Even though I’m a chiropractor, most people who have been reading my articles and blog posts for awhile know that I don’t speak much about chiropractic.  When I first graduated from chiropractic school in March of 1999 and envisioned opening up my practice, I didn’t consider doing much with nutrition and the other lifestyle factors.  And for the first few years of my practice I didn’t do much with regards to nutrition, stress management, detoxification, etc.  It wasn’t until I began helping people with fibromyalgia a few years into practicing when I realized that many people need more than chiropractic care.  And of course my life changed dramatically when I personally was diagnosed with an autoimmune thyroid condition.

Although I’m still a big advocate of chiropractic care, these days I’m admittedly more of a nutritionist and functional medicine practitioner than I am a chiropractor.  Since being diagnosed with Graves’ Disease I went on to achieve numerous certifications in nutrition and herbal therapy, also received a masters of science degree in human nutrition and functional medicine, and I plan to continue receiving ongoing education and training in the years to come, as I’m always looking to expand my knowledge and keep up with the latest research.  Although I still love chiropractic, when trying to restore the health of someone with a thyroid or autoimmune thyroid condition, it is of course important for the person to eat well, take certain nutritional supplements, improve their stress handling skills, minimize their exposure to environmental toxins, etc.

Is Chiropractic Care Necessary For Optimal Thyroid Health?

Most people reading this wouldn’t associate chiropractic care with optimal thyroid function.  And of course most thyroid conditions are actually autoimmune conditions which affect the thyroid gland.  But either way, what the heck does chiropractic have to do with improving the health of the immune system, or someone’s thyroid health directly for those cases which aren’t autoimmune?  Truth to be told, most people with thyroid and autoimmune thyroid conditions don’t need to receive chiropractic care in order to restore their health back to normal.

With that being said, if you understand that chiropractic is more than just cracking backs and twisting and popping necks then you will realize that chiropractic can be important for anyone to achieve optimal health.  This might sound hypocritical of someone who rarely talks about chiropractic in his articles, blog posts, and webinars.  Once again, I’m not suggesting that receiving chiropractic care is necessary in order to restore the health of someone with a thyroid or autoimmune thyroid condition.  On the other hand, chiropractic is about balancing the nervous system.  And the nervous system innervates every cell and tissue in the body.  So if there happens to be “interference” with the nerves which innervate the thyroid gland, then this possibly can result in malfunctioning of the thyroid gland.  Although this probably isn’t a common cause of thyroid malfunction, it’s something to be aware of.  This is especially true for someone who is eating extremely well, has taken many different types of good quality supplements, does a good job of managing their stress, yet still has problems with their thyroid health.

In addition, if someone has a nervous system that is out of balance, since the nervous system controls the immune system, then this person very well might have an immune system that is out of balance as well.  As a result of this weakened immune system, the person will be more likely to develop a chronic infection, which in turn can trigger an autoimmune response.  Or perhaps the nervous system imbalance is making the person more susceptible to the effects of stress, which in turn caused a leaky gut, which in turn caused an autoimmune thyroid condition.  Once again, I’m not suggesting that spinal subluxations (misalignments of the spine causing nerve interference) are common causes of thyroid autoimmunity.  But if you understand the anatomy and physiology of the body then you will realize that a nervous system imbalance can cause a lot of different health conditions.

So why go to a chiropractor for a nervous system imbalance?  After all, isn’t a neurologist a specialist of the nervous system?  Although I’m sometimes critical of medical doctors who don’t try to get to the root cause of the problem, I realize that they have an important role.  And the same holds true of neurologists, as there are many excellent medical doctors who specialize in neurology, and some chiropractors and neurologists have a working relationship and refer their patients to one another.  This really is how it should be, as if a chiropractor is working with a patient and the patient isn’t receiving optimal results then there is a time and place for referring that patient to a medical doctor.  Similarly, if a neurologist is working with a patient who isn’t responding then they should consider referring the patient to a chiropractor at times.  In any case, both chiropractors and neurologists deal with nervous system imbalances in different ways.  I’m not going to say that one way is better than another, although to no surprise I’m more biased with regards to chiropractic care since that is my background.  If someone has a nervous system imbalance and is trying to get to the root cause of their condition, then I think it’s best for them to see a chiropractor initially.  But of course this also depends on what neurological condition the patient is dealing with, as sometimes it is best to see a neurologist first.

