Autoimmune conditions are characterized by the presence of autoantibodies.  It’s no exception with Graves’ disease and Hashimoto’s thyroiditis.  While most endocrinologists focus on improving the thyroid panel (TSH and thyroid hormones), very few conventional medical doctors will do anything to improve the health of the person’s immune system, and thus normalize thyroid antibodies.  The main reason for this comes down to their training in medical school, as they aren’t taught how to address the autoimmune component of these conditions.  And it admittedly can be very challenging to normalize thyroid antibodies, which I’ll talk more about later this blog post.

Before discussing how to lower autoantibodies, I’d like to briefly discuss what antibodies are.  Antibodies, also known as immunoglobulins, are Y-shaped molecules that help to protect the body against foreign substances called antigens.  Examples of antigens include bacteria, viruses, fungi, chemicals, and there can even be dietary antigens.  Essentially antigens lead to the formation of antibodies, and each antibody is manufactured to match a specific antigen.  In autoimmunity, autoantibodies are produced against self-antigens, or against the cells of your own body.

I mentioned that antibodies are also known as immunoglobulins, and there are five immunoglobulin classes found in the serum:

Immunoglobulin A (IgA)

Immunoglobulin D (IgD)

Immunoglobulin E (IgE)

Immunoglobulin G (IgG)

Immunoglobulin M (IgM)

When discussing autoantibodies, we’re mostly referring to IgG.  This includes the antibodies associated with Graves’ disease and Hashimoto’s. IgG is further divided into four subclasses, and the majority of known antibody-mediated autoimmune diseases are caused by IgG1 and IgG3 autoantibodies, although IgG4 plays a prominent role in the pathogenesis of at least 13 autoimmune diseases. (1).

With Graves’ disease, unique IgG antibodies bind to and activate the TSH receptor on the surface of thyroid follicular cells, which leads to an increased production of thyroid hormones (1).  Antithyroglobulin antibodies and antithyroperoxidase antibodies are also predominantly of the IgG class (2).  It has been reported that Hashimoto’s thyroiditis can be divided into IgG4 and non-IgG4 thyroiditis (2).

The 3 Main Types of Thyroid Antibodies

Let’s briefly take a look at the three most common types of thyroid antibodies:

Thyroid peroxidase (TPO) antibodies.  Thyroid peroxidase (TPO) is an enzyme that plays a role in the production of thyroid hormone.  TPO antibodies are the most common type of thyroid antibody.  Although they are more closely associated with Hashimoto’s thyroiditis, many people with Graves’ disease have elevated TPO antibodies.

Thyroglobulin antibodies.  Thyroglobulin is a glycoprotein that is secreted by thyroid follicular cells, and when someone has anti-thyroglobulin antibodies this means that the immune system is attacking and damaging thyroglobulin.  These antibodies are associated with Hashimoto’s.

Thyroid stimulating immunoglobulins.  Thyroid stimulating immunoglobulins are associated with Graves’ disease, and they bind to the thyroid stimulating hormone receptor, which causes the excess production of thyroid hormone.

As I’ve discussed in other blog posts, it’s common for people to have multiple types of thyroid antibodies.  So for example, some people will have both TPO antibodies and thyroid stimulating immunoglobulins, while some will have all three of these autoantibodies.  And since people with Graves’ disease and Hashimoto’s commonly develop other autoimmune conditions it’s also possible to have other types of autoantibodies as well.

What Causes Elevated Thyroid Antibodies?

I’ve spoken about the triad of autoimmunity in the past, as there are three factors which are necessary for autoimmunity to develop, and thus lead to elevated autoantibodies.  These three factors include 1) a genetic predisposition, 2) an environmental trigger, and 3) a leaky gut.  The triad of autoimmunity applies to all autoimmune conditions, and not just Graves’ disease and Hashimoto’s.

A loss of self tolerance is also necessary, and this is when the immune system doesn’t recognize our tissues and organs as being “self”.  I discussed how people develop a loss of self tolerance in a past article, but I’ll list some of the different ways below:

1. Exposure to an environmental trigger
2. Having certain genetic polymorphisms
3. Decrease in regulatory T cells
4. Low selenium levels
5. Low vitamin A levels
6. Intestinal dysbiosis (imbalance of the gut flora)

Can Thyroid Antibodies Be Normalized?

It is possible to normalize thyroid autoantibodies.  However, there are a few things you need to understand.  First of all, different labs will commonly have different reference ranges for the same autoantibodies.  As a result, you might test positive for a specific autoantibody with one lab, but test negative for the same autoantibody with a different lab.  So how do you know which lab reference range is accurate?  First of all, you do need to keep in mind that everyone is different, and we can make the argument that some people might be fine even if their thyroid antibodies are slightly elevated according to the lab reference range.

For example, the Labcorp reference range for TPO antibodies is currently 0-34 IU/mL.  The Quest Diagnostics reference range for TPO antibodies is <9 IU/mL.  I don’t know which reference range is more accurate, and we need to keep in mind that although the units are the same with these two labs, the methodologies can differ between labs, and there are other reasons why different labs have different ranges for the same marker.

In any case, if someone has TPO antibodies that are well above the reference range (i.e. 2,000 IU/mL), then we can conclude that this is abnormal.  On the other hand, if someone has TPO antibodies that are consistently around 50 IU/mL does this mean that the autoimmune response isn’t as big of a concern?  There’s some debate here, as some well known practitioners will say that a lower number doesn’t necessarily correlate with the severity of the autoimmune response, but I think it’s safe to say that most practitioners would still like to see the antibodies on the low side.

It’s also important to understand that it’s not always easy to decrease and normalize thyroid antibodies.  In some people the thyroid antibodies will gradually decrease until they normalize without any setbacks.  For others there will be more of a “rollercoaster” pattern, as the antibodies might fluctuate back and forth until they normalize.  Then there are people with Graves’ disease and Hashimoto’s who don’t experience any significant decrease in thyroid antibodies, and in some cases their antibodies gradually increase over time.  During this latter scenario this usually means that the person’s triggers haven’t been detected and/or removed, the gut hasn’t been healed, and/or there are other underlying imbalances that need to be addressed.  I’m about to discuss this further.

