Hi there, it’s Dr. Davis again and today I’d like to talk to you about the relationship of IBS and your thyroid. In the past, and unfortunately some doctors still feel this way, IBS was considered a diagnosis of exclusion, where the doctor would finally label your symptoms as IBS when they couldn’t think of anything else to call it. As you can imagine, this didn’t lead to much in the way affective treatment. But IBS research has advanced so much in the last 5 years that it has cleared the path to a much fuller understanding of the cause and effects of IBS.
One of the most important relationships it turns out is with low thyroid function
Thyroid function is surprisingly complex, with hormones changing into other hormones, organs affecting other organs, brain-thyroid crosstalk, and the gut affecting pretty much everything.
The thyroid gland affects the energy use of all human cells, and controls the body’s sensitivity to other hormones, but you’ll never have optimal thyroid health with poor digestion, gut infections, inflammation, heart burn or IBS. In fact, it’s best to look at thyroid problems as a bright engine light in your car. When when you see that, its time to investigate, you know, pull over to curb and pop the hood. Don’t just take a drug or supplement that temporarily makes the light turn off. That can lead to a viscous cycle where low thyroid function causes IBS and IBS limits the effectiveness of the thyroid. Unfortunately, I’ve seen many people that have let this cycle churn until they are loosing jobs, spouses and any enjoyment of life.
So I’ve outlined 7 ways that the thyroid and gut inter-relate.
The first Gut-Thyroid Connection is related to Leaky gut
One can say that the gut is the primary immune organ. That’s because 70-80% of the immune system is housed there as the Gut Associated Lymphoid Tissue or GALT, comprised of different types of tissues that store the immune cells like T and B lymphocytes. These cells are responsible for the attacks on foreign invaders or antigens that come in with our food. This is a great system for protection but things can go badly when poor gut health leads to a leaky gut, where large proteins are allowed to pass through the intestinal wall and are attacked by our immune cells leading to an increase in autoimmune disorders like Hashimoto’s Thyroid. To counter this, the thyroid hormones T3 and T4 help decrease the leakiness of the gut by influencing the “tight junctions” between those cells in the small intestine and stomach. Low levels of T3 and T4 have been shown to protect the gut lining from ulcers and separately, inflammation of the gut is curbed by T4 by decreasing intraepithelial lymphocytes. Lastly, the controlling hormones TRH and TSH from the hypothalamus and pituitary to the thyroid help the gut immune system mature.
The second Gut-Thyroid Connection is related– Low Stomach Acid
You may know that low stomach acid or Hypochlorhydria is a common trigger to eventual IBS but a common cause of that low stomach acid is from decreased thyroid function. Decreased gastric acid, is required to eliminate bacteria, and to fully digest your food, especially protein. The result of low acid can be bacterial overgrowth of the small intestine (SIBO), which is the cause of most of the IBS symptoms like bloating, gas, and pain. Low stomach acid can also lead to heart burn because the food in the stomach begins to putrefy and rot. Your body responds by increasing the pressure in the stomach and intestines, shooting that mess up into the sensitive tissues of the esophagus. When this happens every day, it leads to the diagnosis of reflux disease or GERD that can be a pre-cancerous condition. And just like thyroid issues can lead to low stomach acid, low acid can contribute to hypothyroidism. This vicious cycle happens when indigestion in the stomach decreases absorption of important nutrients like Vit B12, Folate, Vit D, Iron, beta-carotene and trace elements that along with a poor diet, sets the stage for autoimmune type hypothyroid problems.
The third Gut-Thyroid Connection is related to T3 to T4 hormone conversion
When the thyroid produces its hormone T4 it must be converted to the active hormone T3 in order to affect the cells of the body. Some of this conversion is done in the liver but a full 20% is converted in the GI tract from T3 sulfate and T3 acetic acid by and enzyme called intestinal sulfatase. This enzyme is produced healthy gut bacteria. So with a shift in the balance of good to bad bacteria, called dysbiosis, or overgrowth of all the bacteria this conversion can’t fully take place leaving you with hypothyroid symptoms even though all your lab tests are normal.
The fourth Gut-Thyroid Connection is related to the Gall Bladder
Among other things, the liver functions to digest fats, assist in mineral absorption and detoxify certain hormones that have built up during the day. With low thyroid, the gall bladder that receives the bile from the liver is weakened, slowing emptying and creating a kind of bile/gall stone sludge. This results in poor detoxification that decreases T4 to T3 conversion but also allows the increase of estrogen. This excess estrogen leads to high levels of binding proteins that prevent thyroid hormones from entering cells.
The fifth Gut-Thyroid Connection is related to constipation
Although IBS comes in a diarrhea variety, the constipation type IBS is more common with low thyroid. The thyroid slows the GI tract causing constipation, that will lead to decreased hormone clearance, especially estrogen and then lower thyroid hormones which then results in a slower GI tract. The vicious cycle of thyroid and gut function is present once again.
The sixth Gut-Thyroid Connection is related Lipopolysaccharides
The cell walls of certain bacteria contain lipopolysaccharides and are toxic. They are part of the infection process stimulating proteins called pro-inflammatory cytokines and result in free radicals that cause further cell damage. This is why we take antioxidants and eat blue berries to decrease this potential damage. This toxicity occurs in overgrowth and is even related to obesity and insulin resistance. Conversely, the increase in these bacteria lipopolysaccharaides reduces thyroid hormone levels, decreases the pituitary instructions to the thyroid and increases autoimmune thyroid conditions.
The seventh Gut-Thyroid Connection is related to cortisol
The gut inflammation that we talked about earlier raises the stress hormone cortisol from the adrenal glands. The affect of this is to inactivate some of the T3, resulting in a lower level of the active T3 hormone. That’s right, stress makes you fatigued and overwhelmed.
So what can we learn from all of this. Well, we know that the thyroid influences the gut and visa versa. So if we want to solve all our problems with IBS, we may have to test both the thyroid and the gut with some of the new sophisticated lab tools we have at out disposal. Then you should seek out a doctor that has experience in both gut and thyroid conditions to really see what the problem is and decide what action to take.
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