I posted my interview with Nora Gedgaudas last week that detailed the whole paleo diet thing. I’m two weeks in and am noticing amazing differences – which I’ll report back on.

Photo by Santiago Design

Anyway, I know a lot of readers on this site have an auto-immune disease of some sort. Nora very kindly talked me through her tips for anyone suffering AI, specifically hashimotos. It all fits. I’ve been told for years the paleo diet is ideal for AI issues. I thought you AI types out there would find it useful (apologies to everyone else…and apologies for my rambly chat…I was having a very “thyroidy” day that day…and you know how that goes…)

Remember, Nora’s out here in Australia in November with Nourishing Australia. I really recommend making it to one of the sessions.


Nora then went the extra mile and emailed me to confirm many of her complex points (your head spinning much from listening to the above?). I love that she uses the word “modulation” as the approach that needs to be taken.

It’s so very much about modulation.

The primary issue at hand is IMMUNE function (specifically, a need for immune modulation).

Most if not nearly all cases of autoimmune thyroid are profoundly tied to gluten sensitivity and/or celiac disease (either as an initiating or complicating issue).  Avoiding ALL gluten and whatever cross-reactive compounds you have a sensitivity to should be 100%, immediate and permanent.  Nearly all available testing for gluten sensitivity currently is quite unreliable…so if you think you aren’t gluten sensitive you may want to seriously reconsider revisiting this though more in depth testing.  If it were me, I’d just assume an issue with gluten and avoid it like the plague.

Healing your gut is hugely important in this.  It will be impossible, btw, without generating healthy glutathione levels.

Shoot for between 80-100 ng/mL 25 OHD (vitamin D) in blood tests.

Determining whether you are TH-1 or TH-2 immune dominance would be a next important step for you.  Roughly 80-90% of all autoimmune thyroid cases do show as TH-1 dominant, however it’s important that a clear determination be made before making any assumptions.  As someone with autoimmune illness, your immune system is polarized.  Although we don’t know in which way we do know it is either TH-1 or TH-2 immune dominant. Anything you take or consume that enhances your dominant immune polarity will make you feel worse.  Examples of a few supplements known to enhance TH-1 include immuno-stimulants such as Echinacea, Astragalus, licorice root extract, lemon balm, pomegranate fruit and maitake mushroom (as just a few examples).  If you recognize any of these as something you react badly to this might be your polarity clue and you should avoid these things strictly in the future.  TH-2 supplements include things like pine bark extract, green tea extract, coffee, grape seed extract, and pycnogenol (typically, flavonoids).  Same thing.  If you have typically done well or at least OK with these TH-2 stimulants then you may want to make a point of adding these to your daily regimen as a balancing support.  If you don’t really know, then we can either test for it when I see you or focus more right now on TH-3 concerns (if you are extremely symptomatic you might not otherwise tolerate testing for TH-1/TH-2 polarity right now).

Your TH-3 immunity (T-regulatory cell) is likely consistently compromised, leaving you more prone to TH-1 and TH-2 polarity effects.
Three things that consistently support TH-3 pathways include vitamin D, omega-3 fish oil/krill oil and anything that will enhance and recycle your glutathione levels.  Note that taking straight glutathione won’t help as it does not survive the digestive process.  You must instead rely on precursors such as selenium (Brazil nuts are great for this), vitamin E (mixed tocopherols rich in gamma tocopherol, with tocotrienols in a glycerine and NOT soybean or other vegetable oil base, along with methyl donors (B12/sublingual methylcobalamin, B6, folic acid, betaine, DMG, TMG and SAMe) and sulfur containing amino acids, particularly N-acetylcysteine (NAC).

Where there is one type of antibody there are often more, as yet undiagnosed.  Poly-autoimmunity is increasingly recognized as exceedingly common.  Cyrex Labs will soon be releasing a 96 tissue antibody panel as a “predictive array” toward determining present and future autoimmune conditions you are vulnerable to.  There may be more you don’t know that could be very helpful to know.

