Celiac, gluten intolerance, causes intestinal inflammation and immunological presentation of the common intestinal protein, tissue transglutaminase (tTG). The result is anti-tTG autoantibodies that stimulate an immune attack on intestines and other tissues.
Heparan-Binding Proteins Involved in Autoimmunity and Allergy
Those familiar with my blog know that I am obsessed with heparin-binding protein domains. The reason that I am focused on these parts of proteins, is because most cells rapidly sweep heparan sulfate polysaccharides across their surfaces from sites of secretion to sites of internalization. During inflammation, proteins with strong heparin-binding domains, consisting of triplets of basic amino acids, e.g. KRK (lysine-arginine-lysine), are internalized along with the heparan sulfate. The result is an aberrant presentation of these internalized proteins to the immune system and production of inappropriate antibodies, e.g. autoantibodies.Basic Triplets in Hasimoto’s Autoantigens
One of my hobbies is checking for the unusual occurrence of basic triplets in autoantigens and allergens. I have found dozens of examples. The most recent is associated with Hashimoto’s Thyroiditis. I knew that attack on the thyroid was common in celiacs, because the celiac autoantigen tTG (it has a basic triplet) is also present in the thyroid and the celiac autoantibodies to tTG also cause an attack on the thyroid. But the autoantigen for Hashimoto’s Thyroiditis is thyroid peroxidase (TPO).
I was momentarily perplexed, but then examined the TPO amino acid sequence and immediately found a couple of basic triplets (KKR and KRK).
MRALAVLSVTLVMACTEAFFPFISRGKELLWGKPEESRV
SSVLEESKRLVDTAMYATMQRNLKKRGILSPAQLLSFSK
LPEPTSGVIARAAEIMETSIQAMKRKVNLKTQQSQHPTD
ALSEDLLSIIANMSGCLPYMLPPK...
Hashimoto’ Thyroiditis Linked to Celiac
Then, I did a PubMed search for “celiac and Hashimoto’s”. As expected, there is a recent paper (see below) that shows that celiac commonly leads to Hashimoto’s Thyroiditis.
An obvious explanation is that the initial attack on the thyroid by anti-tTG autoantibodies of celiac leads to thyroid inflammation and presentation of TPO, with a second round of autoantibodies produced to TPO resulting in Hashimoto’s Thyroiditis. Celiac may be the initial autoimmune trigger for many other autoimmune diseases and allergies.
Autism has been associated with maternal autoimmunity and placental abnormalities. Guess where tTG is found in high abundance?
reference:
Bardella MT, Elli L, Matteis SD, Floriani I, Torri V, Piodi L. Autoimmune disorders in patients affected by celiac sprue and inflammatory bowel disease. Ann Med. 2009;41(2):139-43.
34 comments:
Dr. Ayers,
WOWOW.
Thank you so much for your insights again.
You are on the right TRACK.
Any thoughts as to why the high incidence of maternal and placental autoantibodies these days?
Why the emergence of celiac dz in 1:100 (compared to 1:3000 approx in the 1950's)?
Why r we all so hypothyroid during preg?
Why are the endocrinologists and obgyn missing this?
-G
Dr. B G,
Nice to hear from you.
The high autoantibodies are from chronic inflammation. For some reason the high inflammation decreases overall heparan sulfate production and that leads to a lot of leaky gut/kidney/brain barriers, since HS is a major component of the basement membrane and these barriers. Typical of pregnancies is preeclampsia = leaky kidney proteinuria.
The low HS also leads to inappropriate presentation of proteins and those proteins are preferentially HS-binding, e.g. all of the proteins in the nucleus are strong HS binders and they are also great autoantigens. The allergens are also prize HS-binding antigens.
Pregnancy is all about suppression of inflammation that occurs spontaneously in response to fetal tissues. Hence, the fetus and placental will be attacked unless there is effective suppression. Women have such high levels of diet and obesity-based chronic inflammation that many cannot adequately suppress inflammation enough to get pregnant. They have to resort to aspirin and heparin injections to be fertile and carry fetuses full term. (Anti-inflammatory Diet would eliminate all of the problems.)
Delivery is just release of suppression of inflammation. That is also the origin of inflammation-based depression, which can also be treated by anti-inflammatories -- NSAIDs or preferably the Anti-inflammation Diet.
Since celiac is caused by genetic predisposition, then clearly there is a huge shift in allelic frequencies due to political ..... Just kidding.
Celiac and autoimmunity is hereditary, because it is conveyed to the fetus by passive immunity. The fetal immune system is tutored by the maternal antibodies. (I think that anti-tTG is the key.)
