Dr. Izabella Wentz, PharmD

Thyroid Pharmacist

Are You a Skeptical Scientist?

For The Skeptical Scientists Like Me

Medically reviewed and written by Izabella Wentz, PharmD, FASCP on February 4, 2015

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Celiac, Hashimoto’s, and Gluten

Question from one of my fellow skeptical scientists…

I received this question and, being a skeptical scientist myself, I was excited to answer it.

“Dear Izabella, forgive me for being the skeptic scientist but perhaps, you could explain to me logically, how it is possible to overcome severe autoimmune disease?”

Here is my answer…

As a pharmacist, I have been trained to be extremely skeptical. And I was very skeptical of the impact that lifestyle changes would make on autoimmunity as well until I did my research and testing. I have been trained in scientific literature evaluation and have access to most medical journals and references as an alumnus of my university. We are so lucky to be living in the digital age, where we can search and pull up scientific articles from all over the world from our very own laptops.

Here is basically how I came into this…

PubMed, the largest archive of medical publications, has numerous studies of people eliminating autoimmune conditions following gluten free diets, including Hashimoto’s. Gluten free helped me but did not work for eliminating my autoimmune condition.

So I hypothesized that there must be other triggers, and if I can identify them, it could result in remission. I then came across the research of Dr. Alessio Fasano on zonulin, a protein that is expressed in all autoimmune conditions and associated with increased intestinal permeability.

Gluten is a trigger for zonulin expression, and through further research, I have been able to identify 30+ additional triggers, such as infections in the small intestine.

When there is an increase in intestinal permeability, we are exposed to things in the gut such as foods and bacteria, which can trigger autoimmunity through molecular mimicry (an autoimmune theory).

As a result of Dr. Fasano’s research, Larazotide, a zonulin inhibitor was developed by a pharmaceutical company and is currently in clinical trials. I thought hey if pharmaceutical companies are interested, this must be good. If this drug can effectively block the release of zonulin for a prolonged time, it would be a new blockbuster effective for Celiac disease, all autoimmune conditions and perhaps even cancer.

But the zonulin inhibitor would only be masking the symptoms by blocking zonulin release, it would not address the root causes or zonulin release, such as infections. This drug would most likely have to be taken on a daily basis. You can learn more about Larazotide @ www.albatherapeutics.com

In my research, I also found lifestyle interventions that would have a permanent effect on zonulin release, such as removing gluten, food intolerances, and infections in the small intestine. Lifestyle interventions are slower than taking a pill (which is not available yet anyway) but will result in healing rather than masking symptoms…

Due to my skepticism, I fully researched most interventions for over a year before I reluctantly tried them myself, delaying my own progress. Eventually, curiosity, another one of my predominant traits, won over skepticism.

So, thus, eliminating intestinal permeability in autoimmunity is my working hypothesis as to why the many lifestyle interventions work so well. I have seen really amazing results so far! But I have only worked with Hashimoto’s, not all of the other autoimmune conditions…

Based on Dr. Fasano’s research, the same approach should apply to all autoimmune conditions, although triggers may be different for the particular target organ that is affected. Nonetheless, the intestinal permeability needs to be addressed in ALL cases of autoimmunity. Eliminating gluten should be the first step for everyone with an autoimmune condition.

Hope that isn’t too technical for those of you that aren’t science nerds like me. I explain it to a more lay audience in my book but have all of the references cited so that my fellow scientists can do their own research and cross reference my work.

For my fellow science gurus, here are two of Dr. Fasano’s articles:

  1. Fasano A. Leaky Gut and autoimmune disease. Clin Rev Allergy Immunol. 2012 Feb;42(1):71-8.
  2. Fasano A. Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer. Physiol Rev. Vol 91. Jan 2011. 151-175

I also researched a multitude of other triggers that are not mentioned in Dr. Fasano’s articles but are in my book, Hashimoto’s: The Root Cause.

P.S. Be sure to subscribe to my weekly newsletter to get the Nutrient Depletions and Digestion chapter of my book (for free), recipes, a Thyroid Diet Starter Guide and notifications about upcoming events and new research.

