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What Causes a Goiter?
Dr. Hila Handler - Oct 21 2014 07:54 PM
Sample Array 4 – Gluten-Associated Cross-Reactive Foods and Foods Sensitivity
Checkout the post here explaining the diet and results of this exam.
Here is the post sharing the full results and experiences of the test.
In the quest to heal my thyroid naturally, I first had to ask myself, does the food I eat nourish my body? Although the foods I eat are typically local, free range meats and of course organic, what were my stumbling blocks and were those foods really worth me not healing properly? NO they were not!
It's amazing how attracted we are to foods that are bad for us. Many of us have issues giving up various foods like wheat, sugar, coffee, cereal and so on. When you have thyroid issues, in all cases your body is telling you something is wrong. We can get into what may be bad and good all day long. We also know what these foods do to our body and our thyroid scientifically. Let's face it, most of us know.
But we seem to have blinders on when it comes to doing what we already know, and food is that road block most seem to never be able to get past. We often reach for medications and other treatments rather than looking into our own issues with food.
Does food have a hold on you? My biggest stumbling block was sugar. And we're not talking refined sugar; we're talking organic dried mangoes, organic coconut sugar and organic maple syrup. No matter how organic or pure it was, it's still sugar and my thyroid was none too happy. Once I finally cut this last remaining hurdle from my diet, my weight dropped, my health improved and I am mending like never before. So let me ask, does food have a hold on you? Is what you're eating really worth it?
Common Questions, Misconceptions and Myths of Hypothyroidism and Hashimoto’s Thyroiditis
Like most things in life: here is no black and white only. With new and complex conditions like a hormonal imbalances or compromised autoimmunity, there are only many shades of grey.
I was compelled to write this article as I get daily emails and calls from people stating the things they have done and how tired and frustrated they are with the results.
Let’s get right into them.
1. “I don’t have Hashimoto’s, only hypothyroidism.”
Have you been tested to rule out Hashimoto’s? Most people have not. Doctors don’t like to test for the TPO and TGB antibodies as there is not medication to reduce the immune’s attack on the thyroid gland. 90% of people diagnosed with hypothyroidism have it due to Hashimoto’s disease.
Hashimoto’s Thyroiditis is an autoimmune condition. This means that the immune system gets mutated and starts attacking its own thyroid – which causes hypothyroidism. 70% of your immune system lives in your small intestines (duodenum).
This is important to know as in the case of Hashimoto’s, it’s the digestive tract that needs fixing, not the thyroid alone.
2. “I’m already off gluten, dairy and soy but…”
But, you are still not feeling like yourself, right?
It’s great that so many of us take these really life-altering steps by dropping some of the staple food and learning to re-design our lives without them. For many, these changes do not produce desired results and this is when frustration and doubt step in.
If you have Hashimoto’s Thyroidistis and/or any other autoimmune condition, chances are that you have had digestive issues or infections that triggered this conditions a long time ago. Integrative doctors say that we walk around with Hashimito’s for an average of 8 years before getting diagnosed. During this time, the digestive tract lining gets damaged by food we do not tolerate well (see more on this below), pathogenic bacteria, yeast overgrowth (aka candida) and parasites. Any of them can be the trigger for an autoimmune condition.
So yes, gluten, dairy and soy are considered big food triggers but for many people they may not be enough. Read on.
3. “I eat really well.”
This is one of the first sentences that I hear from people who contact me. It’s not surprising; after all, if they did not eat well and have a love and appreciation for good food and nutrition, they won’t be searching for diet and thyroid-related solutions.
There are a couple of challenges with this belief: what does “eating well” really mean? Many people would perceive for example, protein powders, to be healthy food. In my practice I see amazing results every time I switch a person the product marketing miracle claims to real, unadulterated and whole food.
However, the bigger issue is this: for people with autoimmune conditions it is not so much about what we eat but what our body does with the food we eat. Take eggs as an example. They are one of the superfoods, in fact they are so rich in nutrients that we can survive eating them and nothing else. However, if our body does not tolerate eggs well they become a toxic substance that will inflame the immune system even further. Sadly, the list of “good food” that many people with autoimmune conditions cannot tolerate is long can include nuts, seeds, nightshade vegetables, legumes and grains.
A simple elimination diet would help reveal what food a person is reactive to. For a person with an autoimmune condition, it is of paramount importance to remove food that causes digestive distress.
4. “I’m already a vegetarian.”
I know I’m not going to get in good books with the vegetarians here but if you want to heal yourself, you need to remain open-minded.
