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As well as getting the correct type of thyroid medication for you and the optimal dosage, it’s also important to address other factors that can be contributing to you feeling unwell. Even on thyroid medication and at an optimal dosage.
I thought for a long while that once I reached my optimal dosage on NDT, with lab results to match, that I would return to the level of health and fitness that I had before. But, I didn’t. Even with optimal levels, I still had ongoing fatigue, poor stamina, cystic acne, irregular periods etc. which suggested that I needed to look at other issues and imbalances within my body.
A lot of research led me to many possibilities, but I soon learnt that I had adrenal fatigue,(note: it is more accurately referred to as hypothalamic-pituitary axis dysfunction) partnered with a sex hormone imbalance (oestrogen dominance) and leaky gut (Candida).
Leaky gut is a very common issue for thyroid patients, especially those of us with Hashimoto’s and in fact, various sources such as Thyroid Pharmacist Izabella Wentz, state that a leaky gut needs to be present for Hashimoto’s to even be triggered. But what is it?
Hippocrates, a Greek Physician often considered to be one of the most outstanding figures in the history of medicine, said “All disease begins in the gut” and 2500 years later, we’re just beginning to understand how right he was.
Poor gut health can suppress thyroid function and trigger Hashimoto’s, yes, but low thyroid function can also lead to leaky gut, so it works both ways. Chances are, most of us with Hashi’s have a leaky gut.
‘Leaky Gut’ is used to refer to when the intestinal barrier of the gut becomes permeable from hypothyroidism, infections, food intolerances (especially gluten) or even stress, which then goes on to cause other problems and symptoms. Symptoms of leaky gut include constipation, wind, bloating, impaired metabolism, on going fatigue, mental health struggles, weight gain, a coating on the tongue, a large scalloped tongue, heartburn, acid reflux, bad breath, nutrient malabsorption, skin conditions and more.
They can be quite tailored to the individual and for me, I experienced the fatigue, poor stamina, cystic acne, mental health issues, coated and scalloped tongue and irregular bowel movements. I suspect I’ve had it since a teenager.
Why is the gut important in thyroid health?
The gut assists in converting inactive thyroid hormone T4 to active T3 (what we need for energy and many functions within the body), which requires an enzyme called intestinal sulfatase. However, this enzyme comes from healthy gut bacteria. Bad gut = lack of this important enzyme. Intestinal dysbiosis is an imbalance between pathogenic and beneficial bacteria in the gut, which can significantly reduce the conversion – just one reason why people with poor gut health may have thyroid symptoms but ‘normal’ test results.
Constipation from poor gut health can also have knock on effects. It can impair hormone clearance from the body, which causes oestrogen levels to rise. These high oestrogen levels then decrease the amount of thyroid hormones available, making you feel more hypothyroid and fatigued. It’s a real catch-22 situation. And we know that constipation/non regular bowel movements are a common symptom of hypothyroidism.
Any inflammation within the gut can also lead or contribute to adrenal dysfunction (something else I have experience with!)
A response from the adrenal glands in the face of stress, prolonged over a lengthy course of time, can go on to cause long term adrenal dysfunction. Adrenal fatigue can cause a whole list of symptoms on its own but does also impact thyroid function since they’re both part of the endocrine system and adrenal fatigue is a common, separate condition, that many thyroid patients also have, often without knowing.
According to Izabella Wentz, there are five types of leaky gut:
- The Candida Gut – caused by a high-sugar diet, antibiotics and chronic anxiety.
- The Stressed Gut – caused by emotional stress and adrenal issues, treated with a nutrient dense diet, as well as adaptogenic herbs and minerals to support the stress response.
- The Immune Gut – caused by food sensitivities that can be healed by diet, including bone broth, digestive enzymes, and probiotics.
- The Gastric Gut – caused by a sluggish digestive system and treated with specialized digestive support and enzyme-containing foods.
- The Toxic Gut – caused by environmental toxins and treated with a modified fat diet and liver support.
But the one I want to focus on is Candida, which seems to be hugely common with thyroid patients and something I have experience with myself.
Candida (Yeast Overgrowth)
Candida is a type of leaky gut where you have an overgrowth of yeast in your body, causing all kinds of issues.
