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I’ve been asked about the connection between Lyme Disease and thyroid conditions many times. Here with a guest post is the National Academy of Hypothyroidism, headed by Kent Holtorf M.D.
Written by The National Academy of Hypothyroidism
Is Lyme Disease the Underlying Cause of Your Thyroid Problem?
Thyroid disease in any form can seriously limit overall wellness. Unfortunately, even if a thyroid condition is being treated, patients may continue to experience thyroid dysfunction. Such an occurrence can be due to the presence of an underlying and undiagnosed case of Lyme disease.
Although the connection between Lyme and thyroid disease is not yet fully understood, research suggests that Lyme may contribute to the development of thyroid disease, limit the efficacy of treatment, and worsen symptoms. If this is the case, being familiar with the thyroid and understanding its relationship to Lyme disease may be an essential component of reinstating wellness among thyroid patients.
An introduction to the Thyroid
The thyroid is one of the most widely influential systems in the body. The butterfly-shaped gland, located in the neck, orchestrates numerous bodily functions through the production and coordination of hormones. Some of the most noted areas effected by thyroid hormones include metabolism, neurological function, immune activity, cognitive ability, and weight regulation. Unfortunately, due to the delicate nature of hormone balance, even minor dysregulation of the thyroid can result in significant bodily dysfunction.
Thyroid Disease and Its Effect on the Body
There are many forms of thyroid dysfunction. The most common being hypothyroidism, hyperthyroidism, and autoimmune thyroid disorders like Hashimoto’s thyroiditis. Each condition impacts thyroid ability and by extension the body in specific ways.
Hypothyroidism is a condition wherein the thyroid is unable to produce enough thyroid hormone, specifically thyroxine (T4) and triiodothyronine (T3), to maintain healthy bodily function. Depending on the degree of deficiency, one may experience a general slowing of multiple systems, which is often accompanied by symptoms such as weight gain, fatigue, difficulty thinking clearly, depression, sensitivity to cold, loss of libido, increased PMS severity, and others. The condition is typically treated by supplementing with thyroid hormones.
Hyperthyroidism is the opposite of hypothyroidism in that it causes the thyroid to be overactive resulting in excess T4 and T3 and extreme hastening of bodily function. The systemic acceleration caused by hyperthyroidism triggers symptoms such as weight loss, anxiety, shakiness or jitteriness, insomnia, irritability, ADD/ADHD, intolerance to heat, and others. The condition may be treated with thyroid suppressants, radioactive iodine treatments, or surgical intervention to remove part or all of the thyroid gland.
Autoimmune Thyroid Disease:
Autoimmune thyroid disease involves irregular immune activity that interrupts thyroid function. For example, Hashimoto’s thyroiditis causes the immune system to incorrectly identify the thyroid as a threat. This leads to subsequent release of thyroid antibodies to attack thyroid tissue.
As the thyroid is assaulted, its function is reduced resulting in irreversible and worsening hypothyroidism. Furthermore, as thyroid tissue is destroyed, thyroid hormones are released which can trigger a temporary acceleration of bodily function and symptoms of hyperthyroidism. This is known as Hashitoxicosis.
The Chronic Connection to Thyroid Disease
Thyroid function and the development of thyroid disease is influenced by a great many factors. Perhaps the most impactful being chronic illness. Multiple studies show that chronic conditions such as chronic fatigue syndrome, depression, and fibromyalgia are common contributors to thyroid disease. However, another significant yet often overlooked cause of thyroid malfunction are chronic infections like Lyme disease.
An Introduction to Lyme Disease
Lyme disease is a condition stemming from an infection of a corkscrew bacterium, or spirochete, called Borrelia burgdorferi. This Lyme-causing bacterium is most often transferred to humans through tick bite. Lyme causes a wide array of dysfunction while being exceptionally difficult to diagnose and treat.
Lyme can affect virtually any system in the body, meaning that symptoms are often broad or nondescript. Fatigue, chills, fever, headaches, muscle and joint pain, weakness, swollen lymph nodes, flu-like symptoms, back pain, shooting pains, dizziness, and poor cognitive function are just some of the numerous symptoms associated with Lyme. The breadth of possible symptoms makes Lyme difficult to diagnose. The only symptom uniquely indicative of Lyme is the formation of a “bulls-eye” rash around the location of the initial tick bite, however, fewer than 50% of Lyme disease patients report seeing a rash.
Lyme symptoms may develop as early as a day after infection. But in some cases, symptoms may not appear for years following the initial infection. In fact, delayed occurrence of symptoms is one of the main reasons chronic Lyme often goes undiagnosed. When Lyme disease goes unnoticed and untreated for long periods, late stage symptoms may begin to develop.
Some of these symptoms include:
- Neurological issues
- Mood-related problems including panic attacks, mood swings, anxiety, depression
- Extreme unrelenting fatigue
- Hormone imbalances and deficiencies
- Immune dysfunction and disorders
Unfortunately, these issues often lead doctors to diagnose other chronic conditions such as chronic fatigue syndrome, fibromyalgia, ADHD, or depression. One of the more insidious aspects of Lyme is that it can produce symptoms indicative of other chronic illness while also contributing to their development. As such, a doctor may accurately identify a chronic illness that explains the patient’s symptoms while completely missing the underlying presence of Lyme. This is often the case when a patient is struggling with Lyme-related thyroid dysfunction.
The Connection Between Thyroid Disease and Lyme Disease
An increasing number of studies indicate that Lyme may be associated with the development and continuation of thyroid disease, specifically autoimmune thyroid disease. This is supported by experts who believe that the incidence of Lyme disease may be increased in those with thyroid disease when compared to the general population.
