You know the symptoms all too well – fatigue, dry skin and hair, foggy brain, muscle cramps, headaches, digestive problems, and weight gain among others. You’re sure you have thyroid issues, and now you still have to worry about your gallbladder? Unfortunately, numerous studies prove that it’s true – a low thyroid can lead to a low-functioning gallbladder as well as to the formation of gallstones. The latter often follows from a low-functioning gallbladder, but stones can also form for other reasons.
Thyroid disorder is a collective term for various conditions affecting the thyroid, a gland that regulates numerous metabolic processes. It is estimated that 12% of the total US population suffer from any of these diseases:
- Hashimoto’s Thyroiditis
- Thyroid Nodules
- Various forms of Thyroid Cancer
The most common cause of thyroid problems today is a disease called Hashimoto’s thyroiditis or chronic lymphatic thyroiditis. On top of the abovementioned symptoms, Hashimoto’s manifestations include heart palpitations, night sweats, anxiety, and dramatic weight changes. In our previous post about Hypothyroidism and Gallbladder disease, we have presented Hashimoto’s as an autoimmune disease in which the immune system mistakenly recognizes the thyroid tissue cells as foreign. The antibodies, therefore, proceed to attack and destroy them. We give special attention to Hashimoto’s because it is a popular complaint and a co-existing medical condition amongst gallbladder patients.
How Thyroid Conditions Affect the Gallbladder
Although not exactly the same, the at-risk groups for the diseases coincide. Women (especially pregnant ones), middle-aged and beyond are more prone to developing thyroid or gallbladder conditions. But aside from weakening the immune system as a whole, how exactly can thyroid diseases make a person vulnerable to developing gallbladder issues?
1. By affecting cholesterol metabolism
The thyroid is part of the endocrine system primarily responsible for normal development as well as the regulation of metabolism. Therefore, it is not surprising that disruption of thyroid function would mess up cholesterol production, digestion, and absorption. Thyroid hormone regulation and cholesterol metabolism are connected through Sterol Regulatory Element-binding Protein-2. SREBP-2 is a member of a family of transcription factors that regulate glucose metabolism, fatty acid synthesis, and cholesterol metabolism.
The changes in cholesterol metabolism depend on the specific condition of a patient. Nevertheless, all of these changes increase the risk of developing gallbladder diseases specifically gallstones. Hyperthyroidism promotes a hypermetabolic state characterized by increased energy expenditure even at rest, weight loss, reduced cholesterol levels, and gluconeogenesis. The opposite happens for patients with hypothyroidism who may suffer from hypometabolism. Hypothyroid patients usually have a notable increase in low-density lipoprotein (LDL)-cholesterol. Cholesterol supersaturation of the bile and cholesterol crystallization are two of the major factors contributing to the formation of gallstones.
2. By disrupting normal bile production, composition, and flow
Disturbances to metabolism may lead to a change in the composition of the bile. There could be too much or too little cholesterol in the body, affecting bile flow. In patients with hypothyroidism, delayed gastric emptying has been noted. This can lead to the formation of biliary sludge, gallstones, inflammation of the gallbladder, or other related diseases.
Aside from bile composition and flow, the production of bile, bile acid and enterohepatic circulation is significantly affected. One proof of this gallbladder risk is the increased canalicular bile production in hyperthyroid rats while it diminished in hypothyroid animals.
3. By causing abnormal Sphincter of Oddi, and intestinal motor function
The Sphincter of Oddi expresses thyroid hormone receptors and thyroxine has a direct relaxing effect on the sphincter. When the thyroid is not functioning well, then the motor function of SO is also disrupted. Thyroxine induces inhibition of SO contraction as shown in both animal and human experiments. This results in changes in biliary emptying which is a cause for the increased prevalence of common duct bile stone formation in hypothyroidism.
