While all of the minerals play an important role in the health of individuals, selenium is one of the more important minerals with regards to thyroid health. First of all, selenium is important in the formation of thyroid hormone, as well as the conversion of T4 to T3. Selenium is also important in the synthesis of glutathione. Epidemiological findings link a lowered selenium status to neurodegenerative and cardiovascular diseases as well as to increased cancer risk (1). Selenium is extremely important for optimal immune system health, and a selenium deficiency might make one more susceptible to developing an autoimmune condition such as Graves’ Disease or Hashimoto’s Thyroiditis.

How Does Selenium Enhance Immune Function?

While selenium has many different functions, this blog post will mainly focus on the benefits of selenium with regards to immune system health. But how does selenium enhance immune system function? Selenium can influence immune response by changing the expression of cytokines and their receptors or by making immune cells more resistant to oxidative stress (2). If you’re not familiar with cytokines I would check out my recent blog post entitled “The Role of Cytokines In Autoimmune Thyroid Conditions“. Supplementation with selenium has been shown to stimulate the function of neutrophils, production of antibodies, proliferation of T and B lymphocytes, production of lymphokines, natural killer cell-mediated cytodestruction, delayed-type hypersensitivity reactions and allograft rejection, and the ability of a host to reject transplanted malignant tumors (3).

Selenium is also a cofactor for glutathione. Glutathione is an antioxidant which has numerous functions, and there is evidence that altered glutathione concentrations may play an important role in many autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis (4). If someone is deficient in selenium then this will affect glutathione production, which is yet another reason why it’s important to correct a selenium deficiency.

Let’s take a look at selenium and how it might play a role in autoimmune conditions such as Hashimoto’s Thyroiditis and Graves’ Disease:

Selenium and Hashimoto’s Thyroiditis

Hashimoto’s Thyroiditis is characterized by an increase in either thyroperoxidase (TPO) and/or thyroglobulin antibodies. While there is no hard evidence that a selenium deficiency can trigger an autoimmune response, there is evidence that selenium can lower thyroperoxidase antibodies (5) (6). As a result, those people with high TPO antibodies might benefit from selenium supplementation, or eating selenium-rich foods such as Brazil nuts.

However, there are also some studies which show that selenium supplementation doesn’t lower TPO antibodies (7). Most of the studies involving selenium and TPO antibodies used 200 mcg of selenium, either in the form of sodium selenite, or selenium yeast. Perhaps giving a higher dose (i.e. 400 mcg) would be more effective for some people? However, one does need to be cautious about taking higher doses of selenium, which I’ll discuss in more detail below. What about those people who have high thyroglobulin antibodies? Most of the studies on selenium and thyroid antibodies focus on thyroid peroxidase antibodies. I did come across one study which showed that selenium helped to lower both thyroperoxidase and thyroglobulin antibodies, although it seems that the thyroperoxidase antibodies are affected to a greater extent by selenium supplementation (8).

Selenium and Graves’ Disease

With regards to Graves’ Disease, a population-based study showed that selenium levels were lower in people with newly diagnosed Graves’ Disease (9). As a result, they postulated that there might be a link between inadequate selenium supply and autoimmune thyroid disease. However, this study alone does not confirm that a selenium deficiency can trigger Graves’ Disease, and more research definitely is needed in this area. Another study showed that there is a possible role of selenium supplementation in improving the course of Graves Disease (10), although it also suggested that further clinical trials are necessary to confirm this.

Should You Supplement With Selenium?

I’m sure many people reading this are aware of the benefits of selenium, and are already eating more selenium-rich foods such as Brazil nuts and sardines, and/or are taking a selenium supplement. Although supplementing with selenium might be beneficial, here are a few things you need to keep in mind:

1) If someone has a selenium deficiency then this might be a factor in one’s autoimmune thyroid condition. However, in most cases this isn’t the only factor. In most cases something else has triggered the autoimmune response, and if you don’t remove this trigger then taking high doses of selenium might not have much of an impact on the thyroid antibodies.

2) Selenium can be toxic at high doses. If you supplement with selenium you need to be cautious. While most people are fine supplementing with 200 mcg per day, taking doses higher than this can cause problems. I’ve had numerous patients take 400 mcg of selenium per day, and some people will be fine taking 600 mcg of selenium for a short period of time. But everyone is different, and so you can’t make the assumption that 400 mcg of selenium is safe to take. When I recommend selenium supplements to my patients I recommend a whole food source, as there is a much greater chance of having a selenium toxicity when taking synthetic selenium supplements. However, if you take too high of a dosage of food based supplements this still can potentially lead to a toxicity.

