Many people with hypothyroidism and Hashimoto’s Thyroiditis take thyroid hormone medication, and every now and then I’ll get asked if there is a natural substitute for thyroid hormone.  I deal with both hyperthyroid and hypothyroid conditions, and with hyperthyroid conditions there are some pretty good natural alternatives for the medication.  For example, bugleweed is an herb which has antithyroid activity, and many people choose to take this instead of antithyroid medication.  And motherwort can be used instead of beta blockers in some people with hyperthyroidism.  But are there nutritional supplements or herbs which can effectively manage the hypothyroid symptoms while someone is trying to restore their health back to normal?

Most people with hypothyroid conditions are aware that there are natural alternatives to synthetic thyroid hormone, such as Armour and Nature-Throid.  But while many people do better on natural thyroid hormone, this is still a form of hormone replacement therapy.  In other words, natural thyroid hormone isn’t doing anything for the actual cause of the condition.  Then again, neither is the bugleweed or motherwort many people with hyperthyroid conditions take, as I recommend these to manage the hyperthyroid symptoms while trying to address the cause of the condition.  Even so, some people prefer to take supplements and herbs, and would like to avoid taking hormones whenever possible.

Are There Supplements And Herbs To Take Instead of Thyroid Hormone Medication?

If someone has depressed thyroid hormone levels then unfortunately there are no nutritional supplements or herbs which will replace thyroid hormone.  And this is the case with any hormone deficiency.  However, there are nutrients and herbs which can help to increase the output of thyroid hormone, and in some cases these can be taken while the cause of the condition is being addressed.  So what I’d like to do is talk about some of these nutrients and herbs which might be beneficial in some cases of hypothyroidism.

Iodine. Yes, I’m starting with the controversial iodine.  I’m definitely not suggesting that iodine can be taken instead of thyroid hormone medication, and  I realize that many people with Hashimoto’s Thyroiditis don’t do well when taking iodine.  However, iodine is necessary for the formation of thyroid hormone, as thyroxine (T4) consists of four iodine atoms, while triiodothyronine (T3) consists of three iodine atoms.  Although an iodine deficiency can cause hypothyroidism, most cases of hypothyroidism are caused by Hashimoto’s Thyroiditis.  With that being said, if someone has a non-autoimmune hypothyroid condition and tests positive for a moderate to severe iodine deficiency, then it probably would be a good idea to correct this deficiency.  If someone with Hashimoto’s tests positive for an iodine deficiency then eventually this should be corrected, although other factors may need to be addressed first in order to make sure the person doesn’t have a negative reaction to iodine.

Tyrosine. This is an amino acid, and like iodine, this is also necessary for the formation of thyroid hormone.  As a result, many thyroid support formulas will include tyrosine.  However, very rarely is a tyrosine deficiency the primary cause of hypothyroidism.  And so while supplementing with tyrosine usually won’t cause any problems, it also is unlikely to make much of a difference with regards to thyroid hormone output.

Selenium. This mineral is important for the conversion of T4 to T3.  As a result, if someone has normal levels of T4 but low levels of T3, they very well might have a selenium deficiency.  However, there are other factors which can also interfere with the conversion of T4 to T3, such as high cortisol levels.  Some studies have shown that selenium can help to reduce thyroid antibodies, and while this isn’t always the case, when it does help to lower these antibodies this will minimize the amount of thyroid gland damage, which in turn can help with the output of thyroid hormone.

Iron. Iron is another mineral which is essential for normal thyroid hormone metabolism, and a deficiency of this mineral impairs thyroid hormone synthesis by reducing the activity of heme-dependent thyroid peroxidase (1).  Iron deficiency anemia is very common, and while this might not be the cause of most cases of hypothyroidism, if someone has an iron deficiency I think it’s safe to say that it’s not helping with the thyroid condition.  And so I recommend for most of my patients to not only get a complete blood count, but also an iron panel which includes serum iron, ferritin, iron saturation, and TIBC.

Zinc. Studies show a significant correlation between serum zinc levels and thyroid volume, along with thyroid antibodies and free T3 levels (2) (3).  Once again, taking zinc alone probably won’t make much of a difference in someone with hypothyroidism, although if someone is deficient in zinc it could be a contributing factor.

Ashwagandha. There are a few studies which show that ashwagandha can stimulate thyroid hormone production (4) (5).  In fact, one of these was a case study which showed that taking ashwagandha caused thyrotoxicosis in a 32-year old woman.  However, I’ve given ashwagandha to numerous patients with hyperthyroid conditions without a problem, as it doesn’t seem to directly affect the thyroid gland, but instead affects the hypothalamic-pituitary-thyroid (HPT) axis.  It also affects the hypothalamic-pituitary-adrenal (HPA) axis, which can in turn modulate cortisol levels.  Ashwagandha is commonly given to lower elevated levels of cortisol, but in most cases it can also be safely taken with those who have depressed cortisol levels.  Anyway, some people with low or depressed thyroid hormone levels might benefit from taking ashwagandha.