Same genes, just different diets. That's also why there is no approach to change or even see these trends.
The medicos (ahem) and hospitals and insurance companies are making too much money off of all of the sick people and selling pills. There is no money in preventive medicine and who would change their diet away from satisfying carbs and vegetable oils even if it meant being healthy and active until they were 80.
We also have the myth of old age related illness. That's just more mismanaged chronic inflammation.
A couple questions:
When you go looking for "base triplets", what is the probability that you will find one at random? I.e., how often are these triplets found in the human proteome? It seems to me that with such large molecules one is likely to find such short sequences quite often just by chance.
Down Syndrome is a disease that is more likely to occur when the mother is older. This is associated with a chromosomal anomaly but the effects of the condition are likely to be worse when the mother is older. Chronic autoimmune diseases are also more likely to be present in older people. Have you looked for an autoimmune component to either the effects of the damaged chromosome or it's mutagenesis?
William,
Great questions. The short answer is that the essence of proteins is that they are not random in amino acid sequence. It is possible to examine an amino acid sequence of a protein and to some extent predict shape and function.
Here's an example:
Perlecan, 4391 amino acids or approximately 4390 pairs. Chance of finding one of four possibilities is (2X2) / (20X20) or 1/(10X10) = 0.01 for each pair or 0.01X4390= 44
Actually 24 are present, but look at the distribution:
# RR = 10 (nine in first half)
# RK = 2 (none in first half
# KK = 0
# KR = 12 (one in first half)
(No basic triplets, although 4 would be expected, if random.)
But, this is all rigged, because the function of the protein determines which amino acids are permissible. For example, alpha helices and beta sheets don’t form readily with stretches of basic amino acids and the hydrophilic ends of the basic amino acids preclude their presence in the center of proteins. Too many basic amino acids together will transport cytoplasmic proteins into the nucleus (nuclear localization signals). Essentially all proteins in the nucleus have basic triplets. No bacterial cytoplasmic proteins have two arginines together, because that is a signal for transport out of cells.
Perlecan is part of the extracellular matrix called the basement membrane and it contains sequences that form the attachment sites for heparan sulfate chains. In addition, perlecan is unusual in that only a couple of the pairs of basic amino acids are flanked by neighboring basic amino acids (a typical heparin-binding domain), so perlecan itself doesn’t bind very strongly to heparin.
Basic triplets are always meaningful, because they bind specific cellular components and mediate interactions, without the need for the rest of the rigid protein structures normally required.
The question of age and mutation is interesting. I don't think accumulated mutations is as important as inflammation-damaged tissues. Eggs are cellular oddities, because they are produced and then sit until ovulation and fertilization finishes the meiotic divisions. This isn't mutation damage so much as oxidative stress damage. So I would say with a very broad sweep that aging doesn't happen, but rather inflammation damage accumulates. Aging is just poorly managed inflammation.
The only reason that older people have chronic inflammatory diseases, such as autoimmune diseases, in higher amounts, is that they are permitted to have higher levels of inflammation. I think that the higher chronic inflammation in older people is due to the accumulation of cryptic bacterial. If those bacteria were periodically purged, then longer healthful lives would be readily achievable.
Old age and declining health in our society is cultural, not biological.
Thanks for the great questions.
Dr. Ayres,
Previously, your comments seemed to debunk the Marshall protocol and it's approach to dealing with cryptic bacteria and biofilm. Now, you claim that it is very common in older adults. Can you clarify your thoughts on this matter?
Is it simply that cryptic bacteria and biofilm are very real HOWEVER the Marshall protocol of getting rid of it is wrong? If so, what is the proper way of dealing with cryptic bacteria if not via lowering Vit-D and chronic use of antibiotics?
I think that cryptic bacteria contribute to chronic inflammation and accumulate to cause aging.
I think that very closely monitored use of long term antibiotics and control of resultant inflammation could be used to eradicate cryptic bacteria.
I think that the Marshall and Powell procedures to cure cryptic bacterial infection in chronic diseases are currently empirical and require examination to determine if and why they work. They could be either phenomenal breakthroughs or just first approaches.
The vitamin D receptor part of Marshall's Protocol seems sketchy to me, but it may actually just be the anti-inflammatory activity that makes it work.
The cryptic bacteria/chronic disease hypothesis is still very controversial. Mainstream medicine doesn't have the answers, so a paradigm shift is needed. Unfortunately, the old paradigm prohibits research on cryptic bacteria and the medical industry thrives on treatments for chronic disease. The case of Helicobacter pylori and stomach ulcers shows that medicine will avoid cures in preference for chronic treatment.
Thanks for the comments.