Are All Chiropractors Alike?

Chiropractors definitely are not all alike.  I realize that the same holds true with other healthcare professionals, as one can make the argument that no two dentists are alike, as everyone has their individual practice style.  However, with most dentists the routine will be very similar, and the same is true with many other healthcare professionals.  On the other hand, with chiropractors you never know what you’ll get.  I’m not saying this is a bad thing, but you can go to two different chiropractors and have a completely different experience.

For example, there are over one hundred different chiropractic techniques.  Although many chiropractors treat the entire spine, others only focus on certain areas of the spine.  For example, some chiropractors are referred to as “upper cervical spine specialists” and will only treat the patient’s cervical spine, which consists of the bones in the neck.   Although I use the word “treat” because everyone is familiar with the term, chiropractors actually don’t “treat” the spine, as they deliver what’s called a spinal adjustment.  And so from this point forward I will use the word “adjust” rather than “treat”.  Anyway, getting back to some of the different ways chiropractors adjust the spine, many will use their hands, but some will use instruments to adjust the spine.  Many will use x-rays to detect spinal subluxations, while others will rely on muscle testing, leg checks, computerized scans, and there are other methods as well.

Some chiropractors see a high volume of patients per day and might spend only one or two minutes with each patient.  Others might spend between five and ten minutes with each of their patients, while others will spend 30 minutes or longer with their patients.  Some chiropractors don’t incorporate nutrition into their practice, while others offer a lot of nutritional advice and will try to educate everyone about eating well, avoiding refined foods and sugars, etc.  So hopefully you now realize that different chiropractors have different practice styles.

Should Everyone With A Thyroid or Autoimmune Thyroid Condition Seek Chiropractic Care?

As I mentioned already, most people with a thyroid or autoimmune thyroid condition don’t need to receive chiropractic care in order to restore their health back to normal.  However, there is no question that having a healthy nervous system is important, and since the nervous system controls the thyroid gland, immune system, and other areas of the body, one can argue that it would make sense for many people to at least get checked by a competent chiropractor.  Of course since I’m a chiropractor I’m biased, and I feel that everyone can benefit from chiropractic care.

But what if you had a bad experience with a chiropractor?  Well, all I can say is that when someone has a bad experience with a medical doctor, dentist, or a different type of healthcare professional they usually don’t stop seeing that type of doctor.  For example, if someone has a bad experience with a dentist they very well might not seek dental care, but there is a good chance they will simply give a different dentist a try.  Remember what I said earlier, as different chiropractors practice differently, and so you might need to visit a few different chiropractors before you find one who you’re comfortable with.  I would of course recommend trying to find someone who evaluates everyone individually rather than hire a chiropractor who recommends the same exact treatment plan for  everyone.

For example, a young adult who has a fairly healthy spine probably shouldn’t need as extensive care as an elderly person who has more chronic problems.  While it’s true that some older adults are in better shape than younger adults, the point I’m trying to make is that different people should require different treatment plans.  This of course not only applies to chiropractic care, as I also discuss this from time to time when talking about following a natural treatment protocol for a thyroid or autoimmune thyroid condition.  Regardless of what type of healthcare professional you see, you ideally want to work with someone who will give specific recommendations based on your specific condition.  While there might be some overlap from patient to patient, different people will require different protocols.

In summary, since I’m a chiropractor it’s not surprising that I’m a big advocate of chiropractic.  Although most people with thyroid and autoimmune thyroid conditions don’t need to receive chiropractic care in order to restore their health back to normal, in some cases having a spinal imbalance can lead to thyroid dysfunction and/or a weakened immune system.  After all, the nervous system controls every cell and tissue in the body, and therefore a less than optimal functioning nervous system can lead to numerous health issues.  And so even though most people with a hypothyroid or hyperthyroid condition don’t require chiropractic care to restore their health, many people can benefit from chiropractic care, and one can argue that receiving chiropractic care is necessary to help people to achieve optimal health.

Grains, nuts, seeds, and legumes have numerous health benefits. However, many people are unaware that these foods also contain antinutrients which can interfere with the absorption of other nutrients you consume.  And so while I love eating nuts and seeds, and I’m not “anti-grain”, I do think it’s important for people to realize why they should minimize their consumption of these foods.  And so what I plan on doing in this blog post is to discuss the most common antinutrients, and hopefully after reading this you will have a better understanding as to why you should only eat minimal amounts of these foods.