Please bear in mind that I’m a big proponent of bio-individuality which honors the distinct nutritional needs of every human being. I’m not saying everybody needs to eat meat. I’m saying: listen to your body if it needs meat.
Sadly (or not), I found many of my clients turn a corner when with even small amounts of animal proteins in their diet. This is why:
VITAMIN B12 and IRON - you probably know this part already: we get plenty of vitamin B12 and iron from meat. Both Vitamin B12 and iron are key in converting the T4 to T3.
GLUTAMINE - provides cells in the digestive tract with a vital source of energy that is required for regulating their production. Its role in re-building and strengthening the gut lining is critical.
TYROSINE - is also the precursor amino acid for the thyroid gland hormone thyroxin, and a defect in this may result in hypothyroidism.
5. “I’ve stopped eating goitrogenic vegetables”
This is another highly controversial topic. It is true that food high in goiter will inhibit the thyroid gland’s ability to uptake iodine to produce the T4 hormone. This can be highly frustrating as this food includes some of our all-time favorites like cabbage, broccoli, spinach, Brussels’ sprouts, kale, collard greens, etc.
Here is the good news: when cooked, these vegetables lose 70-80% of their goitrogenic properties. Let’s remember that when we have Hashimoto’s, our primary focus should be in restoring our digestive tract and detoxifying the body – as they were the original triggers of this condition. Omitting these vegetables completely will not address this concern.
These vegetables are richer in vitamins and minerals than any other of their distant veggie cousins. As it stands, most Americans are undernourished, taking out food like this will further make us rely on supplements – which is not the way we should be living and healing.
Lastly, goitrogenic vegetables are rich in a substance called DIM (diindolylmethane) which is key in liver detoxification as well as elimination of mutated estrogen metabolites. Most pre-menopausal women I work with have some level of estrogen dominance which is barely surprising given the estrogenic cocktail of skincare products, cleaners, packaging and food we live in today. Keeping a healthy balance of estrogen, progesterone and thyroid hormone is key not only to the overall hormonal balance but also to the immune system.
6. “I lost my thyroid, is there anything that I can do?”
The short answer is: absolutely YES! I want to empower you with some understanding why that is so:
a. Even if you lost your thyroid, the meds you are taking depend on your gut and your liver for proper break-down and absorptions.
b. If you are only on synthetic T4 (like Synthroid), your body still depends on the health of your liver to convert the inactive T4 hormone to the active T3 hormone utilized by your cells.
c. If you have/had Hashimito’s Disease, you have an autoimmune condition. Why would removing the thyroid gland stop this immune mutation? This is why 50% of people with Hashi’s develop other, often far worse, autoimmune conditions like MS, fibromyalgia, lupus, RA and so many more (it’s a pandemic now).
In all three points, nutritional changes can make a huge difference. Starting with cleaning up your gut and liver to maximize the drug (like Synthroid) utilization to preventing other autoimmune diseases from developing.
It’s true that once you have Hashi’s you have it forever – this includes the author of this article. But, you can get to a place of remission, be symptoms-free and live a full life.
This article was contributed by Magdalena Wszelaki, a certified nutrition coach and the founder of Thyroid Diet Coach and Hormones Balance. Magdalena has managed to reverse her own Graves’ and Hashimoto’s Disease, adrenal fatgue and estrogen dominance. She is in full remission now and lives a symptoms-free and awesome life.
On May 10th, she is hosting a Free Online Hormones Detox WORKHOP titled “10 Toxins Impacting Your Hormones” - designed to help understand the interplay between toxins and the thyroid and how to live the toxins-free life pragmatically and on a budget.
The surprising impact of the liver on thyroid health.
Learn how managing your liver health will free you from thyroid-related symptoms such as fatigue, weight gain, mood swings and hair loss.
We often worry about which thyroid medication is better, which supplement should we add or will getting off gluten result in a recover. They may all play a role but getting to the root cause of a disease is the most effective and fastest way to heal.
Have you ever wondered what your liver would say to you if it had a voice? Most livers would have a lot to moan about given half the chance. The truth is our livers almost always suffer in silence and rarely express their stress. When they do, it often occurs in ways which we do not
associate directly with this vital organ. So, instead of making a big fuss the liver slowly starts to tire (sluggish liver) and this can have a massive affect on our overall health. This may sound scary but the magical factor to remember is the liver has a miraculous ability to heal and regenerate when given the right conditions. The good news is that taking a few simple steps makes the world of difference and it is within your power to make your liver smile again.
