Part 1 of 2 (Part
by Mary J. Shomon
Drs. Richard and Karilee Shames, Authors
of the new book Thyroid
Power, Look at the Mind-Body Aspect of Autoimmune Hypothyroidism
I reviewed the new book Thyroid Power,
and believe that one of the strongest chapters is Richard
and Karilee Shames' discussion of mind-body aspects of autoimmune
hypothyroidism. Their interesting theories about autoimmune
hypothyroidism offer some interesting ideas that may resonate
with some thyroid patients. Mary also wrote an excellent
review of their book.
Most people have a vague sense that the immune system is involved
with thyroid illness. Some even know that the brain is involved
with immune function. Can you explain briefly that important
It turns out that the cause of virtually all cases of low
thyroid is not so much a faulty thyroid gland, as it is an
over-zealous immune system.
As strange as it might seem, common low thyroid is a mild
immune system illness in which the
immune system wrongly attacks the innocent thyroid gland.
The illness is called Hashimoto's Thyroiditis
in honor of the Japanese doctor who first identified it.
Of course, there are other kinds of thyroid
problems: infections, injuries, benign nodules, and cancer,
for instance. But, most simple low thyroid disease is immune-caused.
Normally, the immune system is poised
and waiting to defend the body against foreign invaders such
as virus or bacteria. Part of this job involves constant search-and-destroy
missions by certain white blood cells. These neutrophils and
monocytes are always in motion, hunting down a hiding germ
or cleaning up cellular debris. On a good day, they can even
direct a killer lymphocyte into eliminating a previously normal
body cell that has recently turned cancerous.
All this normal immune function is, of
course, to our benefit. We live in a veritable sea of bacteria
and other creepy-crawlies that are nicely held at bay by this
relentless vigilant system. However, some of us pay a price
for this pervasive vigilance.
warning and for no good reason, our immune system can sometimes
start attacking our normal cells and tissues.
It is clearly a mistake for the body to
be attacking itself, but it does happen. The name for this
seemingly bizarre event is autoimmune illness. Once thought
to be rare, it is now known to be surprisingly common.
For the moment, let us say that recent
research is suggesting runaway environmental pollutants, among
others, as likely culprits.
These deleterious influences appear to
be assaulting our sensitive and delicately balanced immune
systems, causing mixed messages within the body. Some of the
new chemicals our immune system tries to fend off are hormone
mimics. Others are hormone blockers. Still others are immune
disrupters. Many of the thousands of these new chemicals dumped
into the environment are simply low-level poisons.
In a desperate attempt to ward off an
apparent assault from all sides, our confused antibodies are
increasingly attacking our own glands and hormones. No one
knows the exact mechanism, but the results are becoming obvious.
There is compelling recent information that bacterial infection
might be involved in the underlying cause of triggering the
autoimmune effect. What are your thoughts about this?
Yes, in fact you reported in your newsletter that there has
been an interesting research study in Greece regarding the
bacteria Yersinia Enterocolitica. The researchers in the Journal
of Clinical Microbiology and Infection reported that the prevalance
of antibodies to this bacteria was fourteen times higher in
people with Hashimoto's Thyroiditis than in the control groups.
They concluded that there
is strong evidence for an immunopathic causative relationship
between this bacteria and Hashimoto's.
This is just one further example of what
we are calling the multifactorial theory of Hashimoto's Thyroiditis
etiology. In other words, various non-chemical factors might
be combining with the chemical siege to cause our immune systems
to make antibodies against our own thyroid glands.
If you have a family history of low thyroid,
diabetes, or other rheumatic/autoimmune illness, then almost
any serious physical or mental stress might trigger the primed
immune system into mischievous action against the thyroid,
one of its favorite body targets.
Thus, the cause of low thyroid disease
may be viewed as multi-factorial, just as heart disease is
multi-factorial. A person may have multiple
risk factors, each of which can add to that individual's
likelihood of acquiring the syndrome. Most people know that
the risk factors combining to yield heart disease include
family history, smoking, high blood pressure, high blood fats,
stress, lack of exercise, and high levels of homocysteine.