The problem with the cryptic bacteria hypothesis, is well, that they are "cryptic" or unobservable. It is really hard to determine what type of bacteria they may be, and persistent multi-year use of antibiotic without cultures seems to be extremely irresponsible, given the likelihood of resistance strains. Also, if the bacteria are cryptic, it's not even known if they are resistant to widely used strong antibiotics like Cipro or augmentin. I've heard of some people using vancomycin, which is a "last ditch" antibiotic whose use should be carefully controlled because resistance to it means there is no other line of defense.
It just seems that without cultured evidence of the bacteria being there, the risks of antibiotic use for both the patient and society at large are too grave, especially given the high incidence of chronic illnesses where such a protocol would be used. If we could identify a particular strain, as in the case of chronic ulcers, that would make antibiotic use much more palatable.
I use "cryptic" here to mean that with appropriate measures these bacteria can be identified, visualized and treated. I just mean that it is challenging, unlike typical pathogens that are defined by diagnostic media in a Petri dish. These cryptic bacteria have been identified by molecular tools even when they cannot be cultured. They are legion -- see Amy Proal's presentation on the Marshall Protocol web site.
Most of the bacteria that have been identified in tissues are like Chlamydia pneumonae, that move from initial sites of infection to new sites of inflammation after being phagocytosed. Only masked forms of the bacteria survive. It is no surprise that L-forms, lacking cell walls (the major source of bacterial pyrogens) are common in these contexts.
Antibiotic use is problematic for multiple reasons, including resistance, impact on gut flora, and the presence of a whole zoo community of diverse bacteria at the inflammation site. Antibiotic use may be indicated, but research on how the bacteria suppress local immune assault may be more appropriate. If cryptic bacteria induce a form of tissue hibernation, then disrupting hibernation may be the approach of choice instead of antibiotics.
I agree that broad use of antibiotics in any context is hazardous. Antibiotic use in medicine should be considered only in individual cases where ignorance of the causes of a disease and desperation warrant. It is a crude and dangerous stopgap.
In most cases, the human immune system is more than capable of killing pathogens, the problem is usually the body's inability to detect the pathogens.
Thanks for your comments.
Thanks for your comments, Dr. Ayers.
This brings us back to the central issue of dealing with the inflammation.
You write:
Antibiotic use may be indicated, but research on how the bacteria suppress local immune assault may be more appropriate. If cryptic bacteria induce a form of tissue hibernation, then disrupting hibernation may be the approach of choice instead of antibiotics.
If by "disrupting hibernation", you mean lowering inflammation, I would like your thoughts on what is the best way to do that.
In perusing your blog, much of what you're talking about is chronic inflammation caused mostly by metabolic (i.e. diet) factors. Infections and chemical toxicity in humans most often leads to acute inflammation, which is dealt with differently (usually anti-pathogen drugs and/or neutralizing the toxins).
This idea of infection leading to chronic inflammation is a new one. Most importantly, from the point this blog's topic, it is entirely possible that metabolic solutions to low inflammation (i.e. anti-inflammatory diet) would have almost NO EFFECT against the inflammation caused by a pathogen. This is certainly so in the case of an acute infection.
Diet won't treat the inflammation due to an acute staph infection or an STD like syphalis, only antibiotics will. Similarly, it stands to reason that an anti-inflammatory diet will not have an effect on chronic inflammation if the source of inflammation is an infection.
These are all excellent points.
Inflammation is the detection of pathogens or tissue injury with release of signal molecules, e.g. inflammatory cytokines, by immune system cells of various types to result in the local offloading of immune system marine corps. types from the blood stream. Some cells, e.g. mast cells, also release heparin, that also prevents the signaling from spreading beyond the immediate vicinity of the initiating event. Thus, signaling is localized.
Local inflammation can be reduced by components of the anti-inflammatory diet.
If the signaling spreads to the blood stream, then body-wide symptoms also found in some chronic diseases ensue. This came produce fatigue and cachexia. This chronic inflammation also responds to components of the anti-inflammatory diet.
Rampant infections such as septicemia and toxic shock kill via extreme inflammatory signaling, e.g. cytokine storms. These symptoms are also treatable with components of the anti-inflammatory diet.
Cryptic bacteria apparently suppress the consequences of inflammation in their immediate vicinity, so that they are not kill by digestion in phagosomes or oxidative bursts or complement. But these bacteria apparently continue to contribute to system-wide inflammation. This suppression is thought to be the induction of a form of physiological hibernation. Thus, the cryptic bacteria are superimposing their own signaling to block the inflammation pathway (NFkB) needed for the immune system to attack them. Alternatively, this could be the induction of a form of immunological tolerance similar to that used by parasites, e.g. helminths.