Dr Kharrazian, the author of “Why Do I Still Have Thyroid Symptoms” states a few critical body systems which are interdependent to thyroid health: our liver and balanced sugar levels. Today, we will focus on the health of the liver.
Your liver does so much more than you imagined.
The liver is responsible for over 200 functions in the body and is the largest internal organ, weighing in at about 55oz (or 1.5 kg). It is central to so many of the body’s functions and most people are unaware of how vital it is to good health. Some of the major functions of the liver are:
· purifying our blood (50 oz or 1.4 litres a minute),
· regulating the metabolism (through bile production),
· storing minerals and fat soluble vitamins, protein synthesis, glycogen storage and conversion (energy production),
· cholesterol production (which is a good thing! Cholesterol, contrary to Western medicine’s believes, cholesterol necessary as it is the precursor for our steroid hormones, it manages our brain function, nerve function and hormone transportation),
· parasite protection (by filtering protazoa) and…
· more famously... detoxification.
Although the liver is wonderful at healing and amazing at self-recovery, it does take a great deal of abuse in our Western lifestyles. Some of the choices can be fairly obvious (like eating non-organic food, living in a polluted area, drinking contaminated water) but many other choices (like skin care products, house cleaning products, drinking tap water or prescription medication) can create further load which we might not even be aware of. According to the EWG (Environmental Working Group), studies show that an average American is daily exposed to 200 chemical toxins and carries as many as 91 of them.
Where is all the toxicity coming from?
There are a lot of factors which affect whether the liver performs its critical functions effectively and often poor lifestyle choices can put too much pressure on this delicate organ. Here what contributes to our toxic load:
· non-organic food (think: mercury, lead, PCBs and over 130 pesticides)
· air pollution (a long list)
· tap water (think: fluoride, chlorine, PCBs, mercury, lead, parasites)
· skin care products (think: phthalates, BPA, triclosan, parabens)
· house hold cleaning products (think: triclosan, phthalates, parabens)
· medications; both recreational and prescription, including commonly-used ones like corticosteroids, tetracycline and aspirin
· plastics (think: BPA, PFOA)
· cookware like non-stick pans (think: PFOA)
Our body is designed to excrete them. We have a few detoxification organs, namely: skin, lungs, kidneys, digestive tract and, of course, the liver. They are all capable to perform the beautiful job of freeing us from these toxins – the challenge is: when the load is higher than what they can handle, this is when toxicity takes a toll on us.
Early signs of liver problems.
So what symptoms can we expect to experience when our liver is tired? We commonly hear about cirrhosis (permanent scarring) of the liver and the increase in liver disease in the Western world. It’s completely possible to determine them by doing the right blood work and testing for markers like aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT). The challenge is: by the time they are raised, much of the liver damage has already been done.
It’s key to be proactive, educated and step into a preventative mode. How often do you hear about the common symptoms which are associated with liver fatigue as a result of a toxic or stressful lifestyle? You certainly won’t be hearing about them from your doctor. Here are some common symptoms which may be related to sluggish liver detoxification and function:
· Intolerance to HRT (hormone replacement therapy)
· Severe menopausal symptoms
· Estrogen Dominance
· Mood Swings
Blood Sugar Problems
· Sugar Cravings
· Type 2 Diabetes
· Energy slumps
· Waking in the night
· Allergies/ Skin rashes
· Chemical sensitivities (think: someone who can’t stand fumes or perfumes)
· Chronic Fatigue/Fibromyalgia
· Frequent illness
· Anger and irritability
· Foggy brain
· Frequent headaches
· Gall stones
· Intolerance to fat
· Sensitivity to alcohol and/or caffeine
· Acid reflux
· Bloating or constipation
· Irritable bowel syndrome
· Furry tongue
· Bad breath
· Acne and rosacea
· Yellow, red or itchy eyes
· Brown spot on hands, back and face
Abnormal metabolism of fats (lipids)
· Abnormal level of fats in the blood, e.g. high LDL (“bad cholesterol”) and reduced HDL (“good cholesterol”)
· Elevated triglycerides
· Blocked arteries leading to hypertension, heart attacks and strokes
· Fatty liver
The connection of the liver to thyroid health.
Most of us know that our liver is responsible for processing alcohol, but there is so much more. Let’s just look at its connection to the thyroid.
1. Conversion of T4 to T3 thyroid hormone
Our liver (and the digestive tract) is where the conversion of the T4 hormone happens to T3. What many people do not realize is that T4 is an inactive hormone and T3 is the active or bioavailable hormone which our body cell receptors get to use. People who are on Synthroid (or any other brand of thyroxine) are highly dependent on the function of the liver; Synthroid is a synthetic T4 and it therefore needs a well functioning liver to produce the T3 hormone.
