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Thyroid health is critically important. The thyroid gland—which makes and secretes hormones that regulate metabolism—influences cells, tissues and organs throughout the body. As one thyroid expert puts it, “Without your thyroid, you’d wind down like a child’s toy.”1
Unfortunately, in the modern era the small but mighty thyroid gland—and the entire endocrine system of which it is a part—are under attack from many directions. An estimated twenty million Americans suffer from some type of disorder that affects the thyroid, with women far more likely (five to eight times) than men to have thyroid problems. According to the American Thyroid Association, more than 12 percent of the U.S. population will develop a thyroid condition in their lifetime.2 Even so, many conventional health care workers fail to recognize and accurately diagnose thyroid problems.
Eight out of ten individuals with a thyroid disorder have an underactive thyroid (hypothyroidism). Most often, this will be Hashimoto’s thyroiditis, an autoimmune condition in which the immune system attacks (and eventually incapacitates) the thyroid as if it were an enemy. Hashimoto’s is on the rise but is already the most common autoimmune disease in the U.S., prompting massive sales of synthetic thyroid hormones.3 Thyroid authority Raphael Kellman makes the important point that Hashimoto’s actually is not a thyroid disease but rather “an autoimmune disease that affects the thyroid.”4
Based on years of clinical observation, Dr. Robert Thompson, author of The Calcium Lie,5 has developed five distinct categories of hypothyroidism that illustrate the many different ways that thyroid health can go awry. (He admits that “the medical profession does not generally recognize them thus far.”1) They include:
- Type 1 (the failure to produce sufficient thyroid hormones)
• Type 2 (thyroid hormone resistance, where the body is unable to recognize or use the thyroid hormones that it produces)
• Type 3 (autoimmune thyroid disease, including Hashimoto’s)
• Type 4 (severe selenium deficiency)
• Type 5 (Wilson’s Thyroid Syndrome).6
According to Dr. Thompson, the five types are not necessarily mutually exclusive.
For virtually all of these thyroid-related conditions, dietary and environmental factors are major parts of the problem.7 Aspects of modern life that are contributing to thyroid disease include the Standard American high-soy, lowfat and fat-soluble-vitamin-deficient diet; iodine imbalances;8 and exposure to toxic substances,9 notably fluoride.10 Diet and detoxification should, therefore, represent critical elements of any solution. As holistic nutritionist Dr. Ronda Nelson states, “Don’t fix your thyroid, feed it!”11
A singular feature of the modern American diet is its reliance on and love affair with myriad forms of cheap industrially processed soy. As Michael Pollan has observed, “A food scientist can construct just about any processed food he or she can dream up” with soy (as well as corn and “a handful of synthetic additives”).12
Long-time Wise Traditions readers will know, however, that soy isoflavones inhibit the enzyme thyroid peroxidase (TPO), that plays a key role in thyroid hormone synthesis, and they also interfere with thyroid hormone production: “This interference can cause a drop in thyroid hormone levels, an increase in thyroid stimulating hormone and stress on the thyroid gland,” which is “a prescription for thyroid trouble.”13 Even one serving of soy food can pack more of a thyroid-inhibiting punch (“up to three times the goitrogenic potency”) as pharmaceutical drugs intentionally designed for that purpose.13 A health writer who has reviewed the body of evidence on soy and the thyroid advises caution with all forms of fractionated soy, particularly because these products also are likely to derive from genetically modified (GM) soy.14
In the Journal of Medical Case Reports in 2017, Japanese researchers corroborated soy’s role as an “exogenous food” capable of interfering with thyroid hormone production. They presented (to their knowledge) “the first report of the presence of [soy] isoflavone in the serum of a patient with severe hypothyroidism.”15 The report described the case of a seventy-two-year-old woman who showed up at the hospital with sudden-onset severe hypothyroidism after six months of regularly consuming a processed soy-containing “health drink.” Because the woman was an ongoing patient, the researchers had access to her frozen serum from five time points before the hospital admission and continuing for several months after admission. This allowed them to pinpoint the soy isoflavones as the culprit for the patient’s sudden decline, leading the authors to conclude that “consuming health drinks that include soy isoflavone powder extract can lead to severe hypothyroidism.” After immediate discontinuation of the beverage, the woman’s thyroid markers gradually returned to more normal levels.
