Hypothyroid? You May Want to Check for Food Sensitivities

By now, you’ve likely heard about gluten intolerance. The buzz word “gluten-free” is everywhere in the health world. But how impactful is gluten? For those with thyroid issues, it may be affecting you more than you realize.

Thyroid Conditions Are Fairly Common

About 20 million Americans are currently suffering from a form of thyroid disease. And roughly 60% don’t know it. Thyroid disorders are particularly common in women with one in eight females going on to develop a thyroid condition within her lifespan, and women are five to eight times more likely to have thyroid issues than men.

Your Thyroid Can Be Under or Over Performing

A malfunctioning thyroid can lead to either over or under-production of thyroid hormones. These hormones — called T3 and T4 — affect every organ system in your body.

Your heart, central nervous system, autonomic nervous system, bone, gastro-intestinal tract and metabolism all obey the orders of our thyroid hormones.

A Holistic Approach

Whether the issue is hyperthyroidism, hypothyroidism, Grave’s disease, or Hashimoto’s thyroiditis, the symptoms of thyroid issues can vary in severity from moderate to life-changing. That’s why naturopathic practitioners take a holistic approach to tackle thyroid issues from all angles – and that includes nutrition.

The Gluten Intolerance Link

Recent research links gluten intolerance and auto-immune issues, meaning if an auto-immune condition is the underlying cause of your thyroid disorder, your relationship with gluten may be an exacerbating factor. This connection happens so often that some studies suggest gluten intolerance screening for anyone with auto-immune thyroid issues.

Auto-Immune Thyroid Issues

If you have an auto-immune thyroid issue, eliminating gluten entirely is critical to fully understanding your condition. Even eating small amounts can cause immune reactions lasting up to six months, so complete elimination is needed in order to notice any difference in your symptoms.

Gluten-free diets can be tricky to maintain, but the results are worth the trouble. Your gluten intake may be the critical factor affecting the function (or auto-destruction) of your thyroid.

How Does Gluten Lead to Autoimmunity?

When you ignore food sensitivities, your gut often pays the price in inflammation. Over time, inflammatory foods (like gluten) can degrade the delicate lining of your small intestine, leading to permeability or “leaky gut”. When this happens, food particles are able to slip past the protective mucosal layer, between the cells lining the intestinal wall, and reach your bloodstream. The protein portion of gluten — called gliadin — is a common culprit.

Mistaken Identity

The immune system targets these proteins as foreign particles and begins to attack them. Unfortunately, gliadin protein molecules are strikingly similar to the molecules that make up the thyroid gland. Once antibodies to gliadin are created, they can mistakenly attack thyroid tissue. From that point on, you have an auto-immune response to gluten.

A Gluten Intolerance Can Be Hidden

Many people misinterpret gluten intolerance as a “digestive” issue only. But it can affect far more than just the digestive system. Antibodies triggered by this kind of gluten intolerance travel throughout the whole body: the joints, skin, respiratory tract and brain can all be affected. In fact, for some people affected, no digestive symptoms are seen at all. With a wide variety of possible symptoms, gluten sensitivity may take a lot of effort to uncover.

Other Grains Can Mimic Gluten

As if the situation wasn’t complex enough, once the antibodies for gluten have been created, they can mistakenly attack other proteins too. Certain grains, such as corn, oats and rice, are naturally gluten-free yet their proteins are so similar to gluten that they occasionally still elicit an immune response. A naturopathic doctor can help you identify which foods may trigger your gluten sensitivity.

Casein Sensitivity May Also be an Issue

Lactose intolerance is much more common than gluten intolerance. However, the two often overlap. In one study in Italy, roughly 25% of people with lactose intolerance also had celiac disease, a digestive condition that is linked to gluten-related autoimmunity.

This means that for many people, going gluten-free won’t be enough to get to the root of their auto-immune symptoms. If an intolerance to casein (the main protein in dairy) may be at play, patients are often advised to adopt both a dairy-free and gluten-free diet during the elimination phase, with dairy being added back separately to assess casein sensitivity.

How We Test for Gluten Intolerance

There are multiple ways to test for food sensitivities and ascertain whether gluten intolerance may be playing a part in your thyroid issues.