Coleus. Coleus (Coleus forskohlii) is a member of the Lamiaceae or Mint family.  While it can help with numerous conditions such as cardiovascular disorders, abdominal pain, and constipation, it also is commonly used for hypothyroidism, as it can potentially stimulate thyroid hormone production.

Thytrophin PMG. Some think of this as a glandular, although it’s actually referred to as a protomorphogen.  I have been using this in my practice for many years.  This product doesn’t contain any thyroid hormone.  In fact, many people with Graves’ Disease are able to take this, as its main purpose is to help neutralize the effects of the thyroid antibodies.  Thytrophin PMG isn’t meant to be a replacement for thyroid hormone medication, although every now and then I’ll receive an email from someone who is taking this instead of synthetic or natural thyroid hormone.

Thyroid glandulars. There are numerous types of thyroid glandulars, some of which don’t have thyroid hormone, and other products which do include thyroid hormone.  Obviously if someone is looking to completely avoid taking any type of thyroid hormone then they probably will also want to avoid taking thyroid glandulars which have thyroid hormone.  On the other hand, since these usually have a smaller amount of thyroid hormone, along with some of the nutrients and herbs I listed above, many are willing to take a thyroid glandular instead of levothyroxine, Armour, or Nature-Throid.

So these are some of the supplements and herbs which might benefit people who are looking to avoid taking thyroid hormone medication.  Unfortunately there is no natural substitute that can be taken in place of thyroid hormone, and having sufficient levels of thyroid hormone is very important.  While some people might do fine taking some of the nutrients and/or herbs I discussed in place of thyroid hormone, most people with overt hypothyroidism will need to be on some type of thyroid hormone medication, although they might be fine taking a thyroid glandular which has a small amount of thyroid hormone, along with other nutrients and herbs to support the thyroid gland.

I think it’s safe to say that we’re in a “smoothie era”, as millions of people consume smoothies on a daily basis.  There are a number of positive benefits of consuming green smoothies.  I personally have a green smoothie every morning for breakfast, and many of my patients do the same.  But while there are some great health benefits of drinking green smoothies on a daily basis, there are also some potential downsides of drinking these.

Before I discuss some of the potential “risks” of drinking green smoothies on a daily basis, I’d like to briefly mention a few of the primary benefits of green smoothies:

Benefit #1: Green smoothies can make it easier to start the day with a few servings of vegetables.  I look at the food diaries of patients all of the time, and to no surprise, most people don’t eat enough vegetables on a daily basis.  And most people who eat a few servings of vegetables per day don’t eat any during breakfast, but instead eat them during lunch and/or dinner.  Obviously this doesn’t apply to everyone, but it does apply to most people. It definitely applied to me growing up, as for the first few decades of my life I usually had a bowl of sugary cereal with cow’s milk for breakfast.

Benefit #2: Smoothies offer “instant hydration”, as they allow you to start the day off with a couple of cups of water.   To be fair, many people don’t add water to their smoothies, but instead add something else such as cow’s milk, almond milk, coconut milk, etc.  But many people don’t drink enough water, and so I would encourage you to at least add one cup of water to your smoothie.  For example, if you currently add two cups of coconut milk to your smoothies, try adding only one cup of coconut milk and one cup of purified water.  On most days I personally add 1/4 cup of organic almond milk to my smoothies, and 1 3/4 cups of purified water.

Benefit #3: You of course can include other healthy ingredients to your smoothies.  In addition to green leafy vegetables you can add carrots, avocados, and berries.  Many people can also add raw egg yolks and/or coconut oil to their smoothies.  Some people add a type of protein powder to their smoothie, which usually is fine, but just remember that these powders shouldn’t take the place of whole healthy foods.  I know some people have smoothies which consist of almond or coconut milk, strawberries and bananas, some type of protein powder, and nothing else.  While this is healthier than the bowl of sugary cereal I mentioned earlier, you should also add some vegetables and a healthy type of fat such as an avocado or coconut oil.  I can understand not wanting to add a raw egg yolk, although when combined with the other ingredients I mentioned, most people won’t even taste the raw eggs.  But besides the fact that some people find adding a raw egg to be disgusting, if someone is following a strict autoimmune paleo diet then they probably won’t be adding eggs to their smoothies.

So these are some of the health benefits of drinking smoothies.  But there are also some potential risks of drinking smoothies:

Risk #1: Green smoothies are typically goitrogenic. This of course depends on which green vegetables are added to the smoothie, but two of the most common green leafy vegetables added to smoothies are kale and spinach.  And while both of these have healthy nutrients, eating large amounts of raw kale and spinach can potentially inhibit thyroid activity.  Although there might be some risks with those people who have a hypothyroid condition with regards to eating large amounts of raw goitrogenic vegetables, adding 1/2 cup to one cup of these vegetables to a daily smoothie usually won’t cause a problem with most people, even those with hypothyroidism and Hashimoto’s Thyroiditis.  On the other hand, adding a few cups of raw goitrogenic vegetables to your smoothies and having one or two of these on a daily basis might cause problems in some people with hypothyroid conditions.  I spoke about goitrogens in greater detail in an article I wrote entitled “An Update On Goitrogenic Foods and Their Impact on Thyroid Health“.