4 Steps To Lower Thyroid Antibodies Naturally

Earlier I discussed the triad of autoimmunity, and how this will determine whether someone will develop elevated thyroid antibodies.  So for example, if someone has a genetic predisposition for Graves’ disease or Hashimoto’s and they are exposed to a specific environmental trigger and at the same time they have an increase in intestinal permeability (a leaky gut), then autoimmunity is likely to develop.  As a result, it shouldn’t be a surprise to learn that in order to lower thyroid antibodies you need to address these factors:

Step #1: Find the triggers.  Not finding the triggers is probably the biggest reason why someone’s thyroid antibodies don’t decrease.  Finding the triggers can admittedly be challenging at times, and usually involves doing a comprehensive health history, along with the appropriate testing.  In 2018 I wrote a book that focuses on triggers, and while the title of the book is “Hashimoto’s Triggers“, a lot of the information in this book can benefit people with Graves’ disease as well.  I also discuss triggers in my book “Natural Treatment Solutions for Hyperthyroidism and Graves’ Disease“.

Here are some potential autoimmune triggers:

• Food triggers (gluten, dairy, corn)
• Stress
• Pathogenic bacteria
• Viruses (i.e. Epstein-Barr)
• Parasites
• Heavy metals
• Xenoestrogens
• Overtraining
• Estrogen dominance

Step #2: Remove the triggers.  Once the triggers have been detected, obviously the next goal should be to remove them.  Sometimes this is easier said than done.  For example, if someone discovers that a specific food is a trigger, then of course they can remove this food from their diet.  On the other hand, if an infection or chemical is the trigger, then it can be challenging to address these at times.  Certain infections can be difficult to eradicate, regardless of whether someone takes prescription antibiotics or natural antimicrobials.  And some chemicals are more challenging to eliminate from the body than others.

Step #3: Correct underlying imbalances.  Sometimes other underlying imbalances can interfere with healing, which can in turn prevent thyroid antibodies from lowering.  For example, inflammation is associated with autoimmunity, and while finding and removing the triggers will frequently resolve the inflammation, this isn’t always the case.  Sometimes further action is required to resolve the inflammation, such as taking higher doses of natural anti-inflammatory agents (i.e. curcumin, resveratrol, glutathione).  Having deficiencies in vitamin D, selenium, and omega-3 fatty acids can make it very challenging to lower thyroid antibodies.

Step #4: Restore the health of the gut microbiome.  Having a healthy gut is necessary for a healthy immune system, and in some people, healing the gut can be challenging as well.  Although there is a lot of great information on the Internet and in books on gut healing, most people need to do more than just take gut-healing supplements and eat gut-healing foods, as you need to make sure to remove those factors which are interfering with gut healing.  This may sound like common sense, but many people only focus on reinoculation (with probiotics) and gut healing, and while these are important, doing these alone many times isn’t sufficient to restore the health of the gut.  For more information on this please read my blog post entitled “What Is The 5-R Protocol?”

Can Low Dose Naltrexone (LDN) Lower Thyroid Antibodies?

I spoke about LDN in a past article entitled “Low Dose Naltrexone and Thyroid Autoimmunity“, and so I definitely would check this out for more information on LDN.  This is an option for some people with Graves’ disease and Hashimoto’s to consider, as LDN can lower thyroid antibodies in some cases by modulating the immune system.  However, while I’m not opposed to my patients taking LDN, you need to keep a couple of things in mind.  First of all, LDN doesn’t work for everyone.  Second, even when it does work, LDN isn’t doing anything to address the underlying cause of the problem.  That being said, I mentioned earlier how sometimes it can be challenging to find and/or remove autoimmune triggers, and when this is the case there’s nothing wrong with taking LDN to modulate the immune system while still trying to address the cause of Graves’ disease or Hashimoto’s.

Is There a Role for IgG Autoantibodies in a Healthy Immune System?

Over the years some of the labs have lowered their reference range for thyroid autoantibodies, which suggests that there should be no autoantibodies found in healthy people.  For example, some labs use a reference range of ≤1 IU/mL for thyroglobulin antibodies. But multiple journal articles discuss that small amounts of autoantibodies are present even in healthy individuals (3) (4).

One study found 66 autoantibodies that are common and abundant in the population, regardless of age, gender and disease status (3).  It was suggested that IgG autoantibodies might be necessary and perform some key physiological function, including the clearance of intracellular debris during inflammation.  Perhaps some autoantibodies have important physiological functions, and thus should be present in small amounts, while others don’t offer any benefits.  Either way I think it’s safe to say that we don’t know everything about autoantibodies, and I’m sure we’ll learn even more about them in the future.

What Have You Done To Lower Thyroid Antibodies?

If you have the antibodies for Graves’ disease or Hashimoto’s (or both), please let me know what you have personally done to try to lower them, and if you were successful in doing so.  If you were successful in lowering and/or normalizing them please let me know!  And if you were unsuccessful please let me know!  Thank you for sharing your experience with everyone.

Over the last few years there has been a lot of buzz about cannabidiol, also known as CBD.  CBD can be derived from hemp or cannabis, which are both members of the same plant species, Cannabis sativa.  While both hemp-derived CBD oil and cannabis-derived CBD oil offer certain health benefits, not everyone will respond the same to each of these.  Although cannabis-derived CBD oil seems to be a much richer source of phytochemicals and cannabinoids, including a compound called tetrahydrocannabinol (THC), this doesn’t mean that hemp-derived CBD oil can’t benefit people with different types of health conditions…including thyroid and autoimmune disorders.

As for how CBD oil can help with thyroid and autoimmune thyroid conditions, cannabinoids are potent anti-inflammatory agents that can decrease proinflammatory cytokines, while increasing T-regulatory cells (Tregs) (1).  As I have discussed in past articles and blog posts, proinflammatory cytokines promote inflammation, while Tregs suppress autoimmunity.  One of the main proinflammatory cytokines associated with autoimmunity is interleukin-17 (IL-17), which is produced by Th17 cells.  And there is evidence that CBD oil can reduce levels of IL-17 (2) (3).