Other than genetics and chemicals, are
there other risk factors that could account for the energy
epidemic that grips us? Could radiation,
for example, be another cause? We know how deleterious this
can be on sensitive immune balance. With the depletion of
the ozone layer, our exposure to the sun's ultraviolet radiation
Not only is the neck a likely place to
receive much of this added new radiation, but the thyroid
gland is particularly sensitive to it. Even more directly
sensitizing to the delicate thyroid is the increased irrigation
of food crops with brackish water containing significant amounts
of radioactive iodine 131. This potentially toxic isotope
is known to head straight for the thyroid gland and become
One non-chemical immune irritant on the
increase is intestinal parasites.
Once thought to be a problem confined to third world populations,
a wide variety of mild parasitic conditions now affect the
average city dweller in the United States.
Sometimes, without causing any particular
distress, their presence is like a thorn in the side of the
immune system, which makes increased levels of antibody against
them. Increased antibody production against the parasites
has a subtle way of spilling over into increased antibody
production against the thyroid.
Still another possibly suspicious trend
on the increase is the widespread fluoridation
of municipal water supplies. This well-intended activity has
been so widely accepted in today's society that it is shocking
to read the mounting research casting doubt on its safety.
The short-range goal of reducing tooth
decay seems to have blinded many to the long-range risks to
sensitive immune balance posed by fluoridation. We discuss
this in Thyroid Power.
stress of daily life may be as big a factor in
thyroid disease as it is in heart disease. Anxiety and depression
are known to have deleterious effects on immune balance. Also,
the increasingly rapid pace of life may leave little time
for immune-restoring activities like aerobic exercise, muscle
building, or slow stretching. Keep in mind that what is disruptive
to the immune system now, may be disruptive to a thyroid gland
How are these causative factors related to the mind-body connection?
Although it was once thought that the immune system functioned
fairly autonomously, it is now known that this body system
is in constant two-way dialogue with the brain. The control
centers in the brain are continually feeding information to
the immune system, and the immune system is continuously feeding
information back to the brain. Our emotions, our stress level,
and the very fabric of our inner life are directly related
to the quality of this brain-immune conversation.
Current medical science does not provide
easy solutions for people with autoimmune low energy. It is
not simply that the underlying reason for the low energy is
missed, though this is often the case.
when the problem is diagnosed properly, the treatment frequently
In autoimmune conditions, the whole body
is involved, rather than just the organ that has been attacked.
The damaged organ, in this case the thyroid, is referred to
as the "target-organ." This is medical lingo for
the part that displays the symptoms of the total body autoimmune
situation. Interventions are generally directed only at the
target-organ, and not the source of the problem, which is
the entire immune system.
People need to know that taking hormones
and vitamins for autoimmune low thyroid is similar to taking
nose drops or eye drops for hay fever. The drops can
help the symptoms, but
can never fully address the root cause of the problem.
Thyroid doctors do not generally address
the immune system problem because almost every standard medicine
in the conventional medical arsenal is ineffective for autoimmunity.
Recently developed immune-boosting medicines are not appropriate
when the immune system is already in autoimmune overdrive.
Even the new immune-modulator drugs like
Paxone and Avonex are not used for thyroiditis. Unfortunately,
doctors simply do not have a pill to prescribe that will directly
reduce the autoimmune component of low thyroid.
However, many non-drug approaches offer
substantial promise. Before using them, you first need a clear
sense of what is causing your particular version of the illness.
Do you feel then, that stress and emotions might be an autoimmune
trigger in the same way that chemical pollution and/or Yersinia
bacteria are autoimmune triggers?
Yes. The triggering of the autoimmune phenomenon resulting
in common low thyroid (Hashimoto's Autoimmune Thyroiditis)
is indeed possible from stress alone.
The tendency for the autoimmune reaction
is in part genetic. There is presently no way to do much about
that, except to choose your ancestors more carefully! We can,
however, learn ways to reduce the factors that trigger the
autoimmune tendency into a full-blown autoimmune attack.