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  2. Hi,
    I hope more information becomes available on this issue soon. I have hashi’s and ate gluten free for 6 years in an effort to help my thyroid heal, including a period of time being paleo/primal. None of it helped me. I had absolutely no difference in my thyroid after that length of time being gf. 🙁
    I also had blood testing for ALL food allergies, those that are currently available anyhow, which was A LOT. I was also tested for environmental and chemical allergens as well. Literally, almost every box was marked on the full page allergy checklist. NOTHING came back positive, including wheat and dairy, which I thought would come back positive (at least one of them) based on all that I’ve read on autoimmune disorders. Actually, since re-introducing gluten back into my diet a year ago, I feel better than ever.
    I don’t know what direction to “dig” at this point. The only thing I can think that could have triggered my hashi’s is a virus or bacterial infection. I just started the selenium and vitamin E protocol. I’m hoping this will settle my thyroid down. Do you have any other suggestions for me since a leaky gut does not appear to be my problem?
    Thanks,
    EmmaW
    Reply

  3. Hi Emma, Thanks for writing. My first question for you would be what type of tests you had…Were they skin tests or blood tests for your food allergies? Did they measure IgG, IgA or IgE reactions? In addition to foods and leaky gut, hormones, your oral health (blog coming soon), toxins and infections could be triggering your condition. However, I would want to make sure the leaky gut really is not an issue by doing the right tests.
    Reply

  4. Emma, -Don’t kn if this helps but u might want to check on black mold. My brother sent me an article about where person had been diganosised with fibromyalia & it was actually black mold. Apparently it causes some autoimmunities. Good Luck.
    Reply

  5. Try the “Eat Right for Your Type” diet I have been for about a year now and have cleared up my gastrointestinal issues. It is based on three generations of research and post mortum studies. My family has also found it to be helpful with allergies and weight loss.
    Reply

  6. I also was gluten and mostly grain free for over 7 years. The first year or so I felt a lot better but then I became worse again. I became even more strict with my diet thinking that if I just ate perfectly, I would be healed. But after years of spending tons of time and money, not being able to enjoy going places without bringing my own food and having to think about food every minute of the day, I stopped. I wasn’t getting better and I decided it wasn’t worth it. When I got back on gluten and grains, I started sleeping better, my anxiety was better, I got sick less often, my gut and elimination habits greatly improved, and suddenly I didn’t feel cold all the time. I’m far from healed and am still searching for answers but I’m pretty convinced that being gluten free isn’t one of them.
    Reply

  7. BTW, I’ve also started taking copper, zinc, calcium, magnesium, and vitamin D supplements. My vitamin D is always dipping low recently without supplementation. Also, I know that the current proper calcium to magnesium ratio is 1:2 or 1:1, and the current proper copper to zinc ration is 1:15. I’m also taking the Kyolic garlic supplement. I’m hoping that might “kill” something??? I’ve also had a tube put down my stomach to check if anything was amiss, but everything looked fine. I’ve never had ulcers in my life.
    I thought I should add that in case it makes any difference.
    Reply

  8. Those are all really good supplements and required for proper thyroid function. A garlic supplement is a good idea and is a very good antimicrobial.
    Reply

  9. Can you say a bit more about stress and severe Hashimotos. I have had both my sisters die, serious family and marital problems, lost my job, have now been seriously ill for two years. I have Hashimotos, hyperaldosterone, hyperparathyroid, hypertensive heart disease, coeliac disease, osteoporosis and Ménière’s disease. I also have changes to the white matter in my brain caused by chronic hypoxia ischemia. This is worrying because all of my mothers family contract vascular dementia. I feel like I am going mad. It can take 25 minutes to wake me up using water to drip onto my face. I am on 12 different meds a day, a gluten free low calorie version of the DASH diet and I still can’t lose weight. Any advIce would be welcome.
    Reply

    • Maria- When it comes to weight gain these are a couple of things to think about.

      1) What was your recent TSH, Free T3 and Free T4? Sometimes when those numbers are on the outskirts of normal, your metabolic rate may still be impaired making it more difficult for you to burn calories. Most people report feeling well with a TSH between 0.5-2.

      2) What type of medication are you on? Some report more weight loss with T4/T3 combinations (Armour, Nature-Throid, compounded medications) versus T4 medications (Synthroid, Levoxyl, Tirosint) alone. T4 is a precursor to T3, but some individuals do not convert T4 to T3 properly, and the T3 component is the metabolically active one.