Risk #2: Green smoothies can be high in oxalates. Oxalates are substances which bind to calcium, and this interferes with its absorption.  Eating foods high in oxalates can therefore lead to a decrease in bone density.  Another risk is that large amounts of oxalates can cause kidney stone formation.  I actually spoke about this in a post entitled “Should Spinach Be Avoided In Those With Thyroid Conditions?“, as I discussed the risk of loading smoothies with foods high in oxalates, such as spinach and swiss chard.  But it’s not just green leafy vegetables which are high in oxalates, as blackberries, blueberries, and raspberries are also high in oxalates, and of course many people add berries to their smoothies.  Once again, I’m not suggesting that people shouldn’t add berries to their smoothies, or other foods high in oxalates.  But it might be a good idea to minimize the amount of these foods you add to your smoothies.

Risk #3: Smoothies prepared the wrong way can spike up your blood sugar levels. Although I do think it’s fine to add some fruit to your smoothies, some people add too much fruit.  Bananas are one of the most commonly added fruits to smoothies, and while many people do fine adding a small banana to their smoothie, some people will add a few bananas, along with a few servings of other fruits to their smoothies.  This can especially be problematic for someone who has blood sugar imbalances, or an underlying yeast infection.  It’s not uncommon for people to prefer fruit over vegetables, and this definitely describes me.  When I first began making smoothies I probably added too much fruit, but I currently add 1/4 cup of organic berries to my smoothies and in my opinion it tastes fine.  Adding a healthy source of protein or fat will minimize the impact that the fructose will have on your blood sugar levels.  I would recommend adding an avocado, one tablespoon of coconut oil, and/or one or two raw egg yolks.

Risk #4: Some people include unhealthy ingredients in their smoothies. Although I’m fine with most people adding some type of “healthier” protein powder to their smoothie, doing so isn’t required.  And even if you do add a small amount of protein powder, you want your smoothie to consist primarily of whole foods.  Add a small amount of fruit, a few servings of vegetables, a healthy type of fat, etc.  But if you do add a protein powder you want to make sure it’s of good quality, and you also want to carefully read the ingredients and make sure it doesn’t include any artificial colorings or flavorings, as well as other unhealthy ingredients.

So What’s The Final Verdict?

I think most people with thyroid and autoimmune thyroid conditions can have green smoothies without a problem.  Just like anything else, the key is having a “balanced” smoothie.  Some people add too much fruit, while others add excessive amounts of green leafy vegetables.  But most people will do fine adding a small amount of fruit, while adding a few servings of vegetables, making sure to add a variety of different vegetables (i.e. 1/2 cup of arugula, 1/2 cup carrots, 1/2 cup broccoli, etc.).

Some healthcare professionals are opposed to smoothies because they feel it’s better to eat your food rather than drink your food.  In other words, rather than consume some or all of these ingredients in the form of a smoothie, they would recommend to simply have one or two eggs for breakfast, a few servings of vegetables, a serving of berries, a healthy type of fat, some meat, etc.  I can’t argue with this, as I admit that it’s better to sit down and eat a meal rather than drink a smoothie.  However, we live in an “era of convenience”, and whereas most people aren’t going to take the time to individually prepare all of these foods, many people are willing to add them to a smoothie.  Of course it can also be time consuming to make a smoothie, as I know it takes me awhile to make my morning smoothie.  In any case, for those people who are preparing a healthy breakfast I’m not suggesting to replace it with a smoothie.  On the other hand, for those people who aren’t eating a healthy breakfast and/or aren’t consuming a sufficient amount of vegetables each day, then having a daily green smoothie might be a good idea.

Something else to keep in mind is that even if you have a morning smoothie, you obviously still want to eat vegetables throughout the day.  I recommend eating a combination of raw and cooked vegetables.  Some healthcare professionals don’t recommend any raw veggies, but I think having a few servings of these are fine, along with having a few servings of cooked vegetables.  But there are some people who will overdo it with the raw vegetables, as they might have a green smoothie for breakfast, a big salad for lunch, another smoothie as an afternoon snack, and another salad for dinner.  I’m not opposed to people having salads, but they also should try adding in a few servings of steamed veggies each day.

In summary, millions of people consume green smoothies on a daily basis, and there are both benefits and risks of drinking these.  Some of the primary benefits of green smoothies are that they allow you to add some extra vegetables, along with some purified water, and other healthy ingredients, such as healthy fats and protein.  However, green smoothies are usually goitrogenic, can be high in oxalates, and might spike up the blood sugar levels.  You of course want to make sure not to add unhealthy ingredients, which can easily be avoided by sticking with whole foods, and organic foods whenever possible.  Overall I think green smoothies are fine for most people with thyroid and autoimmune thyroid conditions to drink on a daily basis, but you want to make sure not to load it up with too much of a single ingredient, such as green leafy vegetables, fruit, protein powder, etc.

