I often get messages from people with Hashimoto’s and autoimmune disease that say “Thanks for your efforts, but I’ve already tried everything.
I have cut out gluten, dairy, and soy and still have Hashimoto’s. How can your website and book (Hashimoto’s: The Root Cause) help me?”
While changing your diet is a really important first step that will greatly help many of you, if you do not see a complete remission of your condition within 3-6 months, I encourage you to dig deeper. Changing my diet was a really important step in my healing journey, but it was just the beginning.
Digging for Your Root Causes
Dr. Alessio Fasano, world-renowned gastroenterologist, Celiac disease and autoimmunity expert, describes autoimmunity as a three-legged stool that needs three things to be present to manifest:
- The right genes
- The trigger
- Intestinal permeability
While we can’t change our genes, we can reverse the autoimmune condition by removing triggers and intestinal permeability.
Dr. Fasano uses the example of Celiac disease to explain this phenomenon. Celiac disease is a unique autoimmune condition where gluten acts as both the trigger and the cause of intestinal permeability! Once gluten is removed, the body is able to heal and regenerate itself.
Infections have been implicated as triggers in many cases of autoimmunity, and identifying and removing infections may result in a complete remission of the autoimmune condition. You can read more about infections and Hashimoto’s.
Although we can’t always identify and even remove all of the triggers, such as Epstein-Barr Virus (the virus that causes Mono), another option is to fix the intestinal permeability. This will also allow many individuals to put their condition into remission, as the “three-legged stool” of autoimmunity will no longer be able to stand!
Based on my research over the last four years, I’d like to share with you six potential root causes of intestinal permeability. There are of course many additional root causes, but these six are a great place to start.
Note: Some of you may have more than one root cause, and I encourage you to dig!
Root Cause #1: Gluten Sensitivity
Gluten sensitivity and Celiac disease have been implicated in various autoimmune conditions ranging from Hashimoto’s, Graves’ disease and Rheumatoid Arthritis. Various tests can be done to determine if one has Celiac disease/gluten sensitivity. However, the condition may not always show up on tests. Some individuals do not learn of their sensitivity until they remove gluten from their diets.
Gluten sensitivity may be the sole root cause, or it may be one of a few root causes. Every person with an autoimmune thyroid condition should remove gluten from his/her diet. Even in those who do not have Celiac or gluten sensitivity, gluten causes intestinal permeability.
If gluten was the sole root cause, the person should see a complete remission of thyroid antibodies and thyroid function may even return to normal within 3-6 months! If not, we may need to dig deeper…
Treatment: Pretty straight forward… Testing for Celiac/gluten disease, and removing gluten from the diet
Root Cause #2: Gluten Sensitivity & Cross-Reactive Proteins
In addition to gluten sensitivity, individuals with Hashimoto’s may also be reactive to multiple other proteins including grains like rice, quinoa, and corn. Some experts, like Dr. William Davis, author of Wheat Belly, claim that human beings did not evolve to eat “grasses” like wheat, rice, or corn.
Other individuals may also react to dairy, eggs, nuts, seeds, nightshades…
Cyrex labs, ALCAT, Alletess labs offer additional testing options for food sensitivities.
Treatments of Choice: Testing, elimination diet, Paleo diet, Autoimmune Paleo diet, and in some cases a rotation diet may be beneficial. Working with a nutrition coach can be extremely beneficial in this respect. Supplements to help restore the gut lining may be beneficial as well. Systemic enzymes may prevent reactions to new foods, and reduce reactions to current foods.
Ready to try the Autoimmune Paleo diet but not sure where to start? Get my 2-week recipe plan for FREE!
Root Cause #3: Glutamine/Zinc Depletion
Zinc and glutamine are among the two substances that are required for rebuilding intestinal lining. In times of stress, the body will pull these substances from our intestines and uses them for other things, such as the production of adrenal hormones.
In most cases, these substances become available to us through food, and things go back to normal after the stressful time is over, and the gut lining is rebuilt with new ingredients.
This becomes an issue for those under prolonged stress, those with low stomach acid (which is needed to extract zinc from proteins), and those that follow a diet low in animal protein, including vegans and vegetarians, as glutamine is primarily found in animal protein (including eggs and dairy).