      3) What type of diet are you eating? Some report more weight loss with T4/T3 combination vs T4 alone. Some do not convert T4 properly.The Standard American Diet (S.A.D.) full of sugar and simple carbohydrates is perfectly designed to cause us to gain weight year after year. Even yogurts that are marketed as “healthy” contain the equivalent of 16 teaspoons of sugar. Divorcing the S.A.D. is often a step that many of us must take to not just lose weight, but to also feel better. Some diets that have been helpful include the Body Ecology Diet, the Paleo Diet, the Virgin Diet, Autoimmune Paleo Diet, GAPS diet, SCD diet, Weston A. Price Diet, or the Mediterranean Diet. You may need to modify these diets to your own individuality.

      BEST DIET FOR HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/best-diet-for-hashimotos-hypothyroidism

      HOW TO LOSE WEIGHT WITH HASHIMOTO’S AND HYPOTHYROIDISM
      https://thyroidpharmacist.com/articles/how-to-lose-weight-with-hashimotos

      ARE YOUR ADRENALS SABOTAGING YOUR HEALTH?
      https://thyroidpharmacist.com/articles/are-your-adrenals-sabotaging-your-health

      Reply

  10. Don’t eat low calorie or low fat. Your body needs all the nutrients it can get, nutrient rich food is what most of us need. The epidemic of overweight people coincides with the introduction of low fat foods nutritionally deficient and laden with sugar. Read books like,Kat James The Truth about Beauty, or Nourishing Traditions by Sally Fallon. I don’t have a thyroid gland and have taken on the advice given and not looked back.
    Reply

  11. Try adding in lots of healthy fats like coconut oils especially, avacodos, eggs, real butter, olive oil, almonds. You and your brain benefit from good fats. Read up on coconut oil and its health benefits.
    Reply

    • Sandy- You may be interested in checking out the Root Cause Recipe Portal. It is full of autoimmune paleo and paleo recipes. You’re able to organize weekly shopping lists, meal planning, etc. Hope you check it out.

      http://rootcauserecipes.com/

      Reply

  12. I went gluten free almost 8 years after a terrible bout with GI issues, had gall bladder removed and issues still persisted…I’ve had thyroid issues for 20 yrs 1st Graves Hyper then remission then elevated THS and high antibodies tried every thyroid med and got more sick…I went to several endocrinologist and 1 even dismissed me…now I’m with a wonderful DO and I’m taking Vitamins D Selenium Zinc Magnesium …my antibodies dropped dramatically..I did try iodine but my thyroid enlarged I stopped it shrank ..I did have some hair loss but it’s growing back as I increased the zinc and added biotin. .increased do struggle with my weight but have good results when increased portion control added a stay off sugar. ..increased 65 yrs old and take care of a family of 7 so I think I’m doing pretty well and I read every post of Dr Isabella Wentz and her book and I am educated more with every one..Thank you.
    Reply

  13. Hi
    I’ve been diagnosed with Hashimotos 5 years ago. Completely symptomless. No weight gain, in fact I can eat a lot and not gain a pound; no tiredness, I am a dancer and have a bundles amount of energy and rather hyper; good hair; no major stomach problems; maybe my skin was always dry. I probably would have never known if not for the required pre in vitro blood work. Yes, my immune system attacked my ovaries. I’m 39 now supplementing my thyroid and starting to experience some depression, and troubles with focusing. My AntiTpo is still high, I am gluten free, I have been tested for intestinal permeability- absent, I still eat diary products but very sporadically. I don’t know how to help myself and am completely hopeless. Do you have any research about infertility caused by Hashimotos and how to improve mental issues? Thank you
    Reply

    • Anne- thank you very much for your inquiry.

      I do provide a limited number of consultations, however, my consultative schedule is all full at the moment. I have a 12 week online program called Hacking Hashimoto’s that covers all of the strategies that I go through with my one-on-one clients, in a self-paced format, so that participants have access to all of the things I’ve learned about Hashimoto’s without having to schedule costly consults with me or another practitioner. There are a few requirements that you should pay attention to, such as my book is a required read.

      HACKING HASHIMOTOS
      http://hackinghashimotos.com/

      In addition, any person that goes through the program will have the opportunity for a follow up consultation with one of my thyroid pharmacist consulting members.

      Lastly, here’s the link to the book in case you have not read it already.