Before I discuss these antinutrients, you might be wondering “why do these foods have anti-nutrients?”.  Well, some of these antinutrients are included in plants as a form of protection.  This includes lectins, protease inhibitors, and saponins.  These secondary metabolites help to ensure the survival of the seed.  However, they have other functions as well.  What I’d like to do now is discuss some of the more common antinutrients.

Lectins. These are probably the most well known of the different antinutrients, and I have put together a separate article on this entitled “Should People With Thyroid And Autoimmune Thyroid Conditions Avoid Foods With Lectins?“.  Lectins are carbohydrate binding glycoproteins which can affect the turnover and loss of gut epithelial cells, damage the luminal membranes of the epithelium, interfere with nutrient digestion and absorption, stimulate shifts in the bacterial flora and modulate the immune state of the digestive tract (1). Systemically, they can disrupt lipid, carbohydrate and protein metabolism, promote enlargement and/or atrophy of key internal organs and tissues and alter the hormonal and immunological status (1). At high intakes, lectins can seriously threaten the growth and health of consuming animals (1).  In summary, lectins can have a negative effect on the lining of the gastrointestinal tract, as well as the gut flora, which in turn can affect the absorption of nutrients.  Plus they can also affect the breakdown of fats, carbohydrates, and proteins.

Phytic acid. This is a major phosphorus storage compound found in nuts and seeds, as well as grains and legumes.  Phytic acid has the strong ability to chelate certain minerals, especially zinc, calcium, and iron (2). There is also evidence that phytic acid can bind to magnesium and affect its absorption as well (3).  The binding can result in very insoluble salts that are poorly absorbed from the gastrointestinal tract, which results in poor bioavailability of minerals (2).  In summary, phytic acid will affect the absorption of numerous minerals, which obviously isn’t a good thing.

Protease Inhibitors. These can inhibit the proteolytic activity of certain enzymes.  In other words, they will interfere with the breakdown of protein.  For example, certain legumes such as navy beans, red kidney beans, and adzuki beans have trypsin inhibitors (4).  Soybeans and chickpeas also have trypsin inhibitors (5).  Trypsin is an enzyme which breaks down numerous proteins.  What’s important to understand is that eating a lot of foods with trypsin inhibitors can affect the breakdown of proteins.

Oxalates.  These are naturally-occurring substances which belong to a group of molecules called organic acids.  Some of the foods with high amounts of oxalates include spinach, blueberries, blackberries, and almonds.  Foods high in oxalates can affect the absorption of certain nutrients, such as calcium.  Most people can eat normal amounts of foods with oxalates, although people with certain conditions, such as enteric and primary hyperoxaluria, need to eat a low oxalate diet.  I mentioned that spinach and blueberries are high in oxalates, and for those who routinely make smoothies, adding some spinach and/or blueberries is fine for most people.  However, you probably want to avoid adding large amounts of these foods to your smoothies, especially if you have one or two smoothies on a daily basis as I do.  I spoke about oxalates in a blog post I wrote entitled “Should Spinach Be Avoided In People With Thyroid Conditions?”

Saponins.  These are naturally occurring compounds that are widely distributed in all cells of legume plants, and derive their name from their ability to form stable, soaplike foams in aqueous solutions (6).  Although saponins have some health benefits, they also can impair the digestion of protein and the uptake of vitamins and minerals in the gut, and can also cause hypoglycemia (7).  They can also lead to the development of a leaky gut (8).

Solanine.  This is a glycoalkaloid found in species of the nightshades, which include foods such as potatoes, tomatoes, eggplant, and peppers.  Although many people who eat these foods seem to do fine, because they can lead to inflammation and other problems, most autoimmune diets don’t include the nightshade vegetables.  One of the best articles I’ve read on the nightshades is from Dr. Garrett Smith of the Weston Price Foundation.

These are some of the most common antinutrients, although there are a few I didn’t list.  A couple of additional ones worth mentioning are tannins and salicylates.  Tannins might inhibit the digestion of dietary proteins, and might also have some systemic effects.  Salicylates are phytochemicals found in fruits, vegetables, some other foods, and in some over-the-counter medications and prescription drugs.  Most people can eat normal amounts of salicylates, but some people are unable to tolerate smaller amounts.

How Do Antinutrients Affect Thyroid Health?