Of course just as is the case with other natural anti-inflammatory agents, CBD oil doesn’t do anything to address the underlying cause of the condition.  So while CBD oil might be able to help to reduce symptoms by decreasing inflammation, you still want to find and detect the triggers and correct underlying imbalances.  In other words, if you have Graves’ disease or Hashimoto’s, taking CBD oil alone probably isn’t the solution, as you need to remove your autoimmune triggers, correct other underlying imbalances, heal the gut, etc.  That being said, it’s important to add that at times removing the triggers won’t break the inflammatory cycle, and CBD oil might be helpful in this case as well.

Have You Tried CBD Oil?

The purpose of this blog post isn’t to get into detail about the benefits of CBD oil, but instead is to learn about the experiences those with thyroid and autoimmune thyroid conditions have had when taking this.  If you have taken CBD oil to improve your thyroid health (or for any other purpose) please share your experience in the comments section below.  Did you take hemp-derived or cannabis-derived CBD oil?  If you took it for your Hashimoto’s or Graves’ disease condition I’d be especially interested to see if it benefited you, how long it took before you noticed positive changes, and anything else you’d be willing to share to help others who might be interested in using CBD oil.

Since my Lyme disease diagnosis in the summer of 2018, I have done a lot more research on different types of infections.  This not only includes Lyme disease and its coinfections, but viruses, parasites, and fungi.  When it comes to viruses, there is still a lot we don’t know, but books such as Medical Medium and the Epstein-Barr Virus Solution have made people even more aware about the impact that viruses such as Epstein-Barr can have not only on our thyroid health, but other aspects of our health as well.

What I’d like to do is share five things you should specifically know about the Epstein-Barr virus (EBV), although as you go through this information, please keep in mind that some of the information in this blog post pertains to other viruses as well.

1. Epstein-Barr can trigger Graves’ disease and Hashimoto’s.  In January 2017 I wrote an article entitled “Can Epstein-Barr Trigger Graves’ Disease and Hashimoto’s Thyroiditis?”.  In this article I presented some of the research which showed a connection between EBV and thyroid autoimmunity.  Since then I can’t say that there has been a plethora of new studies on EBV and thyroid autoimmunity, although a study published in October 2018 showed that EBV reactivation resulted in the production of thyrotropin receptor antibodies, which are associated with Graves’ disease (1).

In addition to the research, one can’t dismiss the clinical experience myself and other natural healthcare practitioners have had when treating EBV in autoimmune thyroid patients.  I’ve had patients with Graves’ disease and Hashimoto’s get into remission upon treating viruses, including EBV.  However, I’ll admit that it’s not always easy to know when to address EBV (and other viruses), and of course viruses are just one factor that can trigger autoimmunity.  As a result, it shouldn’t be surprising that in some cases where I thought EBV was the main culprit, addressing this stealth infection didn’t result in the person getting into remission.

2. There are many other factors that can trigger thyroid autoimmunity.  Some sources suggest that EBV is the primary factor that causes thyroid and autoimmune conditions, along with other chronic health conditions.  My research and clinical experience demonstrate that there are other triggers of Graves’ disease and Hashimoto’s.  In fact, in my book “Hashimoto’s Triggers” I discuss many of these triggers, including the following:

• Other infections (i.e. H. pylori, parasites)
• Chemicals (i.e. heavy metals)
• Food (i.e. gluten)
• Stress
• Estrogen dominance

3. Research shows that EBV might play a role in thyroid cancer.  One study investigated the relationship between EBV and papillary thyroid carcinoma (2).  In 41 samples, Epstein-Barr Nuclear Antigen 1 (EBNA1) was detected in 65.8% of patients with papillary thyroid carcinoma, which was significantly higher in younger ages.  Another study looked to determine the presence of EBV and thyroid cancer, and the results showed that the EBV DNA was detected in 71.9% of the samples (3).  Thus, the authors concluded that EBV infection may play a role in the development of thyroid tumors.

Of course this doesn’t mean that EBV is the cause of most cases of thyroid cancer.  That being said, if you or someone you know is ever diagnosed with thyroid cancer, it might be worth testing for EBV, and addressing the virus if it appears to be problematic.  How do you know if EBV is causing problems?  As I mentioned earlier, sometimes this can be challenging to determine, but correctly interpreting the test results is important, which I’ll discuss next.

4. EBV testing can be challenging to interpret.  In the past article I wrote on EBV I discussed three commonly tested markers.  This includes viral capsid antigen (VCA)-IgM, VCA-IgG, and Epstein Barr nuclear antigen (EBNA).  I discussed how the presence of VCA-IgM indicates a recent infection with EBV, while the presence of VCA-IgG indicates a past infection.  Most people will test positive for VCA-IgG and EBNA, and in the past it was thought that EBV was in an inactive state if VCA-IgM was negative and VCA-IgG was positive.  However, it seems that this isn’t always the case, and if someone has very high levels of VCA-IgG and EBNA IgG on a blood test (>100 U/mL), this can be an indication of EBV reactivation.

Some practitioners also recommend to test for Epstein-Barr early antigen (EBV-EA) antibodies.  According to Dr. Kasia Kines, author of “The Epstein-Barr Virus Solution”, this marker is usually not tested for when doctors order an EBV panel, and I admit that I didn’t start testing this marker until recently.  According to Dr. Kines, if VCA-IgG, EBNA IgG, and EA IgG are all positive, regardless of what the values are, then this can indicate reactivation of the virus.  Keep in mind that not all practitioners agree with this interpretation, as many won’t recommend any treatment unless if the VCA-IgM antibodies are positive, which rarely is the case.

5. Natural antiviral agents can help…to some extent.  With any type of infection, the number one goal should be to improve the health of the person’s immune system.  This doesn’t mean that you can’t or shouldn’t take action to try to directly eradicate or inactivate the pathogen.  But too many people focus on “killing” infections, and don’t do anything to improve their immune system health.  Once again, if a patient of mine has any type of infection, in most cases I will put them on a protocol to address the infection.  But one question you need to ask is “why did I get the infection in the first place?”

This was one question I asked myself when I found out I had Lyme disease.  And to be honest, it’s still something I ask myself.  To some people this might seem like a silly question to ask.  After all, people get Lyme disease because they were bitten by a tick that is carrying Borrelia Burgdorferi, right?  Similarly, many people get EBV and other viruses because it’s transmitted quite easily through bodily fluids, including saliva.  While this is true, perhaps the better question to ask is not “why do I have this infection”, but “why is this infection having a negative effect on my health?”  Because the truth is that we’re all exposed to potentially pathogenic microbes, and many people have such “infections”, but not everyone presents the same way.