The ringing endorsement of commercial soy by celebrity doctors such as Andrew Weil and Christiane Northrup has helped perpetuate the erroneous belief that products such as soy milk are healthy, but those days may be numbered. In response to a petition submitted almost ten years ago by the Weston A. Price Foundation, the U.S. Food and Drug Administration (FDA) belatedly has proposed revoking food manufacturers’ ability to claim that soy protein reduces heart disease risk. An FDA representative stated, “This is the first time we have considered it necessary to propose a rule to revoke a health claim,” admitting that “the totality of currently available scientific evidence calls into question the certainty” of the supposedly protective soy-heart relationship.16 This landmark shift from an ordinarily intractable agency is good news not just for heart health but also for thyroid health. In fact, the two are intricately interrelated. Cardiovascular symptoms are “some of the most characteristic and common” signs of thyroid disease, and thyroid dysfunction can explain “changes in cardiac output, cardiac contractility, blood pressure, vascular resistance and rhythm disturbances.”17 A thyroid blogger asks, “Could there be people on statin drugs and blood pressure medication…who are actually undiagnosed hypothyroidism sufferers?”18
LOWFAT, LOW-CARB, HELP!
Another piece of dogma that continues to steer Americans’ eating habits—and thyroid health—in the wrong direction is the slow-to-go-away advice to eat a lowfat diet. (Fortunately, this advice also has just taken a major hit; an eighteen-country study published in The Lancet in November 2017 shows no association between total fat or saturated fat intake and heart disease, while pointing to a higher risk of total mortality associated with high carbohydrate intake.19)
The Hormones & Balance website (authored by a holistic health coach who recovered from Graves’ Disease, Hashimoto’s and adrenal fatigue) makes the point that our bodies need good-quality fats to absorb the all-important fat-soluble vitamins (A, D, E and K)—crucial vitamins that thyroid patients often are lacking.20 Secondly, the body needs fats to make hormones; when intake of healthy fats is inadequate, hormone levels “plummet” and the hormone-producing thyroid “similarly takes a hit.”20 Some of the healthiest fats in this (and many other) regards include butter and ghee. As certified nutritionist Kim Schuette points out, both fats are excellent sources of butyric acid, which plays an important role in supporting delivery of thyroid hormones to receptor sites throughout the body.21 Others agree that “high intake of saturated and monounsaturated fat but low intake of polyunsaturated fat would seem to be optimal for thyroid function.”22
Schuette’s discussion of beneficial fats arises in the context of an article focusing on the problems associated with long-term avoidance of complex carbohydrates.21 As healing regimens such as the ketogenic and GAPS diets have gained in popularity (alongside continued fascination with lower-carb paleo and “ancestral” diets), the role to be played by carbohydrates in a healthy diet has become “hotly contested” and “completely confusing.”23
In point of fact, both extremes can be challenging for the thyroid. On the one hand, a diet that is high in refined carbohydrates can lead to insulin resistance, metabolic syndrome and diabetes—diseases strongly correlated with thyroid disorders.24 On the other hand, when individuals who are understandably trying to avoid sugars and refined grains swing to a zero or very-low-carbohydrate diet, this can have the effect of blocking biologically active thyroid hormones, resulting in hypothyroidism symptoms such as fatigue, constipation and depression.21 As one person puts it, “When all available glucose is being conserved for your brain,” the body has no choice but to put the process of thyroid hormone conversion “on hold.”24 To restoke one’s “metabolic fire,” Schuette recommends including properly prepared complex carbohydrates with each meal (including starchy vegetables and soaked legumes and grains), accompanied by plentiful animal fat and/or coconut oil and Celtic sea salt to supply minerals and trace elements, including iodine.21
IODINE AND FLUORIDE
