Most thyroid conditions in the United States occur as a result of two autoimmune diseases: Hashimoto’s thyroiditis and Graves’ disease. In Hashimoto’s thyroiditis, the body produces antibodies — called thyroid peroxidase antibodies (TPOAb) — that attack your gland and make it less able to produce thyroid hormone, making you hypothyroid. In Graves’ disease, antibodies — called thyroid stimulating immunoglobulins (TSI) — trigger your thyroid gland to produce too much thyroid hormone, making you hyperthyroid.
Conventional endocrinology is divided on whether there is any value to testing your thyroid antibodies, primarily because there are few widely accepted ways to lower your antibodies when they are elevated.
The issue of whether you can lower antibodies is especially important with Hashimoto’s thyroiditis. For many patients, antibody levels become elevated — and hypothyroidism symptoms appear — long before the standard blood tests such as thyroid stimulating hormone (TSH), free thyroxine (free T4), and free triiodothyronine (free T3) reflect actual hypothyroidism. If the elevation of your thyroid antibodies can be halted or even reversed, there is a potential to calm or stop the autoimmune process, prevent you from becoming fully hypothyroid, and resolve your symptoms.
Some physicians and integrative practitioners recommend that you not only be tested for thyroid antibodies but if you have elevated antibodies, they should be aggressively treated using a variety of approaches.
Medical treatments for elevated thyroid antibodies
There are two medical treatments being used to address the autoimmune aspect of thyroid disease: low dose naltrexone (LDN) and stem cell therapies.
Naltrexone is a medication that, at high doses, is used to block opioid receptors as part of treatment for addictions. Years ago, Dr. Bernard Bihari discovered that very low doses of naltrexone have an effect on the immune system, and could stop the progression of or even help lower antibodies in a variety of autoimmune conditions, including Hashimoto’s and Graves’ disease. At low doses, usually less than 4.5 mg per day, naltrexone is considered very safe and has few side effects. LDN is also inexpensive, typically costing less than $50 a month. The challenge? Finding a practitioner who knows about LDN and how to use it to treat your autoimmune disease. Two good resources for more information on LDN are LowDoseNaltrexone.org and patient advocate Julia Schopick’s excellent book, Honest Medicine.
Stem cell therapies are also being used to help reboot and reset the immune system for people with autoimmune disease. One type of stem cell transplant, autologous hematopoietic stem cell transplantation, uses stems cells from your own bone marrow, or from external umbilical cord blood. The bone marrow stem cell transplant is performed in the United States, but typically only for severe autoimmune diseases that are not responding to other treatments. The other type of therapy is autologous mesenchymal stem cell transplantation. This treatment — considered experimental and investigative in the United States — involves harvesting stem cells from fat obtained in a mini-liposuction procedure, and reinjecting their own stem cells. Research shows that some patients having stem cell treatment have experienced long-term remissions of their autoimmune disease, reduction of antibodies, and in some cases, even a resetting of autoimmunity. Around the globe, other researchers are reporting even better response rates using fetal stem cells, the use of which is prohibited in the United States.
Supplements to lower thyroid antibodies
Two supplements — vitamin D and selenium — have been demonstrated in research to lower thyroid antibodies. Two other supplements — probiotics and melatonin — show promise in the effort to lower thyroid antibodies.
There is a proven relationship between low vitamin D levels and the incidence of Hashimoto’s thyroiditis and Graves’ disease. More recently, however, researchers have shown that even eight weeks of vitamin D therapy can significantly reduce thyroid antibodies. If you have autoimmune thyroid disease, you should have your vitamin D levels tested, and if you are deficient — defined as having 25-hydroxy vitamin D levels of less than 20 ng/mL — work with your practitioner to supplement with vitamin D until your levels are normal. Note: Some integrative practitioners feel that support for autoimmune disease requires baseline vitamin D levels above 50 ng/mL.
The mineral selenium has been shown in numerous studies to reduce thyroid antibodies. In some cases, the impact on antibodies is significant enough to restore patients to the normal TSH reference range without prescription treatment. Selenium is not easy to get from the diet — the richest source of selenium is Brazil nuts—so supplements may be necessary. A caution: You should not exceed 400 mcg of selenium per day from all sources, including food and supplements because higher levels can cause toxicity.
Melatonin, a hormone produced by the pineal gland, plays a key role in your immune system and has both anti-inflammatory and immunomodulatory effects. Some practitioners include melatonin in autoimmune disease treatment because of its adaptogenic abilities. Melatonin can stimulate your immune system when needed, or calm an overactive immune system.
Probiotics are the “good” bacteria found in a number of fermented foods like yogurt, sauerkraut, kimchi, miso, and kombucha, as well as in supplements. Numerous studies have found that increasing the intake of probiotics enhances the immune system and addressing gut inflammation and imbalances of bacteria may help reduce autoimmune activity.
Dietary changes to reduce thyroid antibodies
A number of dietary changes can reduce thyroid antibodies. The challenge is determining which ones might work for you. Start with two key steps:
Identify your allergies and food sensitivities. This may involve blood tests, or a rotation diet to evaluate your sensitivity to common triggers such as dairy, wheat, sugar, soy, and sulfur in foods, among others. Specifically, you should be evaluated for gluten and wheat sensitivity, as this is a common trigger in people with autoimmune thyroid disease.
Follow a diet that eliminates your triggers, and incorporates anti-inflammatory foods.
Even when specific triggers, allergies, and sensitivities have not been demonstrated, some autoimmune patients have lowered antibodies and resolved symptoms by following specific diet programs, including:
Lifestyle changes to lower antibodies
According to research regarding stress and autoimmunity, stress reduction interventions can have a positive therapeutic effect in autoimmune disease patients, improving your quality of life, reducing symptoms, and in some cases, reducing antibodies. Stress reduction interventions are more than just “relaxing,” however. You need to develop strategies to reduce your overall load of stress, cope with the inevitable stress you face, eat and sleep well, and incorporate a daily activity that physiologically generates your relaxation response.
Some effective stress reduction interventions include breathwork, prayer, gentle yoga, meditative movement like tai chi or qi gong, or activities like needlework, crafting, and coloring. The powerhouse stress-buster is meditation, whether individual or guided. One thyroid patient favorite is The Thyroid Meditation CD and MP3, a guided meditation audio program for thyroid patients.
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Mary Shomon is a thyroid disease, hormonal and autoimmune health writer, and patient advocate. For two decades, Mary has been a leading force advocating for more effective, patient-centered thyroid and hormonal health care. Mary is the New York Times bestselling author of “The Thyroid Diet Revolution,” “Your Healthy Pregnancy with Thyroid Disease,” “Living Well With Hypothyroidism,” and 10 other books on thyroid disease and integrative health. She co-stars in two PBS health specials, “Healthy Hormones,” and “Vibrant for Life.” Follow her on Twitter at @thyroidmary or at her Facebook communities: ThyroidSupport and ThyroidDiet.