Testing for Antibodies in the Blood

Running a food sensitivity panel is one way to start learning what is going on. Although they are expensive to run, and do not always lead to a clear path of action other than the complete avoidance of the foods in question, these blood tests can be vital guideposts in the dark for tricky cases.

IgA and IgG

Both IgA and IgG antibodies are tested. These antibodies are created in response to gluten particles in the bloodstream. IgA and IgG are delayed-response antibodies — they aren’t created immediately, making them a good indicator of a long term sensitivity to gluten. However, a milder case of gluten sensitivity (when antibodies haven’t been created) may be missed, and false negatives can occur if a patient is currently avoiding gluten.

Creating a Benchmark

Your naturopathic doctor may advise running a food sensitivity panel before you begin an elimination diet so that you have a benchmark to work with. While eliminating gluten and dairy are the most common requests, you may be asked to remove one or more other foods based on the results of your food sensitivity panel so that other potential problem foods don’t interfere with the success of your elimination phase.

The Gluten Challenge

Hypo-allergenic diets may be the most powerful tool a naturopathic doctor can prescribe, but no bones about it: these diets can be very difficult and take a long time. The hidden benefit is that the diet you are on during the investigation eliminates your possible triggers, so you should start to feel better right away, even as you uncover the details of your sensitivity.

Luckily, when it comes to auto-immune conditions, removing dairy and gluten are often the main dietary requirements and there are many alternative foods available.

The Elimination Phase

For anywhere from two to six weeks, depending on your individual situation, you’ll remove all dairy and gluten from your diet. During this time, you’ll keep a close eye on your symptoms to see if they resolve or reduce dramatically. If symptoms don’t resolve, you may be asked to remove additional foods: like eggs or soy.

The Challenge Phase

Once your symptoms resolve, you’ll reintroduce each food one at a time. Let’s say dairy first. You’ll have dairy in every meal for three or four days while keeping note of any symptoms or sensitivity reactions. Then you’ll be instructed to stop eating dairy for three days.

If there are no reactions during elimination or in the final phase, a dairy sensitivity can be ruled out. At that point, you can safely add dairy back into your diet.

A Positive Result

Next, you will begin the challenge phase for gluten. Let’s say you did have a symptom response to gluten. At that point, you would be instructed to eliminate gluten from your diet for another three to six months before attempting the challenge again. After a longer break, some food sensitivities are no longer as offensive.

If – on the other hand – your symptoms did return when you reintroduced gluten, your naturopathic doctor may diagnose you with gluten intolerance.

The health of your thyroid affects every cell in your body. If you suspect an autoimmune condition may be affecting how well you feel, please give us a call. As naturopathic doctors we have access to a wide array of investigative tools and lab tests to help you uncover what’s really going on – and come up with a tailored plan to help you feel like yourself again.

Resources:
Fatourechi V. Subclinical hypothyroidism: an update for primary care physicians. Mayo Clinic proceedings.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2664572/ . Published 2009.

General Information/Press Room. Published 2014. American Thyroid Association. https://www.thyroid.org/media-main/press-room/

Ojetti V; Nucera G;Migneco A; Gabrielli M; Lauritano C; Danese S; Zocco MA; Nista EC;Cammarota G;De Lorenzo A;Gasbarrini G;Gasbarrini A; High prevalence of celiac disease in patients with lactose intolerance. Digestion.https://pubmed.ncbi.nlm.nih.gov/15775678/ . Published 2005.

Shahid MA. Physiology, Thyroid Hormone. StatPearls.https://www.ncbi.nlm.nih.gov/books/NBK500006/ . Published May 18, 2020.

Bad Breath: What You Need to Know

Been smelling your own breath lately with all the mask-wearing? The harsh realities of the odors coming from our mouths have come front and center these days. Tic Tacs, mints and chewing gum… can’t fix a true breath problem.

While bad breath (also known as halitosis) isn’t often a symptom of disease per se, it can affect our overall well-being as well as our psychology, work life and relationships. So let’s look into why you (or someone you know) may be dealing with halitosis — and how to fix it!