Iodine is essential for synthesis of thyroid hormones, so it is not surprising that the thyroid gland is where the body stores roughly three-fourths of its iodine. Dr. Ronda Nelson describes this storage system as a “savings account” that periodically requires replenishment.11 In addition to needing to take in adequate iodine, according to Dr. Nelson, we need to have a healthy gut (which facilitates conversion of some portion of iodine to iodide), and we need the right cofactors (especially the fat-soluble vitamins, magnesium, selenium and vitamin D) to enable the transport of iodine and its use by the thyroid. Studies have identified interactions between vitamin A and iodine metabolism, for example, showing that diets deficient in both nutrients impair thyroid metabolism to a greater extent than diets deficient in only one or the other.25 Vitamin A supplementation (with a natural source like cod liver oil) reduces the risk of hypothyroidism and improves iodide efficiency.25
Three toxic halogens (bromine, chlorine and fluorine) are structurally similar to iodine. Because of this similarity, they can take up residence in the thyroid gland, where they exert a negative influence and displace iodine.8 The three elements are all worrisome from a health standpoint. However, the policy of adding unpurified industrial fluoride compounds to municipal drinking water may be particularly egregious because it subjects citizens to systemic negative health effects, without their consent, in exchange for a putative benefit to the teeth. (Even this highly touted dental “benefit” is questionable, given the rising prevalence of dental fluorosis.)26 The compounds added to public water include fluorosilicic acid (an acidic liquid) and sodium fluorosilicate and sodium fluoride (dry powders), all of which also are frequently contaminated with “non-trivial” amounts of arsenic.27 U.S. water utilities not only obtain their fluoride chemicals from the U.S. phosphate fertilizer industry but also from China, where oversight is likely to be “lax and variable.”27
Leading neurology experts agree that fluoride compounds are neurotoxic,28 but the U.S. Centers for Disease Control and Prevention (CDC) persists in celebrating water fluoridation as a major public health achievement. As a result, it is difficult for U.S.-based researchers to obtain funding to study fluoride’s adverse health effects. Researchers in other countries have made greater headway. For example, a 2015 study in the United Kingdom—where about 10 percent of the population receives fluoridated water (in contrast to roughly two-thirds of the U.S. population)—took advantage of the availability of detailed community water fluoridation data and General Practice data on the prevalence of hypothyroidism to assess fluoride’s effects on the thyroid.10
The researchers found that practices located in fluoridated areas were nearly twice as likely to report a high prevalence of hypothyroidism as practices in non-fluoridated areas, raising “concerns about the validity of community fluoridation as a safe public health measure.”10
In rat studies, researchers in India have observed that subjecting rats to a sub-acute exposure to sodium fluoride for thirty days induces thyroid dysfunction, and that the “structural abnormality of thyroid follicles by fluoride intoxication clearly indicates its thyrotoxic manifestation.”29 Other Indian researchers have administered high-fluoride water to rats expressly to study “fluoride-induced changes on…thyroid hormone status.”30 Studying the rats across three generations, the research team documented “generational or cumulative effects of fluoride on the development of the offspring when…ingested continuously through multiple generations.” Because thyroid hormone plays such a crucial role in brain development, the investigators concluded that changes in the thyroid hormone levels may have “imbalanced the oxidant/antioxidant system” and reduced learning memory.30
A human study in India considered school children living in “endemic fluorosis areas” where the children not only exhibited widespread dental fluorosis but also low IQ and other developmental problems.31 Whereas U.S. public health authorities define dental fluorosis as a common and seemingly benign condition that simply “causes changes in the appearance of tooth enamel,”32 fluorosis is actually a sign of chronic fluoride poisoning.26 This particular group of Indian researchers views fluorosis as a marker for developmental disorders, noting fluoride’s known ability to “interfere with thyroid gland function and to cause degenerative changes in the central nervous system [and] impairment of brain function.”31 Like their U.K. counterparts, these Indian investigators are alarmed by the public health policy of fluoridating drinking water, particularly in light of the growth disturbances and underlying thyroid disease detected in their sample of adolescents.
