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Diet, Hashimotos and Thyroid removal

I raised this question earlier although a little differently.

Sometime back, during discussions on this forum and my online reading, there was a mention about Gluten being one of the possible causes of Hashimotos. As I had tried a lot of things and nothing was working for me, I went gluten free. I know some people vouch for it but frankly, I did not see any change at all due to this.

So, the root cause of Thyroid Antibodies is due to diet, an inherent issue in the immune system or some changes in thyroid gland that is triggering is not certain.

So, one thing that struck my mind is if anyone with Hashimotos got his/her thyroid removed and the antibody levels went down. If this is the case then diet as the root cause of Hashimotos is highly unlikely.

So, I would like to know if anyone with Hashimotos got their thyroid removed and how they are doing wrt to antibodies and also as a general health.

A note on my interest in this area - I suffer from Hashi. My symptoms keep increasing almost on a weekly basis. I feel I am progressing towards a situation where I may find it hard to do my regular job. So, I am open to even thyroid removal if someone tells me that it is going to improve my symptoms
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1756321 tn?1547095325
Hey barb.  It would be quite interesting to see if you can pinpoint what triggered your condition. The drug nexium causes oxidative stress and oxidative stress plays a major role in the development of autoimmune diseases.

I should of said in my previous answer that those conditions I mentioned "Food Allergy, Crohn's Disease, Celiac Disease, Type 1 Diabetes" are not listed as causes but listed under "Intestinal permeability in various disorders".

You mention intestinal permeability is not recognized by mainstream medicine but the Lancet, which is a mainstream medical journal, has scientific studies published on that condition.


***

"Since the early 1980s evidence has shown that small intestinal permeability abnormalities in untreated coeliac disease as measured by dual-sugar permeability tests return to normal on a gluten-free diet,1 and that permeability changes correlate with intestinal morphology.2 Moreover, permeability can improve despite continued severe small intestinal morphological abnormalities.2"  

- The Lancet - Intestinal permeability in coeliac disease Volume 358, No. 9294, p1729–1730, 17 November 2001

***

Excerpt from Drug Reporter - New Study Highlights Nexium Dangers...

"The research was conducted using a clinically relevant dose range and yielded several salient points:

PPIs hamper acidification and enzyme activity in endothelial lysosomes

Consequently, protein aggregates collect with increased oxidative stress

Long-term Nexium exposure is associated with endothelial dysfunctions with telomere shortening and accelerated senescence"


***

"When an overload of free radicals cannot gradually be destroyed, their accumulation in the body generates a phenomenon called oxidative stress. This process plays a major part in the development of chronic and degenerative illness such as cancer, autoimmune disorders, aging, cataract, rheumatoid arthritis, cardiovascular and neurodegenerative diseases.

The human body has several mechanisms to counteract oxidative stress by producing antioxidants, which are either naturally produced in situ, or externally supplied through foods and/or supplements."

- Free Radicals, Antioxidants in Disease and Health.  Int J Biomed Sci. 2008 Jun; 4(2): 89–96.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Since "Leaky Gut" and Intestinal Permeability are not recognized by mainstream medicine, the tests are not covered by insurance and are very expensive, plus there is no absolute science that proves they show what they say.

The tests and protocols are only accepted by functional medicine doctors or naturopaths that, also, do not accept insurance and are very expensive.  This, too, is because the efficacy of the protocols are mostly anecdotal and can't be proven by science. What studies have been done are very small and not always well done.  

Neither can a cure or remission for Hashimoto's.  Those whose antibodies go into "remission" may very will find that they ramp up again, later, for no apparent reason, unless the thyroid has been destroyed.  