6 Reasons You Might Have Bad Breath

There are several potential causes of bad breath. Commonly, it’s very simply down to a lack of oral hygiene which may be easy enough to fix. But sometimes there are deeper issues at play. We’ll start by exploring the more benign reasons for bad breath, then cover how and when it may be a red flag for more serious issues.

1 – You May Be Eating Pungent Foods

This will not come as a surprise, but certain foods are linked to transient oral malodor (or temporary bad breath). Garlic, onions and spicy food are common culprits. Sulphur compounds in these foods are particularly high, and when chewing, the bacteria in your saliva release these sulphur compounds from your food.

Volatile Sulphur Compounds (VSC)

Released by the mechanics of chewing and chemically by digestive enzymes, and no longer bound up in the food you ate, these volatile sulphur compounds quickly turn gaseous. Once able to mix with the air, volatile sulphur compounds (VSC) can exit your mouth via the breath.

Tobacco, coffee and alcohol may also perform this foul-smelling trick. It varies, but you may notice a change in breath odour for several hours. (And likely so will your family members, friends and co-workers…)

2 – You May Have Food Sensitivities

Food sensitivities can also contribute to halitosis – and lactose intolerance is a perfect example of this. When the body can’t digest the sugars in milk, the microbes that feast on those particular undigested sugars put off a sulphurous pungent odor that can be smelled on the breath.

Leaky Gut

Further down the system, improperly broken down food can make its way into your bloodstream. Normally, the gut lining works to prevent this. But in situations of chronic food sensitivity and ongoing inflammation, the protective mucosal lining of the digestive system becomes permeable.

Toxins in the bloodstream

Escaped food particles act as toxins in our blood. As the accumulation of toxins builds, we may start to notice symptoms that include bad breath. Your naturopathic doctor can help you identify any existing food sensitivities, work with you to restore your gut lining, and (as a welcome side effect) get rid of chronic bad breath.

3 – The Bacteria in Your Mouth May be Out of Balance

The mouth is an area rife with microbes and bacteria. Many of them play important roles in the first step of the digestive process. Others, such as gram-negative bacteria (like Enterobacteriaceae) take up residence under the tongue, in plaque and in the deep creases between our teeth and gums where they interact with each other, giving rise to halitosis.

No single bacterial species is to blame for bad breath, but together these bacteria cause Volatile Sulphur Compounds to be released. Some of the bacteria that thrive in the depths of the gum line can cause gum diseases such as pericoronitis or periodontal abscess, which can increase the volume of Volatile Sulphur Compounds released even more.

The Diamine Difference & Gum Disease

As we dive deeper under the gums, we see less oxygen and a lower (i.e. more acidic) pH. This acidic pH creates those smelly diamines. When food-trapping gum pockets arise due to gum disease, regular amino acids from the trapped food are converted into diamines.

When that happens, we (and those close to us) smell the difference.

4 – Your Mouth May Be Chronically Dry

Having a dry mouth, no matter the cause, is a serious issue. It’s not only uncomfortable but if the condition is ongoing it prevents the important cleansing function whereby saliva flushes bacteria out of the mouth.

Why We Get A Dry Mouth

Oral dryness can cause discomfort for a number of reasons beyond the obvious (and easy to rectify) dehydration. Mouth breathing is a common culprit, often arising from an obstruction of the sinuses and nasal cavity, and causing increased airflow and subsequent dryness in the mouth. Salivary glands may be infected, blocked or malfunctioning. And many medications also have a dry mouth listed among their side effects.

The Role of Saliva

Saliva is your mouth’s best friend. It helps wash out the mouth, reducing bacteria and preventing tooth decay, gum disease and plaque formation in the mouth. As oral bacteria have been found to have made their way to the arterial plaque of heart disease patients as well as causing issues in the mouth, we know that avoiding a chronically dry mouth is a whole-body problem – with bad breath acting as a red flag.

5 – You May Have a Yeast Overgrowth

If a candida yeast overgrowth appears in the mouth, deeper factors are often at play in the body. A healthy immune system prevents this fungus from taking root and growing. The candida species is commonly found in and on your body, but it seizes the opportunity to grow when the immunity is vulnerable.