Most people don’t consider problems with oral health to be related to health conditions in other bodily areas.  However, having poor oral health can increase the risk of developing certain chronic conditions, and might also play a role in the development of autoimmune thyroid conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.  Of course I’m not suggesting that most cases of thyroid autoimmunity are caused by poor oral health, but this is a factor that is overlooked by most people, yet should be considered.  Fortunately more and more healthcare professionals are realizing that mercury amalgams can cause problems, and some also are aware of the potential risk factors of root canals.

It should make sense when you think about the connection between oral health and the rest of the body.  This is especially true with mercury amalgams, as many people reading this are aware of the risks of these, and it’s not uncommon for me to speak with a patient who has gotten all of their silver fillings replaced.  However, many people don’t make a similar connection with root canals and other health conditions.  Part of this has to do with the approach of most dentists, as while many dental clinics are avoiding the use of mercury amalgams, most still perform root canals on a frequent basis.  In addition, while there are tests which measure the amount of mercury in the tissues, which in turn can be linked to mercury amalgams, there isn’t a reliable test to see if a root canal is causing any health issues.

Is Mercury The Cause Of Your Autoimmune Thyroid Condition?

Before talking about root canals, let’s go ahead and briefly talk about the impact of mercury.  First of all, there is no doubt that having mercury amalgams results in the release of mercury vapors during the act of chewing.  What’s controversial is the effect that the mercury vapors have on our health, and whether this can serve as a trigger for thyroid autoimmunity, as well as other health conditions.  While some studies show that there is no relationship between dental amalgams and Hashimoto’s Thyroiditis (1), other studies have shown that the removal of dental amalgam decreases TPO and thyroglobulin antibodies in patients with autoimmune thyroiditis (2).  I’ll expand on this shortly.  Both the FDA and Centers for Disease Control (CDC) consider mercury amalgams to be safe in most cases.  On the other hand, the World Health Organization (WHO) considers mercury to be one of the top ten chemicals of major public health concern, and mentions how exposure to mercury, even in small amounts, may cause serious health problems (3).

I briefly spoke about the possible relationship between mercury and thyroid health earlier, and would like to expand on this, as there are numerous studies which demonstrate a negative effect of mercury on thyroid health.  Keep in mind that not all of these studies involve inorganic mercury, which is the mercury found in dental amalgams.  Methylmercury is found in fish, and both inorganic mercury and methylmercury can negatively impact the thyroid gland.  One study looked at the role of environmental factors in autoimmune thyroiditis, and showed that replacement of dental amalgams in mercury-allergic subjects resulted in improvement of health in about 70% of patients, and in some cases lead to a normalization of anti-thyroid autoantibodies (4).  Another study looked at the relationship between mercury and thyroid autoantibodies, and showed that there is an association between mercury and thyroglobulin antibodies, but not thyroid peroxidase antibodies (5).  Thyroglobulin antibodies are found in those with Hashimoto’s Thyroiditis.  However, mercury also might play a role in the development of Graves’ Disease, as this autoimmune thyroid condition usually involves the presence of Th2 cytokines.  And I did come across a study which showed that mercury can potentially trigger or worsen Th2 cytokine production in humans (6).  Although these studies focus on the effects of mercury and the immune system, numerous studies have shown that mercury can also have a direct effect on the thyroid hormones (7) (8).

So does this mean that everyone who has mercury amalgams should get them removed?  This remains controversial, as while there is no question that mercury shouldn’t have been used as fillings in the first place by most dentists, sometimes getting them removed can do more harm than good.  In some cases removing these amalgams can exacerbate the autoimmune response of someone who has Graves’ Disease or Hashimoto’s Thyroiditis.  Anyone who is looking to get their mercury amalgams removed should hire a dentist who takes the proper precautions when removing them, such as a biological dentist.  You can find one of these dentists by visiting the website of the International Academy of Oral Medicine and Toxicology or International Academy of Biological Dentistry & Medicine.  Their respective websites are www.iaomt.org and www.iabdm.org.

What Is The Risk Of Having One Or More Root Canals?

While many people reading this are aware of the risks of mercury amalgams, many aren’t aware of the potential risks of root canals.  Although the American Dental Association claims that root canals are safe simply because there is no scientific evidence which show them to be harmful, there also aren’t any scientific studies which show that root canals are completely safe.  Just to let you know, the ADA still considers mercury amalgams to be safe.  Without question this is a controversial topic, as while there are many people who have had their health improve upon removing their root canals, until there are numerous scientific studies which show this then most dentists will continue to recommend this procedure to their patients.

Before talking about the potential risks of root canals it probably would be a good idea to briefly explain what a root canal entails.  First of all, a root canal is usually recommended when the nerve of the tooth becomes infected or the pulp becomes damaged.  I’m not going to get into the details of the procedure, as you can find this information online, but essentially they will drill a hole into the tooth and remove the dental pulp, the decayed nerve tissue, and they will try their best to sterilize the area in order to kill the bacteria.  Once this has been accomplished the tooth will be sealed, and often times a crown will be placed over the tooth.

I left out a number of details, but the main controversy is whether all of the bacteria can successfully be eradicated.  In other words, can the canals be permanently sterilized?  Many reading this are familiar with Dr. Weston Price, who was a dentist who looked at the relationship between dental health and nutrition, and how it impacted our overall health.  Dr. Price took one thousand extracted teeth and sterilized the canals with forty different chemicals in order to see if permanent sterilization could be achieved.  After 48 hours he broke the teeth apart and cultured them, and found that all but one of the teeth had bacteria.  Other biological dentists have confirmed Dr. Price’s findings.