So while I’m going to list some natural treatment approaches for viruses below, in order to receive optimal benefits you need to have a healthy terrain.  Eating a healthy diet is of course necessary.  Since most of the immune cells are located in the gut, having a healthy gut microbiome is essential for fighting off ALL infections, and not just gut infections.  In addition, healthy adrenals are essential to fight off infections, as chronic stress is one of main reasons some people succumb to viruses and other infections.  Reducing your toxic load and supporting your detoxification pathways can also play an important role.

That being said, let’s take a look at some specific natural agents and other therapies for EBV:

Herbs.  Two herbs which can help to inhibit viral replication include licorice root and St. John’s Wort.  However, while some of the other natural agents listed below are low risk, I wouldn’t take these two herbs unless if you’re under the guidance of a competent healthcare practitioner.  I’ll add that while St. John’s Wort has antiviral properties (4), I couldn’t find any evidence showing that it directly impacts Epstein-Barr.  On the other hand, a few studies (in vitro) show that licorice root can prevent EBV replication (5) (6).

Other natural agents.  In addition to licorice root and St. John’s Wort, other natural agents that have anti-viral properties include monolaurin, colloidal silver, quercetin, and olive leaf.

Homeopathy.  Although there is no research I’m aware of which demonstrates that homeopathy can be beneficial for inactivating EBV, recently I started using homeopathy on some of my EBV patients and have seen very good results.  I like the remedies by the company DesBio, although there probably are other companies that offer similar EBV homeopathic protocols.

UV light and ozone therapy.  As I discussed in the blog post I wrote about my experience with chronic Lyme disease, I received multiple UV light treatments and ozone therapy.  Both of these treatments can help with viral infections as well.

Reminder: Don’t Rely on Natural Agents Alone

It’s worth repeating that while taking herbs, nutrients, homeopathy, or even receiving UV light/ozone therapy can help with Epstein-Barr, your number one focus should be to improve your immune system health.  This is the case with just about all infections, as while taking natural antimicrobials or prescription drugs might be necessary at times, if this is the only thing you do then you won’t truly be addressing the cause of the problem.  This is one of the main reasons why it’s quite common for people to have recurrent infections.

I’m sure there are some people reading this who felt that they were living a healthy lifestyle, yet still dealt with an infection such as Epstein-Barr.  If this is the case with you then chances are there is a weak link.  So if Epstein-Barr has been a factor in your health and you have been eating great and doing an awesome job of managing stress, then your immune system health is probably being compromised in other ways.  Perhaps the main “weak link” is another hidden infection, exposure to environmental toxins, toxic mold, or even EMFs.  It’s not always easy to find the reason behind a compromised immune system, but doing so is necessary to overcome a chronic infection.

A Few Other Things To Know About EBV:

• An acute EBV infection doesn’t always result in symptoms.  Many people think of mononucleosis when thinking of EBV.  Mononucleosis, also known as “mono”, is characterized by symptoms such as fatigue, a sore throat, a fever, swollen lymph nodes, and other signs and symptoms.  But not everyone who is initially infected with Epstein-Barr will develop these symptoms.  So Epstein-Barr can be a factor even if you never had “mono” or other virus-related symptoms.
• Epstein-Barr doesn’t just impact thyroid health.  Epstein-Barr has been linked to other health conditions as well.  This includes multiple sclerosis (7), rheumatoid arthritis (8), and lupus (9).  Non-autoimmune conditions linked to Epstein-Barr include Burkitt lymphoma (10), Hodgkin’s lymphoma (11), and gastric cancer (12).

What’s Your Experience with Epstein-Barr?

If Epstein-Barr has been a factor in your thyroid or autoimmune thyroid condition please feel free to share your experience in the comments section below.  Feel free to share anything you’d like, although I’d specifically love to hear about any “alternative” treatments you received and whether you feel they helped or not.

If you have read some of the posted comments from thyroid and autoimmune thyroid forums and Facebook groups, chances are you’ll come across people with Graves’ disease and Hashimoto’s who experienced dramatic improvements in their health just by changing their diet.  Some people do nothing but eliminate gluten from their diet, and yet feel significantly better.  Others need to be more strict with their diet in order to receive great results.  However, one question you might have is whether or not eating well simply helped to improve the health of these people, or did making these dietary changes reverse the autoimmune component of their condition?  I’m going to discuss this in this blog post.

Although the focus of this blog post is on whether changing one’s diet alone can reverse Graves’ disease and Hashimoto’s, I’d like to briefly review the triad of autoimmunity and discuss the four main categories of autoimmune triggers.  According to the triad of autoimmunity, in order for autoimmunity to develop you need 1) a genetic predisposition, 2) an environmental trigger, and 3) an increase in intestinal permeability (a leaky gut).  As you know, we can’t change your genes, but we can reverse autoimmunity by removing the trigger and healing the gut.

Focusing on the environmental triggers, there are four main categories of these triggers:

1. Food

2. Stress

3. Chemicals

4. Infections

As you can see, one of the main categories is food.  So it is possible that food can be a trigger, and if a specific food is the sole trigger, then eliminating this food from one’s diet can reverse the autoimmune component.  If this is the case, then why do some people who eliminate gluten, or perhaps even follow a strict autoimmune Paleo diet for a few months, not get into remission?  There are a few obvious answers, with one being that food isn’t a trigger in everyone.  In many people the main trigger is stress, chemicals, and/or infections.  If this is the case, then eating well alone won’t reverse one’s condition.

Another reason why a person who follows a strict AIP diet might not get into remission is because they have multiple triggers.  In other words, certain foods might be a trigger, but they might have one or more triggers from the other categories I listed above.  I see this quite frequently, as a person might feel significantly better when eliminating certain foods, but they are still symptomatic, their thyroid antibodies are still high, etc.  This usually means that not all of the triggers have been removed.

