Why Do So Many People With Thyroid Conditions Have Gut Problems?

Millions of people have problems with their gastrointestinal tract. Some of these people have overt symptoms such as bloating, gas, abdominal pain, constipation and/or diarrhea. On the other hand, not everyone with gut problems experiences digestive symptoms, as they might present with other types of symptoms such as fatigue, brain fog, muscle and joint pain, neurological problems, or numerous other symptoms. The goal of this blog post is to discuss why so many people have “gut problems”. Then in the next post I will discuss what you can do to overcome these gut problems, which in many cases is the most important factor in restoring one’s immune system health.

But before I do this, I’d like to briefly discuss the importance of having a healthy gut in people with thyroid conditions. Most thyroid conditions are autoimmune in nature. In other words, the autoimmune component of Graves’ Disease or Hashimoto’s Thyroiditis is what’s responsible for the thyroid hormone imbalance. So what is looked at as being “thyroid conditions” are really “immune system conditions”. Approximately 70% of the immune system is in the gut. And if someone has a compromised gut, this needs to be addressed in order to have a healthy immune system.

So let’s go ahead and look at five of the main reasons why many people have problems with the gut:

1) Poor diet. It of course all starts with one’s eating habits. While I’m sure many people reading this information have made some wonderful changes to their diet, the truth is that most people don’t eat well. It’s not uncommon for me to speak with someone who is eating a whole foods diet that is mostly organic, gluten free, etc. Yet many of these people still have digestive issues. And the reason for this is because most chronic health conditions take years to develop, yet most of these people made these changes after the development of their health issues. This described myself as well, as while I ate better than most people before being diagnosed with Graves’ Disease, I still was eating a decent amount of processed foods. It wasn’t until after I was diagnosed with an autoimmune thyroid condition that I made such dramatic changes.

Of course there are some people who were eating well for many years before they were diagnosed with a chronic health condition, yet still currently have gut problems. And I’ll talk about some of the other reasons why this could happen. In fact, I’d like to talk about one of these reasons now, which has to do with food intolerances. The truth is that it is possible to have an intolerance to any type of food. And if someone has a condition such as leaky gut syndrome then it’s not uncommon to have multiple food intolerances, and it can be a challenge to determine which foods someone is reacting to.

However, even if someone doesn’t have a leaky gut they can be sensitive to certain foods, which of course eventually can lead to a leaky gut. For example, although someone can be sensitive to any food, some of the most common food allergens include gluten, dairy, eggs, corn, and soy. Obviously people can have sensitivities to other foods, but these are the most common allergens, and many people who are eating a healthy diet are eating some of these foods. So for example, someone might be eating an organic diet and be 100% gluten free, yet they might be eating some dairy products. And while one can argue that some dairy products are healthier than others (i.e. raw dairy), if someone is sensitive to casein, then this can cause gut issues in some people regardless of the type of dairy they’re consuming. Similarly, if someone is both gluten free and dairy free but is eating foods with corn, and if they happen to have an intolerance to corn, then this can lead to gut issues.

The focus so far has been on people who have been eating somewhat healthy diets yet still might have gut issues, but of course the majority of people who have gut issues don’t eat well. Most people eat too many refined foods and sugars, too much fast food, and they don’t eat enough fruits and vegetables. I didn’t want to focus on this here because most people reading this know that they should avoid the processed foods, and eat mostly whole foods. But they might not be aware that in some cases eating a healthy diet can still cause health issues if the person has an intolerance to one or more of the foods they commonly eat.

2) Antibiotic use. The bacterial flora are very important when it comes to maintaining the health of the gastrointestinal tract. While I’m thankful that we have antibiotics, as there are times when they are necessary, taking antibiotics will disrupt the gut flora, thus resulting in overgrowth by pathogens, invasion and translocation of toxins, and in some cases life-threatening infections (1). And it’s not just the gut that is being affected, as a study which involved 70 females with urinary tract infections treated with antibiotics showed that after antibiotic therapy, the lactobacillus population had not been restored in the majority of patients, and uropathogenic bacteria were found to dominate the urethra and introitus (2). The same study suggested that artificial supplementation of indigenous bacteria (probiotics) is necessary to restore the flora back to normality.

The problem is that most people who take antibiotics don’t end up taking probiotics to help restore the normal gut flora. And as I discussed in my article entitled “Can Taking Probiotics Improve Thyroid Health?“, not all probiotics are the same, and some people who take probiotics aren’t getting sufficient amounts due to either low potency, low viability, or a combination of both factors. And the truth is that antibiotics are overprescribed. For example, if someone has a cold with some of the classic symptoms (i.e. fever, runny nose, sore throat, etc.) and they visit their primary care physician, there is a good chance that they will be prescribed antibiotics. However, if the pathogen which caused the illness was viral then taking the antibiotic won’t help. And even if the pathogen is a bacteria, most of the time medication isn’t necessary to take, as the body’s immune system will frequently be able to eradicate the pathogen. Once again, I’m not suggesting that antibiotics aren’t necessary, as if someone has a bad infection then they might need to take antibiotics. But most people who take antibiotics don’t think of the consequences this will have on their gut health.