      AMAZON
      http://www.amazon.com/gp/product/0615825796?ie=UTF8&camp=1789&creativeASIN=0615825796&linkCode=xm2&tag=thyroipharma-20

      Reply

  17. I totally believe in this Isabella because I’m living it! I read your book, found the root cause of my Hashimotos recently as a result (Yersinia), and now I’m working through Christa Orecchio’s Gut Thrive program to heal my leaky gut (confirmed by ELISA allergy testing). It’s interesting because my cousins and my sister on one side of the family are popping up with autoimmune disease (thyroid, celiac, ITP, anemia) and the next generation (ie our parents) are popping up with cancer (colon, lymphoma). My Grandmother (their mother) died of lymphoma, was severely osteoporotic and had part of her thyroid removed due to Cancer. The root cause is most definitely the gut…and as we realize this we are changing as a family, one person at a time. Gluten removal was a HUGE improvement for all of us, and I so appreciate this post that you’ve posted here. I am also a clinical pharmacist with Hashimotos, now studying to become a holistic nutritionist in Canada. I could not be more convinced about the importance of GUT HEALING as my own health status improves daily with the focus being on my gut. Thanks to YOU and Christa, I have renewed hope. I cannot tell you how much I appreciate all that you’ve done to reach out and help others. I hope to be able to one day do the same in one capacity or another. One question for you: I found out part way through the gut thrive program that I have Yersina. The program focuses on ousting out the bacteria/fungus/virus/heavy metals/parasites that may be plaguing you by starving them, hitting them with botanicals and enzymes and then rebuilding the microbiome and subsequently healing and sealing the leaky gut. It aims to heal the body with food and ultimately get off of supplements. I’m inclined to continue with this program and forgo any antibiotics for the time being (not bad for a pharmacist, hey?). In your experience, do you think that I can conquer a bug like Yersinia with such a program (I’m hoping that you are somewhat familiar with it)? My one concern is that I will finish the reseeding phase only to find that I need to take antibiotics, which will potentially undo or kill any of the good (and expensive) bacteria that I have reseeded with. Your thoughts would be greatly appreciated. Thank you again!!
    Sincerely,
    Allison from Canada:)
    Reply

  19. Hi, Thanks so much for your work. I have Lupus, and am determined to reverse it. My story is long and laborious. I’ll spare you that, but the short version is I developed tons of food allergies, all in the last 7 years, and after child birth. After my second daughter, I even began having complex partial seizures. I now eat a complete allergen free diet, and take supplements, which seem to be helping. I did a fecal transplant, hoping to cure myself, about a year ago. I stopped having seizures after that, but still had other symptoms. I now know that I was still getting allergens in my diet. I also hadn’t yet discovered the leaky gut thing. My question to you is, would your book be helpful to me, having Lupus? Do you have other suggestions? I am hopeful, for the first time ever! Thank you!
    Reply

  22. I have had rheumatoid arthritis since a teenager. When I could not longer move my arms and hands, I was desperate. A doctor mentioned gluten sensitivity. Since my mother had multiple auto immune diseases, including celiac, I took the hook. Went on Metratrexate which almost killed me. Then tried Enbrel. In 3 days, I could move again. Since the gluten free diet, I have had no flare-ups. Not a difficult diet to do unless you are a foodie.
    Reply

  23. You have a lot going on. If I was you, I would do a low carbohydrate diet, eating mostly lean meat, fish, and many vegetables. Do not buy process foods of any kind.You can have some olive oil and butter. Do not eat sugar until you start losing weight and can have a little as a reward once a week only. I lost a lot of weight playing Richard Simmons dance DVD’s and dancing around my kitchen island. (I couldn’t do his dances so I made up my own.) At first I
    could only do 5 min., but I improved until I could do a whole lesson.
    These are things that have worked for me. I have a few auto-immune diseases myself and my weight fluctuates especially when I am on prednisone. Do not buy gluten-free processed products. They often have more calories than the original.Good luck.
    Reply

  24. Hi Izabella, Thanks for the article. I have to agree. I have been chasing remedy for my auto immune diseases for 28 years…to little or no avail. Now I am about out of hope as my exhaustion levels are very severe. The foggy headedness is thick as mud. I am struggling to find a thyroid medication to bring my TSH back down into normal range and stop this Hashimotos. This is the 3rd year of it being anywhere from 60-200 points out of range. uggg. I find giving up is becoming a more common companion. How does one FIX leaky gut? When I take Nature Throid I go back to sleep…even adding additional Adrenal support. THERE HAS TO BE AN ANSWER to this insane madness. I have been in natural health care for 28 years, watching what I eat, doing cleanses etc.
    Reply

