Hashimoto's Hypothyroidism and Oprah Winfrey
I love Oprah. My sister 'M' loves Oprah. It would be a gigantic understatement to say that all my girlfriends and co-workers love Oprah.
Now, with that said, I feel extremely, deeply saddened when I see the most well connected woman and influential/popular educator sooooo disconnected with her health and hormones. Have you been there? Unable to control your body or weight? Like a typical Oprah nut, I spent a few nights madly emailing her about year ago in Jan 2008 about vitamin D and weight loss and optimal health (and my 50# weight loss story). Where did it go? Filed in the big phat Oprah-empire round file??
Who has not been in her precise shoes?
Read about Oprah's Thyroid Club HERE (NY Times).
Hashimoto's hypothyroidism is one of the most common female (and male) afflictions of the late 20th and 21st centuries. Nearly every one of my diabetes patients has Hashimoto's.
Why are 45+ million Americans burning their Thyroid to a toast, like Oprah?
In my 20's -- stressed, eating dorm food, trying do everything 'right', instead of gaining the freshman 'fifteen', I gained F-O-R-T-Y lbs (b/c... hey... can you say overachiever?).
[Another college curiosity was observing how my hormones/ cycles/ periods became imperceptibly and immutably N*SYNC with my female dorm-mates. Mense shifts are apparently secondary to pineal gland and pheromones (link and other refs from an astute friend, thanxxx dude). Recall, pheromones are picked up by the nose- vomeronasal system and subsequent hypothalamus/limbic brain (paleopallium).]
What was going on with that college weight gain, mood fluctuations, difficult concentrating, sluggishness, coarse hair/skin, skin tag growth/insulin resistance, cold intolerance, resistance to weight loss/exercise, high cholesterol, mental fog and general feeling of clinical cr*ppiness??
I wish I knew back then...
Oprah... let's try to clue you in, my honeybun... from my sad life lessons.
For me, in hindsight, there were a few situations that may parallel Oprah's, that are backed up by the medical literature that cause thyroid dysfunction.
How to Give Yourself Hashimoto's Thyroiditis 101:
--lack of sunlight/vitamin D/indoor habitation
--more mental stress
--sleep deprivation... (excessive mochas/lattes at Berkeley cafes)
--excessive 'social' calendar
--inherent family history of autoimmune disorders (who doesn't??)
--wheat, wheat, and more wheat ingestion ('comfort foods' craved in times of high cortisol/stress, right? how did I know the carbs were killing me?)
--lack of nutritious food containing EPA DHA, vitamin A, sat fats, minerals, iodine, etc
--lack of play, exercise, movement (or ?overtraining perhaps for Oprah's case)
--weight gain -- which begins an endless self-perpetuating vicous cycle of all the above (Is it stressful to balloon out for no apparent reason? YES)
Of course, it turns out there is a hheeeyyuuggee link between sunlight/vit D/melatonin and the neuroendocrine system.
These four research groups below discuss how our Hypothalamus-Pituitary-Thyroid-Gonad Axis is tightly affected by melatonin, Thyroid Hormones, neuropeptides like brain tachykinins, and our reproductive sex steroids (Estrogen and Testosterone).
Melatonin influences on the neuroendocrine-reproductive axis.
Díaz López B, Díaz Rodríguez E, Urquijo C, Fernández Alvarez C. Ann N Y Acad Sci. 2005 Dec;1057:337-64.
The neuroendocrine-reproductive axis designates the functional activity of the hypothalamus-pituitary-gonadal axis. A delicate synchronization of many inputs at these three different levels is vital for normal reproductive function. From the median basal hypothalamus, the median eminence releases gonadotrophin releasing hormone into the portal circulation to reach the anterior pituitary gland.
Evidence for pineal gland modulation of the neuroendocrine-thyroid axis.
Vriend J. Neuroendocrinology. 1983;36(1):68-78.
Although melatonin administration has been reported to inhibit blood T4 levels in both rats and hamsters, under certain experimental conditions melatonin administration can be demonstrated to have a counter-antithyrotrophic effect resulting in increased blood levels of T4 and thyrotrophin... The effects of melatonin on the neuroendocrine-thyroid axis are similar to its effects on the neuroendocrine-gonadal axis, leading to the hypothesis of a common site of action for the thyroid and gonadal effects of melatonin.