By suppressing hibernation, I do not mean lowering inflammation. In fact the local lowering of inflammation is a problem and the anti-inflammatory diet may make it easier for cryptic bacteria to live. But since the diseases caused by the cryptic bacteria are a result of the chronic inflammation to which they contribute, then eliminating the inflammation will make the cryptic bacteria irrelevant -- they are something that we can live with as long as they are restrained.
Chronic inflammation does, however, provide the basis for the accumulation of more cryptic bacteria through leaky gut/kidney/brain/blood barriers. So, it is important to eliminate all symptoms of chronic inflammation.
All inflammation is controlled by signaling within individual cells. The physiology that we see as inflammation is nothing more that the aggregate of all of the individual cells responding to their own inflammatory signaling. NFkB controls the signaling in each of these cells and NFkB is also controlled directly by dietary components, e.g. curcumin, and by a variety of receptors acting through the inhibitor of NFkB. High glucose reacts with proteins to produce advanced glycation end products (AGE) that bind to a receptor (RAGE) that triggers NFkB and inflammation. Omega-3 oils and derivative prostaglandins act through nuclear receptor proteins (PPAR) to inhibit the impact of NFkB. Onion thiols contribute to H2S and modify inflammation.
There doesn't seem to me to be a separation between the inflammation in acute and chronic situations and diet affects both. Diet determines the radius of impact of singular inflammatory events, e.g. inflammation depletes heparan sulfate proteoglycans that immobilize cytokines and thus enhances their spread to more cell layers. This is the opposite of the effect of short heparin chains that serve to block inflammatory cytokine interactions with receptors and also minimize inflammation.
Diet has both acute and chronic impact and the immune system is directly displayed to the diet by the juxtaposition of immune cell repositories and the absorptive structures of the gut. The immune system is bathed in each meal we eat. Over time the dietary lipid composition transforms the body's lipid stores so that the brain and other tissues have derivative predispositions to inflammation. We are what we eat.
Thanks for contributing to the discussion.
This is great stuff. I thank you for your comments.
Dr. Ayers,
As a people watcher, especially in the supermarkets, I used to be intrigued by shopping trolley contents and the levels of obesity,(judging BMI and fat percentages.)
You have made me aware of inflammation, and I am amazed at the large percentage of the population, especially past 50, that can be judged at the severity of inflammation in their faces and necks. Even in relatively slim individuals. Obesity is only part of the issue. Long term vegetarians seem to be very prone.
Your cryptic bacteria hypothesis, is fascinating and intriguing and seems to be utterly plausible.
Dr. Ayers,
Thank you for your careful and patient answers to questions from your readers.
[i]I think that the higher chronic inflammation in older people is due to the accumulation of cryptic bacterial. If those bacteria were periodically purged, then longer healthful lives would be readily achievable.[/i]
I hypothesize that menatetrenone (vitamin K2 MK-4) can break up biofilms and expose the sheltered pathogens to the immune system. This exposure can cause inflammation and a die off reaction.
EDTA has been shown to break up biofilms by taking away the calcium from the biofilm structure ([url="http://pubmed.gov/16517655"]PMID 16517655[/url]). Vitamin K regulates calcium in the body, and we don't seem to get as much of it as our ancestors did, as the MK-4 form is found in quantity in organ meats and marrow. For me, 5mg of K2-MK4 makes my teeth nice and smooth.
StephenB
StephenB,
I know very little about vitamin K, but it seems to be another deficiency caused by poor gut flora and modern diets.
I don't know if it will destabilize biofilms. EDTA should demineralize biofilms and make the bacteria vulnerable. But I would expect that only to work in laboratory cultures. EDTA in people, I would expect to be useless, because if it was used at high enough levels to impact biofilms, it would certainly be lethal. At lower levels, it would not affect the biofilms and would just make people mineral deficient.
Vitamin K supplements sound like a good idea. It should be relatively easy to use vitamins D and K to improve bone density and dental health. Unfortunately, it is too cheap and readily available for research to ever be done.
Thanks for the comments.
Hi Dr. Ayers. EDTA, I think, does have limited use. Keep in mind that there is sodium EDTA (approved in adults for use via IV for lead poisoning) and calcium EDTA. The sodium form is very dangerous since it latches on so strongly to Ca, and has caused death. Orally, however, it has a far safer profile. If the biofilms are in the gut, I have heard that it can be effective in breaking them up (ie there is a die-off response and pathogens show up on tests that they did not before). Calcium EDTA in IV form doesn't have the safety issue of the sodium form. I have heard that hospitals keep them in separate areas so as not to mix them up.
