Datis Kharrazian, PhD, DHSc, DC, MS, MMSc, FACN
Did you know the bustling community of trillions of microbes living in your gut can play a role in managing autoimmune diseases like Hashimoto’s?
Decades ago, scientists began hypothesizing a connection between the gut microbiome (all the microorganisms residing in our intestines) and the thyroid gland.
In recent studies, scientists looked closely at individuals with the autoimmune thyroid diseases Hashimoto’s and Graves’ disease. They discovered that people with these conditions had different types of bacteria in their guts compared to healthy individuals.
Distinct groups of bacteria have been associated with various facets of thyroid function. Among these, bacterial genera such as Gemella, Enterococcus, Faecalibacterium, and Patescibacteria have been identified in abundance in individuals with Hashimoto’s. This suggests a connection between the microbiome in our gut and the health of our thyroid gland.
Understanding this complex relationship can further support how we diagnose and treat autoimmune thyroid diseases in the future.
I teach you how to manage autoimmunity in my course Autoimmunity: Solving the Puzzle.
Supporting a healthy gut microbiome to help prevent or manage autoimmunity
Improving and repairing gut health is frequently a foundation to managing autoimmune diseases like Hashimoto’s. Clinically, we frequently see issues such as insufficient stomach acid, poor gallbladder function, insufficient pancreatic enzyme secretion, overgrowth of small intestinal bacteria, fungal or parasitic infections, leaky gut (intestinal permeability), dysfunctions in motility leading to either constipation or diarrhea, inflammation, and more. Addressing gut health is a complex topic that should be taken into a north-to-south approach, as upstream breakdowns cause downstream issues, including poor gut microbiome health.
Learn how to manage your gut health in my course Gut Health: Solving the Puzzle.
A healthy gut microbiome is essential to “oral tolerance.” Oral tolerance refers to the immune system’s ability to tolerate and accept certain foods without triggering an immune reaction. It is the body’s way of appropriately responding to food while protecting itself from harmful compounds. When someone loses oral tolerance, they may develop sensitivities to certain foods and experience symptoms or even see their symptoms worsen. This eventually can spill over into loss of “self-tolerance,” or autoimmunity — when the immune system begins attacking body tissue.
The gut microbiome plays a significant role in oral tolerance. Research suggests that a healthy and diverse gut microbiome is essential for maintaining oral tolerance. The gut bacteria help regulate the immune system and promote a balanced immune response to food. They also aid in developing self-tolerance.
To achieve a healthy gut microbiome, it is recommended to follow certain strategies:
- Consume a diverse range of produce and whole plant products in your diet. I have some of my patients consume up to 20 different plant fibers in a day in just a spoon-sized serving—you only need about a tablespoon of the diversity to feed the good gut bacteria in addition to your regular fiber intake. I recommend what I call the Microbiome Mashup: Blend a mix of veggies, fruits, and herbs in advance, then portion it into ice cube trays and freeze. Add a cube daily to a smoothie or soup. In addition to the Microbiome Mashup, aim for at least 25g a day of fiber in your meals.
- Limit the consumption of meat and dairy products from animals raised on antibiotics. This can help reduce the intake of antibiotics that may disrupt the gut microbiome.
- Avoid excessive alcohol consumption, as it can negatively impact the gut microbiome.
- Minimize antibiotics unless absolutely necessary, as they can disrupt the balance of gut bacteria.
- Choose organic produce whenever possible to reduce exposure to pesticides and herbicides that may affect the gut microbiome.
Nutrients that support oral tolerance
While diet is the main pathway to health, certain nutritional compounds can also support oral tolerance.
Omega-3 fatty acids, found in sources like fish, emu, and algae oil, are important for maintaining a healthy balance of essential fatty acids and promoting the function of regulatory T cells (T-reg cells) involved in oral tolerance.
Vitamin D is also crucial for oral tolerance as it plays a role in immune regulation. Adequate vitamin D levels are necessary for the proper function of T-reg cells and for maintaining a balanced immune response.
Glutathione is a master antioxidant that helps dampen inflammation in the gut. Inflammation in the gut can inhibit gut bacteria diversity, so it’s important to reduce it. Taking high-quality, absorbable glutathione supplements, such as s-acetyl glutathione or oral liposomal glutathione, can be beneficial. Glutathione precursors, like n-acetyl cysteine, can also be taken to support glutathione production in the body.
Short-chain fatty acids (SCFAs) are compounds produced by the gut bacteria during the fermentation of dietary fiber. They have profound impacts on gut, immune, and brain health. Butyrate is one of the three primary SCFAs that supports gut health, helps repair leaky gut, and helps regulate gut inflammation.
High-fiber diets aren’t appropriate for everyone
Although a wide diversity of plant fibers supports a healthy gut microbiome and oral tolerance, the truth is that not everyone tolerates fiber the same.
Individuals with certain digestive disorders may find that high-fiber diets exacerbate their symptoms. These can include inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), or small intestinal bacterial overgrowth (SIBO). People who have had gastrointestinal surgeries may need to limit fiber intake. For some people with autoimmunity, lectins, nightshades, and oxalates may be problematic. Some of these people even thrive on a carnivore diet and the complete avoidance of plant fibers.
Remember that everyone is different, and that various research findings and recommendations rarely apply to everyone. Always listen to your body, keep an open mind, and avoid falling into dogmatic cult-like approaches to diet and health.
There is no one autoimmune protocol
Managing autoimmune diseases such as Hashimoto’s can be a complex and ongoing process. It is crucial to approach it with realistic expectations as autoimmune diseases are incurable. However, the goal is to strive for remission of the autoimmune disease, which can lead to improved function and a better quality of life.
As Hippocrates wisely stated, “All disease begins in the gut.” My extensive clinical experience has shown this is often (though not always) the case. Gastrointestinal (GI) dysfunctions are the most overlooked and exceedingly common disorders today, affecting about 70 million Americans and counting.
To minimize symptoms and support your body’s journey towards remission, it is essential to focus on several key pillars. First and foremost is addressing diet and nutrition. Identify and manage food triggers. This can play a significant role in managing autoimmune thyroid conditions.
Additionally, managing stress and emotional well-being is crucial. Stress can profoundly impact autoimmune diseases. Implementing effective stress management techniques is vital for overall health and remission.
Lastly, optimizing gut health is of utmost importance. As discussed in this article, the gut plays a central role in immune function, and addressing any underlying gut dysfunctions can positively impact autoimmune thyroid conditions.
Healing requires personalized attention and ongoing commitment. By addressing these pillars, you can support your body’s ability to achieve remission and improve overall well-being.
Mustafa Genco Erdem et al., ‘Oral Microbiota Signatures in the Pathogenesis of Euthyroid Hashimoto’s Thyroiditis’, Biomedicines 11, no. 4 (26 March 2023): 1012, https://doi.org/10.3390/biomedicines11041012.