Although there aren’t any research studies I’m aware of which show a correlation between root canals and specific health conditions, there have been numerous people with different health conditions whose health improved dramatically upon removing their root canals.  In fact, in the article I just mentioned, Dr. Price stated that “the bacteria in root canals favor destruction of the nervous system and many other systems, resulting in the creation of autoimmune reactions”.  While a root canal isn’t the trigger for most autoimmune thyroid conditions, if someone who is following a natural treatment protocol has one or more root canals and doesn’t see an improvement in their health, then they might want to consider having these removed.

Should You Have Your Root Canals Removed?

If you have mercury amalgams and root canals and were to visit a biological dentist, there is an excellent chance they would advise you to replace your silver fillings.  There is also a pretty good chance they would recommend to remove any root canals you have as well.  This admittedly is a tough decision to make in some cases.  A few years ago I had a cavity in the back of my mouth that was between my teeth.  While I felt some discomfort at times, none of the dentists were able to spot it on the on the dental x-rays.  And by the time one of the dentists discovered the cavity it was too late.  Because it was towards the back of my mouth I decided I didn’t want a root canal, and I decided to get an extraction.

However, the decision isn’t as easy if someone needs to get a root canal in the front of their mouth.  If one needs a root canal in one of their front teeth and they choose to get an extraction, it probably is a good idea to get this replaced.  Truth to be told, it might also be a good idea to get it replaced if it’s towards the back of the mouth, but it’s arguably even more important to get some type of replacement for an extracted tooth in the front of the mouth.  The two options usually given are bridges and dental implants.  And there are pros and cons with each of these.

A dental bridge involves a non-removable prosthesis which is attached to the surrounding teeth.  The problem with these is that the healthy teeth surrounding the replacement tooth will usually need to be filed.  With regards to dental implants, many people receive these and seem to do fine.  However, there are a few drawbacks.  First, they are very expensive, and if someone doesn’t have dental insurance then they will be spending thousands of dollars on this.  Second, it’s an extensive procedure that will take months to complete.  And finally, most dental implants are made out of titanium, and while many people do fine with these implants, some people will react to titanium.

As a result, if someone currently has a root canal on a tooth that is towards the back of the mouth it might be best to get it extracted and not get a bridge or implant.  On the other hand, if someone has one or more root canals in the front or side teeth, then the decision to get the tooth removed can be more difficult.  Obviously the decision is ultimately up to the person, but regardless of where the root canal is, it probably would be a good idea to seek the opinion of a biological dentist to discuss the different options you have.  After all, while I have experience working with a biological dentist, and have read articles and watched videos conducted by biological dentists who spoke about root canals, I’m of course not a dentist.  And while this doesn’t prevent me from giving my opinion when someone asks about mercury amalgams or root canals, in many cases it is wise to speak with a biological dentist about this.

So hopefully you have a better understanding about the potential risks of dental amalgams and root canals.  A few different studies have shown that mercury can have a negative effect on thyroid health, as it can affect both the immune system, thus causing an increase in thyroid autoantibodies, and it can also have a direct effect on thyroid health.  As for root canals, although there aren’t any scientific studies which show that they are harmful, there also is no proof that they are safe.  And there have been many people with different health conditions who experienced a dramatic improvement in their health upon removing one or more root canals.  Does this mean that everyone with mercury amalgams and root canals should have them removed?  This remains controversial, and while there is no question that many people with thyroid and autoimmune thyroid conditions can benefit from getting these removed, it probably is best to consult with a biological dentist about this.

Many people who have an autoimmune condition follow an autoimmune paleo diet.  This is similar to a “standard” paleo diet, with a few additional restrictions.  While a standard paleo diet allows the consumption of eggs, nuts and seeds, along with the nightshade vegetables, an autoimmune paleo diet excludes these foods.  So essentially the person is allowed to eat meat, fish, vegetables, fruits, certain coconut products, and some spices.  But is this the ideal diet for everyone with Graves’ Disease and Hashimoto’s Thyroiditis?

Before answering this question I’d first like to talk in greater detail about the similarities and differences between a “standard” paleo diet and an autoimmune paleo diet.  Here are the main foods which are allowed on a standard paleo diet:

• Meat (beef, pork, chicken, lamb, etc.) and fish
• Eggs
• Fruits
• Vegetables (including the nightshades)
• Nuts and seeds

Foods which are excluded in a “standard” paleo diet include all grains, legumes, and dairy products.  And of course anything refined should also be avoided.  A standard paleo diet is restrictive with regards to what foods you can eat, although keep in mind that it is nutrient dense, and the goal isn’t to restrict calories.  As a result, while some people do struggle initially to follow a paleo diet, after awhile many of these people do perfectly fine and wish they had followed this sooner.  Many people do better upon avoiding the grains, legumes, and dairy products.  However, when someone also needs to avoid eating eggs, nuts and seeds, along with the nightshade vegetables, this makes it even more challenging.  And of course it’s even more challenging for a strict vegetarian or vegan to follow an autoimmune paleo diet, as they won’t be consuming any meat or fish.