3) How about eating a couple of Brazil nuts per day? Brazil nuts are a rich source of selenium, and some people can get all of the selenium they need by eating one or two Brazil nuts on a daily basis. This doesn’t mean you should eat a bunch of Brazil nuts if you have a selenium deficiency, as while Brazil nuts are healthy, more isn’t necessarily better, and if someone has gut issues then eating Brazil nuts might not be the best choice. The reason for this is due to the lectins and phytic acid, which can affect digestion. I discussed this more in my blog post entitled “Should People With Thyroid and Autoimmune Thyroid Conditions Avoid Foods With Lectins?” A better option might be a whole food selenium supplement, as I briefly mentioned before. And the reason for this is because while a synthetic selenium supplement will correct a selenium deficiency, selenium (as well as other minerals), works best in the presence of other nutrients and cofactors.

To summarize, if someone has low selenium levels then this might make them more susceptible to developing an autoimmune thyroid condition. However, I think it’s safe to conclude that most cases of Graves’ Disease and Hashimoto’s Thyroiditis are not caused by a selenium deficiency. This doesn’t mean that a selenium deficiency can’t be a factor. Any mineral deficiency should eventually be corrected, and a selenium deficiency can compromise immunity, as well as cause problems with the conversion of T4 to T3, and will also affect the production of glutathione.

Echinacea is one of the most commonly used herbs. You can find echinacea at just about any health food store, in retail stores (i.e. Walmart, Target), and pharmacies usually have supplements with echinacea. Many people take echinacea to prevent the onset and reduce the severity of colds, the flu, and other conditions. But when it comes to autoimmunity, there is controversy about whether echinacea is safe to take.

With any autoimmune condition there is the presence of pro-inflammatory cytokines. I won’t discuss this in detail, as you can refer to my blog post entitled “The Role of Cytokines In Autoimmune Thyroid Conditions“. In this post I briefly talk about Th1 and Th2 dominance. Hashimoto’s Thyroiditis is known as a Th1 dominant condition (1), while Graves’ Disease is known as a Th2 dominant condition (2). What this essentially means is that each condition is characterized by the activation of different cytokines. Once again, I discuss this more in my post.

In his wonderful book “Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal?”, Dr. Datis Kharrazian discusses how different nutrients and herbs can be used to help balance the Th1/Th2 pathways. He discusses how with a Th1 dominant condition you want to stimulate the Th2 pathways, while with a Th2 dominant condition you want to stimulate the Th1 pathway. There is evidence that echinacea stimulates the Th1 pathway, and thus according to the “Th1/Th2 balancing theory”, it would be beneficial for those people with Graves’ Disease, but not recommended for those people with Hashimoto’s Thyroiditis.

Controversy Over Balancing The Th1/Th2 Pathways

While there is no question that The Th1 and Th2 pathways play a role in autoimmunity, trying to balance these pathways by using certain supplements and herbs is controversial. In addition to echinacea, there are other herbs and nutrients which can stimulate one or both pathways. With regards to echinacea, I have given this herb successfully to many people with both Graves’ Disease and Hashimoto’s Thyroiditis. Now to be fair, Dr. Kharrazian explains that not all cases of Hashimoto’s Thyroiditis are Th1 dominant conditions, and not all cases of Graves’ Disease are Th2 dominant conditions. The only way to know for certain is by testing the cytokines. However, I’ve had people who tested as Th1 dominant do fine when taking echinacea. On the other hand, I’ve had some people with a Th2 dominant condition not tolerate echinacea well.

So I’m not suggesting that everyone can take echinacea without a problem. What I am saying is that there is no conclusive research I’m aware of which proves that echinacea only stimulates Th1 cytokines. Just a few years ago it was thought that curcumin and resveratrol only stimulated the Th2 pathway, and because of this it was recommended for people with Th1 conditions to avoid these nutrients. However, research over the past few years shows that both curcumin and resveratrol can benefit people with Th1 and Th2 dominant conditions by regulating Treg/Th17 balance (3) (4). The truth is that there is a lot about herbs and other nutrients that we still don’t know.