Aside from the Sphincter of Oddi, intestinal motility also becomes abnormal in thyroid patients. The transit time of food is hugely altered. Coupled with a leaky gut, low acid, and irregular GI movement, the digestive and biliary systems can really go haywire! This causes symptoms like diarrhea, constipation, malabsorption, or dyspepsia. The fact that excess thyroid hormones may cause myopathy, a condition that prohibits muscle fibers to work properly, can also be a contributing factor. This means that muscle movement starting from the esophagus down to the rectum may be gravely affected.
4. By increasing the risk of gallstones and common bile duct stones
There is a significant association between the common bile duct stones and previously diagnosed hypothyroidism. In fact, up to 11% of previously-diagnosed thyroid patients have or will experience common bile duct stones in their lifetime. This is a result of the Sphincter of Oddi malfunction.
Gallstones, on the other hand, may be a consequence of a few things – disruption in cholesterol metabolism, decreased bile flow and biliary sludge formation, and the effect of thyroxine on our body. An animal experiment, it showed that high doses of thyroxine may induce the formation of gallbladder stones. Despite the research studies on the project, however, the role of thyroid diseases with respect to gallstone formation still needs further investigation.
Can Hashimoto’s and other Thyroid Diseases be Cured?
This question cannot be answered by a simple yes and no given the breadth of thyroid diseases. As the American Thyroid Association puts it, all thyroid diseases can be treated to achieve normal thyroid function. However, it might mean a lifetime of therapy or medication.
Conditions like thyroid cancer can be solved through surgery and radioactive iodine treatments but even as it is “solved”, the curative treatment may result in hypothyroidism. In cases like Graves’ diseases, hypothyroidism, hypothyroidism, and Hashimoto’s which involve autoimmunity, some treatment options can restore thyroid function and keep symptoms at bay. But at the end of the day, the anti-thyroid antibodies remain.
When talking about autoimmune and thyroid diseases, you may come across the term “remission”. It is the state of absence of disease activity in patients with chronic conditions. At this stage, the patient has addressed all the underlying triggers and has done the necessary lifestyle and dietary changes. This is an ideal goal or stage for anyone with Hashimoto’s since it means that the gut is healthy, nutrients are absorbed properly, and the patient is in a pretty stable status.
Be Wary of False Negatives
Up to 90% of Hashimoto patients have thyroid peroxidase (TPO) antibodies and/or thyroglobulin (TG) antibodies. Yet, there can be cases where people with full-blown Hashimoto’s do not test positive for thyroid antibodies. This is known as the seronegative Hashimoto’s. Similarly, the opposite can happen – just as you are feeling better through a new health regimen or some supplements, you can suddenly test positive. Sadly, some practitioners who do not have enough experience with autoimmune diseases may interpret it as “curing” thyroid disease. On the other hand, some may take it as a cue to “wait and see”.
To be cured means that a person’s immune system must finally be able to recognize the thyroid tissue and stop considering it as an invader. Unfortunately, no medical intervention can entirely stop this autoimmune process. The reason for a false negative, as mentioned in my previous post, is that like any autoimmune disease, it comes and goes in expressing itself. It may be more active or less active at different times. It is also possible that the immune system is so down that the body cannot even make the antibodies.
When this happens to you, it is best to take a second test. If your doctor doesn’t know about this or if you are not asked to make dietary and lifestyle changes, rather asked to “just wait and see”, you may want to consider working with a different practitioner.
How to Manage Hashimoto’s and Other Thyroid Diseases Naturally
1. Avoid triggers
Exposure to chemicals, stress, toxic and illnesses can mess up the body’s natural rhythm, the gut’s ability to function and trigger the creation of antibodies.
2. Watch your diet
Avoid gluten, fast foods and too much added sugar. Food allergens and unhealthy choices may aggravate leaky gut, cause inflammation, and make the immune system go overdrive.
Detoxification and cleansing on a regular basis help in lowering inflammation and improving overall body function.
4. Heal the gut
As we know, the gut plays a crucial role in a lot of diseases. When you have a leaky gut, holes in the lining of your intestines become larger, making it vulnerable to infection, infiltration, and inflammation. The Gallbladder Menu can be a guide for what you can and cannot eat.