Some individuals who followed vegan/vegetarian diets and then introduced animal proteins back into their diets have been able to put their Hashimoto’s in remission. I believe this is because the glutamine and other ingredients allowed them to rebuild their gut lining.
Solutions for this root cause: glutamine supplements, zinc supplements, bone broths, gelatin, well-cooked meats, Betaine with Pepsin (digestive enzymes to extract zinc from food), and any of the nutrient dense diets listed in this blog post.
Note: Other nutrients like vitamin D are also required for proper gut barrier function. Most of these interventions and supplements will help for just about everyone with Hashimoto’s. I maintain a list of Hashimoto’s recommended supplements.
Root Cause #4: Parasites
You may think that parasites are only present in malnourished third world countries. Not so. Depending on the sources, 30-70% of Americans may be infected with parasites. Current detection methods miss many parasites, and honestly, how many of you have been routinely tested for parasites?
A parasite found in the intestines can cause a tremendous amount of damage and has the ability to cause intestinal permeability, food sensitivities, and autoimmune disease. If you are someone who developed your condition after a period of intense stress, I urge you to get tested, as stress makes us more susceptible to parasites.
Unfortunately, diets are a short-term fix. People with parasites have multiple food sensitivities that don’t go away no matter what they eat or don’t eat. A person may feel better initially after removing sensitizing foods, only to start feeling worse once new foods become reactive. You can be on the perfect diet, and take loads of supplements, but if you have a parasite, it doesn’t matter; you will not be able to recover fully.
There are many different types of parasites, including worms, amoebas, and protozoa. Different treatments work for different parasites, thus while general parasite cleanses can sometimes help, I prefer to figure out the specific type of parasite through advanced testing, such as the GI-MAP or BioHealth Labs 401H test. For parasites in autoimmune disease, I take the approach “guilty until proven innocent,” as I have seen many people with 5-10 negative tests for parasites finally come up positive on one of the above-mentioned tests.
You can order the GI-MAP or BioHealth’s GI Pathogen Screen with H. pylori Antigen (401H) tests yourself or through a functional medicine practitioner. You can learn more about the functional medicine approach to thyroid.
Temporary Fix: probiotics, low carbohydrate diets, and diets such as the Autoimmune Paleo Diet will make it easier for us to tolerate the parasite symptomatically, but will not result in the elimination of the parasite or the autoimmune condition.
Solution: antiparasitic herbs tailored to the parasite, specific antiparasitic medications, certain supplements, the probiotic S. boulardii and low carbohydrate diets will help as well.
Root Cause #5 Small Intestinal Bacterial Overgrowth (SIBO)
SIBO is an overgrowth of bacteria in the small bowel or small intestine. This overgrowth can be caused by antibiotic overuse and starchy foods, among others. The SIBO results in intestinal permeability as the body tries to get rid of the excess bacteria.
Testing: Small Intestinal Bacterial Overgrowth test by BioHealth can be self-ordered by patients and gastroenterologists, and major Academic Treatment Centers will have access to advanced diagnostic tests.
Treatment Options: antibiotics, antimicrobial herbs, elemental diet and diets like the Specific Carbohydrate Diet, Low FODMAPS diet, and GAPS diet are the treatments of choice for SIBO.
Root Cause #6 Fungal Infections
The fungus Candida can cause intestinal permeability and has been implicated in autoimmune disease and food sensitivities. Liz Schau, the holistic nutritionist, was kind enough to share her Hashimoto’s remission story after overcoming Candida.
Testing: Gut testing such as the GI-MAP may help determine if there is an overgrowth of Candida in the bowels.
So What’s Your Root Cause?
I encourage you to Dig at it! It’s not always the same for each person, and I wrote my book to help you figure that out! I cover each of the above-mentioned root causes in great detail and provide much more information on many additional root causes, and how to find yours.
If you haven’t picked up a copy of my book, Hashimoto’s: The Root Cause yet, I hope that you will consider getting going into the New Year. In January 2011, I decided to take charge of my health, and I am so glad that I did. Wishing you all the best in your health journey!
PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free by going to www.thyroidpharmacist.com/gift. You will also receive occasional updates about new research, resources, giveaways and helpful information.
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- Sategna-Guidetti C, Volta U, Ciacci C et al. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. The American Journal of Gastroenterology. 2001;96(3):751-757. doi:10.1111/j.1572-0241.2001.03617.x.