Modulation of the hypothalamo-pituitary-gonadal axis and the pineal gland by neurokinin A, neuropeptide K and neuropeptide gamma.
Debeljuk L, Lasaga M. Peptides. 1999;20(2):285-99.
Tachykinin concentrations in the hypothalamus and pituitary are regulated by steroid hormones. In the hypothalamus, estrogens and testosterone increase tachykinin concentration. In the anterior pituitary gland, estradiol and thyroid hormones markedly depress tachykinin concentrations.
REVIEW. Melatonin and the thyroid gland.
Lewinski A, Karbownik M. Neuro Endocrinol Lett. 2002 Apr;23 Suppl 1:73-8.
The confirmation of these relations in clinical studies in humans meets numerous difficulties, resulting - among others - from the fact that, nowadays, human beings, as well as certain animal species, used in experimental studies, have been living far away from their natural and original habitat. It makes almost impossible to compare the results obtained in particular studies performed in different species, on the pineal-thyroid interrelationship. (Yes...we may be jacking up our hormones with artificial light, computer screens and TV.)
Oprah Likely Needs Vitamin D
Vitamin D ties everything together. The above two pictures come from the below research article (Sunlight--can it prevent as well as cause cancer?). The authors review: "The active form, 1.25D,, is a full member of the endocrine system, and as such interacts with virtually every organ in the body (31, 32). Especially noteworthy is its interaction with the sex and pituitary hormones (32-34), e.g.,the promotion of l-a-hydroxylation of 25D, by prolactin (34), since some of these interactions provide a mechanism for participation of 1.25D, in the control of cell growth in the reproductive organs . . . The Darwinian view of evolution suggests that loss of body hair in Homo sapiens should have some survival advantage, and it is difficult to think of reasons other than that this provides ready access of sunlight to the skin . . . lack of sufficient sunlight contributes to the known high incidence of carcinoma of the prostate in black American men and to the more aggressive progression of carcinoma of the breast in black women."
Vitamin D interacts with all the steroid nuclear receptors especially Thyroid Receptors and Vitamin A/Carotenoid Receptors (The concept of multiple vitamin D signaling pathways. Carlberg C. J Investig Dermatol Symp Proc. 1996 Apr;1(1):10-4.)
Oprah has a few risk factors for low blood vitamin D:
--stress -- our body burns up Vitamin D to maintain cellular processes under stress and infections
--wheat consumption (Stephan discusses this very well: Vitamin D and Celiac/Gluten Sensitivity) (and ?leaky gut prevent absorption of fat soluble vitamins)
--living north of the 37th latitude where UVB solar radiation (the activating wavelength for vitamin D) is scarce for 40-50% of the calendar year
Unless Oprah is receiving bio-identical hormone replacement, then her natural steroid sex hormones are likely to be 'off' and this would affect her Thyroid as well. Women from age 35 yo and up start experiencing declines in sex hormone due to the atresia (dissolving) of the eggs in the ovaries, one of the main sources of Estrogen and Testosterone. After Menopause (average age: 51 yo), nearly all the eggs are gone. Again, as the above emphasizes, the lack of significant sex hormones will profoundly affect the Hypothalamus-Pituitary-Thyroid glands.
What can help Oprah's Thyroid and take her to optimal health?
--Richard, at Free the Animal Oprah's Recipe For Failure -- And My Solution For Success, started this conversation and many of his fans chimed in.
--Scott Miller wrote:
"Here are ten quick mistakes I see her making that will sabatoge her efforts:
 Eating starches and grains.
 Eating low fat foods (like the egg whites rather than full eggs)
 Eating too often...How many omnivores in nature eat five times per day, regularly, like clockwork?
 Using fat-free dressings.
 A stunning lack of variety in salad-type vegetables (pretty much always romaine lettuce).
 Having a killer temptation like those blue chips in the house.
 Stead-pace aerobics violate the power law of human conditioning.
 And doing aerobics too often.
 Slow-twitch-fiber-only strength training.