By the way, all of this isn’t meant to criticize Dr. Kharrazian’s findings, as I think he has an incredible amount of knowledge, does a ton of research, and I commonly recommend his book to people who have Hashimoto’s Thyroiditis. All I’m saying is that more research needs to be done to find out the impact echinacea has on autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis.

Some people can have an allergy to echinacea. In fact, a systematic review which looked at the safety of echinacea said that although severe allergic reactions are rare, in some people, taking this herb will lead to gastrointestinal problems and rashes (5). The truth is that this can happen with numerous other herbs, as while most people don’t experience adverse reactions when taking herbs, there are risks involved, and some people do experience a negative reaction when taking them. People who are specifically allergic to plants in the daisy family are more likely to have an allergic reaction to echinacea.

Should People With Autoimmune Thyroid Conditions Avoid Echinacea?

At this point you’re probably wondering whether people with Graves’ Disease and Hashimoto’s Thyroiditis should take echinacea, or completely avoid this herb. There is some concern that taking echinacea can either trigger the development of an autoimmune thyroid condition, or that it might exacerbate a preexisting autoimmune condition. I did come across some evidence involving a couple of patients which showed that taking echinacea might have caused a flare up of their autoimmune condition (6). However, these people also took spirulina, and so it is impossible to determine if it was due to the echinacea, spirulina, or combination of both which flared up the autoimmune response. But even if the flare-up was due to the echinacea, one can’t conclude that taking echinacea will lead to the same results in other people with autoimmune thyroid conditions.

I personally took echinacea when I was following a natural treatment protocol for my Graves’ Disease condition. However, I don’t give echinacea to all of my patients, and so I can’t say that everyone with an autoimmune thyroid condition needs to take echinacea. For the most part, the people who I have recommended to take echinacea have experienced positive results, although there have been a few exceptions. In addition, Kerry Bone, who is an herbalist with over 25 years of experience, commonly recommends echinacea to his patients with autoimmune conditions.

As I’ve discussed in other articles and posts in the past, the quality of the herb is important. While my goal isn’t to promote any specific brands, you do want to be cautious about what you take, and this of course applies to any supplement or herb. There are also numerous species of echinacea, and when I do recommend echinacea to my patients I recommend a product which has both Echinacea angustifolia and Echinacea purpurea.

An Important Reminder About Immune Modulating Herbs

It is important to remember that if someone takes an herb such as echinacea, or any other herb which affects the immune system, the ultimate goal remains to address the underlying cause of the condition. Even if many people can benefit from taking echinacea, the truth is that taking this herb usually won’t do anything to address the cause of the autoimmune thyroid condition. So taking echinacea won’t do anything for weak adrenals caused by chronic stress, a leaky gut due to allergens or a poor diet, a hormone imbalance, etc. On the other hand, if someone with Graves’ Disease or Hashimoto’s Thyroiditis has a pathogenic infection of any type, then echinacea can help in the eradication of this pathogen by modulating the immune system.

What is YOUR Experience With Echinacea?

I’m sure many people reading this post have taken echinacea, and I’d be interested in find out what type of experience you have had with this herb. Did you have a positive experience when taking echinacea? Or did it seem to exacerbate your symptoms, increase your thyroid antibodies, etc? Of course it’s common for people to be on numerous supplements and herbs, and so many times it can be a challenge knowing if a specific supplement or herb is responsible for improving or exacerbating one’s condition. But some people are able to pinpoint their improvement or worsening of symptoms due to a specific supplement and herb, and if anyone reading this feels that echinacea helped to improve their health, or perhaps made it worse, then I’d like to hear about this experience.

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

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

The Challenges Of Finding The Trigger

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

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

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

How Do You Know If The Trigger Has Been Removed?

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

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

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

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

Downregulating NF-kappaB Is Important

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

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

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

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

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

Cytokines play an important role in the pathogenesis of conditions such as Graves’ Disease and Hashimoto’s Thyroiditis. But what exactly are cytokines? They are similar to hormones, and some sources actually classify them as a type of hormone. Either way, cytokines are immunomodulating proteins, peptides, or glycoproteins that are involved in cellular communication (1). They are regulators of host responses to infection, immune responses, inflammation, and trauma (2).

