I decided to create a series of episodes covering the different factors that can help you lower and eventually normalize your thyroid antibodies. In today’s part five of my series, I’m discussing the link between infections and autoimmune thyroid conditions. I talk about the significance of recognizing hidden infections, when to consider testing and retesting, natural treatment approaches for addressing infections, the value of working with a practitioner, and more. If you would prefer to listen to this part, you can access it by Clicking Here.
In this presentation, I will discuss lowering thyroid antibodies by addressing infections. Like environmental toxins, I think that infections are an overlooked factor when it comes to the challenges in reversing the autoimmune component of Graves’ and Hashimoto’s.
Numerous studies suggest that viruses, bacteria, and other microbes can lead to the development of an autoimmune condition. How do certain microbes trigger an autoimmune response? I won’t get into great detail here, but essentially what happens is the immune system responds by producing what’s called type one interferons and pro-inflammatory cytokines. These are directed at the microbe. This in turn results in T cell and B cell activation, which can ultimately result in an autoimmune response.
However, there is also the concept of molecular mimicry. What this essentially means is some bacteria and viruses have amino acid sequences that are similar to those in humans. As a result, when a human is exposed to such a microbe, the immune system not only will attack the bacteria or virus, but since the microorganism has the same amino acid sequence as the human tissues, the immune system will also target the tissues of the human, which causes inflammation and can potentially trigger an autoimmune response.
Let’s talk about some of the different viruses and bacteria and other microbes, starting with Epstein-Barr Virus (EBV). Most people will test positive for EBV. Just because you test positive for this doesn’t mean it’s an autoimmune trigger. That being said, some studies have correlated EBV with both Graves’ and Hashimoto’s. Again, it can be a factor, but just because you test positive for EBV doesn’t mean it is the factor.
How do you test for EBV? It is tested for through the blood. There are other methods, like the GI Map, which is a comprehensive stool panel. Also tests for EBV as well as cytomegalovirus. Most of the time, this will come back negative because you will not find EBV in the stool most of the time. Usually, we test for it in the blood.
There are three what’s called IgG markers that you would want to test for, if you choose to test for EBV. There is an IgM marker. The three IgG markers include viral capsid antigen (VCA) IgG, EBV nuclear antigen IgG, and early antigen IgG. Many practitioners will test for VCA IgM and the nuclear antigen, but they won’t test for the early antigen. If the early antigen is positive, this may indicate a reactivation of the virus.
I will say that most people I test will have elevated VCA IgG and nuclear antigen IgG antibodies, but even when they are very high, this doesn’t always confirm that EBV is causing a problem. If you have those two along with the early antigen, then that also doesn’t 100% confirm a reactivation. Some healthcare practitioners will say it does, but I don’t think it does.
On the other hand, if you have the VCA IgM antibodies elevated, this typically will indicate an active infection.
Cytomegalovirus is another virus. Like EBV, it is a type of herpes virus. One study shows that cytomegalovirus along with some other microbes may be involved in the pathogenesis of Hashimoto’s and Graves’.
COVID-19, a newer virus. When COVID hit in 2020, definitely saw an increase in mostly hyperthyroidism and Graves’ as well as subacute thyroiditis, which initially presents as hyperthyroidism. COVID also could be a factor.
I won’t talk about all the different viruses, but there are others, like herpes simplex and parvovirus. Viruses can potentially be a trigger.
Let’s talk about some bacteria. We have your Yersinia enterocolitica, which is a bacteria that can lead to numerous health problems, including enterocolitis, acute diarrhea, pseudoappendicitis. There is evidence in the research that Yersinia enterocolitica can play a role in the development of Graves’ and possibly Hashimoto’s.
Helicobacter pylori, or H-pylori, is a bacteria located in the stomach. A number of studies link H-pylori with both Graves’ and Hashimoto’s. In addition to potentially being a direct trigger possibly, H-pylori can also interfere with the production of stomach acid, which can cause problems with digestion, lead to yeast overgrowth and bacterial overgrowth, which also can affect permeability of the gut. This is part of the triad of autoimmunity.
There is definitely controversy over H-pylori. Some practitioners will say you don’t want to treat for it unless the person is having overt symptoms like heartburn or acid reflux. But I have had patients even without those symptoms go into remission when addressing H-pylori.
If I have a patient with Graves’ or Hashimoto’s, and H-pylori is clearly positive, even in the absence of symptoms, I will recommend typically an herbal protocol. The person sometimes will choose to take antibiotics. I usually would not. It’s up to the person. If the person is experiencing reflux or other symptoms like heartburn, even then, you might want to consider a natural approach. Then I could understand if someone wants to get more aggressive. Most of the time, I would recommend a natural approach.
I should mention with H-pylori, there are numerous testing options. I will talk more about testing. I just want to mention here, because H-pylori, there are 3-4 ways of testing. You can test through stool; blood, which looks at antibodies; the urea breath test. You usually want to do the breath test or stool. You can test through the saliva as well.