It’s also worth mentioning that a person might clean up their diet and not feel better, and then prematurely decide that food wasn’t the main trigger, when the real problem is that they weren’t strict enough with their overall diet.  For example, someone might completely go gluten and dairy free, but they might react to another food (i.e. corn).  Or perhaps cross contamination is an issue, as a person might think they’re completely avoiding a certain food, but somehow they’re getting exposed to it.  This is especially a concern when eating out.  These are just a few things to consider when evaluating your diet.

Which Foods Can Be Triggers?

The truth is that you can have an immune system reaction to any food.  However, this doesn’t mean that all foods are potential autoimmune triggers.  For example, while I don’t do a lot of IgG food sensitivity testing, I have done such testing on some of my patients, and I’ve seen people test positive for healthy foods such as broccoli and asparagus.  While one can argue that eating these foods might cause inflammation (if one is sensitive to them), and perhaps even prevent the gut from healing in this situation, they aren’t autoimmune triggers.

On the other hand, gluten, dairy, and corn are potential triggers of autoimmunity.  This is why most natural healthcare practitioners will advise their autoimmune patients to avoid these foods.  This is especially true when trying to restore one’s health, but a strong argument can be made to continue avoiding these common allergens even after achieving a state of remission.

How Can Food Trigger Autoimmunity?

Something called molecular mimicry may explain why certain foods can trigger autoimmunity.  I’ve discussed molecular mimicry in past articles and blog posts, as it seems that certain foods contain antigenic substances that have amino acid sequences similar to those of human proteins (1).  When someone eats these foods, this can result in the production of antibodies that not only react against the food antigens, but the body’s own tissues.  An example of this is gluten, as there is some evidence that gluten has a similar amino acid sequence to the thyroid gland, which can cause the body to develop antibodies not only against gluten, but the thyroid gland as well.

Removing Your “Leaky Gut Triggers”

In addition to environmental triggers playing an important role in thyroid autoimmunity, it’s also important to mention that different factors can cause a leaky gut.  In the past I’ve mentioned how gluten causes a leaky gut in everyone, and so if gluten is the only autoimmune trigger and is also the only “leaky gut” trigger, then avoiding gluten alone might be the solution to reversing the autoimmune component of Graves’ disease or Hashimoto’s.  I say “might” be the solution because even after removing the trigger and healing the gut, you might need to do things to reduce proinflammatory cytokines and increase regulatory T cells, which is also necessary to suppress the autoimmune component.

Cure vs. Remission vs. Improvement

In some of my webinars and articles I’ve discussed the difference between “cure” and “remission”, and how Graves’ disease and Hashimoto’s can’t be permanently cured since they involve a genetic component.  While “getting into remission” doesn’t sound as good as “being cured”, this still involves the elimination of one’s symptoms, normalization of thyroid markers (include thyroid antibodies), and correcting other imbalances related to the autoimmune thyroid condition.  And it is possible to stay in remission for a prolonged period of time, as I’ve been in remission from Graves’ disease since 2009, although I’ve dealt with some other health issues over the years, most notably Lyme disease, which I discussed in a previous blog post.

On the other hand, many people experience an improvement in their symptoms and/or labs upon changing their diet, but they don’t go into remission.  For example, they might have a reduction of their symptoms, but they don’t completely go away.  Or their blood tests might improve, but they’re still not in balance.  Keep in mind that in some cases of Hashimoto’s the thyroid panel can’t be normalized, which is why you also want to monitor the thyroid antibodies, along with other tests that were out of range.  If you experience some positive changes after modifying your diet but don’t get into remission, please don’t become discouraged, as this is very common.  When this is the case, in most cases there are other triggers/imbalances that need to be addressed.

How Do You Know If Food Is Your Only Trigger?

As for how to know if food is your only trigger, in my opinion, the best way to find out is through an elimination and reintroduction diet.  If you avoid all of the allergenic foods (gluten, dairy, corn, etc.) and your symptoms resolve and your thyroid panel and antibodies normalize, then you know that food was the main culprit.  On the other hand, if your symptoms don’t improve and/or your blood tests don’t normalize, then there are most likely other triggers present.  As I briefly mentioned earlier, sometimes removing the trigger alone isn’t sufficient, as you might need to do other things to reduce the inflammation.

I mentioned IgG food sensitivity testing earlier, and you might wonder if this is something you should consider doing.  In some cases this can detect food triggers, although false results are common, which is why I don’t recommend such testing to all of my patients.  Earlier I also mentioned that not every food that tests positive on an IgG food sensitivity panel is an autoimmune trigger. I realize that many people don’t want to stop eating foods that have gluten and dairy, but this is the best way to find out of these are triggers.  Plus, even if gluten isn’t a trigger it’s best to be avoided, especially while healing your gut.

Is It Necessary To Eat A Strict Diet If Food Isn’t The Main Trigger?

If you’re pretty sure that certain allergens aren’t a trigger in your case, you might wonder if it necessary to continue avoiding these.  For example, if you followed an elimination diet for at least 30 days and didn’t experience any improvement in your symptoms or thyroid markers, is it okay to reintroduce gluten, dairy, and other common allergens?  I get this question asked a lot, and I usually recommend to continue avoiding the “allergenic foods” at least until one’s health has been restored…even if they aren’t responsible for triggering autoimmunity.

This is especially true with gluten, as I reminded you earlier how the research shows that gluten causes a leaky gut in everyone.  And since dairy and corn cross react with gluten (eating these foods can produce gluten antibodies), one can argue that it’s best to avoid these foods as well.  In fact, some natural healthcare practitioners recommend for people with autoimmune conditions of all types to permanently avoid gluten, dairy, and corn.  I’d be lying if I told you that I’ve avoided all of these 100% since I’ve been in remission.  But I’ll also admit that anytime myself or anyone else with an autoimmune condition is exposed to these food allergens they’re taking a risk.

What’s Your Experience With Avoiding “Food Triggers”?

Please feel free to share your experience with eliminating some of the allergenic foods discussed in this blog post.  If you received good results when avoiding gluten, dairy, corn, etc., and perhaps even achieved a normalization of your thyroid antibodies after doing this, please feel free to share your experience in the comments section below.  On the other hand, if you strictly avoided these common allergens and didn’t see any positive changes, I’d like to hear from you as well.  Perhaps you didn’t notice a difference in your health when avoiding gluten, dairy, or corn, but noticed a significant improvement when avoiding another food or allergen (i.e. soy, eggs, nightshades, etc.)