There are many other factors that influence thyroid health and the functioning of the endocrine system as a whole. Dr. Ronda Nelson puts stress at the top of the list of factors to address. In addition to lowering one’s stress, Hashimoto’s expert Izabella Wentz considers it fundamental to support the liver and adrenals, balance the gut and evaluate “root cause” factors such as infections and toxins.3 Although tackling suboptimal thyroid health may seem like a daunting prospect, many of the same steps that one might take to adopt a Wise Traditions diet and lifestyle will go far toward nourishing the thyroid.
ENDOCRINE-DISRUPTING CHEMICALS, HYPOTHYROIDISM AND AUTISM
Holistic medicine pioneer Raphael Kellman has made it one of his missions to publicize the link between hypothyroidism and autism spectrum disorders.33 Many strands of evidence support this link. Dr. Kellman notes, in particular, that the developing fetus and infant are highly susceptible to the array of endocrine-disrupting chemicals (EDCs) that have been associated with both thyroid disease and autism, including polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), perchlorates, phthalates, dioxins, bisphenol A (BPA), heavy metals and more.
Dr. Kellman notes that, in cancer, “the dose makes the poison”—but endocrine-disrupting chemicals “play by different rules.” He continues, “Here, one can say, ‛the timing makes the poison.’ …In other words, neurological development is like a chemical ballet, dependent on the right hormone message being sent and received at precisely the right time and in the right amount. This ballet opens windows of vulnerability.” In short, “Even low doses of EDCs, which may have little effect on adults, can have devastating effects on the unborn, neonate and child.”33
1. Thompson R, Barnes K. Hypothyroidism. http://www.calciumlie.com/five-types-hypothyroidism/.
2. American Thyroid Association. General information/press room. https://www.thyroid.org/media-main/abouthypothyroidism/.
3. Wentz I. Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back. New York, NY: HarperOne, 2017.
4. Kellman R. Hashimoto’s thyroiditis: we can win this battle! Huffpost, April 24, 2015. https://www.huffingtonpost.com/dr-raphael-kellman/hashimotos-thyroiditis-we_2_b_7118690.html.
5. Thompson R, Barnes K. The Calcium Lie: What Your Doctor Doesn’t Know Could Kill You. Brevard, NC: InTruth Press, 2008.
6. Wilson D. Wilson’s thyroid syndrome: the thyroid’s role in depression, anxiety, and other symptoms. https://www.alternativementalhealth.com/wilsons-thyroid-syndrome-the-thyroids-role-in-depression-anxiety-and-other-symptoms-3/.
7. Struja T, Kutz A, Fischli S, et al. Is Graves’ disease a primary immunodeficiency? New immunological perspectives on an endocrine disease. BMC Med 2017;15: 174.
8. Brownstein D. Iodine: Why You Need It, Why You Can’t Live Without It (3rd edition). West Bloomfield, MI: Medical Alternatives Press, 2008.
9. Luo D, Pu Y, Tian H, et al. Association of in utero exposure to organochlorine pesticides with thyroid hormone levels in cord blood of newborns. Environ Pollut 2017;231(Pt 1):78-86.
10. Peckham S, Lowery D, Spencer S. Are fluoride levels in drinking water associated with hypothyroidism prevalence in England? A large observational study of GP practice data and fluoride levels in drinking water. J Epidemiol Community Health 2015;0:1-6.
11. Nelson R. Diet for thyroid health. Restoration Health, July 13, 2017. http://blog.restorationhealth.net/diet-for-thyroid-health/.
12. Pollan M. Omnivore’s Dilemma: A Natural History of Four Meals. New York, NY: Penguin Press, 2006.
13. Daniel KT, Onusic S. Wise thyroid. Wise Traditions 2012;13(1):60-64.
14. Shomon M. Soy and the thyroid: a look at the controversies. Verywell, April 25, 2017. https://www.verywell.com/soy-and-the-thyroid-3231800.