Why Is An Autoimmune Paleo Diet So Restrictive?

Why are so many foods excluded from an autoimmune paleo diet?   Well, there are a few different reasons.  An autoimmune paleo diet excludes foods people with autoimmune conditions are commonly sensitive to such as gluten, dairy, eggs, and corn.  These foods can cause inflammation and/or exacerbate an existing inflammatory condition.  Gluten can directly cause an increase in intestinal permeability (a leaky gut), which is a factor in many, if not all autoimmune conditions.  Other foods such as all grains, legumes, and the nightshade vegetables are restricted because they contain antinutrients which not only affect the absorption of nutrients, but like gluten, can also have a negative effect on the gut.  So it’s not just gluten which potentially can cause a leaky gut, but other foods can potentially cause this as well.  Essentially those foods which are excluded from an autoimmune paleo diet are those foods which can cause gut inflammation and/or an increase in intestinal permeability.

I must admit that I do like the autoimmune paleo diet, and I commonly recommend this to my patients with Graves’ Disease and Hashimoto’s Thyroiditis.  However, there are a few “flaws” with this type of diet:

1) Some people do fine eating one or more of the restricted foods. A good example of this is eggs.  There are many people who are able to eat eggs without a problem, especially egg yolks.  And eggs are an excellent source of nutrients.  With regards to dairy, although I recommend for people to avoid dairy while trying to restore their health, some people with autoimmune thyroid conditions do okay when consuming dairy products.  This is especially true with raw dairy products.  I’ve also had some people with Graves’ Disease and Hashimoto’s Thyroiditis eat small amounts of gluten free grains and still receive good results.  I’ve also had a few patients eat soaked nuts while following the protocol and do well.  The problem is that it’s difficult to predict who will do fine eating some of the restricted foods, which is why many healthcare professionals recommend for all of their patients with autoimmune thyroid conditions to avoid all of these foods.

2) It is possible to be sensitive to the “allowed” foods. Someone can be strictly following an autoimmune paleo diet and then find out that they are sensitive to another food they are eating which is permitted.  For example, they might have a sensitivity to chicken or beef, or even a vegetable or fruit they are eating on a frequent basis.  And while sometimes a person will experience negative symptoms upon eating these foods, other times there won’t be any overt symptoms.  This admittedly can be frustrating, as a person might be following a strict autoimmune paleo diet and might be feeling better from a symptomatic perspective.  But upon doing some retesting they notice their numbers aren’t improving.  For example, someone’s thyroid panel might worsen even though they are feeling better, and  while this doesn’t mean this is due to a food allergen, it is possible.  Perhaps a better example is someone who initially tests positive for an increase in intestinal permeability, and upon getting this retested a few months later the results show that their leaky gut has gotten worse.  Once again, this might not necessarily be attributed to a food sensitivity, although it very well might be.

3) Some people find the diet to be too restrictive. I find this to especially be true with those patients who have Graves’ Disease, although sometimes this will also be the case with those who have Hashimoto’s Thyroiditis.  The problem with Graves’ Disease is that the increased metabolism usually leads to weight loss, which can be extreme in some cases.  While some people with an autoimmune hyperthyroid condition will lose a small amount of weight (i.e. 5 to 10 pounds), others will lose 20 pounds or greater.  As an example, when I was dealing with Graves’ Disease I lost over 40 pounds.  Many people find it difficult to gain weight when dealing with Graves’ Disease, and sometimes this is true with Hashimoto’s Thyroiditis patients as well.

Of course everyone is different, and many of my patients with Graves’ Disease do fine when following an autoimmune paleo diet.  On the other hand, others struggle with the restrictive diet.  Although I try to encourage my patients to stick with the diet, if someone is about to break the diet due to the fear of losing even more weight, I’d much rather them eat some “forbidden” yet healthy foods (i.e. eggs, nuts, seeds, tomatoes, etc.) than completely ruin their diet by eating junk food.  And so there are times when I’m fine with people reintroducing one or more of the excluded foods and see how they do.  When taking this approach I will always have them reintroduce one food at a time for three consecutive days.  For example, if someone wants to reintroduce nuts, I’d have them start with almonds, and preferably soak them overnight to help reduce the antinutrients.  Then I would have them eat some almonds for three consecutive days and to pay close attention to any symptoms they might experience.

Who Should Follow An Autoimmune Paleo Diet?

I currently recommend an autoimmune paleo diet to just about all of my patients with Graves’ Disease and Hashimoto’s Thyroiditis.  However, as I just mentioned, I will make modifications if necessary.  Plus, one needs to consider that autoimmune thyroid conditions are a little bit different than many other autoimmune conditions.  For example, there is the concern of goitrogenic foods, which in my opinion isn’t a huge concern in people with hypothyroid conditions.  But it’s still something to be aware of, and I have discussed this in other articles.  Eating foods rich in iodine such as seafood and sea vegetables is commonly recommended with other autoimmune conditions.  And while many people with autoimmune thyroid conditions do fine eating these foods, some people get worse when eating foods rich in iodine.  I’ll soon be releasing an article which talks about the impact of seafood and sea vegetables on thyroid health.

