but she said that would not be warranted and that raising my metabolism was not what she had in mind, to begin with — just getting rid of the TSH, while settling in the thyroid range my body chooses, as long as that is within what is considered normal.

I can understand her wish to tamper with key metabolic things as little as possible. However, if I ever receive my T3 supplements (I ordered them online at mymexicandrugstore.mx), I will try to supplement a little bit of that and see how I feel.

For the bad news of the day, after one year of constant and considerable decline, my TPO antibodies rose again, from 535 to 731 (normal: below 5.61!) The TGO antibodies have decreased (could this be due to the Anatabloc supplementation?) and are now within acceptable limits — but they were never that high to begin with (from 4.25 to 3.52, they should be below 4.11.)

Anyway, I do feel better with this (loosely) Peatian diet and the little T4 I am taking. I have more zest for life, more energy and my circadian rhythms are excellent — at night, there is this magnificent tired feeling, like when I was a child and I would drop in the evening, brain foggy, muscles tired, to only wake up in the morning, refreshed and ready to take on a new day. This is in itself a superb achievement and might bring with it a lot of good.

Let me not forget my “pre-diabetic” story. It turns out one should never buy cheap blood sugar monitors. After so much worrying about it, the serum glucose lab test revealed a nice 84 in a range of 60 to 105 mg/dl. My home measurement that morning: over 110. So I stopped DIY-ing in this department. 

Heart: curiously high diastolic pressure, more often than not, and a puny pulse pressure.

You can see from the upper part of the graph above that I am trying my hardest to push my calories intake and my body reacts, by packing on pounds. I fight back by reducing calories, only to start again pushing my luck. I am curious if I changed anything after all this effort, if I went past 1600 calories a day while maintaining my weight -- I shall soon check on Cronometer. 

And finally, in the ears department: another infection, this time in the right ear. I took cyprofloxacine. The otolaryngologist said I should maybe consider a CT scan or an X-ray. I said no way. She insisted, maybe at least an ultrasound? I already did that and they found nothing, just some inflamed lymph nodes. She still seemed worried. I told her about my progesterone and pregnenolone supplementation and the ear pains and now the repetitive infections — she said she would not be surprised if those played a role, because the ears are lined with mucous tissue and they react to hormones.

Dr. C.I. Parhon: A True Pioneer of Endocrinology

I decided to take a short trip to Romania and visit my father. He is doing great, no health issues whatsoever -- I am so proud of him!

I wanted to take advantage of being in Bucharest to check in with the endocrinologist who diagnosed my Hashimoto's last year, maybe discuss my current treatment options with her, but she was on a maternal leave.

As I was trying to find a good alternative, I made a fabulous discovery: there is an entire hospital attached to an institute devoted to endocrinology in Bucharest! The National Institute of Endocrinology was founded in 1946 by Dr. Constantin I. Parhon, who wrote, with Moise Goldstein, the very first treaty of endocrinology, over 800 pages, published in French, in 1909!

There are 42 medical doctors specializing in endocrinology working at the hospital which can host 400 patients. There is a research facility as well, which just got 10 million euros in funding, so things look quite promising... Maybe Dr. Ray Peat should be invited to test some of his theories?

The incredible Dr. Parhon also became the first president of Romania, when the King was forced to abdicate! How about THAT?

Dr. Parhon's fabulous accomplishments include founding yet another hospital, dedicated to old people this time, the first Geriatrics Hospital in the world -- as Parhon considered old age more of a disease than a natural state.

Parhon appointed a woman as director of this Institute of Gerontology and Geriatrics, presumably a former student and follower of his, Dr. Ana Aslan.   She went on to develop a line of youth promoting products that attracted quite a following (A. Onassis, J. Kennedy were among her clients). I think I will try to get a hold of these patented products, "the first medicine designed to delay human aging processes".  And I am in the process of locating a copy of Dr. Parhon's book "Old Age and Its Treatment".

I almost feel grateful to my Hashimoto's for enlarging my horizon... Um... Not really.

I figured there must be some pretty impressive endocrinologists in Bucharest, with such an outstanding school behind them, so I pursued my research.

I scheduled an appointment with none other than the Head of the Romanian Society of Endocrinology, Dr. Mihai Coculescu, whose impressive list of publications on PubMed and whose views on thyroid and estrogen went straight to my heart.  I'm thinking I should bring him Dr. Peat's books, maybe something develops... It would be worthwhile to see Dr. Peat invited to one of these mainstream congresses of endocrinologists. Anyway, the RSE publishes Acta Endocrinologica since...1938. It also publishes "The Romanian Journal of Diabetes, Nutrition and Metabolic Diseases".

I bought for five dollars, from the selection of a street vendor in Bucharest, "Clinical Endocrinology", published in 1976, authored by two of Parhon's collaborators, Stefan Milcu and Marcela Pitis, to which Dr. Coculescu, back then a young research assistant, is listed as a top contributor.

Here is Dr. Coculescu, delivering a speech at the Romanian Academy (in Romanian):

He talks about another illustrious Romanian endocrinologist I knew nothing about, Dr. Paulescu, who first discovered insulin, in 1921.  Dr. Paulescu is a controversial figure because of his antisemitic views.  Many claim that he was robbed of his Nobel prize.

Dr. Parhon is not much talked about in Romania nowadays because he was a communist. I guess Dr. Parhon was either inspired, or a student of Dr. Paulescu's. As Dr. Parhon was openly opposing antisemitism, his relationship with Paulescu must have been at least strained. Fascinating...

Back to 2013: confident that Romania boasts a mighty tradition of endocrinology, I crowned my stay in sunny Bucharest with another doctor's visit and a panel of brand new blood tests, of which I might soon write.