If you want to read more about some of this go to www.thyroidbook.com and order the book by Datis Kharrazian.  You’ll thank me.

For the time being I would go on a purely anti-inflammatory diet that would include elimination of nightshades and even nuts (along with the rest of PBPM recommendations) for a time until you get inflammation under control.

Note that both TPO antibodies and anti-thyroglobulin antibodies (as well as TSH levels) can fluctuate in all directions and can fluctuate between positive and “negative” levels (high or low) throughout the course of the Hashimoto’s autoimmune condition.  Once Hashimoto’s has advanced to where more of the thyroid has been destroyed TSH levels tend to remain more chronically elevated.

Autoimmune triggers (and aggravators) can include antigen exposure (i.e., gluten, casein, soy, others), heavy metal toxicity (especially when one possesses antibodies to these substances), excess estrogen, gut inflammation and lipopolysaccharides (by product of small intestinal bacterial overgrowth/SIBO).  Additionally, chronic infections and viruses such as EBV, cytomegalovirus and measles, as well as parasitic infections can all trigger and exacerbate autoimmune processes.  With Hashimoto’s in particular there is also a strong genetic component, but the active expression of those genes would have been most influenced by epigenetic factors.  The etiology of autoimmune expression is complex.  Exacerbating and driving epigenetic influences include antigen/gluten exposure, hypoglycemia and insulin surges, estrogen surges, and stress.

Thyroid hormone supplementation in Hashimoto’s is only useful where elevated TSH is concerned, but even then is not likely to be sufficient to stave off the complex array of other symptoms which are immune related and not thyroid-specifically focused.  However, sufficient thyroid hormone is certainly necessary for repairing the gut and other key metabolic and brain-related processes.  Also, sufficient thyroid hormone is needed to dampen inflammatory cytokines and can make the autoimmune piece easier to wind down.  Conversely—if you are supplementing with too much thyroid hormone this can suppress TRH (thyrotropin-releasing hormone) which is essential to producing the peptides that actually repair the gut.  Too much thyroid hormone or too little can lead to generation or exacerbation of what is commonly termed “leaky gut”.  Careful dosing with the appropriate thyroid hormone source (if needed) is essential.  Nature-throid (containing both T3 and T4) is known to be gluten-free.  Synthetic T4 works well for some—others are sensitive to all the additives they contain.  “Synthroid” contains potential gluten sources, confectioner’s sugar and other potentially reactive compounds.  Compounding pharmacies can usually provide sources of T4 that are additive free.  This would, of course, be best discussed with your prescribing physician or a licensed natural health care provider.

There is reason to suspect that any depressed functioning thyroid might be iodine deficient (and/or bromide toxic), but haphazard supplementation can lead to adverse reactions and accelerated thyroid destruction in individuals with autoimmune thyroid.  Iodine is known to stimulate TPO (thyroid peroxidase) synthesis and you are actively producing antibodies against TPO.  Avoiding an activation of this tendency is important.  This is a complex and controversial topic and one that should be discussed and carefully understood before implementing any iodine supplementation strategies.  For now (and probably long term), it’s definitely best to avoid any iodine supplementation at all.

If you want to go about this more or less strictly from a dietary approach you can try the gluten-free/dairy-free approach combined with approximately 6-9 cups of green leafy and fibrous non-starchy vegetables per day (some of this can be juiced), a few brightly colored berries, grass-fed meat (including organ meats) and wild caught fish.  Coconut products are good, too (milk, cream and oil).

Grass-fed bovine colostrum and proline-rich polypeptides can also be combined to powerfully aid in healing of the gastrointestinal mucosa and modulate your immune function.  There is abundant peer-reviewed literature supporting this.  You can Google “Proline-Rich Polypeptides” (sometimes also called “Colostrinin”–a particular patented version) for a wealth of information about the benefits of colostrum-related therapies.

The very good news here is that there are predictably helpful things you can do to successfully modulate autoimmune issues by addressing its underlying mechanisms. SO much more is known now than even just a year or two ago.  The realm of functional management of autoimmune conditions is advancing rapidly!