Certain cytokines play a pro-inflammatory role in autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis. In other words, these cytokines promote inflammation. Two examples of pro-inflammatory cytokines include Interleukin 1 (IL-1) and tumor necrosis factor alpha (TNF-α). However, there are also anti-inflammatory cytokines, as these cytokines act in concert with specific cytokine inhibitors and soluble cytokine receptors to regulate the human immune response (3).

What Role Do Cytokines Play In Autoimmunity?

There is considerable evidence implicating that the actual destruction of thyroid cells in autoimmune thyroid conditions may be caused by different and multiple mechanisms, including auto reactive T-lymphocytes, natural killer cells, and cytokines (4). The most significant factor that is likely to be involved in the induction of autoimmunity is a defect or deficiency in the immune regulation, particularly a disturbance in the balance between the effector T cells and regulatory T cells that prevent the development of autoimmunity (4). In other words, dysregulation of cytokine production can play a big role in the development of autoimmune thyroid conditions.

Some people reading this are familiar with the Th1 and Th2 pathways. Each of these pathways consist of different cytokines. The Th1 pathway consists of T-Helper cells which include the cytokines IL-2, IFN-γ, and tumor necrosis factor-α (TNF-α) (4). The Th2 pathway consists of B cells, and is characterized by the secretion of IL-4, IL-5, IL-6, IL-10, and IL-13 (4). High amounts of Th1 cytokines are commonly found in Hashimoto’s Thyroiditis (5), and thus Hashimoto’s is typically known as a Th1-dominant condition. Graves’ Disease is thought to be a Th2-dominant autoimmune condition (6).

Using Nutrients and Herbs To Balance The Th1 and Th2 Pathways Is Controversial

Some natural healthcare professionals will focus on balancing the Th1 and Th2 pathways. In other words, they will order a blood test to look for the presence of different cytokines in an attempt to determine if their patient is Th1 or Th2 dominant, and then give specific supplements or herbs depending on whether the person is Th1 or Th2 dominant. For example, if someone is Th1 dominant, they will recommend specific supplements and/or herbs to help stimulate the Th2 pathway. Similarly, if someone has a Th2-dominant condition they will do things in an attempt to stimulate the Th1 pathway.

You ideally don’t want to give anything that will stimulate the same pathway the person is dominant in. For example, the herb Echinacea supposedly stimulates the Th1 pathway, and thus shouldn’t be taken by someone who is Th1 dominant. And since most people with Hashimoto’s Thyroiditis are Th1 dominant, this would suggest that most people with this condition should avoid Echinacea. Studies do in fact show that Echinacea does affect the Th1/Th2 balance (7), although this doesn’t mean that everyone who has a Th1 dominant condition needs to avoid Echinacea. While some people don’t do well when taking Echinacea, other people with Hashimoto’s Thyroiditis do fine when taking this herb. In any case, there is controversy over using nutrients and herbs to balance the Th1 and Th2 pathways, and for more information I would consider reading a journal article written by Dr. Parris Kidd entitled “Th1/Th2 balance: the hypothesis, its limitations, and implications for health and disease“.

Understanding Nuclear Factor Kappa B

Nuclear Factor Kappa B (NF-kB) is a transcription factor, and activation of NF-kB is associated with pro-inflammatory cytokines such as IL-1 and TNF alpha. In other words, when an autoimmune response is triggered, the immune system will activate pro-inflammatory cytokines, which in turn will activate NF-kB. This in turn will contribute to the inflammatory process. Some studies suggest that NF-κB can also have anti-inflammatory roles by directly inhibiting expression of pro-inflammatory genes and by manipulating the expression or activity of anti-inflammatory cytokines such as IL-10 (8).

NF-kB has often been referred to as a central mediator of the immune response, since a large variety of bacteria and viruses can lead to the activation of NF-kB (9). Some studies have shown that NF-kB may function more generally as a central regulator of stress responses, since different stressful conditions, including physical stress, oxidative stress, and exposure to certain chemicals, also lead to NF-kB activation (9). What’s important to understand is that the activation of NF-kB is a normal process, but it’s the chronic activation of this transcription factor which leads to problems.

Downregulating NF-kB Is An Important Factor In Restoring One’s Health

When someone has an autoimmune thyroid condition, one of the goals is to do things which will help to downregulate NF-kB. While the pharmaceutical industry focuses on developing anti-inflammatory drugs which inhibit NF-kB, there are natural supplements and herbs which have been proven to accomplish this and don’t come with the potential side effects of these drugs. I’ve discussed these supplements and herbs in different articles and blog posts, but let’s take a look at them again:

Turmeric. I think turmeric is a wonderful herb, as there are many clinical trials involving this herb, and you can read about many of the benefits in a separate article I wrote entitled “Turmeric and Thyroid Health“. While I frequently recommend this herb to help with inflammation and to downregulate NF-kb, there are many other benefits this herb has to offer.