2. Storage of Vitamin B12
Our liver is the storage organ for vitamin B12. A compromised liver function, will impair vitamin B12 levels which will also impact the ability of our body to convert T4 to T3.
3. Production of new thyroid hormone
The liver Phase Two detoxification phase (see below) excretes metabolizes hormones – this means hormones that have been “used” by the body to make space for new ones. A sluggish liver won’t be getting rid of the “used thyroid hormone” to make space for new ones – this further amplifies thyroid-related symptoms.
Phase One and Phase Two of liver detoxification.
The liver’s detoxification method includes two phases which are referred to as Phase One and Phase Two.
Phase One is known as oxidation and Phase One as conjugation. In Phase One, the liver uses oxygen and enzymes to burn toxins. This process is called oxidation as it makes the toxins more soluble in water so they can be more easily excreted from the body by the kidneys and the liver. Most environmental toxins are fat-soluble to start with, and therefore difficult or impossible to eliminate without the liver's help. Did you know that the chemicals produced in Phase One are more toxic than those which originally entered the body?!
This phase of liver detoxification is inhibited by nutritional deficiency, toxic exposure and medications such as acetaminophen (brand name Tylenol), alcohol consumption, and low protein intake that deplete glutathione which is needed for acetaminophen detoxification.
To free itself of toxins produced by Phase One detoxification, the liver performs a Phase Two called conjugation. In this phase, oxidized chemicals are combined with sulfur, specific amino acids or organic acids, and then excreted in bile and urine.
Both phases are dependant on vital substances which are required to activate the catalyst for toxin conversion and they must work in balance so that no harmful toxins are left to circulate.
There are six pathways in Phase Two and each one is responsible for converting a different set of substances (e.g. estrogen, thyroid hormones, heavy metals, histamine, phenol, salicylates, biliruben, nicotine, bacterial toxins, caffeine). The six pathways are called:
1. Amino Acid Conjugation pathway
2. The Glutathione pathway
3. The Sulphation (sulfation) pathway
4. The Methylation pathway
5. The Glucoronidation pathway
6. The Acetylation pathway.
Methylation and sulphatation pathways explained.
For an example of how these pathways work let’s look at the methylation pathway in more detail. This allows methyl groups to pass through the liver and out of the body safely. This pathway detoxifies estrogen, dopamine, histamine and heavy metals. To support this pathway we can increase our intake of choline (avocados/eggs/non-GM soy lecithin) and B vitamins.
The sulphation pathway detoxifies excess neurotransmitters, steroids, thyroid hormones, phenol and excess bile acids. This pathway is often burdened by frequent use of non steroidal anti inflammatory drugs (NSAIDS). We can support this pathway through an increase in high sulphur foods (e.g. egg yolk, broccoli, onion or MSM).
If Phase Two is not working effectively then the highly toxic chemicals formed in Phase One cannot be converted and this can cause a lot of toxicity issues in the body such as tissue damage or disease. It may also cause excess hormones to circulate through the bloodstream instead of being excreted and this can lead to hormonal imbalances which may affect the thyroid gland or our estrogen levels.
Healing Powers of the Liver and Diet.
The most magical point to remember when we learn about the liver, is how effectively it can rebuild itself. By giving it the right tools nutritionally and following a lifestyle plan that avoids nasty environmental toxins (which confuse and hinder the liver), we can literally regenerate this wonderful organ.
By detoxifying the body and giving it the right nutritional tools, your liver’s functions may be restored to full health. Foods and herbs which support liver healing and detoxification can be used to make dramatic changes to symptoms associated with a sluggish liver and give long lasting healing effects.
About the Authors and Hormones Detox FREE Workshop
The authors of this article, Magdalena Wszelaki (certified nutrition coach) and Josie Lincoln (nutritionist (UK) and detox expert), are hosting a Free Online Hormones Detox WORKHOP titled “10 Toxins Impacting Your Hormones” - designed to help understand the interplay between toxins and the thyroid and how to live the toxins-free life pragmatically and on a budget.
If you have thyroid problems, you may likely have an auto-immune disease, thus making it a necessity to have the proper diet. Most functional health care practitioners that have found the most success helping auto-immune thyroid patients heal demand that their patients have the correct diet. Why? It all starts in the gut! Heal your gut first, and then hopefully healing elsewhere will follow.
