The Challenge of Suppressing The Autoimmune Response

Whenever I work with someone who has an autoimmune thyroid condition, one of the main goals is to suppress the autoimmune response.  After all, with conditions such as Graves’ Disease and Hashimoto’s Thyroiditis, we’re dealing with an autoimmune condition which is affecting the thyroid gland.  And while it might be important to provide thyroid support, either in the form of thyroid hormone for hypothyroid conditions, or antithyroid medication or herbs for people with hyperthyroidism, these won’t do anything to address the autoimmune component.

This is what’s frustrating about working with most endocrinologists.  My goal isn’t to criticize endocrinologists, as while there are many who are close minded and don’t want to hear anything that has to do with natural treatment methods, there are some open minded endocrinologists as well. When I was diagnosed with Graves’ Disease I saw an endocrinologist, and in addition to being very knowledgeable, she was also extremely polite, and she took a more conservative approach by recommending prescription medication over radioactive iodine.  But she didn’t recommend anything which would address the autoimmune component.  Of course I didn’t expect her to recommend anything to address the cause, as I realize doctors aren’t trained to do this in medical school.

The Challenges Of Finding The Trigger

Before one can even think about suppressing the autoimmune component, it is important to find out what has triggered the autoimmune response.   Once this has been accomplished it of course is necessary to remove the trigger.  I talk a lot about this during my webinars, articles, and blog posts.  So for example, if gluten happens to be the trigger, then one must remove gluten from the diet.  If a pathogen such as H. Pylori is the trigger, then this needs to be detected and eradicated.  If stress is the main factor then one needs to work on reducing the stress levels while improving their stress handling skills.  If a specific toxin triggered the autoimmune response then this toxin needs to be detected and then removed.

The problem is that there can be many different factors which trigger an autoimmune response.  But that’s what testing is for, right?  Well, testing can be valuable, but you can’t test for everything.  There are dozens of different tests available, and most people can’t afford to do all of them.  Fortunately this usually isn’t necessary.  However, some detective work usually is required, and in some cases it can be a challenge to determine what has triggered the autoimmune response.  So for example, I’ll frequently recommend a saliva test and the controversial hair mineral analysis, which combined will help to evaluate the adrenal glands, and to some extent the gut (by looking at secretory IgA), mineral imbalances, and toxic metals.  These all can be factors which can lead to the development of an autoimmune condition.

But there can be other factors as well.  Although toxic metals such as mercury can trigger an autoimmune response, there are other toxins which also can affect immunity.  And while there is comprehensive testing available to determine which toxins you might have built up in your tissues, there is no comprehensive test which will determine the levels of all of the different toxins.  Plus, everyone responds to toxins differently.  For example, two people might be exposed to the same amount of a specific toxin, yet one person might not have any reaction, while another person might go onto develop an autoimmune thyroid condition due to this exposure.  Of course the person who went onto develop an autoimmune thyroid condition probably had a genetic predisposition for the condition.  But as I’ve discussed in past articles and blog posts, not everyone with a genetic marker for Graves’ Disease and Hashimoto’s Thyroiditis will develop these conditions, even when exposed to certain “triggers”.

How Do You Know If The Trigger Has Been Removed?

What happens once the trigger has been detected and removed?  Well, it depends on the situation.  For example, if gluten, or some type of intestinal pathogen caused a leaky gut which in turn triggered the autoimmune response, then this could get a bit complex. One first needs to remove the factor or factors which caused the leaky gut to occur.  So if gluten was the culprit, then this needs to be removed from the diet.  If H. Pylori was responsible for the leaky gut, then this pathogen needs to be eradicated.

However, just removing the factor which caused the leaky gut might not be enough, as you probably will need to do some things to rebalance the gut flora and repair the leaky gut.  On the other hand, if a toxin such as mercury triggered an autoimmune response, then one might only need to focus on reducing the levels of this toxin.

Assuming the trigger has been removed, the immune system very well might calm down on its own.  As a result, the person might notice a reduction in their symptoms and a decrease in thyroid antibodies.  However, while it’s great to see the thyroid antibodies decrease, one can’t rely on this alone, as the antibodies can fluctuate.  And just because someone has thyroid antibodies which fall within the normal reference range doesn’t mean that the autoimmune response has been suppressed.  This is why other factors need to be looked at, such as the secretory IgA.  Some people will do testing to see if the Th1 and Th2 pathways have been balanced, but this isn’t completely reliable.  The truth is that no single method by itself is reliable when trying to determine if the autoimmune response has been suppressed, which is why one needs to look at numerous factors:

• A dramatic improvement in the person’s symptoms
• Normal thyroid hormone levels
• Normal thyroid antibodies
• Normal secretory IgA
• Possibly balanced Th1/Th2 pathways
• In some cases one might also need to consider testing for an increase in intestinal permeability

Downregulating NF-kappaB Is Important

Last week I released a blog post entitled ” The Role of Cytokines In Autoimmune Thyroid Conditions“.  In this post I spoke about something called Nuclear Factor Kappa B (NF-kB), which is associated with pro-inflammatory cytokines.  When something triggers an autoimmune response, the immune system activates pro-inflammatory cytokines.  This will result in the activation of NF-kB.  Why is this important?  Well, this contributes to the inflammatory process, and chronic activation of NF-kB will help to perpetuate the autoimmune response.

The problem is that removing the trigger might not necessarily inactivate NF-kB.  So let’s revisit the previous example where gluten or H. Pylori caused the development of leaky gut syndrome, which in turn triggered an autoimmune response.  If someone eliminates the allergen or pathogen which caused a leaky gut, and then goes onto repair the leaky gut, NF-kB might still remain activated, which in the case with someone who has Graves’ Disease or Hashimoto’s Thyroiditis will mean that the autoimmune response will still be active.  And so one needs to focus on downregulating NF-kB.

The good news is that there are numerous supplements and herbs which can help with this, which I discussed in the blog post on cytokines.  I focused on fish oils, vitamin D, turmeric, and resveratrol.  There have been clinical trials which demonstrated that these nutrients can help to downregulate NF-kB.  And of course one’s diet also plays a big role in controlling inflammation.

With that being said, some people who consult with me are already eating well, are gluten-free, and are already taking supplements such as fish oils, vitamin D, and possibly even turmeric.  Yet they might still be symptomatic, have high thyroid antibodies, etc.  Why is this the case?  In most cases, the reason why the autoimmune response is still active in these people is because the trigger hasn’t been detected and/or removed.  This can be frustrating, and I deal with this factor with some of my patients from time to time, as while I’m very successful in helping to restore people’s health back to normal, there are times when I’ve focused on a person’s adrenals, gut, hormones, toxins, and perhaps other areas, and yet the autoimmune component remains active.  Dealing with autoimmunity is very challenging, and for some people it takes more detective work than others to find out what the trigger is.

In summary, in order to suppress the autoimmune component of Graves’ Disease or Hashimoto’s Thyroiditis, it is necessary to find out what has triggered the autoimmune response, and then of course remove this trigger.  This could become complex when there are numerous factors involved.  And then once the trigger has been removed and the compromised areas of the body have been addressed (i.e. weak adrenals, a leaky gut, etc.), it is important to downregulate NF-kB.  Sometimes it can be a challenge to find out what is triggering the autoimmune response, which can become very frustrating to both the doctor and patient.