Of course, natural supplements always help. Below is a guide for your must-haves in managing thyroid health.
- Vitamin D – We have dedicated a full blog entry on the Benefits of Vitamin D. And we are putting this first again because research has shown that about 90% of patients suffering from thyroid disorders are also deficient in Vitamin D! The best source of this vitamin is still daily sun exposure but making sure you have a daily dose will go a long way. For best results, get D3 infused with vitamin K2 for optimum absorption. D3 K2 Mulsion – Vitamin D and K2 Combination (available on Amazon) provides 2000 IUs of vitamin D3 and 180 mcg of K2 (MK7) in 10 drops.
- Selenium – This mineral is crucial for normal thyroid function and iodine recycling. It helps regulate thyroid production, supports the conversion of thyroxine to T3 – a form which the cells can use, and it also protects the thyroid tissues from stress.
- HCl and Digestive enzymes – Aside from being low on Vitamin D and Iodine, patients with Hashimoto’s and thyroidism often have low stomach acid as well. This is why more than 50% of thyroid patients also have SIBO. Parasites and bacterial overgrowth cannot be controlled, food is not efficiently digested, and nutrients are not absorbed. By supplementing with Betaine HCL and Digestive Enzymes, you can improve gut health significantly.
- Probiotics – A digestive flora with the right amount of good bacteria, is a healthy gut. Reinoculating with probiotics will help repair the GI lining, reduce inflammation, and eventually help the thyroid with its function.
- Glutathione – We have done a lengthy enumeration of the anti-aging benefits of glutathione. But the bottom line is that glutathione is an effective supplement because it is such a powerful antioxidant.
- Adaptogen – Last but not least, including Adaptogen into your daily regimen if you are struggling with thyroid issues is a decision you won’t regret. It has been proven that adaptogenic herbs help reduce thyroid and adrenal concerns by balancing hormones and improving the body’s way of coping with stress.
Abrams, J. J., & Grundy, S. M. (1981). Cholesterol metabolism in hypothyroidism and hyperthyroidism in man. Journal of lipid research, 22(2), 323-338.
Inkinen, J., Sand, J., & Nordback, I. (2000). Association between common bile duct stones and treated hypothyroidism. Hepato-gastroenterology, 47(34), 919-921.
J. Laukkarinen, J. Sand, R. Saaristo, J. Salmi, V. Turjanmaa, P. Vehkalahti, I. Nordback (2002) Is bile flow reduced in patients with hypothyroidism?, Surgery, Volume 133, Issue 3, 2003, Pages 288-293, ISSN 0039-6060,
Laukkarinen, J., Kööbi, P., Kalliovalkama, J., Sand, J., Mattila, J., Turjanmaa, V., … & Nordback, I. (2002). Bile flow to the duodenum is reduced in hypothyreosis and enhanced in hyperthyreosis. Neurogastroenterology & Motility, 14(2), 183-188.
Laukkarinen, J., Sand, J., Saaristo, R., Salmi, J., Turjanmaa, V., Vehkalahti, P., & Nordback, I. (2003). Is bile flow reduced in patients with hypothyroidism?. Surgery, 133(3), 288-293.
Layden, T. J., & Boyer, J. L. (1976). The effect of thyroid hormone on bile salt-independent bile flow and Na+, K+-ATPase activity in liver plasma membranes enriched in bile canaliculi. The Journal of clinical investigation, 57(4), 1009-1018.
Mullur, R., Liu, Y. Y., & Brent, G. A. (2014). Thyroid hormone regulation of metabolism. Physiological reviews, 94(2), 355-382.
Shin, D. J., & Osborne, T. F. (2003). Thyroid hormone regulation and cholesterol metabolism are connected through Sterol Regulatory Element Binding Protein-2 (SREBP-2). Journal of Biological Chemistry.
Völzke, H., Robinson, D. M., & John, U. (2005). Association between thyroid function and gallstone disease. World Journal of Gastroenterology: WJG, 11(35), 5530.