 Strength training too often. "
Besides the paleolithic lifestyle, Oprah could use some natural neolithic bio-identical hormone replacement, starting with the big 'D':
--Vitamin D to blood [25(OH)D = 70 ng/ml] which will probably require about 8000 IU daily in the morning (Cannell doses 1000 IU per 25 lbs -- Oprah reports weight is ~200 lbs)
--Cortisol Reduction -- rest, relaxation, meditation, turn off the Crackberry
--Correct hGH Deficiency-- eat enough fat/protein, carb restrict, sleep well and enough, induce some strain/pain/gain on the muscles, food deprivation 18-36 hr 2-3x/wk
--Correct excess insulin -- stop wheat
--THYROID Replacement-- correct gradually to tolerance and mood, energy, cognition (Dr. Davis goal TSH: 1.0; Free T3: upper nl)
--Estrogen (estriol E3 primarily) -- restore to personal youthful levels prior to peri- and menopausal changes; provides cognition (our brains are FULL of estrogen-receptors), mentation/memory, skin/hair/mucuous membrane functioning, immunity, etc
--Natural Progesterone -- calms and restores all the other cycles (Avoid Provera, Levonorgestrol, which are progestins, man-made, associated with cancer and lower HDL 20-30%)
--Testosterone -- yes women need this just like men... provides confidence, vitality, well-being, affiliation, motivation, zest, in addition to libido
How to Stop the Autoimmune Process of Hashimoto's
When one of our organs is jacked how do we recover it? Can we induce our immune system to heal and restore function? Certainly! With time, appropriate nutrients and stimulus, I believe depending on the extent of the incurred damage, our bodies have the capacity to regenerate itself. With Vitamin D repletion and Wheat-Cessation, I have observed a trend of improved TSH (including my own from 1.3-1.9 to 1.0 when my 25(OH)D stays above 60 ng/ml). Why? Vitamin D interacts intimately with thyroid, vitamin A/carenoid and other steroid hormone controls, including the sex hormones.
These below nutrients and lifestyle changes have been shown to aid the Thyroid to heal and restore functionality:
-stopping wheat which triggers our immune systems: innate+humoral
-stopping wheat which triggers genetic expression of stress responses
-stopping wheat which results in rapid rises of insulin
-stopping beans, peanuts, legumes (lectins)
-stopping dairy (which contain opioid-like proteins like wheat)
-stopping grains (rice, corn, etc) -- which are all grass-derived (*ha * I didn't say WEEDS but that's what I mean)
-proper nutrients which are the building-blocks of the Thyroid Gland and Thyroid Enzymes: proteins (taurine, leucine, arginine, OKG, L-carnitine, etc), minerals (IODINE, Mg, Zn, Se, Chromium, Bo, etc)
-B-vitamins (including α-lipoic acid)
-Vitamin D3 (goal 25(OH)D=70 ng/ml)
-Vitamin E (tocopherols, tocotrienols)
-Vitamin K1 K2
-Carotenoids (grassfed meat, wild seafood, Krill oil/Astaxanthin)
-EPA + DHA (ditto) -- high dose if extreme inflammation is present
-Antioxidants (Flavonoids, CoQ10, ALCAR/α-LA, Pycnogenol, etc)
-Avoid dietary and environmental toxins (nitrite preservatives, plastic, petroleum, bisphenol, heavy metals (Lead, Mercury), endocrine disrupters, pesticides, dioxins, etc)
Hashimoto's Thyroiditis Related to Autoimmune Genes
All autoimmune conditions are related to differences in our immune system. Even Migraines are associated with a certain type of immunity variation (Prevalence of HLA DQB1*0602 allele in patients with migraine). Hashimoto's is strongly tied to HLA DR5 types, vitamin D receptor anomalies, and CYP1 alpha hydroxylase (vitamin D activation enzyme) variations. It turns out also that Addison's Disease is tied to the same Cyp enzyme variant or what is known as a polymorphism.
A promoter polymorphism of the CYP27B1 gene is associated with Addison's disease, Hashimoto's thyroiditis, Graves' disease and type 1 diabetes mellitus in Germans.
Association of vitamin D receptor gene 3'-variants with Hashimoto's thyroiditis in the Croatian population.
Vitamin D receptor gene polymorphisms are associated with risk of Hashimoto's thyroiditis in Chinese patients in Taiwan.
Vitamin D receptor genotype is associated with Addison's disease.
Vitamin D 1alpha-hydroxylase (CYP1alpha) polymorphism in Graves' disease, Hashimoto's thyroiditis and type 1 diabetes mellitus.
Vitamin D receptor gene polymorphisms in Hashimoto's thyroiditis.