Resveratrol. I also like resveratrol a lot, and just like turmeric, I have written a separate article entitled “Can Resveratrol Benefit People With Graves’ Disease and Hashimoto’s Thyroiditis?“. Resveratrol also has the ability to help with inflammation and can downregulate NF-kb.

Omega 3 Fatty Acids. Higher doses of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) can also help with inflammation and downregulate pro-inflammatory cytokines (10) (11). I recommend omega 3 fatty acids to just about all of my patients, usually in the form of fish oil supplements. Vegetarian sources such as flax oil and chia seeds can also be good sources of omega 3 fatty acids, although some people have difficulty converting alpha-linolenic acid into DHA and EPA.

Borage oil, Black Currant Seed oil, and Evening Primrose oil. These are all forms of gamma-linolenic acid (GLA), and can also help with inflammation and reduce the production of pro-inflammatory cytokines (12) (13).

Vitamin D3. I’ve spoken about the benefits of vitamin D in numerous articles and blog posts. Vitamin D plays a huge role in controlling inflammation, and unfortunately most people I work with are deficient in vitamin D. This is true even for many people who live in sunny areas. Of course not everyone is deficient in vitamin D, but the only way to know for certain is through testing, and I recommend for just about everyone with a thyroid or autoimmune thyroid condition to have their vitamin D levels tested.

Ginger. I don’t speak about this herb too much, although there is evidence that ginger may act as an anti-cancer and anti-inflammatory agent by blocking the activation of NF-kB through the suppression of the pro-inflammatory cytokine TNF-alpha (14) (15). I suppose I’ll need to work on a future article entitled “Ginger and Thyroid Health”!

There are other agents which have the ability to downregulate NF-kb and pro-inflammatory cytokines, but these are some of the more researched ones. And of course I’m not suggesting that those people with an autoimmune thyroid condition such as Graves’ Disease or Hashimoto’s Thyroiditis need to supplement with all of these. In just about all people I will recommend omega 3 fatty acids (usually in the form of fish oils), a source of GLA, and to supplement with vitamin D3 if someone has a deficiency. It also can be beneficial to include turmeric and/or ginger as part of one’s diet, or in some cases to take a supplement consisting of these herbs. In any case, hopefully you now have a better understanding as to what cytokines are, and what role they play in autoimmunity.

When it comes to following a natural thyroid treatment protocol, probably the biggest challenge for most people is eating well.  However, while many people realize the importance of eating well, most people don’t do enough to manage their stress levels.  And a big reason for this is because most people don’t block out the time to manage their stress.  And since stress is a big factor in many people with thyroid and autoimmune thyroid conditions, it is essential for everyone with these conditions to block out some time to work on their stress handling skills ON A DAILY BASIS.

I’ve spoken about the importance of stress management in the past, and I’m sure this won’t be the last time I discuss this topic.  The reason I bring it up on a frequent basis is because I’ve seen people follow a natural treatment protocol and eat well, take good quality supplements, improve other aspects of their health, and yet not receive optimal results because they didn’t do a good job of managing their stress levels.  Obviously there is only so much one can do to reduce the stress levels in their life.  But even though many people are unable to modify the amount of stress they’re exposed to on a daily basis, just about everybody can improve their stress handling skills.

How Much Time Should You Dedicate Each Day To Stress Management?

You might wonder how much time you need to block out each day to work on your stress handling skills.  This will vary from person to person, as someone who deals with a great amount of stress on a daily basis will probably need to dedicate more time to managing their stress when compared with someone who doesn’t deal with as much stress.  Another factor to consider is one’s personality type.  Most people are familiar with Type A and B personalities, with a Type A personality typically being more “hard driving and competitive”, whereas a Type B personality is associated with being more “laid back”.  There are more than just these two personality types, and my goal isn’t to discuss these in this post, but I just want to point out that someone who has a “laid back” personality usually won’t be affected as much from the stress as some other personality types, and thus probably won’t need to spend as much time managing their stress.