I've searched and searched and can not find any connection between Nexium or any other PPI as a cause for Hashimoto's.  It's a well known fact that many people with hypothyroidism have acid reflux and resort to products such as Nexium or other PPI's to reduce acid, when instead they need "more" acid, not less.  If you could post a link to a scientific paper, that would be great as I'd love to see a connection, since I took a PPI for years just prior to being diagnosed with hypothyroidism/Hashimoto's... I've had no problem posting links as long as it's not a competing site...
Helpful - 0
1756321 tn?1547095325
Sorry about the double up. Medhelp smh lol
Helpful - 0
1756321 tn?1547095325
There is a sugar molecule test -  lactulose and mannitol ratio - for intestinal permeability aka leaky gut.  Conditions listed to cause intestinal permeability from the Journal of Neurogastroenterology and Motility's article "Techniques of Functional and Motility Test: How to Perform and Interpret Intestinal Permeability" are: Food Allergy, Crohn's Disease, Celiac Disease, Type 1 Diabetes.
Helpful - 0
1756321 tn?1547095325
"The Intestinal Permeability Assessment gastrointestinal test directly measures the ability of two non-metabolized sugar molecules to permeate the intestinal mucosa. The patient drinks a premeasured amount of lactulose and mannitol. The degree of intestinal permeability or malabsorption is reflected in the levels of the two sugars recovered in a urine sample collected over the next 6 hours." - Geneva Diagnostics
Helpful - 0
1756321 tn?1547095325
My mother developed Hashimoto's thyroiditis after taking nexium (acid lowering drug). This drug caused oxidative stress! Her Hashi's went into remission eventually after stopping nexium. I found out that oxidative stress does a number on TPOAb. My TPOAb rose from 470 to 1900 during my year of hyperthyroidism. My stomach acid depleted and my antioxidant levels were low. Antioxidants fight free radicals (reactive oxygen species). Just to add, when my mother and I started eating brazil nuts (high in selenium) our TPOAb dropped 80 IU. Not bad really considering we had other oxidative stress issues. :)

Medscape - Selenium and the Thyroid Gland...

"Most authors attribute the effect of supplementation on the immune system to the regulation of the production of reactive oxygen species and their metabolites.  In patients with Hashimoto's disease and in pregnant women with anti-TPO antibodies, selenium supplementation decreases anti-thyroid antibody levels and improves the ultrasound structure of the thyroid gland."

An excerpt from the article "What thyroid patients should know about Oxidative Stress"...

"Some Causes of oxidative stress

There are quite a few situations mentioned in articles and studies which can cause your body to be overly stressed from the results of oxidation and all the reactive oxygen species. They include, but are not limited to:

excess endurance exercising
excess weight lifting
lack of key antioxidant nutrients like Vitamin C, Vitamin E, Selenium, Magnesium and other minerals
excess radiation or sunlight
smoking (huge cause of oxidative stress)
excessive drinking or drug use
over-exposure to toxins in our air, water and foods like pesticides, chemicals, heavy metals and more
prescription medications
processed foods with all their artificial dyes, additives or flavorings
excess physical trauma
Graves disease aka hyperthyroidism
excess copper levels from the MTHFR defect"
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Antibodies attack thyroid components... The thyroid is always the target of the antibodies, so when the thyroid is destroyed, there's nothing left for the antibodies to attack.  For some reason, something causes the body to determine that the thyroid is "foreign" and it produces the antibodies to attack and destroy it... Nobody knows exactly what that is, at this point.

There is NO concrete science that says gluten molecules so closely resemble thyroid tissue that antibodies attack gluten thinking it's thyroid or that gluten has anything to do with causing Hashimoto's.  There's, also, no proof that once the thyroid is removed, antibodies would continue to attack gluten molecules.

There's also no recognized condition called "leaky gut", other than what I described above, where the colon actually gets a hole in it and that's a life threatening condition that requires immediate medical care.  This is why functional medicine doctors are leaning away from the term "leaky gut" and moving toward the term "intestinal permeability".  

There is no blood test to prove that molecules escape the gut and get into the blood, because there's no proof that this actually happens.

Science is beginning to back up the importance of the gut as it relates to inflammation throughout the body, but it does not back up the role of gluten (or any particular food) as a cause for Hashimoto's, nor does it back up "leaky gut" or "intestinal permeability" as the cause. However, we know there are a lot of things that trigger Hashimoto's, so perhaps an allergy could possibly do it. It's just that not everyone has the same allergy... Isabella Wentz is very careful to point out that everyone may have a different "root cause" for their Hashimoto's or they may have a variety of root causes.  The biggest thing I disagree with her on is that Hashimoto's can be reversed - maybe it can for a short time, if antibody counts can be lowered temporarily via the use of selenium or something, but there are no studies that say reversal is long term or can be cured.
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1 Comments
>There is no blood test to prove that >molecules escape the gut and get >into the blood, because there's no >proof that this actually happens.