The kidneys are vital organs that play an important role in filtering our blood.  Since thyroid hormone affects every cell and tissue in the body, it shouldn’t be a surprise that having hypothyroidism or hyperthyroidism can have an impact on kidney health.  In this blog post I’m not only going to discuss the relationship between the thyroid gland and the kidneys, but I’m also going to give you some information that will help you to determine if your kidneys are working properly.  As a result, this blog post won’t only be beneficial for those with thyroid and autoimmune thyroid conditions, but will be valuable to anyone with kidneys (which hopefully describes YOU!).

I’d like to start out by discussing some of the basics of kidney function.  First of all, each kidney consists of filtering units called nephrons, and each nephron includes a filter called the glomerulus, along with a tubule.  These structures are part of the renal cortex, which is the outer part of the kidney.  The glomerulus filters your blood, and the tubule helps to remove toxins, reabsorbs ions, water, and nutrients, which in turn helps to maintain blood pH and electrolyte balance.  There is also something called a collecting duct, which reabsorbs solutes and water, which in turn forms urine.

Let’s go ahead and list some of the functions of the kidney in bullet-point format:

• Acid-base balance
• Maintaining fluid balance
• Regulation of electrolytes
• Removal of waste materials from food, medications, and toxic substances
• Regulation of blood pressure
• Production of certain hormones (i.e. erythropoietin) that help to produce red blood cells
• Activation of vitamin D

Health Conditions Involving The Kidneys

There are many health conditions associated with the kidneys, and I’m going to list a few of them below:

• Chronic kidney disease
• Kidney stones
• Glomerulonephritis
• Acute nephritis
• Polycystic kidney disease
• Urinary tract infections
• Acidosis
• Uremia
• Nephrotic syndrome

What Is Chronic Kidney Disease?

I’m not going to discuss all of these conditions I listed above, but I do want to discuss chronic kidney disease (CKD).  CKD is a common condition that refers to a long-term loss of kidney function.  It is identified by the presence of an abnormality of kidney structure or function (or both) for at least 3 months (1).  Some of the common risk factors for developing CKD include a family history, smoking, high blood pressure, diabetes, and obesity.  I’ll talk about the relationship between thyroid hormone imbalances and CKD shortly.

How is Chronic Kidney Disease Diagnosed?

As I mentioned earlier, CKD is identified by the presence of an abnormality of kidney structure and/or function for at least 3 months.  Specifically, one of the following needs to be present for at least 3 months (2):

• Decreased estimated glomerular filtration rate (eGFR) (<60 mL/min/1.73 m2)
• Albuminuria (urinary albumin-to-creatinine ratio ≥30 mg/g)
• Structural abnormalities (from imaging)
• Urine sediment abnormalities (hematuria, red or white blood cell casts, oval fat bodies or fatty casts, granular casts, and renal tubular epithelial cells)
• Electrolyte and other abnormalities due to tubular disorders
• Histological abnormalities
• Previous history of kidney transplantation

While diagnosing CKD might seem to be complex, in many cases a simple comprehensive metabolic panel (CMP) can provide the necessary information.  A urinalysis can also come in handy.  Some of the markers related to kidney function on a CMP include:

• Estimated glomerular filtration rate (eGFR)
• Blood urea nitrogen (BUN)
• Creatinine
• Electrolytes (sodium, potassium)

Of these, the eGFR is the most helpful, with creatinine next.  If someone has an elevated creatinine and depressed eGFR, this is an indication that there is kidney dysfunction occurring.  However, there are a few important things you need to understand.  Since CKD is diagnosed if the abnormality is present over a period of 3 months, you can’t diagnose CKD by one abnormal CMP.  In other words, if a SINGLE test shows that you have elevated creatinine levels and a low eGFR, this isn’t diagnostic of CKD.  I’ve had patients who showed these findings on a CMP, only to have these values normalize upon retesting them.

I also mentioned that a urinalysis can be helpful in diagnosing kidney dysfunction.  Protein in the urine (proteinuria) can be an important indicator of renal disease and the types of proteins found in the urine help to distinguish glomerular and tubular disorders (3).  In addition, if casts and/or blood cells are present in the urine then this can also provide some important clues about the causes of kidney dysfunction (3).

The Different Stages of Chronic Kidney Disease

Another thing to keep in mind is that there are different stages of chronic kidney disease.  The stage of CKD is based on the eGFR and the level of proteinuria.  Patients are classified as G1-G5 based on the eGFR, and A1-A3 based on the albumin:creatinine ratio (4).  What’s important to understand is that the lower the eGFR, the worst the kidney function.  For example, if someone has a GFR between 45 and 59, this is considered to be a mild to moderate reduction in kidney function, whereas if they have a GRF between 15 to 29 this is considered to be a severe reduction, with a GFR <15 indicating kidney failure.

The Kidney Stone-Oxalate Connection

Although I’m not going to discuss kidney stones in this blog post, in the past I’ve written an article about oxalates, which are a common cause of kidney stones.  If this is something that interests you please check out my article “Oxalates, Kidney Stones, and Thyroid Health”.

The Relationship Between Thyroid Health and Kidney Health

Thyroid hormones affect the development and physiology of the kidneys.  As a result, thyroid dysfunction can affect renal blood flow, glomerular filtration rate, tubular function, electrolyte homeostasis, and kidney structure (5).  Similarly, kidney disease can have a negative effect on thyroid health.  What I’d like to do next is specifically look at the relationship between hypothyroidism and kidney health, as well as hyperthyroidism and kidney health.

Hypothyroidism and Kidney Health

Multiple case studies have shown that overt hypothyroidism can cause elevations in creatinine, reduced renal blood flow, and decreased GFR (6).  However, this usually won’t cause chronic kidney disease, and correcting the thyroid hormone imbalance will usually result in normalization of these markers.  That being said, I did come across a case report involving a 75-year old woman who had CKD caused by hypothyroidism (7).  As for the impact of kidney dysfunction on thyroid health, mild to moderate kidney dysfunction usually won’t cause thyroid hormone imbalances, although as I’ll discuss shortly, chronic kidney disease can cause overt hypothyroidism.