To get started in this series of articles, we want to start with a list of foods anyone with thyroid problems has must stay away from at all costs.
Foods to Avoid:
1) Number 1 on our list is Gluten. We will dive more in detail into this later, you must cut gluten out of your diet if you want healing with your thyroid. Wheat, grains, oats and so on are the most obvious. But you have to watch foods that hide gluten, such as sauces, (BBQ, soy, teriyaki) lunch meats, monosodium glutamate, non-dairy creamers, some spices, chewing gum fillers, binders, brewers yeast, etc.
2) All Sugars: agave, maple syrup, white sugar, coconut sugar, corn syrups and so on
3) Dairy and eggs
4) Soy products
6) High glycemic foods, bananas, high fructose fruits, dried fruits, etc.
7) Nuts, seeds and grains
8) Beans and legumes
9) Most processed foods, coffee and so on
10) Mushrooms and also nightshades
You may not like this list, but if you want healing you will have to work hard for it and ask yourself, what's more important, food or your health?
Studies have easily shown that the most common cause of a goiter has to be Hashimoto’s. However, what many people don't realize is that medication, outside factors and other substances can cause them as well. Let's face it; our bodies are bombarded with toxic substances daily. At some point our bodies may fail to detox and control what's coming in. And in our world, this is not going to get better but worse.
Here is a small list of specific various compounds and meds that cause goiters:
- Aminosalicylate Sodium
- Various Heavy Metals
Before we state what causes a goiter, we will briefly describe what it is. Basically a goiter is too much tissue growth of the thyroid. It is not a swelling of the thyroid like many think. In the US the most common cause of this is people with Hashimoto's going undiagnosed for so long. It is not from iodine deficiencies. Natural health care practitioners typically go this route first or blame the issue on the consumption of too many goitrogenic foods. This is just not the case, they are not testing their patients, or they do not understand how to read the test results properly and are putting people under a blanket diagnosis to make it easier to treat.
The goiter can and will form when there is too much TSH or even HCG present in the body. If your thyroid gland is exposed to too much of either of these, you will likely end up with a goiter.
Iodine deficiency can cause a goiter to form, but here in the US that's very rare. So make sure you have a health care practitioner that knows how to read thyroid test panels properly and understands exactly what causes goiters. If you're not being properly diagnosed, you will not be properly treated. If you're not properly treated, your condition will likely worsen.
Many times people fail to change their diet when they have thyroid problems. Our diets can make or break our health. One such diet change that someone with thyroid issues may want to consider watching out for is goitrogens. This is even more of a food you will need to avoid if you have hypothyroid issues.
Here are just a few high goitrogen foods:
• All Soy Based Foods
• Peanuts, yes that means peanut butter
• Brussels Sprouts
• Mustard Greens
Eating these veggies listed here can worsen a thyroid condition. For someone healthy it isn’t a problem and they are not going to end up with a thyroid condition from eating them. But when you have thyroid issues the more you can do to improve your condition the better. You also don't have to cut these 100%. Having some of these veggies listed in limited quantities, assuming your thyroid condition is not worsening, may be okay for some.
Why do goitrogens cause the thyroid issues? They can inhibit the metabolism of iodine. If iodine is not utilized properly by the thyroid gland then the thyroid hormone will not form.
When you have thyroid issues, everything you can do to improve your health should be considered!
Hashimoto's in the United States is by far the biggest cause of hypothyroidism. So what is it? From Guyton’s Textbook of Medical Physiology regarding hypothyroid patients, “The thyroid glands of most of these patients first have autoimmune “thyroiditis,” which means thyroid inflammation. This causes progressive deterioration and finally fibrosis of the gland, with resultant diminished or absent secretion of thyroid hormone.”
As an auto-immune disease, basically the body will make antibodies or immune cells that will attack the thyroid. If this process continues too long, eventually the damage can become irreversible. It is key to find a physician that can help you find the cause of the autoimmune process, or as we typically call it, the trigger. Thyroid medications will not fix the autoimmune process that is attacking the organ. This is something not common in the medical care system, they rarely help find the cause of the autoimmune disease rather just try and medicate or treat the symptoms.
Here are some lab markers used to diagnose Hashi's:
- TPO or Thyroid Peroxidase antibodies: diagnoses the Hashimoto’s - most often found, these antibodies are basically against an enzyme in your thyroid.
- TG or Thyroglobulin antibodies: diagnoses the Hashimoto’s - attacks a protein in the thyroid gland.
Disclaimer: The FDA says only a drug can treat a disease.