Loren Cordain has a wonderful article entitled “Cereal Grains: Humanity’s Double-Edged Sword“.  In this article he talks about some of the antinutrients and focuses on the risks of cereal grains.  Towards the end of this article he discusses how cereal grain consumption can lead to the development of autoimmune conditions.  As he discusses in his article, the genetic component that is most closely associated with the expression of autoimmune conditions are those genes which code for the human leukocyte antigens (HLA).  The HLA is subdivided into different classes, and Dr. Cordain discusses how lectins are potent inducers of HLA class II molecules.  I also mentioned earlier how certain antinutrients, such as lectins and saponins, can potentially cause a leaky gut, which in turn can trigger an autoimmune response.

In his article Dr. Cordain also talks about how these antinutrients “might induce cross-reactivity and hence autoimmunity by virtue of peptide structures homologous to those in the host”.  In other words, the structures of these antinutrients might be similar to certain structures in the human body, and as a result the body might produce autoantibodies.  This is known as molecular mimicry, which has been proposed as a pathogenic mechanism for autoimmune disease.

There isn’t much evidence when it comes to direct effects of these anti-nutrients on thyroid health.  In other words, while consuming some of these anti-nutrients might cause a leaky gut and trigger an autoimmune response, they don’t seem to directly stimulate or inhibit thyroid activity.  However, there is evidence that soyasaponins, which were isolated from soybeans, increased the levels of serum thyroid hormones, which lead to lipid peroxidation (9).  Lipid peroxidation involves damage to the membranes of fats, and has been implicated in conditions such as atherosclerosis, irritable bowel disease, retinopathy of prematurity (ROP), borderline personality disorder, asthma, Parkinson’s disease, kidney damage, preeclampsia and other conditions (10).

Is It Best To Completely Avoid These Foods?

I definitely don’t think that most people permanently need to avoid nuts, seeds, and beans.  But I do think it’s a good idea to minimize one’s consumption of these foods.  I love nuts and seeds, and I can easily eat a few cups per day, but most people probably should limit their consumption to half a cup per day total.  As for grains, although there are some healthy nutrients in grains, we don’t need to eat grains to survive.  Plus, although there are some healthy nutrients in grains, remember that the antinutrients will reduce the absorption of these nutrients.  With that being said, I think that eating a small amount of grains is fine for many people, preferably gluten free grains.  On the other hand, many people seem to thrive when eliminating grains from their diet.

Soaking And Sprouting Can Improve Nutrient Absorption

Soaking and sprouting nuts, seeds, beans, and grains can help to reduce the anti-nutrient content of these foods.  This in turn can improve the contents of certain essential amino acids, total sugars and B-group vitamins (11).  Of course many people aren’t willing to take the time to do this, and keep in mind that this won’t completely eliminate the anti-nutrient content of these foods.  As a result, it’s best to minimize your consumption of these foods, and if someone has gut issues then it’s probably a good idea to avoid eating them altogether until the gut is healed.  With that being said, if someone is a vegetarian or vegan it can be challenging to follow a gut repair diet and completely eliminate all of the foods with antinutrients, and so eating soaked nuts, seeds, beans, and grains can make it a lot easier to follow such a diet.  I’ve had some people follow a gut repair diet and do okay while eating small amounts of these soaked and sprouted foods.  On the other hand, some people aren’t able to heal the gut unless if they completely eliminate these foods from their diet.

In summary, due to the antinutrients present in nuts, seeds, legumes, and grains, one wants to try to minimize their consumption of these foods.  The reason is because these antinutrients can interfere with the absorption of certain nutrients such as zinc, calcium, iron, and magnesium, and can also lead to certain health issues, such as a leaky gut.  Although all people need to be careful not to eat too many of these foods, people with autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis will especially want to reduce their intake, and in many cases it’s best to avoid these foods altogether.

Lipopolysaccharides (LPS) are referred to as endotoxins, and they are large molecules found in gram-negative bacteria.  Although most people with thyroid and autoimmune thyroid conditions have never heard of lipopolysaccharides, these can have a profound effect on one’s health.  This is especially true for those people with Graves’ Disease and Hashimoto’s Thyroiditis, although they can also affect those with non-autoimmune thyroid conditions.

