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.
Well crap. According to Dr. Haskell Armour actually causes an autoimmune response...that's a problem since that's what I'm currently taking. I suppose I should really get my antibodies tested at least once to make sure Hashimoto's is what's causing my hypothyroid, and then find myself a doc who will prescribe the compounded T3/T4. Thank you so much for the link to his site! I look forward to hearing about your results with his protocols.
ReplyDeleteThat Dr. Datis Kharazzian guy seems a little sketchy to me. I thought about getting his book but after reading some of the 1 star reviews on amazon; I wonder if he's just pushing his own special supplements. Maybe I should get it though, to find out more about th1 and th2.
Yes, I think so too, you need to see about those antibodies... If it is not Hashimoto's, you can safely stay on Armour, I hear so many people swearing on it. The only reason I didn't insist on trying it myself was Dr. Haskell's remark that it might fuel the autoimmune fire.
ReplyDeleteHowever, I am a bit worried that I might be one of those for him levothyroxine causes hair loss. That is why I feel tempted to risk it and get Armour. If I see serious hair loss, I will, antibodies or no antibodies...
But I have yet to find someone to prescribe me T3, doctors don't really do it here. It is not clear to me how important it is to that protocol. Also, that heavy metal chelator he mentions, I have yet to find a source.
I don't know what to say about Dr. K, he did not convince me 100% when I read him. I mean, it takes a leap of faith to believe in that "balancing act". Why would balanced Th1 and Th2 act differently than when they are not balanced? They have different jobs to do and the numbers and proportions in which they develop to do them are required by their respective jobs. If there are more firemen where a building is on fire, why should we also call for the police or the marines to "balance them out"? That's what I remember thinking when I read his book.
Plus, I have yet to find someone willing to do that extensive immune system panel. I got halfway there, I convinced them at a sophisticated science lab in Romania to do it for me, but it was not complete, and they said that I was the first person to ever request the Th1 to Th2 ratios. That was something they did only in the process of scientific research. So, I don't know, if you are in the States and have access to that kind of stuff, AND Dr. Kharazzian's theory seems OK to you, maybe you should give it a try. Meanwhile, the Haskell attempt seems much easier, and if that works, why bother with the "obscure" Th1 and Th2?
"for him"="for whom". The comment form makes it really unpleasant to check one's draft, and then there is no possibility to fix typos and grammar. :(
ReplyDeleteLove the fireman analogy. If fact I really love your whole writing style... no worries about the spelling error at all.
ReplyDeleteI didn't know levothyroxine can cause hair loss. Perhaps you could try getting Cynoplus (contains T4 and T3) and Cynomel (T3 only) from www.mymexicandrugstore.mx. My understanding is that both are needed for his protocol. I'm hoping to find the compounded sublingual forms since I'm not real confident in my gut's ability to absorb properly.
The Th1 and Th2 balance is a bit confusing to me. Although, I did come across a couple articles that explain it pretty well: http://www.drkaslow.com/html/immune_restoration.html
http://www.anapsid.org/cnd/diagnosis/cheneyis.html.
(sorry, I don't know the html code to make hyperlinks)
I could get the test from a place in Miami, FL but it's $350 plus overnight shipping of the blood sample. I'll have to get a bit more familiar with the whole Th1, Th2, cytokine relationship before I make that investment. And like you said, there are other approaches that seem easier.
Thank you for the excellent links, GuavaGirl! And you're too kind about my writing style!
DeleteOK, so if I understand correctly:
Th1 works inside the cells, dealing with viruses, yeast, cancer and intracellular bacteria. It MAY BE responsible for killing thyroid cells.
Th2 works outside the cells, responding to toxins, allergens, normal bacteria and parasites. It is also responsible for creating antibodies, cleaning up after Th1’s killing of innocent cells. Now, if antibodies kill cells, like other scientists and most of our doctors seem to think, well then, Th1 needs to be exonerated and we need less Th2 in our lives.
Of course a balance is desirable, you don’t want Th1 to kill more cells than Th2 can clean up. But… You don’t want Th1 to kill any thyroid cells, to begin with! Or, if Th2 is the culprit, you don’t want them kill thyroid cells, so why worry about Th1 at all? Let them be. They’ll increase when they are needed.
So, I still don’t get the need to balance Th1 and Th2 in and of themselves.
My immune phenotype showed a "functional" decrease of B cells — they’re the guys who make antibodies. They looked like an infection had just depleted them. I had had no infections at the time I did that checkup, only high Anti-TPOs, Anti-TGOs and Anti-Gliadins. Anti-dsDNA, as well. My immune system had depleted itself fighting its ghosts. I still don’t know what was going on. Meanwhile, the Anti-dsDNA disappeared, and the others had calmed down considerably. Then, the ear infections occurred and now I have high Anti-TGOs, right back. So, my Th2 has been in overdrive for a while now. It might need support. I certainly don’t see how increasing Th1 might help.
Maybe that’s what Dr. Kharazzian meant by balancing? You increase the one which fought the most and had the most casualties, so to speak? That would make sense. But then, if Th2 did the killing, why replenish the killer reservoir?
Can he have made so little sense or am I making things up here? :) I’ll have to pick up that book again, it’s been a while. I remember liking the part where he differentiates autoimmunity from hypothyroidism, and then failing to be convinced by his explanations, the need for that expensive test and the closed circuit supplement providers.
What do you think about Wilson's Syndrome? I am very tempted to try that one out as well, maybe even before I try Haskell's system. I hope my T3 will make it these days, it has been over a month since I ordered it from mymexicandrugstore...
My comments disappeared :( N
ReplyDeleteI'm not sure what happened there -- I moderate comments, but I have published every comment I received so far... Sorry!
ReplyDeleteAttempting to balance the Th1 and Th2 seems like risky business. So far from what I've read, they can fluctuate wildly, and unless you get regular blood tests you'll never really know if your efforts are having an effect. Your summary sounds about right though. I still have to do some more reading though before I feel like I grasp it completely; I've been working overtime so I haven't had the time.
ReplyDeleteMaybe I'll look into Dr. Kharazzian's book as well. It's just a huge turn off that one has to use his supplements and his doctors.
As for Dr. Haskell, he seems to be the only one with the theory that hypothyroid is the cause of Hashimoto's, not the other way around. So I'm hoping I get some time soon to look into the whole antibodies thing some more.
As for Wilson's syndrome, I do believe that increasing temp will improve hypothyroid, as long as you can keep it up continuously. I don't really think one can "reset" their hypothalamus to make that happen though. Although, this guy has and interesting theory in the topic:
http://fixlowbodytemp.com/
Also, here's a forum on the topic:
http://bodytemp.eu/
I do know that being cold can be a trigger for an autoimmune attack. I have Raynaud's syndrome and cold is one and only trigger for it. So for me keep body temp is important. It would seem logical to think that cold could also be triggering Hashimoto's. I think low body temp is both a symptom and a cause of hypothyroid. Plus, being cold places stress on the body, enacting a whole cascade of stress response processes. So there is definitely value in keeping body temp up, by whatever means possible; hot showers, warm clothes, stimulating foods, increase metabolism, etc.
Sorry to hear about your problems getting T4. There are some non-prescription desiccated thyroid products which may help you, there listed on this page:
http://www.stopthethyroidmadness.com/natural-thyroid-101/