The problem is that some people aren’t aware of the type of personality they have.  For example, some people might think they have a laid back attitude, but they really are more of a Type A personality.  As a result, they might not think that chronic stress is having an impact on them, even if it is a big factor with regards to their health.  So before you make the assumption that you don’t need to spend any time managing your stress because you have more of a Type B personality, you might want to carefully evaluate yourself, and perhaps even get the opinion of some family members and friends to help determine whether or not you really do have a “laid back” personality.

Regardless of the personality type or the amount of stress one deals with on a daily basis, in my opinion everyone should block out at least 10 to 15 minutes per day to work on stress management.  And those who deal with a good amount of stress each day and/or have more of a Type A personality will need to block out even more time to improve their stress handling skills.  These people might need to block out anywhere from 30 to 60 minutes a day to focus on their stress handling skills.

What If You Simply Don’t Have The Time To Manage Your Stress?

For many people it is a challenge to block out the time to manage their stress.  For example, some people will wake up early to go to work, won’t get home until the evening, and after eating dinner and spending time with the family they don’t have much time to relax for a few minutes, let alone take some time to manage their stress.  Another example might involve a stay-at-home mom who has a few young children, and blocking out time in this case can also be a challenge.  And even if she could block out some time, there is no guarantee that it would be uninterrupted time.

While it might be a challenge for some people to block out 30 to 60 minutes each day for stress management, most people can find at least 10 to 15 minutes per day to work on this.  It might mean waking up 10 to 15 minutes earlier, although if someone deals with a great amount of stress I think it’s more beneficial to either 1) work on stress management in the middle or end of the day, or 2) break up the stress management “sessions”.  For example, an ideal situation would be to dedicate 10 to 15 minutes in the morning to improving your stress handling skills, and then do this again in the afternoon, and then right before going to bed.  I realize this isn’t practical for some people, but doing this will help to start your day with a lesser amount of stress, and then if you have a stressful day it will allow you to spend some time during the day to work on this.  Then by working on your stress handling skills right before going to bed it will help you to end the day with a reduced amount of stress, which can help greatly for those who have a difficult time falling and/or staying asleep.

As I’ve discussed in other blog posts and articles, the adrenal glands are essential when it comes to managing stress.  Cortisol is known as the “stress handling hormone”, and while eating well and taking certain supplements can benefit the adrenal glands, the best way to keep your adrenal glands healthy and strong is by becoming an expert in managing your stress.  This is just as important as eating well, and perhaps even more important.  After all, we’re all going to deal with chronic stress, although some people will deal with a greater amount of stress than others.  In addition, you never know when an acute stress situation will present itself, and those who continuously work on improving their stress handling skills will be in a much better position to handle these situations when they do come along.  Whether it’s a trauma, an unexpected death of a friend or family member, or another acute stress situation, this is something that everyone faces during their lifetime.  And while our adrenals are equipped to handle these acute stress situations, many times these situations lead to prolonged, chronic stress, which our adrenals were not designed to handle.

What Can You Do To Better Handle The Stress?

For information on how to improve your stress handling skills I will refer you to an article I wrote in the past entitled “7 Stress Management Tips To Help Restore Your Thyroid Health“.  There of course are other things you can do for stress management which I didn’t list in the article.  The first three tips I give in this article are to 1) be aware of the impact stress has on your health, 2) eat a healthy diet, and 3) exercise regularly.  Doing these three things alone can help greatly when it comes to managing the stress.  But for many people this isn’t enough, and since many people underestimate their stress handling skills I think it’s a good idea to do other things to help manage their stress.

For example, you can block out 10 to 15 minutes one or more times each day and do some deep breathing and meditation.  If you don’t have experience with this then you might want to check out the website www.getsomeheadspace.com, as they offer ten free ten-minute meditation lessons.  May people aren’t familiar with biofeedback as a form of stress management, but this can also be a great way to improve your stress handling skills.  For more information on this I recommend visiting www.HeartMath.com, as they have videos you can watch to better understand how this might be able to help you.

In summary, managing one’s stress can be a big challenge when following a natural treatment protocol.  Many people have poor stress handling skills, and it is important to block out some time each day to work on stress management.  At the minimum you should block out 10 to 15 minutes each day to focus on this, although some people will need to dedicate more time on improving their stress handling skills.  The amount of time you need to spend on this will depend on how much stress you deal with on a daily basis, as well as your personality type.