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Christine Maren D.O., and Dr. Christine Maren, PLLC are not affiliated with The Health And Wellness Business Association (HAWBA)

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This week we’ve been talking about the thyroid-g

This week we’ve been talking about the thyroid-gut connection. If you’re just tuning in be sure to check out the other posts...⁠
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The thyroid has numerous connections to intestinal function, including altered motility (see previous posts). To bring it full circle, altered motility is a setup for constipation, but also bacterial overgrowth, which is one reason for the strong association between hypothyroidism and SIBO.⁠
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Does any of this sound familiar? If you’re having lights go on all over the place about your unresolved digestive and/or thyroid symptoms, here are some of the tests I recommend to my patients:⁠
1️⃣ A full thyroid panel, which includes TSH, free T4, free T3, as well as Thyroglobulin (TG) and Thyroid Peroxidase (TPO) antibodies.⁠ Reverse T3 is nice to have as well, but not a deal breaker.⁠
2️⃣ Complete Blood Count (CBC) and Iron Panel to check for anemia and iron levels.⁠
3️⃣ Nutrient testing for zinc, selenium, Vitamin D, Vitamin A, and some of the B vitamins.⁠
4️⃣ Iodine testing can be helpful as well, though cumbersome, since a 24 hr urine iodine is most accurate.⁠
5️⃣ Organic Acids Test (aka: OAT), a urine test which screens for a variety of factors including nutrient levels and fungal overgrowth or dysbiosis.⁠
6️⃣ GI Map, a stool test that screens for a number of intestinal pathogens, as well as other markers for intestinal health like enzyme function and fat malabsorption.⁠
7️⃣ SIBO breath test, which measures hydrogen or methane gas produced by overgrowth of bacteria in the small intestines.⁠
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Have you worked with a functional medicine doctor and looked at some of these labs? Were they helpful / did they provide insight into treatment?⁠

If you want to understand the three root causes be

If you want to understand the three root causes behind Hashimoto’s and other autoimmune diseases, read this article at https://drchristinemaren.com/articles/ (🔗 in bio). You’ll learn about the interplay between⁠
1️⃣Genetics⁠
2️⃣Environment⁠
3️⃣Gut health⁠
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Until recently, genetics and environment were the main two recognized causes of autoimmunity; but they didn’t really explain the entire picture.⁠
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Check out the article to find out my full functional medicine approach to Hashimoto's and hypothyroidism!

We're diving super deep into the thyroid + gut con

We're diving super deep into the thyroid + gut connection, so let’s continue by exploring how the thyroid affects the gut and entire gastrointestinal/digestive system.⁠
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As you probably remember from grade school biology, digestion begins in your mouth with the production of enzyme-rich saliva which initiates the breakdown of food, specifically starches. So, it’s really important to have enough saliva production to get this process started off right. ⁠
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However, research has shown that a significant amount of people with autoimmune thyroid disease, such as Hashimoto’s, lack adequate amounts of saliva and experience “dry mouth”. This is due in part to the over-production of pro-inflammatory cytokines which hinder normal production of saliva.⁠
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Your thyroid also plays an important role in production of stomach acid which can result in symptoms like reflux, nutrient deficiencies, and other digestive ailments like SIBO (small intestinal bacterial overgrowth) and SIFO (small intestinal fungal overgrowth).⁠
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Studies also show the link between atrophic gastritis and autoimmune thyroid disease.⁠
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But there’s more! ⁠
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There are other organs that play a crucial role in the proper assimilation, break down, and absorption of macro and micronutrients which are also impacted by thyroid health.⁠
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For example, your liver produces enzymes and bile essential to digestion and assimilation of proteins, sugars, and fats (read yesterday’s post for more details on this one). ⁠
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The liver/ gallbladder also works hard to metabolize toxins (like pesticides or heavy metals), alcohol, and control the amount of glucose released into your bloodstream.⁠
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However, your liver and gallbladder cannot function optimally without (you guessed it!) a healthy thyroid, and research has shown the liver is the organ most affected by hyper - and hypothyroidism.⁠
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So, an unhealthy thyroid ➡️ can contribute to liver and gallbladder dysfunction ➡️ which hampers optimal digestion ➡️ and contributes to nutrient malabsorption ➡️ and affects T4/T3 conversion ➡️ which in turn is a set up for bacterial overgrowth... ⁠
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Tag someone below who needs this info!⁠

What do you know about low T3 and the importance o

What do you know about low T3 and the importance of peripheral conversion between T4 to active T3? And what does gut health have to do with it?⁠
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Some people have persistent thyroid symptoms because of low T3... how does this work? Check back on yesterday’s post for a primer...⁠
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The success of this process is also largely dependent on the production of primary bile acids in your gallbladder.⁠
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These primary bile acids are secreted from the gallbladder into your small intestine following the consumption of fats, where gut bacteria metabolize them into what’s known as “secondary bile acids.”⁠
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Secondary bile acids increase the activity of the iodothyronine deiodinase enzymes (the enzymes which play a central role in the conversion of T4 to active T3.)⁠
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These bile acids are dependent upon the mineral selenium, which is often depleted in patients with gut and thyroid health issues.⁠
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And hypothyroidism itself has also been shown to impede bile flow from the gallbladder which further affects T4/T3 conversion.⁠
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This bile is also naturally antimicrobial, which may further explain the connection between thyroid disease and specific bacterial gut infections, like SIBO (scroll back a few posts for that one).⁠
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It really is a vicious cycle...⁠
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What questions do you have? I can't give specific medical advice on IG, but I've got tons of resources to help you on this journey.⁠
⁠
PMID: 32545596⁠
https://doi.org/10.1016/j.mce.2017.01.053⁠
PMID: 32545596⁠
https://doi.org/10.1038/nature04330⁠
PMID: 8427195⁠
PMID: 12660641

The composition of our gut bacteria, referred to a

The composition of our gut bacteria, referred to as our gut microbiome, affects our body’s ability to assimilate and absorb key micronutrients such as:⁠
✔️iodine⁠
✔️selenium⁠
✔️zinc⁠
✔️iron⁠
✔️B-vitamins⁠
✔️vitamin A⁠
✔️and tyrosine⁠
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All of which are essential to healthy thyroid function and are common micronutrient deficiencies seen in those with autoimmune thyroid disease like Hashimoto’s.⁠
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Although not fully understood, gut microbiota also influence the conversion of T4 to T3---T3 being the active form of thyroid hormone.⁠
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It is hypothesized that the intestines and gut microbiota influence the activity of iodothyronine deiodinase enzymes which play a central role in the conversion of T4 to active T3.⁠
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At least in part this is attributed to the influence of gut microbiota on the availability of micronutrients like selenium and zinc which are needed for converting T4 to T3.⁠
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But it likely goes further than that and we don’t fully understand the activity of the gut microbiome, which itself is thought to be an endocrine organ.⁠
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This is by no means an exhaustive review of all the ways the thyroid impacts the gut, but it further validates the connection between the two systems.⁠
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Have you noticed a connection between gut and thyroid health?⁠
⁠
PMID: 32545596⁠
https://doi.org/10.1016/j.mce.2017.01.053⁠
PMID: 32545596⁠
https://doi.org/10.1038/nature04330⁠
PMID: 8427195⁠
PMID: 12660641

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