Gut-Thyroid Connection – Connecting the Dots
So you are sure you have a thyroid problem, after all you have every symptom on every list on every website you can find. You are fatigued, you’re losing hair, gaining weight, have bloating and cramping and you just can’t get out of bed in the morning. Sound familiar?
So you go to your doctor, get your thyroid prescription because you have a high TSH and take it excitedly ready to wake up tomorrow morning with so much energy that nothing can bring you down! But after you take it the first day…. you still feel tired. Maybe it takes some time to kick in, so you wait a few more days…. but unfortunately it doesn’t seem to be working. Not only are you tired, you haven’t lost 10 lbs. in a week and you still feel irritable and your digestion isn’t any better.
You go back to the doctor and say that you think you might need a higher dose because you feel a tiny bit better but not good enough. They give you a higher dose and run your labs again. Your previously elevated TSH comes back normal and you are told to stay on the medication and return in 6 months. As time goes by, nothing changes.
Does this sound like you? This is the case for far too many people. In fact I would venture to say it’s the case for the majority of people. Their TSH normalizes, but they don’t feel much better. Who cares about TSH if you are exhausted, right?
The reason this happens so frequently is because the thyroid malfunctions much less frequently than people believe. The number of thyroid conditions has been increasing and it seems that traditional medicine has no answer.
I feel the biggest reason for this is because the thyroid is a multi-systems organ. Yes, that term is new and I just officially coined itJ
What does that mean? It means that the thyroid is one of the many organs in the body that is not really a master to its self. It acts more like a servant to other masters. It has very little power to act on its own and really just follows instructions from the brain and the brain is often fooled.
The most common reason I see the brain get fooled is due to alterations in normal gut metabolism. Yes, that is right, I think the most common reason someone has a thyroid problem at this current time in history is because they have a gut problem.
One of the things that is important to understand is that the gut microorganisms are beneficial to the human body. They do a lot of the processing of nutrients and breaking down of food so that we can properly absorb nutrients. At the same time, the gut flora themselves need nutrients to stay alive themselves. Certain organisms like fungi and certain bacteria thrive on sugars and carbohydrates while others live on fats and other minerals. When these microbes aren’t in balance, it affects the nutrients that you get.
Two specific nutrients related to the thyroid that can be altered are selenium and iodine. If you have inflammation, dysbiosis or SIBO then the absorption of these nutrients can be altered. As your gut gets healthier, the absorption of these nutrients improve and can properly supply the thyroid with the needed nutrients.
The Gut and Conversion of Inactive T4 to Active T3
Probably one of the most commonly missed factors related to thyroid health is the conversion of T4 to T3. T3 is the active form and is what provides the most feedback correlated to your TSH which is most commonly measured. Conversion of T4 to T3 is inhibited by many processes, but the gut is a major culprit both directly and indirectly in its conversion.
About 20% of T4 in your body is directly converted by the “good” bacteria in your gut. How many people would like 20% more energy? Most people if they had 20% more energy wouldn’t even go see the doctor. So this is a critical step, but it there is more.
In the liver where 60% of your T4 is converted to active T3, there is an enzyme call 5’-deiodinase (5-d) that is responsible for converting T4 to T3. When you have a leaky gut, small bacterial particles called endotoxins are released into your blood stream and decrease the ability of 5-d to be able to convert T4 to T3. As of now there aren’t any studies determining how much the decrease, but another 5-10% decrease in conversion is significant.
Lastly when you have leaky gut, it promotes the development of autoimmunity. Autoimmune thyroid disorders are definitely on the rise and once you develop an autoimmune thyroid disorder it doesn’t go away. The most common autoimmune thyroid disorder is Hashimoto’s which accounts for approximately 90% of thyroid autoimmune conditions. What this means is that your thyroid is under attack from your own immune system. This is associated with leaky gut and molecular mimicry (usually associated with a food) that tricks your body into attacking your own thyroid.
Healing the gut does not reverse what it created but it does allow the immune system to calm down and stop attacking your thyroid. The longer you have an autoimmune condition that you don’t treat, the more likely you will develop true thyroid problems. So getting to the root of your autoimmunity early is critical.
Constipation and your Thyroid
The time it takes for food to go in to your mouth and then come out the other end we call transit time. Transit time that is slow (constipation) creates some problems in estrogen clearance. You see the liver is responsible for binding estrogen and then releasing it into the bowels in order to be eliminated in your next stool. The catch is when these bound estrogens spend too much time in the bowels, certain organisms are able to undo the work which the liver has done and release estrogen back into circulation. Essentially instead of eliminating estrogen properly you recycle it and your estrogen levels continue to rise. The rise in estrogen increases something called TBG (thyroid binding globulin). This excess TBG binds to your active T3 hormone and makes it unusable for energy.
What makes this worse is that with the T3 wrapped up by TBG, it slows down the liver. The liver can process less estrogen and the already elevated estrogen gets even higher. This is also why added estrogens in the form of hormone replacement therapy or birth control pills often cause weight gain.
Side Note: Based on my clinical observations and patient experiences, estrogen lab testing is currently inaccurate and unreliable. Many patient show up with “low estrogen” on blood lab work and still have extremely high levels of estrogen. Instead of blindly following a lab test, you must assess whether you have symptoms of estrogen dominance and proceed accordingly.
So if you think you have a thyroid problem or you started on thyroid medication and don’t feel any different, then I recommend you start looking at the gut. Finding a competent gut doctor can be difficult, so I would recommend starting with my ebook on a healthy gut and then looking further into finding someone to help you restore your gut and get your thyroid, energy and life back on track.