I came across an article which discussed whether the rise in asthma and allergies can be at least partially related to antibiotic use (3). The article mentioned how epidemiologic studies have found strong connections between receiving treatment with antibiotics and the development of asthma and allergies. In this article the following question was asked: “How do changes in gut flora influence respiratory allergies?”. And the response was something called “oral tolerance”, which involves the immune system responding upon the ingestion of certain allergens, and this immune system response allows the rest of the body to be tolerant of allergens so that allergic reactions don’t occur. So in other words, if the gut flora is compromised, then this will have a negative effect on oral tolerance, and thus will make someone more susceptible to developing a food sensitivity.

Another study looked into how early antibiotic administration affects oral tolerance (4). The results of the study suggest that taking antibiotics early in life has a negative effect on tolerance to a specific antigen when this antigen is introduced while the person is taking antibiotics. The study hypothesized that “antibiotic treatment early in life might facilitate allergic sensitization to novel food antigens”. The authors of the study suggested that if an infant needs to take antibiotics then it might be a good idea to avoid the introduction of new food ingredients in order to minimize the risk of them developing a food allergy.

3) Chronic stress. Although stress seems to be blamed for the cause of many different conditions, there is plenty of evidence which shows that stress can cause problems with the gastrointestinal tract. The enteric nervous system is the intrinsic nerve supply of the gastrointestinal tract, and the enteric nervous system is connected to the brain by parasympathetic and sympathetic pathways forming the brain-gut axis (5). Corticotropin releasing factor (CRF) is a hormone which helps to regulate the central stress response, and it has been demonstrated that stress can cause an increase in intestinal permeability and can lead to an increased susceptibility to colonic inflammation (5). Physical and psychological stresses are widely accepted as potential triggers of certain gastrointestinal conditions such as peptic ulcer, irritable bowel syndrome, or inflammatory bowel disease (6).

I just mentioned how stress can potentially cause a leaky gut to occur. As for the mechanism behind this, it is thought that stress leads to the altered release or response to neuroendocrine factors (such as corticotrophin-releasing hormone) in the intestinal mucosa, and this either directly or indirectly acts on the cells of the small intestine, which causes intestinal barrier dysfunction and the uptake of proinflammatory material from the gut lumen (7).

Another journal article I came across stated that the major effects of stress on gut physiology include: 1) alterations in gastrointestinal motility; 2) increase in visceral perception; 3) changes in gastrointestinal secretion; 4) increase in intestinal permeability; 5) negative effects on regenerative capacity of gastrointestinal mucosa and mucosal blood flow; and 6) negative effects on intestinal microbiota (8). The same article discusses how melatonin can have protective effects against stress-induced lesions in the gastrointestinal tract, and how taking probiotics might affect the brain-gut interactions and attenuate the development of stress-induced disorders in both the upper and lower gastrointestinal tract. With regards to melatonin, many people use this hormone to help with sleep-related issues, but there is plenty of research which shows that melatonin can also benefit the health of the gastrointestinal tract (9) (10) (11).

4) Pathogens . Of course certain pathogens can have a negative effect on gastrointestinal health. For example, viruses such as norovirus and rotavirus can affect the gastrointestinal tract. Some bacteria which can have a negative effect on the GI tract include shigella, campylobacteria, and C. difficile. Giardia and cryptosporidium are parasites which can affect the gut. Although we can’t completely avoid all of these pathogens, some of the things we can do to minimize our exposure to these and other pathogens include practicing proper hygiene and avoiding uncooked or undercooked meat. With regards to hygiene, a lot of people rely on hand sanitizers, but they aren’t a substitute for soap and water.

While being exposed to certain pathogens can affect the health of the gut, having a compromised gastrointestinal tract will make one more susceptible to an infection by a pathogen. For example, if someone eats a poor diet and/or deals with chronic stress on a daily basis, this can affect the gut and immune system, making them more susceptible to an infection by a virus, bacteria, or parasite. Of course I realize that in some cases people will get an infection even with a healthy gut and immune system, but having a healthy body will of course reduce the likelihood of getting such infections.

5) Toxins. There is still a lot that isn’t known about the impact of toxins on gastrointestinal health. With regards to the routes of entry, environmental toxins taken orally may be modified in the GI tract by gastric pH, digestive enzymes, or even bacteria that live in the intestines (12). Environmental toxins that are internalized by skin absorption or by inhalation may be secreted into the lumen through the biliary system and lead to toxicity (12). Also, toxins suspended in air make their way into the intestinal tract by drainage from the sinuses into the pharynx and esophagus (12).

When talking about toxins, one can’t overlook the effect that certain medications have on the gastrointestinal tract. Pharmaceutical agents of several types interact with the small bowel mucosa causing impairment of transport processes for fluid and electrolytes, amino acid, lipid and sugars as well as vitamins (13). It is well known that NSAIDs have a negative effect on the gastrointestinal tract (14) (15) (16). But other prescription drugs can cause problems with the gut, and even over the counter drugs such as aspirin can cause gastrointestinal injury in some cases (17).

So hopefully you have a better idea as to why problems with the gastrointestinal tract are so common. In the next blog post I will discuss what you can do to have an optimally functioning gastrointestinal tract. While there can be numerous factors which can lead to the development of an autoimmune thyroid condition such as Graves’ Disease or Hashimoto’s Thyroiditis, the truth is that many people will be able to restore their immune system health just with the information included in this blog post, along with the second part I will be releasing.