Hyperthyroidism and Kidney Health

Hyperthyroidism causes an increase in renal blood flow and GFR, with the GFR increasing about 18–25% among hyperthyroid patients (8).  Thyroid hormones increase the plasma renin, angiotensin II, and serum angiotensin converting enzyme levels (8).  If you have elevated thyroid hormone levels and you get a comprehensive metabolic panel you probably will see a decreased creatinine.  This is not only due to an increase in the filtration rate, but also is caused by a decrease in muscle mass (9).  Usually the serum sodium and potassium will be normal on a CMP, although there are exceptions, with hypokalemia (low potassium) being more common than hyponatremia (low sodium).  The good news is that most of these imbalances are reversed upon balancing the thyroid hormone levels, although sometimes the person will need to rebuild muscle mass (i.e. do weight-bearing exercises) to increase the creatinine.

Chronic Kidney Disease and Thyroid Health

Now I’d like to look more specifically at the relationship between chronic kidney disease and thyroid hormone imbalances:

Hypothyroidism and Chronic Kidney Disease

Recent studies show that hypothyroidism is associated with a higher risk of cardiovascular disease and death in CKD (10).  There is also increasing evidence that hypothyroidism is a risk factor for the development of CKD, as well as its progression (10).  The reverse seems to be true as well, as the research shows a higher prevalence of subclinical and clinical hypothyroidism in those with chronic kidney disease (11).

Since thyroid hormones affect every cell and tissue in the body, it probably isn’t surprising to learn that hypothyroidism can have a negative effect on kidney health.  But how can severe kidney dysfunction cause hypothyroidism?  There are a few possible mechanisms.  One involves the retention of iodine due to impaired kidney excretion (11).  This actually may be a mechanism that can also cause hyperthyroidism in some people with CKD.  In addition, CKD may cause dysregulation of the hypothalamic-pituitary-thyroid (HPT) axis (11).  Finally, the peripheral conversion of T4 to T3 may be impaired in CKD, resulting in low T3 levels (12).

When someone has CKD and low T3 levels, along with an elevated TSH, many practitioners would look to address this by giving the patient thyroid hormone replacement.  However, when doing research for this blog post I came across a few different sources which mentioned how clinicians need to exercise caution in treating patients with low T3 levels/elevated TSH, as this can lead to a negative nitrogen balance (12).

This poses a bit of a dilemma for someone with CKD who has low T3 levels, as having healthy thyroid hormone levels is very important.  While giving thyroid hormone replacement might not be wise in some cases of CKD, addressing the cause of the conversion problem is an option to consider.  In the case of CKD, some of the factors that commonly affect the conversion of T4 to T3 include chronic metabolic acidosis, chronic protein malnutrition, and decreased clearance of proinflammatory cytokines (12).

Hyperthyroidism and Chronic Kidney Disease

Although hyperthyroidism doesn’t cause CKD, it can accelerate it (12).  The problem is that many people in the earlier stages of CKD aren’t aware that they have any kidney issues.  If you had one of the risk factors (i.e. smoking, high blood pressure, obesity, diabetes) prior to developing hyperthyroidism then of course there is a greater chance that you have CKD, which means that in someone with hyperthyroidism there is an even greater urgency to decrease the thyroid hormone levels.

Conventional Treatment Methods for CKD

The treatment for CKD depends on the severity of the condition.  Of course with any type of kidney disease you want to make sure you address some of the risk factors I mentioned earlier.  Unfortunately this frequently is accomplished through medication, which further stresses out the kidneys.  For example, if someone has high blood pressure, medication very well might be necessary, but this shouldn’t be the only treatment recommended.  Similarly, if someone has type 2 diabetes, medication such as Metformin might be a good idea to take on a temporary basis, but doing other things to address the cause of the condition is important.  Of course if someone is smoking then quitting is the only good solution, although I realize that it’s not easy to do.

If someone reaches what’s referred to as “end-stage” kidney disease, then the two options usually given are dialysis or having a kidney transplant.  Dialysis is a treatment that removes waste products and extra fluid from your blood (since your kidney is no longer able to do this).  And a kidney transplant is when someone donates a healthy kidney which replaces one of your non-functioning kidneys.  Of course neither of these options are desirable, which is why you want to do everything you can to maintain the health of your kidneys.  Perhaps in the future stem cell therapy will be an option (13), but even if this is the case in the future keep in mind that 1) stem cell therapy is expensive, and 2) my guess is that not everyone with CKD will be a candidate to receive it.

Can Homeopathy Help With Chronic Kidney Disease?

In November of 2015 my cat “Cookie” was diagnosed with chronic kidney disease.  Cookie lived a great life, and she was 17 years old at the time, but I was still sad when she was diagnosed with CKD.  The veterinarian gave Cookie 2 to 3 months to live.  I gave her fluids daily, but after a few weeks she was going downhill fast, vomiting frequently, and her appetite was decreasing.  I should add that I brought Cookie to the vet for some acupuncture treatments, which didn’t seem to help much.

One day I was in a pet store, and I asked the owner if she could suggest any natural remedies for my cat.  She suggested a homeopathic formula called RenoAid by the company HAMPL.  And so I started giving Cookie the homeopathic formula.

To make a long story short, I was very skeptical about the homeopathy helping, but I figured I had nothing to lose but the $35 I spent on the bottle.  It was the least I could do to try to help Cookie.  Cookie gained her appetite back and seemed to be back to her old self.  I know for certain it was the homeopathic formula that helped, as a few weeks later we went away on a one-week cruise, and we left Cookie with a friend.  The friend did give Cookie the homeopathic formula while we were away, but only once or twice per day (I had been giving it to her six times per day), and when we came back from the cruise Cookie started losing her appetite again.  I gave her the RenoAid more frequently and fortunately her health improved.

Cookie passed away in July 2017, approximately 18 months after the vet told me she had only 2 or 3 months to live.  The homeopathy didn’t cure her CKD, but it allowed her to live a happy life for 1 1/2 years.  I’m telling this story not to encourage people with CKD to receive homeopathy, but just as a reminder that natural treatment options can be powerful.  Unfortunately I’m unaware of a similar homeopathic product for humans, but I’d like to discuss some things you can do naturally to support the health of your kidneys.