  25. I am so happy to.come across your article. I am a health coach who specializes in food and chemical sensitities. I also have hashimotos. Recently added Alcat testing to my program here. Is that the other testing you are referring to? I had things show up I had no idea I was sensitive to. Anyway I get my labs redrawn very soon and with TPO antibodies at over 800 to start with I hope to see a differenece.
    Let me know and the testing. Thank you !
    Reply

  26. Hi
    I have issues of digestion, weight gain hair loss and ezema..thought it was from gluten.. Can you help..I’ve been homeless for 3 Years struggling with stress..pls help
    Reply

  27. Thank you so much for all the information you provide on this fabulous website. I have a few questions and can’t seen to get a straight answer out of my care providers.
    My hypothyroidism was diagnosed 3 years ago, after the birth of my second child. I have been on thyroxine since then, and had remained steady in my thyroid blood test results.
    I suffered a miscarriage 18 months ago, then fell pregnant soon after. My thyroid levels were closely monitored throughout the pregnancy, and remained stable. However, my baby girl had several birth defects, including a very serious heart condition, requiring open heart surgery when she was just one week old. She is healthy and doing well now, at eight months old.
    For the last several months, I have been incredibly fatigued again, and my TSH was found to be far too high. I asked for antibody testing as well, and found I have Hashimoto’s disease. My endocrinologist says I’ve had it for years. I’m so concerned about my children developing it, especially my daughters. In particular, I’m worried about my youngest, wondering if I passed the thyroid antibodies directly to her during the pregnancy. Is it just expected that she will develop Hashimoto’s? Is there anything I can do to help minimise the risk of her Hashis being triggered? I have been avoiding gluten and dairy in her diet so far, but that is a big decision to make long term if it is not necessary. I know it is a complex disease and many factors at work, but I would hate to think that my actions are making it more likely to be triggered at a younger age.
    I personally have been gluten free for 3 years (even though I only recently realised it was related to my thyroid problems) and have recently cut out dairy. In currently doing an elimination diet to identify other foods I am sensitive to.
    Should I automatically exclude gluten from all my kids’ diets? Or use a wait and see approach? Any advice you could offer would be much appreciated. Thanks!
    Reply

  28. Thyroid disease from out of no where at late 30’s. Very under control. Now 50 years old, an injury to my side and shallow breathing became bronchitis and then pneumonia, which became sarcoidosis. All related? Auto immune diseases? Can’t get sarcoidosis into remission. Hate the prednisone!
    Reply

  29. I’ve done an extensive ALCAT food sensitivity test. Felt great for a year or so after. Thinking of doing another. What test do you find most helpful?
    Reply

  30. Oh thank goodness I’m not the only one!! I have Hashi’s. I went gluten-free for almost a year and it made absolutely no difference. I think the added stress of being so gluten restrictive actually made me feel worse! Side note–yes, I tested for celiac via blood test and also did IgG, IgA, and IgE tests. I don’t have leaky gut to my knowledge…my bowels and digestion are regular and seem normal. I wish I did know what would make a difference with the Hashi’s because it certainly hasn’t been avoiding gluten!
    Reply

  31. I recommend the Alcat food sensitivities test, and using the SCD OR GAPS DIET. IT doesn’t help much to stop eating gluten if you keep eating other things gs that stimulate the immune reactivity, which is way more than the regular IGE TESTING you get from Western medicine. Consult with a naturopathic Dr re gut healing strategies while avoiding ALL of the foods identified
    Reply

  32. OMG! This is me too!! Was thinking about doing ANOTHER food sensitivity test as a last straw. So over it!!!
    Reply

  33. Hello Dr Isabella Wentz, Thank you for this most helpful information. I am working now with a very good doctor who is helping me to find out the “root Cause” of my 33 old problem with thyroid. We started having Skype calls in March 2015 and she has had me to do some elimination diets to help me to find out what is the root cause of my thyroid problems. And it looks like it will be glutton. Anyway, I since I live and work overseas I wanted to find out if your book: The Root Cause is available through Kindle Edition? The reason why I ask is because since I live overseas, I don’t mind spending 25 or 30 dollars for your book but the shipping is twice as much. So just wanted to find out if your book is available or will it be available soon in the Kindle Edition? Thank you very much for your help with this matter. Sincerely, Elizabeth
    Reply

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