Still, EDTA is a far cry from being a vitamin. Kids with gut disbiosis seem to respond to vitamin K supplementation in a manner consistent with this biofilm hypothesis. I have myself seen and heard reports from parents following a protocol of introducing small amounts of K2-MK4 and ramping up (die-off reaction followed by improvements in their condition). I have a strong feeling that biofilm disruption is going on, but that of course would need to be verified in a controlled manner. Another good thing about vitamin K is that it acts systemically, not just in the intestine.
Hi Dr. Ayers,
I enjoy your blog very much! I have Hashimoto's thyroiditis for the last 9 years. At one point I had the Celiac Disease test panel, but tested negative. I have lowered wheat to a very small amount most of the time (downfall for pizza).
I recently decided to try to rehab the thyroid and have managed to reduce dosage of T4/T3 from 120 to 105 and then to 90 mcg, keeping my TSH steady (thyroid is increasing it's own output).
I've accomplished this through a combination of getting my 25(OH)D3 above 60 ng/mL (77-87 typically), low carb (A1c 4.8, fasting insulin 5.2)/higher sat fat, elimination of added n-6 PUFA, and recently increasing iodine intake (kelp supplement).
After this post, I decided to test my TPO and anti thyroglobuline antibodies, to keep track of the count. the thyroglobulin antibodies were in range (<20IU/mL), while the TPO was 301 (range <35 IU/mL). My prior TPO test was 4 years ago: as of 9/05 my TPO count was 197. Any speculation of why would it go up like that?
My goal is to go gluten-free and hopefully see the TPOs go normal. I'm going to take glutamine regularly to try to rehab the gut. I had hoped the much reduced wheat intake and much improved D levels (2 years above 50 now) would have made a difference in the TPO.
Thanks for your blog and for the behind the scenes explanations!
Alex
Dr Ayers ... most of your info is beyond me, but, I can attest to the outcome of high inflammation !
1) I have Hashimoto's Thyroiditis
2) Suspecting gluten intolerance, my doc recommended going gluten-free, which I did 9 months ago - feel much better - recently went of all grains, even GF ones, in attempt to further heal
3) My last preganancy (3+ yrs ago) resulted in a safe birth and healthy child, but he was induced 5weeks early due to preeclampsia - wish I had known about inflammation then as I ate a lot of grains during pregnancy !
4) Difficulty getting and staying pregnant with first child 10 years ago when I was following a lowfat vegan diet - two miscarriages, clomid and Pg supps before successful full-term
5) I attribute most, if not all, of my health issues to that period of time where I followed the lowfat vegan diet ...
Now trying to heal with meat, eggs, omega-3s etc - no grains, very little fruit, some veg ...
thanks for your research and your blog !!
Alex,
Autoimmune thyroiditis results from an immunological attack on the thyroid that can be started by antibodies that are initially produced in an inflammatory attack upon another tissue. Thus celiac is typical, but virus attacks, e.g. Epstein-Bar virus (EBV) that causes mononucleousis, can also cause Hashimoto's thyroiditis. From your low results on celiac screening, I would think that a prior viral attack would be likely. Unfortunately, your inflammatory diet at that time produced the antibody background that is causing the current problem.
I think that I know a lot about how the autoimmune diseases start. There are some treatments for autoimmune diseases, e.g. helminth therapy and IL-2/mAb therapy, but these are exotic. I don't have a way of producing tolerance to self antigens in order to suppress your current immunological problem.
It is wise to avoid compounding the problem with leaky gut contributions to cryptic bacterial infections, as you are doing. Maybe the gut is the secret as the helminth therapy hints. I will surely write about any headway I make on treatment of autoimmunity.
Thanks for your comments.
Elizabeth,
Sorry that you had so much bad advice. All of your problems could have been taken away with sound medical advice as opposed to what is commonly given. Unfortunately all of your fertility/pregnancy issues were due to flawed physicians. Your body worked just fine, it was just getting the wrong signals. It takes a lot of physical robustness to succeed, as you have, under the onslaught of inflammation.
Imagine how simple dietary changes would have changed your future-- you would probably have a half dozen kids by now! Starting now means that staying healthy for the next three decades with minimal physical changes is relatively easy. If you do not continue to feel that you are at your peak (or better) of age 30, you are exhibiting signs of inflammation.
Thanks for your comments. I am only sorry that I could not have helped you a decade earlier.
thanks again for your comments and for visiting my newbie blog :) .. lots and lots of amazing info here - I like that your family is and has been the driving force for you :)
Dr. Ayers,
I just found your blog. What an eye opener! I wish I had had access to info like this earlier in my life. As a child I was diagnosed with Hasimoto's, which then "resolved" itself by my 20s -- my thyroid kicked in.