Natural Treatment Options For Kidney Health

1. Eat a healthy diet.  This of course is the case with any chronic health condition, as you want to eat mostly whole foods, including plenty of vegetables.  I need to mention that if someone has already been diagnosed with CKD then they will want to make sure not to eat too much protein.  This frequently is the case for those with Graves’ disease or Hashimoto’s who follow an autoimmune Paleo (AIP) diet, as many people will eat a lot of meat.  Just keep in mind that you don’t need to eat a lot of meat when following an AIP diet.  I realize that many people eat a lot of meat because they don’t feel full unless if they eat meat with every meal…this is especially true with those who have hyperthyroidism.  But ideally you want to eat mostly vegetables, which is true with just about any healthy diet.

2. Stay hydrated.  Drinking plenty of water is important for optimal kidney health.  I recommend to drink purified water or a good quality spring water out of a glass bottle, and to try your best not to drink tap water or water in plastic bottles.  I realize this might not be possible 100% of the time, as if you go to a restaurant or travel then there might be times when you drink tap water or water out of a plastic bottle.  But don’t underestimate the impact that chemicals in the water will have not only on your kidney health, but your overall health as well.  One thing to keep in mind is that while there are no studies which show that bisphenol A (BPA) can cause or contribute to CKD, BPA (and other chemicals) will build up when the glomerular filtrate rate decreases (14).

3. Minimize your consumption of sugar.  I mentioned how having diabetes is a risk factor for CKD.  But being prediabetic is associated with a modest increase in CKD (15).  And let’s face it, many people with prediabetes will eventually develop “full blown” diabetes.  After all, it’s not as if someone has healthy blood sugar levels one day and the next day they develop type 2 diabetes.  Obviously it takes time for this condition to develop.  If you have high blood glucose and/or insulin levels but haven’t progressed to type 2 diabetes yet I’d check out my blog post entitled “Insulin Resistance, Hypoglycemia, and Thyroid Health”.  If you already have diabetes then you can read my article on the 4 types of diabetes.

4. Normalize your blood pressure.  As I discussed in a past article I wrote on blood pressure, hypertension is common with both hyperthyroidism and overt hypothyroidism.  But many times high blood pressure is unrelated to thyroid hormone imbalances.  Other causes of hypertension include smoking, obesity, stress, adrenal problems, and sleep apnea.  Sometimes it can be challenging to find the cause of hypertension.  While medication is an option to consider in some cases, if you have high blood pressure it makes sense to also try to improve your diet and lifestyle, and certain nutritional supplements may also be beneficial, including fish oils, CoQ10, and aged garlic.

5. Balance your thyroid hormone levels.  After reading this blog post you should have a basic understanding as to how both hyperthyroidism and hypothyroidism can affect the health of the kidneys.  Even if the thyroid hormone imbalance isn’t the primary cause of the kidney dysfunction, having either hyperthyroidism or hypothyroidism can worsen the kidney condition.  This is especially true if someone has hyperthyroidism in the presence of CKD.

6. Reduce your toxic load.  Exposure to certain environmental chemicals can cause renal injury due to excessive oxidative stress (16).  Two of these chemicals include perfluoroalkyl acids and dioxins.  Heavy metals can also have a negative effect on the kidneys, although the extent and the expression of renal damage depend on the species of metals, the dose, and the time of exposure (17).  I came across another study which showed that arsenic exposure can be related to CKD (18).  While it’s impossible to completely eliminate your exposure to environmental toxins, you can 1) minimize your exposure to environmental chemicals and 2) do things to eliminate chemicals from your body.

7. Lower high oxalate levels.  Oxalates not only can cause kidney stones, but in some cases oxalate crystals are associated with renal inflammation, fibrosis and progressive renal failure (19).  In the past I have tested high for oxalates, which I’m certain was due to my diet, as I was eating plenty of high oxalate foods at the time (i.e. spinach, berries, and nuts).  Having high oxalates doesn’t mean that you need to eliminate all foods high in oxalates, but it probably would be a good idea to minimize your exposure to them.  The test I recommend is the Organic Acids Test from Great Plains Laboratory.

8. Take natural agents to support kidney health.  I don’t think this is necessary for everyone to do, and I can’t say that I commonly recommend supplementation for kidney health, but if you have a current kidney issue then this is something to consider.  When doing research in this area I found some of the following natural agents to be beneficial for the kidneys:

Cordyceps sinensis.  There is evidence that cordyceps can improve renal function and specifically decrease serum creatinine, increase creatine clearance, reduce proteinuria, and alleviate CKD-associated complications (20) (21).

Astragalus.  There is evidence that astragalus can improve the renal function of CKD patients (22) (23).

Poria cocos.  This is a medicinal fungus that showed to benefit rats who had CKD (24).

Green tea polyphenols.  One study I came across showed that green tea polyphenols can help with early renal damage (25).

Curcumin.  Curcumin can help with many different health conditions, and a few studies show that it can help those with CKD by reducing inflammation and oxidative stress (26) (27).  Another study showed that it can be useful in the prevention and treatment of renal fibrosis (28).

Resveratrol.  A few different studies show that resveratrol can prevent renal injury due to its antioxidative properties (29) (30).

Glutathione.  The kidneys are highly dependent on an adequate supply of glutathione to maintain normal function (31), and so doing things to increase glutathione levels is important.  This can be accomplished through diet (i.e. consumption of cruciferous vegetables), taking glutathione precursors (i.e. N-acetylcysteine), or an acetylated or liposomal glutathione supplement.

You may have noticed that most of the natural agents listed can help to reduce inflammation and oxidative stress, which is why they can help with CKD.  If someone has CKD then perhaps they’ll want to take a kidney support product consisting of a few of the agents I listed here, but otherwise I would just focus on eating well, making sure you’re well hydrated, perhaps drink green tea on a regular basis, and do what’s necessary to have healthy glutathione levels.

Have you seen any relationship between your thyroid condition and kidney function?  If so, please share your experience in the comments section below.  Remember that you can find out some good information by doing a simple comprehensive metabolic panel and looking at the eGFR. You can also get some valuable information from a urinalysis.