[Genetic markers in thyroid autoimmune diseases]
Steve Jobs: Addison's Disease?
Via Apple headquarters, Mr. Jobs issued a statement reporting that he was receiving treatment for 'protein wasting' for what doctors believed was caused by a 'hormonal imbalance.' He states he does not have cancer. Could Mr. Jobs be suffering from the same ailment as our late great president John F Kennedy? Mr. Jobs was reported to consume a vegetarian diet which are often devoid of EPA and DHA -- protectors against autoimmune disease as well as pancreatic cancer (see below). EPA and DHA are long chain omega-3 polyunsaturated fatty acids (PUFA) which ONLY come from animal sources. EPA and DHA are like Comcast and DSL -- they provide the reliable high-spped connections for electronic conductions in our nervous systems (compare v. lame lowtech modem/omega-6). Our brain is comprised of inordinate amounts of DHA and EPA. Every cell membrane. Unfortunately humans do not induce enough of the enyzmes to convert vegetarian omega-3 ALA to EPA + DHA in our bodies. If you are not stressed, then it is unlikely to matter. ALA from vegetarian sources would sufficiently maintain health. Most people however undergo some degree of stress or oxidative damage from daily living (like...umm...breathing or... hard breathing at Crossfit or HIIT). Although Mr. Jobs apparently did not have the most aggressive form of pancreatic cancer, he had surgery a few years ago for a neuroendocrine tumor in the pancreas. Addison's may also originate from metastatic tumors to the adrenal glands.
Has Mr. Jobs been under stress? Maybe...
(1) Cancer survivor
(2) Rolled out the best neolithic tech advances of our times: iPOD, iPHONE
(3) Apple innovator/revivor/evolver
o Modulatory effects of EPA and DHA on proliferation and apoptosis of pancreatic cancer cells.
o Omega-3 fatty acids improve liver and pancreas function in postoperative cancer patients.
o Fish oil and treatment of cancer cachexia.
Do you want Pancreatic Cancer??
Consume a lotta Omega-6 refined veggie oils like Sunflower or Safflower oil
and/or develop Omega-3 Deficiency
and/or eat a lot of Fructose
and/or a USDA Whole Grain Diet:
Opposing effects of n-6 and n-3 polyunsaturated fatty acids on pancreatic cancer growth.
Effect of dietary omega-3 and omega-6 fatty acids on development of azaserine-induced preneoplastic lesions in rat pancreas.
Carcinogen-induced lesions in the rat pancreas: effects of varying levels of essential fatty acid.
Effect of dietary intake of fish oil and fish protein on the development of L-azaserine-induced preneoplastic lesions in the rat pancreas.
Dietary glycemic load, added sugars, and carbohydrates as risk factors for pancreatic cancer: the Multiethnic Cohort Study.
Dietary sugar, glycemic load, and pancreatic cancer risk in a prospective study.
Etiology of nonresponsive celiac disease: results of a systematic approach.
Aldolase C in neuroendocrine tumors: an immunohistochemical study.
Dietary fructose enhances the development of atypical acinar cell nodules in the pancreas of rats pretreated with N-nitrosomorpholine.
Hormone Imbalances and Organ Failure
Like Oprah, several hormonal imbalances can lead to organ failure due to an autoimmune process. In Addison's, the organ mainly affected is the adrenal glands which provide Cortisol and other cholesterol-derived hormones to the body. Without a minimal amount of Cortisol, we do not make muscles or store fat. Addison's leads to muscle wasting, weight loss, dizziness, and depression. Excessive Cortisol, on the other hand, causes a condition known as Cushing's where excessive abdominal weight gain, moon-face, thin-skin, muscle wasting, fatigue and insomnia occur.
Other Thyroid Sources:
- Dr. Stephen Langer MD, Berkeley physician and author Solved: The Riddle of Illness
- Dr. Mark Hyman: Thyroid Blog I and Thyroid Blog II
- Mary Shomon Resources
Hormone Balancing Resources:
- Dr. Uzzi Reiss, MD OBGYN: Natural Hormone Balance
- Dr. Michael Colgan, PhD: Hormonal Health -- Nutritional & Hormonal Strategies for Emotional Well-Being & Intellectual Longevity
- Colgan, The Sports Nutrition Guide
- Dr.Cheryle Hart, MD OBGYN: Hormones By Hart