With regards to the restrictive diet, I’m open to patients reintroducing egg yolks after one month if they’re struggling on the diet.  And while I prefer for patients to avoid grains, if adding a few servings of gluten free grains each week will make someone more compliant with the other recommendations then I’m usually fine with them trying this.  The same thing applies with properly prepared nuts.  This doesn’t mean that everyone will do fine eating these foods, but if they are going to stray from the diet I’d rather them eat a small bowl of rice than a bowl of whole wheat pasta or a slice of pizza. Obviously there are certain foods I won’t allow under any circumstances, although just because I recommend avoiding a specific food doesn’t always mean the patient will follow my recommendations while trying to restore their health.  It’s not uncommon for me to receive an email from a patient who ate something they weren’t supposed to, and sometimes it can be challenging for them to  get back on track with the diet.  Just remember that while you want to continue eating well even after you have restored your health back to normal, you won’t necessarily have to follow a strict autoimmune paleo diet on a permanent basis.

In summary, an autoimmune paleo diet is recommended by many natural healthcare professionals to those people with Graves’ Disease and Hashimoto’s Thyroiditis, as well as those with other types of autoimmune conditions.  Although I commonly recommend this type of diet to my patients with autoimmune thyroid conditions, some people do fine eating some of the restricted foods, and it’s possible to be sensitive to foods which are permitted.  In addition, some people find this diet to be too restrictive and therefore have a difficult time sticking to it.  As a result, there are times when I will make modifications to this diet if necessary, although I do encourage people to try to stick as close to the diet as possible for optimal results.

In the last post I discussed some of the basics of autoimmunity, including why some people develop specific autoimmune conditions such as Graves’ Disease and Hashimoto’s.  I also discussed the role of human leukocyte antigen (HLA) in autoimmunity, as well as the importance of regulatory T cells in preventing autoimmunity.  In this post I will discuss the autoimmunity timeline, which will help you to better understand the different stages of thyroid autoimmunity.

If you read the last post then you probably understand that in order for autoimmunity to develop, a combination of genetic and environmental factors are necessary.  However, having a genetic surface marker and being exposed to an environmental trigger usually isn’t enough to lead to an autoimmune condition.  If this were true, then many more people would develop autoimmunity, as many people with these genetic markers are exposed to one or more environmental triggers, yet don’t develop an autoimmune condition.  And so other factors are necessary, such as a decrease in regulatory T cells, and perhaps an increase in intestinal permeability (a leaky gut).  Healthy mitochondria are also important, as several mitochondrial proteins have been implicated as regulators of apoptosis in the immune system that are required for prevention of autoimmunity (1).  I’m sure there are other factors as well which we’re unaware of at this time.

Understanding The Autoimmunity Timeline

But in addition to understanding what factors can lead to the development of an autoimmune thyroid condition such as Graves’ Disease or Hashimoto’s Thyroiditis, it is also beneficial to understand the autoimmunity timeline.  After all, most chronic health conditions take many years to develop.  And then when they do develop, it can take many more years for symptoms to manifest.  So let’s go ahead and look at different stages of autoimmunity:

Stage #1: Pre-autoimmunity. This is the most critical time to prevent an autoimmune condition from developing.  As I mentioned numerous times in the last post, having a genetic marker and being exposed to an environmental trigger usually won’t cause an autoimmune condition without other factors being present.  I mentioned a decrease in regulatory T cells as being a factor.  A leaky gut can also be a factor in some, if not all autoimmune conditions.  Mitochondrial dysfunction can also be a factor.  But it usually takes years for people to develop a significant decrease in regulatory T cells, a leaky gut, or mitochondrial dysfunction.

So the goal in most people should be to do whatever is necessary to have a healthy immune system, a healthy gut, and healthy mitochondria.  Obviously there is a lot of overlap, as someone can’t have a healthy immune system without having a healthy gut.  And one also needs healthy mitochondria to have a healthy immune system.  Of course there are many factors which can have a negative effect on the these areas, such eating a poor diet with a lot of refined foods and sugars, consuming common allergens such as gluten and dairy, being exposed to prolonged chronic stress, getting insufficient sleep for many months or years, toxic overload, an acute or chronic infection, etc.

As you can see, there are a lot of different factors which can  set the stage for autoimmunity.  Keep in mind that in most cases, if someone has a genetic marker for an autoimmune condition, a SINGLE exposure to an environmental trigger isn’t going to cause autoimmunity.  After all, most people deal with chronic stress these days, everyone is exposed to toxins, etc.  However, if someone is FREQUENTLY exposed to one of more of these factors, then over time this can cause a decrease in regulatory  T cells, lead to a leaky gut, and/or cause mitochondrial dysfunction, and set the stage for autoimmunity.  So perhaps the best way to think of it is that we’re all exposed to one or more of these triggers, but it’s the frequent exposure to these triggers over time which increases the likelihood of someone developing an autoimmune condition.