The primary disease-causing mechanism of Lyme is the promotion of inflammation. Borrelia burgdorferi that has spread throughout the body can trigger inflammatory responses in any system, organ, or tissue, in which it has taken residence. This is part of the reason why Lyme is able to cause such a large collection of symptoms.
Studies also suggest that Borrelia bacteria may contribute to the development of Hashimoto’s. It is believed that the longer the immune system is exposed to spirochetes like Borrelia burgdorferi, the likelihood of autoimmune disruption and subsequent illness like Hashimoto’s increases. This may also explain why inflammation of the thyroid gland, or thyroiditis, is exceptionally common among patients with chronic Lyme disease.
The Importance of Thorough Testing
The first step to resolving any sort of thyroid issue is accurate testing. At minimum, assessment of thyroid function should include testing thyroid stimulating hormone (TSH), circulating levels of T4, T3, and reverse T3, sex hormone binding globulin (SHBG), and thyroid antibodies.
Using these metrics is currently the best way to get an accurate picture of thyroid activity. Unfortunately, standard testing for thyroid disease typically relies solely on TSH values, which does not supply an accurate representation of thyroid function.
If your thyroid symptoms remain after being diagnosed and treated, an underlying chronic condition may be present. In such a situation, it is critical that Lyme disease be considered as a possible cause.
Because Lyme is able to masquerade as many other conditions, it is important that testing be as thorough as possible. To accurately identify the presence of Lyme, multiple tests that focus on specific indicators should be utilised.
Effective testing for Lyme disease may include some or all of the following:
- Assessing biomarkers of Lyme such as natural killer cell count and function
- Brain MRI and SPECT scans
- Lumbar puncture
- Lyme Borrelia culture test
- Neuropsychological testing
- Polymerase chain reaction (PCR) test
- Western Blot serologic testing
Treating Lyme-Related Thyroid Disease
To resolve thyroid dysfunction caused by Lyme disease it is essential that the underlying infection be treated in full. Doing so requires an integrative approach that attends to the infection itself while also resolving any other systemic effects stemming from it.
The structure of a Lyme treatment depends highly on the specific needs of the patient. Ideally, a Lyme literate medical doctor (LLMD) is brought in to craft a patient-specific treatment plan. A customised plan is likely to employ multiple treatment approaches designed to resolve specific dysfunction allowing for complete systemic restoration.
Some of the therapies and treatments that may be used to resolve Lyme and related dysfunction include:
- Antibiotics, both prescribed and natural
- Hormone balancers or other hormone supplements
- Immune modulators
- Low dose immunotherapy
- Ozone therapy
- Peptide therapy
- Stem cell treatments
In addition to these medical interventions, patients may be required to make significant changes to their lifestyle.
Some lifestyle modifications that may be a necessary part of effective treatment include:
- Adopting a nutrient dense, anti-inflammatory, or autoimmune diet
- Engaging in patient-appropriate physical activity
- Practicing better sleep hygiene
- Quitting smoking or use of other drugs
- Reducing or eliminating both physical and mental stress
Bringing an End to Lyme-Related Thyroid Dysfunction
On its own thyroid disease can be challenging to treat. However, in the presence of an underlying chronic condition such as Lyme it becomes exceptionally more difficult to resolve.
Completely resolving thyroid disease associated with Lyme requires awareness of the signs and symptoms of the condition, willingness to pursue proper testing, and patient-specific treatments that attend to all affected systems.
If your condition has not improved after being treated for thyroid disease, speak to your doctor about the possible influence of Lyme.
- ILADS. ” International Lyme and Associated Diseases Society.”https://www.ilads.org/
- LDA. “Lyme Disease Association, Inc.”https://lymediseaseassociation.org/
- Joseph J. Burrascano Jr., M.D. “Advanced Topics in Lyme Disease. Diagnostic Hints and Treatment Guidelines for Lyme and Other Tick Borne Illnesses.” http://www.lymenet.org/BurrGuide200810.pdf
- GLA. “Global Lyme Alliance.” https://globallymealliance.org/
- Kent Holtorf, MD. “Everything You Need to Know About Lyme Disease: Symptoms, Diagnosis, and Treatment.” Holtorf Medical Group.
- Kent Holtorf, MD. “Lyme Disease and Hypothyroidism: Is There a Connection?” Holtorf Medical Group.
- Singh SK, Girschick HJ. “Lyme borreliosis: from infection to autoimmunity.” Pediatric Rheumatology, Children’s Hospital, University of Würzburg, Würzburg, Germany.
- Benvenga S et al. “Human thyroid autoantigens and proteins of Yersinia and Borrelia share amino acid sequence homology that includes binding motifs to HLA-DR molecules and T-cell receptor.” Thyroid. 2006 Mar;16(3):225-36.
- Raveche ES at al. “Evidence of Borrelia autoimmunity-induced component of Lyme carditis and arthritis.” J Clin Microbiol. 2005 Feb;43(2):850-6.
- John D. Bleiweiss, M.D. “When to Suspect Lyme.” https://www.cassia.org/essay.htm
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Rachel Hill is the highly ranked and multi-award winning thyroid patient advocate, writer, speaker and author behind The Invisible Hypothyroidism. Her thyroid advocacy work includes writing articles, authoring books, producing her Thyroid Family email newsletters and speaking on podcasts, as well as being a founding board member for the American College of Thyroidology. She is well-recognised as a crucial contributor to the thyroid community and has a large social media presence. Her books include “Be Your Own Thyroid Advocate” and “You, Me and Hypothyroidism”.