LPS are the major components of the cell wall of gram-negative bacteria (1).  Under normal circumstances they protect the cell membrane.  However, when a gram-negative bacteria dies, the LPS of this bacteria is released.  LPS can cause numerous biological effects, such as fever, leukocytosis (high number of white blood cells), iron deficiency, platelet aggregation, thrombocytopenia, and blood clotting disorders (2).  LPS from gram-negative bacteria is one of the most potent innate immune-activating stimuli known.  An alteration in the LPS response may play a role in the pathogenesis of a number of inflammatory diseases (3).

The Role of LPS In Autoimmunity and Leaky Gut Syndrome

Lipopolysaccharides can lead to an increase in intestinal permeability, also known as a leaky gut (4) (5).  I’ve spoken about the relationship between leaky gut syndrome and thyroid autoimmunity in other articles and blog posts.  There are numerous factors which can cause a leaky gut, and lipopolysaccharides are one of these factors.  So having high levels of LPS can increase one’s chances of developing a leaky gut, and this in turn can increase one’s chances of developing Graves’ Disease or Hashimoto’s Thyroiditis.

The company Cyrex Labs has an intestinal permeability test that measures the antibodies against LPS.  When this shows positive findings for LPS it usually means that there has been infiltration through the intestinal barrier into the systemic circulation.  In other words, there will be the presence of lipopolysaccharides in the bloodstream, and the person will usually have an increase in intestinal permeability (a leaky gut).  However, I’ve had some patients test positive for LPS antibodies on a Cyrex Labs test, but not show any signs of hyperpermeability.

For those who aren’t familiar with Cyrex Labs, their Intestinal Antigenic Permeability Screen tests for the presence of three types of antibodies that are associated with an increase in intestinal permeability.  These include the Actomyosin antibodies, the Occludin/Zonulin antibodies, and the Lipopolysaccharides (LPS).  Both the Actomyosin and Occludin/Zonulin antibodies directly relate to the presence of a leaky gut.  So in other words, if either of these two antibodies are outside of the normal range then this indicates that someone has a leaky gut.

However, the presence of LPS alone doesn’t necessarily indicate that someone has a leaky gut.  The presence of LPS does indicate intestinal dysbiosis (an imbalance of the gut flora), and dysbiosis is commonly associated with a leaky gut.  As a result, if someone does the Cyrex Labs test and has a positive test for LPS, but both the Actomyosin and Occludin/Zonulin antibodies are negative, then this means the person has intestinal dysbiosis in the absence of a leaky gut.  Of course this is assuming the person doesn’t have suppressed immunoglobulins, which can result in a false negative on the Cyrex Labs test and is something to be aware of.

What Are The Causes Of Elevated LPS?

Remember that lipopolysaccharides are endotoxins which are found in gram-negative bacteria, and that LPS is released when a gram-negative bacteria dies.  When someone has high levels of LPS this is associated with intestinal dysbiosis.  And there are numerous causes of intestinal dysbiosis, and some of the more common causes include antibiotics, chronic stress, and food allergens (6).

LPS and Thyroid Health

LPS can affect thyroid health in numerous ways.  As I have already mentioned, LPS can lead to the development of a leaky gut, which can in turn trigger an autoimmune thyroid condition.  However, there is also evidence that LPS can suppress the hypothalamic-pituitary-thyroid axis (7).  Remember that the hypothalamus produces thyrotropin-releasing hormone (TRH), which stimulates the pituitary gland to secrete TSH, which in turn signals the thyroid gland to secrete thyroid hormone.  A more recent study shows that LPS can downregulate pituitary and thyroid function (8).  In addition to decreasing TSH secretion, it also affects secretion in follicular cells directly (8).  In other words, LPS can decrease thyroid function not only by affecting the pituitary gland, but also by directly affecting the cells of the thyroid gland.  However, while it seems to result in a decrease in thyroxine (T4), it doesn’t seem to decrease the conversion of T4 to T3.

In summary, lipopolysaccharides are large molecules found in gram-negative bacteria, and they are elevated in intestinal dysbiosis.  LPS activate the innate immune system, and can lead to the development of inflammatory conditions, as well as a leaky gut.  This can in turn trigger an autoimmune response, leading to a condition such as Graves’ Disease or Hashimoto’s Thyroiditis.  There is also evidence that LPS can suppress the hypothalamic-pituitary-thyroid axis.