15. Nakamura Y, Ohsawa I, Goto Y, et al. Soy isoflavones inducing overt hypothyroidism in a patient with chronic lymphocytic thyroiditis: a case report. J Med Case Rep 2017;11:253.
16. U.S. Food and Drug Administration. Statement from Susan Mayne, PhD, on proposal to revoke health claim that soy protein reduces risk of heart disease. October 30, 2017. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm582744.htm.
17. Klein I, Danzi S. Thyroid disease and the heart. Circulation 2007;116(15):1725-1735.
18. Trentini D. Is your thyroid KILLING you? Heart disease. Hypothyroid Mom, January 7, 2013. http://hypothyroidmom.com/is-your-thyroid-killing-you-heart-disease/.
19. Dehghan M, Mente A, Zhang X, et al. Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet 2017;390(10107):2050-2062.
21. Schuette K. Recovery from a low-carb diet. Wise Traditions 2016;17(3):19-24.
22. Iwakura MR. Low carb high fat diets and the thyroid. http://perfecthealthdiet.com/2011/08/low-carb-high-fat-diets-and-the-thyroid/.
23. Schoenfeld L. Is a low-carb diet ruining your health? Chris Kresser, August 26, 2014. https://chriskresser.com/is-a-low-carb-diet-ruining-your-health/.
24. Paleo Leap. Meet your thyroid: a paleo introduction. https://paleoleap.com/thyroid-a-paleo-introduction/.
25. Brossaud J, Pallet V, Corcuff J-B. Vitamin A, endocrine tissues and hormones: interplay and interactions. Endocr Connect 2017;6(7):R121-R130.
26. Cross D. The fluoride fantasy: what the American CDC fluorosis data really mean. UK Councils Against Fluoridation, December 8, 2010. http://www.ukcaf.org/what_the_cdc_fluorosis_data_really_show.html.
27. Fluoride Action Network. Fluoridation chemicals. http://fluoridealert.org/issues/water/fluoridation-chemicals/.
28. Grandjean P, Landrigan PJ. Neurobehavioural effects of developmental toxicity. Lancet 2014;13(3):330-338.
29. Sarkar C, Pal S. Ameliorative effect of resveratrol against fluoride-induced alteration of thyroid function in male wistar rats. Biol Trace Elem Res 2014;162(1-3):278-287.
30. Basha PM, Rai P, Begum S. Fluoride toxicity and status of serum thyroid hormones, brain histopathology, and learning memory in rats: a multigenerational assessment. Biol Trace Elem Res 2011;144(1-3):1083-1094.
31. Singh N, Verma KG, Verma P, Sidhu GK, Sachdeva S. A comparative study of fluoride ingestion levels, serum thyroid hormone and TSH level derangements, dental fluorosis status among school children from endemic and non-endemic fluorosis areas. Springerplus 2014;3:7.
32. Centers for Disease Control and Prevention. Fluorosis. https://www.cdc.gov/fluoridation/faqs/dental_fluorosis/index.htm.
33. Kellman R. The thyroid-autism connection: the role of endocrine disruptors. http://nancymullanmd.com/pdf/TheThyroidAutismConnection.pdf.
This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly magazine of the Weston A. Price Foundation, Winter 2017.
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Steven Lavitan says
In Ronda Nelson’s article A primer on the Thyroid, she mentions in the gray box labeled “Serum Markers to Test for Thyroid Dysfunction”, Reverse T3 is a good marker of stress if it is low. Isn’t high Reverse T3 a sign that the wrong Iodine is getting chopped off T4? And doesn’t high Reverse T3 mean stress is a problem.
Kristi Richman says
Very helpful,information packed article.Thank you.
I have idiopathic hypothyroidism since my childhood and have to take mediaction ever since. The key for me to improve my thyroid health was to cut out all soy bean products (I was a vegetarian and vegan for a few years) and switch to a gluten free and low-fiber diet. I am also very careful with algae, use non-iodized salt and only buy high-quality dairy with a low amount of artificial iodine. The food the animals get is full of iodine, and neither this fact nor the amount of iodine in dairy is on the label.