In the case of bad breath, this underlying immune dysfunction alters the balance between your immune system and oral microbes. Candida and other microbes proliferate. Volatile Sulphur Compounds and methyl mercaptan (another player in the malodour scene) are then produced and released.

6 – You May have Ear, Nose and Throat Problems

While 90% of halitosis cases arise from the mouth alone, other systems can also be involved: Calcium deposits in the tonsils can cause a 10-fold increase in Volatile Sulphur Compound levels if they are overloaded; foreign bodies in the nose (often seen in children) are slowly dismantled by bacteria, resulting in breath odour; and infected sinuses can leak pus on the back of the tongue.

While bad breath is typically transient (think: morning breath) it can linger. For those dealing with chronic halitosis, you know just how impactful it can be.

But don’t worry. Your naturopathic doctor can help you battle your bad breath.

The Importance of Oral Hygiene

Oral hygiene is paramount when treating halitosis. Brushing, flossing, and regular dental check-ups are the foundation of good oral health. Unchecked cavities, gum disease and other dental pathologies must be addressed if you want to achieve better-smelling breath and the health benefits that come with it.

But it is important to remember that the mouth is a delicate area, it is the starting point of a carefully balanced digestive system which requires a fine balance of moisture and bacteria to work optimally.

Mouthwash

Gurgling with mouthwash is a powerful tool in your halitosis arsenal. Anti-bacterial agents flush unwanted microbes from the crevices of your teeth, tongue and gums. However, conventional products typically include an array of irritating ingredients as well.

Irritating Ingredients in Conventional Mouthwash

Artificial food dyes make mouthwash look good on a shelf, but these components can be detrimental to your mouth (and body). All nine FDA- approved artificial food dyes are linked to various health concerns. These range from sensitivities all the way to cancer.

Meanwhile, acidic stabilizing agents and alcohol can strip your teeth of and temporarily soften the enamel (make sure to brush before using mouthwash and not after for this reason).

A Better Way to Rinse

Herbal mouthwash is a safer (yet effective) approach. The right combination of botanicals can deliver multiple beneficial medicinal actions. Peppermint, for instance, is antimicrobial, anti-inflammatory and helps to increase salvation. A handful of herbs and essential oils can combat bad breath on multiple fronts.

Additionally, unlike the antibacterial agents found in conventional mouthwash, these herbal ingredients don’t kill as many of the good bacteria, preserving a balance.

Oil Pulling

Oil pulling – a traditional remedy originating in India – has many therapeutic benefits. An organic oil, such as coconut or sesame, is swished around in the mouth for about 20 minutes. During this period, antioxidants in the oil break down the cell walls of harmful bacteria, effectively killing them. These bacteria stick to the oil and are “pulled” out of your mouth.

There are many benefits to oil pulling. By reducing the formation of plaque, this technique can help prevent dental cavities, gingivitis, periodontitis and, of course, bad breath.

Tongue Hygiene

While odorous bacteria are often in the gums, poor tongue hygiene also poses a problem.

The back of the tongue in particular is a source of concern. Large papillae (bumps on the tongue often containing multiple taste buds) trap particles and microorganisms that lead to bad breath. A backlog of white blood cells, saliva constituents and flakes of dead cells may all be found here – even in those with otherwise good oral hygiene.

While tongue scraping gives some short term relief, recent studies show the benefit over time is minor. Cleansing your tongue (gently and regularly) won’t cause any harm. If you’re struggling with bad breath, it may be worth a shot. But remember: there are other options.

Healthy Habits To Reduce Bad Breath

For many cases of chronic bad breath, sticking to a few simple lifestyle habits can achieve great benefits:

● Reduce your sugar intake
● Check for food sensitivities (especially dairy and wheat)
● Drink plenty of water
● Practice good oral hygiene
● Eat an alkalizing diet (including raw apples and spinach)
● Increase your intake of probiotic foods
● Drink more green tea

In some cases, further investigation may be warranted. Underlying medical conditions — like sinus infections, acid reflux and diabetes — may be contributing factors to halitosis, so it is important to check in with your naturopathic doctor for the right testing and to tailor a health plan specifically for you.

Let’s face it. Chronic bad breath can put a damper on social life without you even knowing it!

Resources:

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