But I am clearly prone to autoimmune problems. The day after the birth of my first child, I awoke with crippling RA in my hands and knees. I breastfed, and the RA did not really abate until I had fully weaned my baby. When you wrote that "Delivery is just release of suppression of inflammation" it really rang true for me. I have read since that in some women, birth and breastfeeding trigger RA. I was able to ameliorate some of the pain with fish oil but I was on a super-inflammatory diet -- almost vegan/grain based with loads of sweets. Ugh! Everyone told me to cut out meat and dairy and increase whole grains.
Anyway, three years later after the birth of my second child I am having RA pains again. Trolling the interweb brought me to you and others who advocate a sugar free, low or no grain etc. diet. I was tested for celiac, it came back negative, but I have cut all grains out of my diet anyway. For years I practically lived on bread. I wish I had known . . .
Just had some blood work done. I am deficient in vitamin D -- probably not a surprise! And now I am borderline hyperthyroid -- .23 TSH and my thyroglobulin is off the charts -- 393. Could this be residual from my earlier Hashi's? I know I should go to an endo, but I have had such bad experiences with doctors who just want to put me on a lot of drugs. I am definitely going to fight this with diet.
Now I am trying to figure out a healthy way to raise my kids in a sugar/grain dominated culture.
Any thoughts or advice, greatly appreciated and please keep up the good work.
Aggie,
I am surprised that you tested neg. for celiac. I still think that your Hasimoto's started there. You are wise to avoid grains. The rest of your autoimmune/allergy problems can be controlled with the anti-inflammatory diet. Joint pain/inflammation can be substantially reduced with castor oil/menthol/Vick's and vagus nerve exercises.
I think that the big things for raising healthy kids are:
1. Make sure that the mother to be is eating an anti-inflammatory diet and is free from symptoms of inflammation before getting pregnant. Everyone knows that folic acid is important, but most women start out deficient in vit. D or DHA and end up with unnecessary problems like preeclampsia. Excess inflammation contribute significantly to infertility, prematurity, autism, etc.
2. Breastfeed exclusively for at least six months, then continue to breastfeed while introducing solid foods. Avoid grains for at least the first year. Extended breastfeeding improves the lifelong health of kids.
3. Educate the kid's gut flora with the anti-inflammatory diet outlined on this blog: low carbs, no HFCS, high protein/fat, avoid vegetable oils (except olive), supplement with omega-3s.
4. Vitamin D is a big deal. If you can avoid chronic inflammation, then routine modest exposure to sunlight is all that is needed. With signs of inflammation, then supplement with vitD3.
5. Get plenty of exercise.
I think that it is pretty straightforward, available and cheap. Attention to vit. D alone, especially early on (-1 to +5 yrs.) will eliminate a lot of dental bills.
Thanks for your comments.
Hi, Dr. Ayers.
This post as confirmed a few things for me. Thank you. I believe I may be Celiac, but have never been tested. I have almost all of the symptoms for it, however, and removing gluten bearing grains from my diet improved my health tremendously. I have been diagnosed with Hashimoto's, and have been on Synthroid for the past 8 years. I am 47 years old as of this February, and have had 4 previous miscarriages. One of my main concerns has been the possibility of pregnancy so late after finally overcoming my health issues. Your words on inflammation and aging are helpful. I have adopted a primal/paleo diet for the past year, which seems very similar to your anti-inflammatory diet. I am still having regular menses and hopefully my next pregnancy will turn out well. Thanks again for your very informative article.
Katt
Rain,
I think that your responses are rather typical for gluten intolerance and subsequent chronic diet-based inflammation. High inflammation should make pregnancy and gestation difficult. Changing to an anti-inflammatory diet would help most women struggling with infertility problems.
I hope that you have checked your serum vitamin D. Most people with your symptoms are deficient and vitamin D deficiency can contribute significantly to your problems. I my opinion preeclampsia may be precipitated by an omega-3 oil deficiency (and associated inflammation), so make sure that you have adequate DHA and EPA (fish oils) in your diet.
Thanks for your comments. Let me know how it works out.
Thank you for your response, Dr. Ayers. I have not had my serum Vitamin D levels checked, but I do know about the liklihood of a deficiency. I have been taking 10,000 IU since winter began, while during the summer I was taking 5,000 IU along with a regular outdoor walk. I have been a bit more lax with the fish oil, but do take it when I remember to do so. Once I can get in to see my doctor next, I will certainly ask about the Vitamin D check. My lipid panel came back all within acceptable levels, though my blood calcium is apparently a little low. Thanks again!