I’ve discussed leaky gut syndrome in the past, as this is commonly associated with conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.  In fact, some researchers believe that ALL autoimmune conditions are associated with an increase in intestinal permeability (a leaky gut).  I’m not sure if I agree with this, as while I don’t test every single one of my patients for a leaky gut, of those people I have tested for this who have elevated autoantibodies, a few of them have come back with negative results.   In any case, if it is determined that someone has a leaky gut then you want to consider implementing the 4R protocol.

But what is the 4R protocol?  Before talking about this I would briefly like to remind everyone reading this what happens when someone has a leaky gut.  In a normal, healthy gut, the cells of the intestines (enterocytes) should be held close together by tight junctions.  Tight junctions regulate the permeability of ions, macro molecules, and cells via the paracellular pathway (1).  In other words, these tight junctions prevent larger molecules and other substances from passing between the cells of the intestine.

However, certain factors can break down these tight junctions, and thus lead to what’s referred to as an “increase in intestinal permeability”.  An “increase in intestinal permeability” is synonymous with a “leaky gut”.  So disruption of these tight junctions leads to an inadequate epithelial barrier, and this in turn results in an incontrollable water and electrolyte loss, and is implicated in the pathogenesis of numerous autoimmune and inflammatory diseases (1).

In the past I’ve discussed the intestinal permeability test from Cyrex Labs, which can measure the antibodies against these tight junction proteins.  Occludin and zonulin are two tight junction proteins.  Occludin is part of the main component of proteins which hold together the tight junctions, while zonulin is a protein which regulates the permeability of the intestine (2).  When someone has a leaky gut, there will be elevated antibodies to both occludin and zonulin, and this is what the test from Cyrex Labs measures.  This test also detects antibodies against actomyosin, which helps to regulate intestinal barrier function.

Hopefully you now have a better understanding of what a leaky gut entails.  Now let’s take a look at what the 4R protocol involves:

1. Remove.  First of all, you want to remove the factor or factors which caused the increase in intestinal permeability.  So for example, gluten is a common factor which can lead to an increase in intestinal permeability.  However, there can be other factors which can cause a leaky gut to occur.  In addition to gluten, other food allergens can be a factor.  Certain pathogens can also compromise the tight junctions, thus causing an increase in intestinal permeability.  Unfortunately stress can also be a factor, as high cortisol levels can lead to a decreased secretory IgA, making someone more susceptible to developing a leaky gut.  Certain medications such as NSAIDs can also cause a leaky gut.

Sometimes it admittedly can be a challenge to determine what is causing the increase in intestinal permeability.  Although it’s easy enough to avoid gluten and dairy, what if another food is responsible for the leaky gut?  There are many different types of pathogens, and so how can one determine if a specific pathogen is the culprit?  Everyone deals with stress, and so how do you know if this is the trigger?  Some detective work is usually required, which is one reason why it’s not recommended to self treat your condition.  Although finding the trigger under the guidance of a natural healthcare professional can still be challenging, in my opinion it still is best to work with someone who has the knowledge and experience dealing with these conditions.

After removing the factor or factors which caused the leaky gut, you want to focus on the next 3 components of the 4R protocol:

2. Replace. You want to replace those factors which are necessary for proper digestion.  Some examples include digestive enzymes, betaine HCL, and dietary fiber.  I frequently give digestive enzymes to my patients and recommend for them to consume enough dietary fiber.  As for betaine HCL, whether someone should take this or not depends on the patient.  The goal isn’t for the person to take digestive enzymes and/or betaine HCL on a permanent basis, but many times it is a good idea for patients to take these while following a natural treatment protocol to make sure they’re digesting the food they’re eating and the nutrients from the supplements they’re taking.

3. Reinoculate. This is where prebiotics and probiotics come into play.  Remember that the probiotic strain does make a big difference.  For example, bifidobacterium lactis HN019 is great for intestinal dysbiosis, while Saccharomyces boulardii can help with a yeast infection and play a role in gut repair.  Prebiotics such as inulin can help to enhance the growth of the beneficial bacteria.  For more information on probiotics I recommend checking out my article entitled “Can Taking Probiotics Improve Thyroid Health?“.

4. Repair. It of course is important to repair the gut.  L-glutamine is an amino acid, and this is one of the best nutrients used for gut repair.  When I’m working with someone who has a leaky gut I’ll commonly recommend at least 5,000 mg of L-glutamine per day, and with some people I’ll recommend higher doses.  I mentioned before that Saccharomyces boulardii can help with gut repair.  Certain herbs can help with the mucosal lining such as slippery elm, marshmallow root, and aloe vera.  Zinc can also be beneficial.  However, certain foods can help with the healing of the gut as well, including bone broth, cabbage juice, and fermented foods such as sauerkraut and kimchi.