One trigger is
age. Some people's internal time clock goes off,
and their autoimmune thyroiditis gets triggered. This can
occur at any age, for no apparent reason, without another
precipitating event. On the other hand, some women's thyroiditis
is triggered by fluctuations in their female hormone levels,
specifically at the unsettled times of puberty or menopause.
Other women find that the end
of pregnancy is a trigger. This response is named
post-partum thyroiditis. Many women who are diagnosed with
postpartum depression, or postpartum low energy, actually
have autoimmune inflammation of the thyroid gland.
Other triggers that have been described
range from accidents, operations, and severe infections, to
bulimia, crash dieting, and major changes in lifestyle. A
few of our patients suffered from specific trauma to the neck
(especially whiplash), which apparently triggered their long-term
Scientists believe that the antibody inflammation
gets started secondary to cell destruction from some other
mechanism. This other mechanism can cause irritation and damage
to the thyroid cells through the effects of outside chemicals,
free radicals, food allergy, and perhaps other irritants.
It is even possible for severe
stress alone to be a trigger. This should not be
totally surprising, when considering the number of documented
incidents in which stress has been shown to affect immune
function. It may be part of the genetic makeup of certain
individuals to be anxious and worried, which in itself predisposes
them to this kind of triggering effect.
Fortunately, this is one genetic tendency
where intervention has been successful. You might not be able
to change your genetic makeup, but you can learn to be less
stressed by life events, reducing the likelihood of triggering
further autoimmune difficulty.
In fact, keeping your mental state in
optimal health will reduce the likelihood that Yersinia, chemical
pollution, and perhaps a host of other external factors will
be able to trigger you into thyroiditis.
Stress does affect your immune function.
It is certainly known and accepted in medical circles that
severe stress can trigger hyperthyroidism, and perhaps Hashimoto's
thyroiditis. The exact causal mechanism for this is not clear,
but it is tempting to speculate.
Shomon: So what does
it mean to handle extra stress properly?
We've all heard about stress-reduction activities. When you
are going through difficult situations, this is definitely
the time to utilize any stress-reduction training you've had.
You could choose meditation, self-hypnosis, or specific relaxation
exercises from biofeedback or yoga. It is certainly the time
to begin getting some exercise or to increase your exercise
program, if you already have one. Ideally, you would initiate
such a stress-reduction program before you were in the midst
of big changes.
This could also be a good time for increased
interactions with friends, or a time for some counseling
sessions with a professional. Many people have found that
biofeedback sessions can be very useful during stressful times.
The act of quieting the mind using meditation techniques helps
relieve the biochemical difficulties caused by the stress.
A combination of several of these techniques
is known as imagery. Imagery involves imagining yourself in
a relaxing locale. It's like a mental vacation. In addition,
you can "see" a positive outcome to a problematic
situation, or can mentally envision your world getting better.
Some call the process "visualization",
but we find that people are very diverse in the ways they
perceive. Instead we use "imagery", as imagination
can take many forms, including sensations, smells, and feelings.
What practical things would you suggest someone with autoimmune
hypothyroidism can start doing right now in their path toward
For sufferers of autoimmune thyroiditis, why not visualize
your immune system getting smarter, and leaving your thyroid
alone? Just imagine it getting the point that its best job
will be to protect you from outside invaders, like bacteria
and viruses. Picture it leaving your glandular system, especially
your thyroid, completely free to do its job, unencumbered.
The medical field specializing in the
mind's effect on immunity is called psycho neuroimmunology.
Its practitioners and researchers tell us that the brain is
constantly talking to the immune system, and that the immune
system constantly provides vital information to the brain.
Knowing this, you might therefore want
to employ the above, or similar, imagery exercises on a regular
basis. You might also want to consider more advanced forms
of self-hypnosis and enhanced affirmation strategies. Our
own books on this topic are Healing With Mind Power and Creative
Imagery in Nursing.
I find it interesting to consider how being more mentally
in control of the immune system might enable patients to better
cope with their autoimmune thyroid problems. But are there
specific practical things to focus on?
That is certainly a fair question.
Here are some of our best tips for doing exactly that, based
upon over 20 years of clinical experience each, both with
thyroid individuals and thyroid recovery groups.