Let’s talk about Lyme next. Lyme is caused by bacteria known as Borrelia burgdorferi. Typically transmitted through a bite from a tick. There is also evidence that fleas might transmit. Maybe even mosquitoes. That’s more controversial. Definitely ticks. Probably fleas. Possibly mosquitoes.
There is some evidence that Borrelia burgdorferi may be involved in the development in autoimmune thyroid conditions. I was diagnosed with chronic Lyme in 2018, 10 years after my Graves’ diagnosis. It didn’t play a role in my Graves’ diagnosis, but in some people, it could be a factor.
I was also diagnosed with bartonella, which is another tick-borne infection that in some cases can be a potential trigger.
Let’s talk about parasites. They also can potentially be a trigger. To be honest, there is not a lot of evidence in the research showing that parasites can trigger autoimmunity. I have seen it in my practice. Someone with Graves’ or Hashimoto’s has a certain parasite. A common one is Blastocystis hominis. Like H-pylori, people will say you don’t want to treat every case of this. Some practitioners will recommend treating it regardless, even if the person is not experiencing any symptoms.
I think they can be a problem at times. I can’t say I treat everybody for parasites. There are some practitioners who won’t even do testing, but they will assume everybody has parasites and will treat everybody for parasites. I have had some of these people on my podcast who take this approach.
I have also had other practitioners who won’t treat every case of parasites, even when it’s detected on a test. They might just look at the symptoms. If the person is not having gastrointestinal symptoms, they might choose not to treat the parasite. Still a good amount of controversy with parasites.
There is candida or other types of yeast. When we think about yeast, we usually talk about candida, but it’s not the only yeast out there. Even though yeast can be pathogenic, it’s not like you can’t have a fungal infection. Most of the time, it’s more of an overgrowth that is opportunistic. It’s normal to have yeast in the gut microbiome. It’s when it gets too out of hand. If you have low stomach acid or if you are eating a lot of refined sugars, for example, that could also be a factor in yeast overgrowth.
SIBO, small intestinal bacterial overgrowth. Most bacteria should be in the large intestine. With SIBO, the bacteria build up in the small intestine for different reasons. It’s not really an infection; it’s too much bacteria in the wrong place.
I wanted to bring it up here along with candida and yeast overgrowth because some people may have that question. They are not infections, but they definitely can affect the gut and also play a role in autoimmunity. Maybe not necessarily direct autoimmunity although there is some evidence that candida might. At the very least, both yeast overgrowth and bacterial overgrowth in the small intestine can affect permeability of the gut, which is part of that triad of autoimmunity.
There is also something called SIFO, small intestinal fungal overgrowth, where there are too many fungi in the small intestine.
Limitations of testing for infections is what I want to talk about next. For example, parasites, the reason why some practitioners will not test their patients for parasites is because the tests aren’t perfect. You might do a comprehensive stool test, and it might look negative for parasites. That doesn’t 100% rule out parasites. A little bit of a catch-22. Sometimes, you have to use your judgment.
I like to do testing. If someone has parasites or SIBO or H-pylori, I like to see it on a test. I don’t want to blindly treat it. You need to keep in mind that sometimes you might have false negatives. Then it’s a judgment call. If you strongly suspect someone might have parasites or another type of gut infection, there is a time and place for treating, even if it comes back negative on a test.
H-pylori, not all tests are created equal. Sometimes, you will see a stool antigen test come back negative, whereas it might be positive on a urea breath test. Or vice versa. The GI Map and a few other tests do PCR testing, specifically quantitative PCR testing. They might detect H-pylori, where other tests aren’t detecting it.
Just because it’s detectable doesn’t mean it’s out of range. Debatable, but it depends on the person. If it’s detectable, and the person is having overt digestive symptoms, especially heartburn or reflux, maybe you would want to treat it. If they are not having any gut symptoms, but it’s detectable and not elevated, then you might not want to treat H-pylori.
Lyme, false negatives are very common. Just going to a conventional lab especially. That’s why there are special labs. When I dealt with Lyme, I wanted to get tested initially at a regular lab. The doctor I went to didn’t think I had Lyme, so I went to a Lyme specialist. I got the test through a company called Medical Diagnostic Laboratories. That ended up detecting Lyme as well as bartonella. There are other companies such as IGeneX, which is the most well-known for testing Lyme and coinfections. Galaxy Diagnostics is another one. There are others. I use MDL.
Even these specialty labs aren’t perfect. Sometimes, you might suspect someone has Lyme or bartonella. It might come back negative.
Speaking of bartonella, a lot of practitioners will test for Lyme but will stop there, and they won’t look at other tick-borne infections like bartonella or babesia.
Let’s talk about some of the potential treatments. Of course, there is a time and place for antibiotics and antiviral agents, the conventional treatments. I want to focus on the natural remedies. I am not going to spend a great amount of time on the different herbs that can help. I am just going to go through these quickly.