Yeast exists in the gut naturally and, in the right amount, isn’t an issue, but high stress, antibiotics and sugar can cause it to thrive and become power hungry. Have hormonal issues? Still feeling fatigued? Stressed a lot? Have any other on going symptoms? Please do check for candida. My guess is that you have it.
The Signs I had Candida
For me, my usually regular periods started to become massively irregular and could come at any time. At twenty two, I also began breaking out in severe, cystic acne. I’m not talking a few pimples, I mean that so much of my face was covered in these deep, painful cysts that they joined up to cause mountains of pain on my cheeks. They left deep scarring and bruising that lasted months. Doctors checked for STI’s, PCOS and even ran bloods on my sex hormone levels but came up with no answer. I was sure I had an imbalance of too much oestrogen after researching in books and online. It turns out I was right.
Having leaky gut with a sex hormone imbalance isn’t unusual, since with leaky gut often excess hormone isn’t being cleared from the body effectively, and leaky gut itself can lead to adrenal fatigue which also impacts, causes and worsens hormonal imbalances such as that of oestrogen and progesterone. It’s a bad cycle!
A candida overgrowth, often caused by a high sugar diet, high stress levels, anxiety and antibiotic use, is very common in thyroid patients. In my case, dysbiosis had occurred, following extremely high stress levels for years (both mentally and physically), various rounds of antibiotics and a high sugar diet (I’ve always had an intense sweet tooth). My first appointment with a functional medicine practitioner confirmed the overgrowth but trying to pin-point when exactly it started was hard, since I’d never gone to the loo regularly enough (just once every 1-2 weeks until I reached my twenties) and it was most likely in place to trigger my Hashi’s at seventeen years old.
So, How Do You Treat Candida?
Since being confirmed as having a leaky gut in the form of candida, I’ve been taking probiotics daily to replenish the good bacteria in my gut, Epsom salts to detox, digestive enzymes to help move things along and absorb nutrients from my food properly, apple cider vinegar and Grapefruit Seed Extract – a natural remedy to clear my body of the excess yeast.
I’ve also cut out alcohol, am following a very low sugar diet (see this link on the exact foods my functional medicine practitioner included on my candida diet/cleanse), and implementing helpful foods such as anything high in protein, chia seeds, coconut oil, turmeric, cinnamon, flaxseed, hemp oil, oregano and garlic, all to support my gut health and the process of overcoming candida.
Supplements that can also boost the body’s resistance to yeast include folic acid, Vitamin C, Zinc, Pyridoxal-5-phosphate, Vitamin A, riboflavin, magnesium and selenium. Caprylic acid is a naturally occurring anti-fungal found in coconut oil which can also help combat candida, as it kills off bad organisms but doesn’t affect useful organisms. Handy!
How Long Does it Take To Overcome?
For most patients, following this kind of treatment for a few months is long enough to restore the correct balance of yeast and good bacteria in the gut, but for some, it can take longer. It of course also depends on how strictly you’re following the advice of your doctor (I see a functional medicine practitioner, since conventional medicine doesn’t really recognise leaky gut as an issue to be treated) and how severe your case is.
After the balance has been restored, you can often reintroduce more foods, but bearing in mind that you’ll need to promote good gut health going forward, so as not to relapse again.
Overcoming a leaky gut and especially candida, can result in much improved energy levels, skin complaints resolving, sex hormones in better balance and even better mental health.
Understanding What’s Going on in YOUR Gut
There is also a new scientifically-backed personalised gut health service from Thyrve, that includes customised probiotics and dietary recommendations based on your own gut health. The test-to-treatment service can help with weight maintenance, fitness, skin health, metabolism, mood, digestion, bloating and more, due to how important gut health is to your overall health. The status of your gut is the best indicator of your health. You can check them out here.
You can click on the hyperlinks in the above post to learn more and see references to information given.
Written by Rachel, The Invisible Hypothyroidism
This post may contain affiliate links, to find out more information, please read my disclosure statement.
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Rachel Hill is a highly ranked and award-winning Thyroid Patient Advocate, blogger and author. She has worked with The National Academy of Hypothyroidism, The BBC, The Mighty, Yahoo, MSN, Dr. Hedberg, Thyroid Refresh and ThyroidChange, to name just a few. She is well-recognised as a useful contributor to the thyroid community and also contributed the foreword to Emily Kyle’s The 30-Minute Thyroid Cookbook. She received Six 2018 WEGO Health Award Nominations.