I would think the other way. In order to prove this theory, one has to measure constituents of blood and look for components other than RBC, WBC blood + other regular cells
649848 tn?1534633700
COMMUNITY LEADER
Hi sharanbr...  When we discussed this before, it was noted that the science has not proven the claims that gluten "causes" Hashimoto's.  There are some people that have a problem with gluten, but not everyone does.  

There are any number of things that can trigger an autoimmune condition.  Everyone is different and we all have different triggers.  For one, it might be diet related; for another, an autoimmune might be triggered by a virus - for instance, my son's Type I Diabetes was triggered by a severe case of strep throat when he was 10 yrs old.  For others, it may be environmental.  There have been links made to stopping smoking and hypothyroidism/Hashimoto's... I stopped smoking in mid 2007 and began having symptoms of hypothroidism shortly after that... was that a trigger?  I don't know.  

It's my own opinion and studies are beginning to show that the gut is, in some ways, responsible for many, if not most, of our inflammation, though finding the link is not the least bit easy, as I, personally, have found out.  The gut is affected by, both, internal and external stimuli, and like so many areas, there can actually be more than one issue at play, but doctors tend to hone in on one aspect and don't look at the full picture.  In my case, they concentrated on H. Pylori, but haven't taken food sensitivities into account.  I was treated for H. Pylori, but have since realized that there are some foods that cause distress, as well.

My point is:  just because you eliminated gluten, doesn't mean you eliminated "all" the food triggers you might have... did you do a full elimination diet? Did you eliminate soy, dairy, eggs, nuts, seeds, etc?  I thought I had a problem with flour products, but it turns out I can eat "some" products with flour and not others, so is my problem yeast, instead of flour?  I haven't figured it out yet... I've also switched to more organic type foods, which eliminates a lot of chemicals and seems to help, as well.

Once the thyroid is removed, antibodies would go into remission, because there is nothing left for them to attack. We've had some members who had their thyroid removed... some are doing well, others do not do well.  That's partially because it's not necessarily the antibodies that are causing the trouble; they may contribute to some inflammation, but it's other things that are causing the majority of your symptoms.  Most often, it's a matter of having thyroid hormones, along with vitamin/minerals at optimal levels.  Of course, a good diet and exercise are always necessary, along with finding those foods or other products (may be personal care, cleaning, laundry or other products) that may be contributing to/triggering inflammation.

I think I've noted before that antibodies will also go into remission once the thyroid "dies off", which is part of the natural process of Hashimoto's.  Thyroid removal for Hashimoto's is not usually done, except in cases of cancer or when nodules are causing interference with swallowing, breathing or other issues.

You may have read or watched the series of videos by Pharmacist Isabella Wentz, which may be where you're getting some, if not a lot, of your information.  If so, you know that simply picking one item, such as gluten, to be the culprit will leave you disappointed.  If you haven't read Dr Wentz's blogs or seen her videos I might suggest you do so, because there's some good information; however, as I noted previously, the science, simply isn't there to prove conclusively that gluten or any other food is the cause of Hashimoto's or any autoimmune condition.  

Conventional medicine, at this point, does not recognize a condition called "leaky gut", except as a very serious, life threatening condition in which the colon actually gets a hole in it.  Dr Wentz and others like her, have now switched to the term "intestinal permeability", which carries, slightly, more credibility, but is still not widely accepted...
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1 Comments
Barb,

Thanks. I have a few of follow-up questions and comments.

You mentioned that once thyroid is removed there is nothing to attack and hence antibodies drop down. But if you go by diet theory then the trigger is actually diet and not thyroid gland itself. They propose that certain food have similarities with thyroid composition and antibodies are for that in response to that. So, removing thyroid with no change in diet so never reduce antibodies if diet is the cause. In other words, if someone's thyroid is removed and his antibodies come down then definitely diet cannot be the issue, at least for this subset of people. your thoughts?

If gluten causes leaky gut then there has to be some way to measure this. For example, if food particles leak into blood stream, why can't these be measured through simple blood test. We routinely check for so many type of cells, bacteria, virus in our blood. So, this should also be do-able?

I am somehow not very convinced about leaky gut because there is no scientific study while, to me, it looks it should be possible to prove that people do have leaky gut due to certain diet intake. Your thoughts?
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649848 tn?1534633700
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