Stage #2: Silent autoimmunity. In this stage, autoimmunity has already been triggered.  However, there has been very little or no tissue damage, and therefore no symptoms are present, and the blood test results are negative at this point (i.e. normal TSH and thyroid hormone levels).  This is what happens with pretty much all autoimmune conditions.  However, the duration of this stage will vary greatly depending on the autoimmune condition.  For example, if someone has elevated thyroglobulin antibodies, which are associated with Hashimoto’s Thyroiditis, then there is a good chance that these will cause damage to the thyroid gland.  And if nothing is done to address the autoimmune component then the damage can be so extensive that the person might reach the point where they need to take thyroid hormone medication.

However, the person with Hashimoto’s Thyroiditis can be in the “silent” phase for many years.  With Graves’ Disease it may be a different story, as my guess is that the silent phase isn’t nearly as long.  And the reason for this is because when dealing with autoimmune conditions which involve tissue damage (i.e. Hashimoto’s, multiple sclerosis), the tissue damage can be minimal for many years, and so in some cases it can take a long time for the person to develop symptoms, which I’ll discuss next in phase #3.  Graves’ Disease is different from many other autoimmune conditions in that it doesn’t necessarily involve tissue damage.  The TSH receptor antibodies don’t seem to damage the TSH receptors, but apparently stimulate them, which results in the release of thyroid hormone.  And the symptoms of Graves’ Disease are usually more noticeable initially than those of many other autoimmune conditions.  Although in some cases it might take many years between the time someone develops Graves’ Disease autoantibodies and the time they develop hyperthyroid symptoms, in my opinion this is less likely to happen.

Stage #3.  Symptoms present with some tissue loss. Although stage #2 might involve some tissue damage, it’s very minimal, and it’s in stage #3 where this damage reaches the point where the person begins to experience symptoms.  Once again, it can take many years for this to happen.  So with the person who has Hashimoto’s Thyroiditis, what frequently will happen is that due to the tissue damage to the thyroid gland, the person will begin to experience some symptoms.  As a result, they might visit their medical doctor, who will run a thyroid panel, and at this point the TSH might be elevated, or it still might look fine.  Obviously one can’t rely on the TSH alone, but unfortunately this still is what frequently happens at many medical doctor’s offices.  And if the TSH is within the lab reference range, regardless of how the person feels, they might be told that everything is fine since the tests are within the normal reference range.  On the other hand, a smart doctor will run a more comprehensive panel which not only evaluates the thyroid hormone levels (which probably will also be normal), but they will also look at the thyroid antibodies, in this case thyroperoxidase antibodies and thyroglobulin antibodies.

Unlike Hashimoto’s Thyroiditis, when someone with Graves’ Disease is experiencing symptoms there usually is a correlation with the blood test results.  So for example, if someone has elevated TSH receptor antibodies and begins experiencing hyperthyroid symptoms (i.e. increased pulse rate, heart palpitations, tremors, etc.) then there is a good chance the TSH will be depressed and/or the thyroid hormone levels will be elevated, although this isn’t always the case.  As I’ve mentioned in other articles and posts, for some people with Hashimoto’s Thyroiditis and Graves’ Disease, the thyroid antibodies will show up as being negative when doing a blood test.

Stage #4.  Symptoms are present and there is greater tissue loss. This is the “final” stage of autoimmunity, as it’s when the person’s symptoms will usually worsen, there will be greater tissue loss, and the blood tests will be positive.  Although some people might be diagnosed with an autoimmune thyroid condition in stage #3, especially those with Graves’ Disease, many people with Hashimoto’s Thyroiditis won’t be diagnosed until they reach stage #4.  And the reason is because most of the symptoms of Hashimoto’s Thyroiditis can’t be measured.  In other words, if someone with Hashimoto’s Thyroiditis is in stage #3 and presents with negative blood tests, yet they are experiencing symptoms such as fatigue, brain fog, and hair loss, these symptoms can’t be measured.  On the other hand, if someone with Graves’ Disease is in stage #3 they very well might have an elevated heart rate, which will be detected almost immediately when the vital signs are being taken.  Getting back to Hashimoto’s Thyroiditis, if someone is in stage #3 and has negative blood tests, often times doing a good case history and conducting a thorough physical exam can determine if  someone has a thyroid condition.  But this isn’t always the case, and unfortunately, many medical doctors see such a high volume of patients that they won’t perform a thorough physical exam if all of the tests look good.

In summary, different autoimmune conditions are characterized by different types of autoantibodies.  There are a few factors which will determine whether autoimmunity will develop, as a genetic marker is usually present, and an environmental trigger is also necessary.  However, other factors are usually necessary to set the stage for autoimmunity, such as a decrease in regulatory T cells, a leaky gut, and/or mitochondrial dysfunction.  So in order to prevent autoimmunity, or restore the health of someone who already has an autoimmune condition it would appear to be necessary to have high numbers of regulatory T cells, a healthy gut, and healthy mitochondria.  I also discussed the four stages of autoimmunity, which should also help you to understand the progression of most autoimmune conditions.