In the opening paragraph of this post I discussed how some researchers hypothesize that in addition to genetic and environmental factors, loss of intestinal barrier function (a leaky gut) is necessary to develop autoimmunity (3).  However, these same researchers also feel that once the autoimmune process is activated, it is not auto-perpetuating, but rather can be modulated or even reversed by preventing the continuous interplay between genes and environment (3).  In other words, not only can a leaky gut be cured, but the autoimmune process can be modulated and in many cases even reversed.

I’ve been mentioning this for many years due to my personal experience with Graves’ Disease, along with the experiences of many of my patients with autoimmune thyroid conditions.  But even though the research shows that the autoimmune process can be modulated, most medical doctors don’t do anything to address the autoimmune component of Graves’ Disease and Hashimoto’s Thyroiditis, as they just focus on managing the thyroid symptoms.  This doesn’t mean that addressing autoimmunity is an easy process, as it can be a challenge finding out what the trigger is.  And if someone has a condition such as leaky gut syndrome it can take a good amount of time to correct the problem.  But in most cases it is worth the “hassle”, especially when compared to receiving radioactive iodine and/or having to take thyroid hormone medication for the rest of your life.

In summary, leaky gut syndrome is common in autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.  And when dealing with a leaky gut, one wants to implement the 4R protocol.  Doing so not only can help to correct the leaky gut, but if this is what’s responsible for one’s autoimmune condition then it can be the key factor in restoring their overall health back to normal.

Many people with thyroid and autoimmune thyroid conditions have problems with their adrenal glands.  Although eating well, doing a good job of managing one’s stress, and getting sufficient sleep are probably the three most important factors when it comes to having healthy adrenals, sometimes supplementation can help to restore the health of compromised adrenals when combined with these other factors.  In this post I’m going to discuss six supplements and herbs which can benefit people with adrenal problems.

1. Vitamin C.  The adrenal glands have one of the highest concentrations of vitamin C in the body (1).  Ascorbic acid is a cofactor required both in catecholamine biosynthesis and in adrenal steroidogenesis (1).  As a result, anyone who deals with a good amount of stress needs to make sure they eat foods rich in vitamin C.  However, in my opinion it usually is a good idea to also have the person take a vitamin C supplement.  Most vitamin C is sold as ascorbic acid, but I usually recommend a whole food vitamin C supplement for two reasons.  The first reason is because ascorbic acid is just one component of vitamin C, and you want to consume the required cofactors as well.  The second reason is because ascorbic acid supplements are made from corn syrup, and most corn in the United States is genetically modified.

2. Vitamin B.  The B vitamins are also beneficial for those who are constantly “stressed out”.  Like vitamin C, in most cases there is little risk in taking a B complex supplement since the B vitamins are water soluble.  However, taking high doses of some of the individual B vitamins can cause problems.  Like vitamin C, some of the B vitamins also play a role in the synthesis of hormones important to adrenal health.  For example, vitamin B3 is involved in the synthesis of adrenal hormones.  Vitamin B5 is also important for adrenal health, and can aid in the secretion of the steroid hormones.  Vitamin B6 is involved in the synthesis of norepinephrine.  When someone is stressed out these vitamins will become depleted, and so if someone is dealing with chronic stress then it usually is a good idea to supplement with a vitamin B complex.

3. Ashwagandha.  Ashwagandha (Withania somnifera) is one of the most beneficial herbs for the adrenals.  Although this herb can potentially stimulate thyroid hormone production in hypothyroid conditions, in most cases it doesn’t seem to exacerbate one’s hyperthyroid condition.  As a result, Ashwagandha can usually be used for adrenal support in both people with hypothyroidism and Hashimoto’s Thyroiditis, or hyperthyroidism and Graves’ Disease.  If someone has elevated cortisol then giving Ashwagandha and Rehmannia can help to lower the cortisol levels.  However, Ashwagandha can also benefit people with depressed cortisol levels.  In addition to benefiting people with adrenal problems, Ashwagandha has many other benefits, as I have written about in my article “Ashwagandha and Thyroid Health“:

4. Licorice.  Licorice is an herb I frequently recommend for those people who have depressed cortisol levels.  Glycyrrhizin is the main compound in licorice root, and is what helps to lower cortisol levels by inhibiting the enzyme responsible for the conversion of cortisol to cortisone.  However, licorice also can cause an elevation of blood pressure, and so it typically is contraindicated in those with hypertension.  Licorice also can help to decrease inflammation of the gastrointestinal tract as well.  For more information on Licorice you can read my article entitled “Licorice and Thyroid Health“:

5. Eleuthero.  Eleuthero (Siberian Ginseng) is a great herb for those who deal with chronic stress on a daily basis.  Of course this describes just about everyone, but this doesn’t mean that everyone should take Eleuthero.  I usually recommend this herb to those patients who deal with a lot of stress AND do a poor job of handling it.  Of course the goal is to work on improving one’s stress handling skills so they don’t have to rely on taking Eleuthero.  There is some concern that taking Eleuthero might increase the production of thyroid hormone, but most people with hyperthyroid conditions do fine when taking it.  In fact, when I was following a natural treatment protocol for my Graves’ Disease condition I personally took Eleuthero for a number of months without any problem.  But of course everyone is different, and so if someone who has a hyperthyroid condition takes this herb and feels that it’s exacerbating their condition then of course I would advise them to stop taking it. For more information on Eleuthero check out my article entitled “How Eleuthero Can Help People With Thyroid and Autoimmune Thyroid Conditions“.

6. Phosphatidylserine.  Phosphatidylserine is produced naturally by the body, although you can also get this from foods.  It can also be taken as a supplement.  It is important in maintaining cellular function.  I frequently will recommend this for those who have high cortisol levels.  Clinical studies show that phosphatidylserine can weaken the cortisol response (2) (3).  And although these studies involved giving phosphatidylserine to those who had high cortisol levels due to exercise-induced stress, in my experience it doesn’t matter what type of stress resulted in the elevated cortisol levels.

Which Of These Supplements/Herbs Should You Take?

As I suggested in the beginning of this blog post, while taking certain supplements and herbs can help with the recovery process, taking supplements isn’t a substitute for eating well, getting sufficient sleep, or managing stress.  These factors are without question more important than taking supplements.  In fact, in some cases just eating well and improving one’s stress handling skills can do wonders for the adrenals.  With that being said, sometimes it is can be beneficial to take one or more of the supplements I discussed.

If someone is dealing with chronic stress on a daily basis and is having a difficult time handling the stress, then in addition to working on their stress handling skills they might benefit from taking a vitamin B and vitamin C supplement.  Taking either Ashwagandha or Eleuthero can also be beneficial in helping someone to better deal with stress.  If someone has depressed cortisol levels (and they don’t have hypertension) then taking an herb such as licorice can be beneficial.  On the other hand, if high cortisol levels are an issue then they might want to consider taking Phosphatidylserine, or if they prefer an herbal approach then taking the herbs Ashwagandha and Rehmannia can also help to lower elevated cortisol levels.

As usual, I do think it’s a good idea to work with a competent natural healthcare professional, as they will evaluate your adrenals, and if you have compromised adrenals they will determine which of these supplements and herbs are best for you.  Of course I realize that many people aren’t going to take my advice and will self treat their condition, and if this describes you then just make sure you start with very small doses, especially when taking any of the herbs I mentioned.  Although most people do fine taking the herbs, everyone is different, and every now and then someone will experience a negative reaction.  For the most part vitamin B and vitamin C are safe to take, although I still would be cautious about taking very high doses of these on your own.

Plus, keep in mind that there are other supplements and herbs which can help with adrenal health.  For example, the herb rhodiola is an excellent herb which can benefit people with compromised adrenals.  Biotin can also be beneficial for adrenal problems.  Some people can also benefit from taking an adrenal glandular, although you usually don’t want to take these for a prolonged period of time.

In summary, there are numerous supplements and herbs which can benefit people with compromised adrenals.  Although eating well, getting sufficient sleep, and doing a good job of managing stress are all important factors, taking supplements and/or herbs can frequently help to speed up the recovery process.  While taking a vitamin B and C supplement usually won’t cause problems, I would recommend working with a competent natural healthcare professional before taking the herbs I discussed.  Even though most people do fine when taking the herbs I discussed, every now and then someone will have a negative reaction.