I can't believe I have only just found your website - what a treasure trove of information. Thank-you.
I have recently been diagnosed with auto-immune thyroid disease (I'm 50)
My TSH is 13 mIU/L
Thyroglobulin 655 U/L
Thyroperoxidase 1622 U/L
T4 and T3 normal low.
Slightly enlarged thydoid - but no other symptoms, not yet on medication.
FYI - a little history.
ANA titre 1 in 64 at age 18 - measured after I got swollen knees
(puffy fluid filled)
All my life I suffered constipation, PMS (sore lumpy breasts) Bad menstrual pain, reactive hypoglycemia, easy weight gain.
15 years ago I started the Zone diet, plus high dose fish oil. PMS, menstrual pain and joint pain and swelling reduced by about 80%. Fixed the blood sugar issue. lost weight.
1 year ago I switched to only paleo food choices (no grains or legumes, no dairy, minimal omega 6, etc), and added vitamin D supplements. PMS and menstrual pain gone, Joint pain and swelling gone, constipation gone, stable weight.
When I turned 50 last year I got blood tests and discovered the thyroid issue. My guess is I've always had the anti-bodies but only now is the thyroid wearing out.
I have also a history of infertility (but have 2 wonderful adopted kids) Given how well I am without grains I suspect they were a problem.
Dr Rodney Ford has written some interesting info on gluten intolerance - he says the standard Celiac tests don't pick up most people who are intolerant and his figure is 1 out of 10 people have problems with gluten.
He uses this test and states
"High IgG-gliadin antibody levels are indicative of an immunological reaction to gluten, which can manifest as significant poor health – The Gluten Syndrome."
http://www.drrodneyford.com
Anyway I've not been tested however don't plan on going back to gluten grains.
My diet is anti-inflammatory - yet my thyroid is going downhill!
Is there anything more you would suggest?
Julianne
Julianne--I would suspect your lifelong issues and the thyroid are related to low progesterone. I found this great article just yesterday, and since your post sounds SO very familiar to me, I think you may see a light bulb go off when you read it also...it even explains the thyroid troubles when you are already doing everything 'right'.
http://www.tidesoflife.com/essential.htm
Incidentally, I found this article while researching what was posted here on a comment about progesterone and fructose...which I cannot seem to find any support for. So, whomever posted that, I'd love to see some follow up posts of links to supporting info for that view.
Thanks.
Julianne,
I think that hormone disruption is always secondary to primary disease. That makes thyroid or steroid hormone problems doubly difficult to treat, because the consequences of the hormone have to be treated until the primary problem (s) is resolved.
Autoimmune thyroiditis, Hasimoto's, is typically a secondary consequence of viral infection or as indicated, gluten intolerance.
This means that treating the gluten intolerance will be needed before the autoimmune treatment, via repair of the immune system, can be successful.
Many people with Hashimoto's benefit from avoidance of grain plus an anti-inflammatory diet as you have done. I think that the missing piece is the repair of the gut flora needed to repair the immune system (Tregs).
I think that you would benefit from probiotics, pectin, inulin and perhaps lactulose to repair your simplified gut flora and regain immunological tolerance. You need exposure to new gut flora and diverse veggies to supply the fiber upon which they grow. That means fresh garden veggies that aren't too clean.
I hope that this helps. Let me know.
Father has success using helminth therapy to treat his son's autism
http://www.the-scientist.com/2011/2/1/42/1/
Just wondered if you could comment on this study and what you think may be going on.
http://www.ncbi.nlm.nih.gov/pubmed/22126672
Scand J Gastroenterol. 2012 Jan;47(1):43-8. Epub 2011 Nov 30.
Gluten-free diet and autoimmune thyroiditis in patients with celiac disease. A prospective controlled study.
Metso S, Hyytiä-Ilmonen H, Kaukinen K, Huhtala H, Jaatinen P, Salmi J, Taurio J, Collin P.
Source
Department of Internal Medicine , Tampere University Hospital, Tampere , Finland.