Berberine is one that could be very effective. You could take it as part of goldenseal. The most abundant alkaloid of goldenseal is berberine. These days, you see a lot more berberine supplements than goldenseal supplements. You could treat with goldenseal or berberine.
I recommend working with a practitioner, not self-treating, of course. I know a lot of people will self-treat, but still, I will be biased because I am a practitioner. If you self-treat, keep in mind you could have die-off symptoms. You might feel worse before you feel better. You might want to start slow.
Berberine could help with bacteria, yeast, parasites,
Oregano oil is very potent. It could affect some of the good microbes. You don’t want to take it for a really long time if you take it. Another reason to work with someone. Oregano oil can help with bacteria, yeast, parasites as well.
We have garlic. Of course, you can eat garlic, but you can also take it in supplement form. As a supplement, it has other benefits, like supporting cardiovascular health. It also has antimicrobial effects. Bacteria, even viruses, yeast, parasites.
Even if you eat garlic, like if you add it to your food, which is what I do, I also take a garlic supplement, too. We use a lot of garlic when cooking, so that will also be beneficial. It’s not like you have to take it as a supplement. I take it as a supplement more to support cardiovascular benefit. I am not taking it as an antimicrobial on a consistent basis.
Mastic gum is not as well known. I won’t say it’s specific for H-pylori. When practitioners use it, it’s usually for H-pylori in combination with other agents.
Caprylic acid, that could help with not just yeast but bacteria and parasites as well. It’s more well-known for yeast.
Speaking of parasites, some of these other ones I mentioned can help, but there is also wormwood. Wormwood, black walnut, and clove oil are the three herbs that are typically used for parasites.
Olive leaf can help with yeast, but also viruses, as can quercetin. A lot of people take quercetin for allergies or a histamine intolerance. It has antiviral properties.
Monolaurin for yeast and viruses.
Then there are others like colloidal silver. When I was dealing with Lyme and bartonella, I took some herbs. I took homeopathy, too, which I won’t get into here. Homeopathic formulas could also be helpful. I also took some colloidal silver.
Now I hear a lot about methylene blue, which I eventually will have a guest expert to focus on that. I am not the person to focus on that. I can’t say I use a lot of methylene blue in my practice. I would like to have someone who focuses on it.
I should also mention that even taking probiotics and prebiotics can also help. You need to think of it in the gut microbiome especially. A lot of these microbes are in the gut microbiome. Not all of them. Some viruses are outside.
When talking about the gut, like H-pylori and parasites and even candida overgrowth in the gut, taking probiotics, Lactobacillus and Bifidobacterium-based probiotics, Saccharomyces boulardii. Spore-based probiotics can also make a difference. In some cases, maybe only taking probiotics can help. I found that sometimes taking probiotics won’t help with infections. Something to keep in mind.
I mentioned the antibiotics and antiviral drugs. Time and place for these. This is why it’s a good idea to work with a practitioner to get recommendations. If someone works with me, whenever I can, I’ll recommend more natural approaches.
There is a time and place for antibiotics. For example, if someone has SIBO, and they go through an herbal antimicrobial protocol, and if it’s not really helping, they might have to take an antibiotic such as Rifaximin or Xifaxan, which are the same thing pretty much. That is specific for SIBO. If someone has H-pylori, and for whatever reason, they are not responding to the natural protocol- I really hate when people with H-pylori take antibiotics because they are taking multiple antibiotics. I can’t say that there is not a time and place for antibiotics. Sometimes, antibiotics are necessary.
Getting back to the testing. Should you test for infections? I don’t test everybody for infections. It really depends on the person. There are practitioners who will recommend a comprehensive stool panel on every single patient. They will look for things like H-pylori and parasites and opportunistic bacteria.
I think there is value in this. I don’t recommend it to everybody, but I could understand why some would. If someone is having certain digestive symptoms, that’s not improved by changing one’s diet. They might want to look into a comprehensive stool panel or maybe a SIBO breath test, especially if they experience a lot of gas and bloating when eating certain types of foods.
Organic acids test is not specific for infections, but very good for fungi, including yeast. For yeast overgrowth, I like the organic acids test. It also looks at Clostridium, which is a bacteria.
There is also blood testing for viruses, tick-borne infections. When I dealt with chronic Lyme and went to MDL, that was a blood test.
I think the testing for infections should depend on the person. Like I said, there is an argument that everybody should have a comprehensive stool panel or even an organic acids test. Some practitioners will recommend every single one of their patients get these tests.
I don’t do that. If the patient wants to do these tests, even if I don’t think it’s necessary, that’s fine. If I think there is a good chance it will show something, I will recommend it.
That’s the thing about testing. You don’t know until you do the testing. That’s why there is no right or wrong. It’s up to the person. If they want to do comprehensive or conservative testing.
I can’t say I’m always conservative. I tend to be on the more conservative side. Sometimes, I recommend more comprehensive testing, depending on the situation. Ultimately, it is up to the person.
That’s all I wanted to cover with regards to infections. I hope you found this information to be valuable. As usual, I look forward to catching you in the next episode.
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