Abstract
Abstract Objective. Early diagnosis and dietary treatment with a gluten-free diet might slow down the progression of associated autoimmune diseases in celiac disease, but the data are contradictory. We investigated the course of autoimmune thyroid diseases in newly diagnosed celiac disease patients before and after gluten-free dietary treatment. Material and methods. Twenty-seven consecutive adults with newly diagnosed celiac disease were investigated at the time of diagnosis and after 1 year on gluten-free diet. Earlier diagnosed and subclinical autoimmune thyroid diseases were recorded and examined. Thyroid gland volume and echogenicity were measured by ultrasound. Autoantibodies against celiac disease and thyroiditis, and thyroid function tests were determined. For comparison, 27 non-celiac controls on normal gluten-containing diet were examined. Results. At the time of diagnosis, the celiac disease patients had more manifest (n = 7) or subclinical (n = 3) thyroid diseases than the controls (10/27 vs. 3/27, p = 0.055). During the follow-up, the thyroid volume decreased significantly in the patients with celiac disease compared with the controls, indicating the progression of thyroid gland atrophy despite the gluten-free diet. Conclusions. Celiac patients had an increased risk of thyroid autoimmune disorders. A gluten-free diet seemed not to prevent the progression of autoimmune process during a follow-up of 1 year.
Hello Dr. Ayers,
I found your blog by chance and it seems like you know a lot about Hashimoto's. I was diagnosed 2 years ago with it after gaining 30 lbs in 3 months (for previous 8 years maintained a healthy weight pretty effortlessly), was tired constantly, my hair started falling out, along with a host of other symptoms. Tests came back that showed by TSH was 18 and my antibody count was through the roof. I was of course given the requisite prescription and sent on my way. I didn't feel better though. I was having debilitating heartburn and still exhausted. My levels see-sawed for a year going from hypo to hyper, and my MD told me that was just my thyroid fluctuating and that I just have to "stick with it" until my thyroid completely died. Swell advice.
I decided to see a Naturopath instead. He put me on a gut healing protocol (involved killing the bad bacteria and then healing with probiotics)to heal my leaky gut and some of my symptoms were marginally better. Months went by and I still had some swelling of my thyroid and fluctuations. I went back to my Naturopath and told me to go gluten free. I have been GF for over 9 months and it seems the inflammation in my thyroid is all but gone. I don't have heartburn or eczema anymore and I have more energy. What I can't seem to fix is losing the 30 lbs I gained. I feel pretty good besides the excess weight on me.
I decided to try Atkins (the healthy version where I don't eat the artificial food and sweetners, and keep the real fatty meat in moderation). I eat more vegetables than Atkins suggests (I like variety), and also kept my carbs under 20 grams a day. I have been doing this for 3 months...end result, I have lost 6 lbs. Ouch. My fiance is doing it as well and eating the exact same thing as me and he has lost 25 lbs. Double Ouch.
I have tried other diets as well; the slow carb, restricted calories to 1200-1600 a day, etc. No luck.
I am so frustrated.
Other aspects of my health; I was on birth control pills for 10 years and recently stopped taking them when I started Atkins. I was having night sweats, horrible PMS, couldn't lose weight, and painful periods. I think I have estrogen dominance. I have started taking DIM supplements to combat that and I had the least painful period in years of being on the BC.
I was recently tested for thyroid levels and my Free T4 is within range, my TSH is low at .21 so my doctor is putting my dose at .112 instead of .125.
List of supplements I take; DIM, fish oil, D3, Selenium, Zinc, Calcium, Multi, L-Lysine, RAW brand probiotics with 85 billion live cultures and 32 probiotic strains.
I exercise moderately. I have started using the Kettle Bell and Kettleworx in the last couple of months. I also take frequent walks that are usually around 1-2 miles long. I have a desk job but make a point to get up often and meander around the office so I am not just sitting there all day.
I see from your blog you suggest eating veggies from local growers and to just rinse them lightly so that helpful bacteria make it's way into your gut. I plan on starting this. I also grow my own herbs and will not wash them as much as I used to.
Stats; 5'9.5", 33 years old, 184 lbs, no children.
Is there any other suggestions you have for me? I know some people think that a desire to lose weight is vain, but I would like to get back to my lighter self before my wedding, and to alleviate some of the wear and tear on my joints. I just want to feel better.
Thank you for your help.
Hannah
Dr. Ayers,
I have tested positive to antiTPO and antiTireoglobuline for about a year and a half, when my antiTSH receptor was also out of range (it then remained consistenlty at the upper point of borderline). BUT! My TSH has been constantly suppressed (0.02, then 0.01 last October), and my FT3 and FT4 were normal, then a little bit hypo last fall, then normal again, and consistently hyper from June to October.
I have had mono (but not the EB virus), and I test negative for celiac, even if I get a painful edema from wheat (and soy), so I m staying away from that. They think I also have intestinal dysbiosis (I have had a series of infections in the meanwhile).
What is going on with me?
Can you point me to further studies like this one? It is very fascinating, and I would like to learn more.
It was really very helpful article to understand problems and its solutions for celiac patients. Thanks for sharing valuable content
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