I am constantly working on my theory of the cause of Graves’ Disease and hyperthyroidism. Scientific theories have to be able to account for all the observations and to be strong enough to be able to generate testable hypotheses. Following is my current theory and I think it’s really good, but as with all scientific theories, this one may change, become more refined, or get discarded. Time will tell.
There are many observations about hyperthyroidism that can be seen as clues to the cause of this disease. Not only are these clues useful for finding the causes, but any theory of hyperthyroidism must account for these observations.
Here are some of these observations:
1. Between 8 and 9 times as many women get hyperthyroidism (Graves’ Disease) as men.
2. Persons who smoke tobacco have a much higher risk of developing this disease.
3. Persons who smoke tobacco have a much higher risk of developing ophthalmopathy or thyroid eye disease (TED) which is associated with Graves’ Disease. However TED has been demonstrated not to be caused by high levels of thyroid hormones.
4. RAI (radioiodine therapy for hyperthyroidism) often initiates or increases the severity of TED, while treatment by antithyroid drugs does not.
5. Cats and dogs also get hyperthyroidism (usually not Graves Disease, meaning no immune system involvement), while most other animal species rarely display this disease.
6. Certain people, especially those of Asian descent, may develop hypokalemic paralysis, in which the muscles become impermeable to potassium and paralysis results.
To understand thyroid disease I have formed theories of nutrition that I haven’t seen anywhere in print.
There seem to be four classes of nutrients: minerals, vitamins, proteins, and lipids (fats). All of these nutrients are essential for biochemical processes to take place in the body. A deficiency of any one of these can slow down metabolic processes.
Of the four classes of nutrients, minerals are the most long lasting in the body. Vitamins, proteins, and lipids move through the body on a daily basis, but the body conserves minerals because of their importance.
Because of this long-lasting character of minerals, when a long-term or chronic condition such as a thyroid disease occurs, then the first suspicion must be of a mineral deficiency.
Vitamins are essential to facilitate mineral metabolism and proteins and lipids combine with minerals to form the essential biological chemicals that the body needs. A vitamin, protein, or lipid deficiency can result in a mineral deficiency. To correct a mineral deficiency causes by a vitamin, protein, or lipid deficiency, not only must the vitamin, protein, or lipid be replenished, but the mineral must be also.
Because of the interaction of minerals, vitamins, proteins, and lipids, supplying the body with less than all four of these can result in deficiencies of the others. For example, we know that selenium is facilitated by vitamin E. Taking excessive amounts of supplemental vitamin E without also taking selenium can result in the body becoming deficient in selenium.
Likewise copper metabolism is facilitated by vitamin C. Taking excessive amounts of vitamin C without also supplementing copper can deplete the body of copper. Replenishing the copper requires some, but not an excessive amount of vitamin C. It also requires the presence of all the other nutrients necessary for copper metabolism.
Also taking excessive amounts of one mineral can deplete other minerals. Here is an example I’ve seen in several people. Hemoglobin production requires two key minerals, iron and copper, along with many vitamins, proteins, and lipids. A deficiency of iron will cause iron-deficiency anemia. A deficiency of copper will cause copper-deficiency anemia. Both minerals are necessary.
If a person takes an excessive amount of iron without copper, copper will become deficient and the person will become anemic. Many people go to a doctor and are found anemic. Usually the doctor will prescribe massive doses of iron, sometimes as much as 200 milligrams per day (about 15 mgs. per day is adequate). Then the doctor is surprised because the anemia doesn’t go away. If this iron supplementation is continued then copper becomes so deficient that the person will develop a thyroid disease.
Each vitamin facilitates the metabolism of one or more minerals. The B complex vitamins are very important in facilitating the metabolism of the trace minerals that are essential for bodily functions. Taking excessive amounts of B complex vitamins without an adequate supply of minerals can result in mineral deficiencies.
Because of the interactive effects between minerals, it is essential to keep minerals supplied in the proper balance. Likewise, it is essential to supply vitamins such as the B complex vitamins in the proper balance. Many nutritional experts warn about the problems that can result from taking some B vitamins without the others. They urge people to take a balanced B complex rather than individual B vitamins.
Taking individual B vitamins in unbalanced amounts causes problems because it disrupts the underlying mineral balance. Thus you can get a mineral unbalance in two ways: by ingesting minerals that aren’t balanced and by ingesting vitamins that are unbalanced.
Supplementing vitamins and minerals is a powerful tool, but it is double-edged: you can quickly correct a nutritional deficiency with the use of supplements, but you can also quickly disrupt the balance of minerals.
As you will see later, I believe that hyperthyroidism is caused by an imbalance of minerals in the body. Some minerals are depleted and this causes major problems. Taking any one of a long list of nutrients can further deplete these deficient minerals and make hyperthyroidism worse. This is what most hyperthyroidism sufferers experience: most nutritional supplements make them worse.
Besides nutritional supplements we have to consider heavy metal toxicity. It appears to me that the danger from heavy metal toxicity is twofold: first, heavy metals replace and deplete essential metals from biological processes by mineral competition; and second, heavy metals are especially problematic because of their long half-life in the body. It seems that the heavier the metal the longer is stays in the body and the less it takes to cause disruption to nutrient balance.
Cadmium is a particularly toxic metal especially for the thyroid. Later we will look at how cadmium toxicity depletes zinc and copper and causes both hypothyroidism and hyperthyroidism.
This is a short introduction to my theories of the basic nutritional processes underlying deficiency diseases. The basic idea to remember is that nutrients need to be balanced and imbalances can cause further imbalances. Ingestion of imbalanced amounts of nutrients or toxic metals can disrupt the balance of nutrients required for proper health and endocrine function.
Nutritional Cause of Thyroid Disease
Thyroid disease is characterized by some big observations and any theory about the cause of thyroid disease must account for these observations. The biggest observation is that thyroid diseases are primarily diseases of women. Nearly 90% of all thyroid disease occurs in women.
The other big observation is that smoking greatly increases the probability of getting Graves’ disease and also of getting thyroid eye disease (TED). The theory must account for these observations.
Thyroid disease results from a disruption of the endocrine and immune systems. The endocrine system and the immune systems are often talked about as separate systems, but they are so interrelated that many people refer to it as one system, the immuno-endocrine system. However, it’s useful to talk about separate endocrine and immune systems for illustrative purposes.
Nutritional deficiencies cause a disruption of both endocrine and immune functions. The endocrine and immune systems are so closely related because their functions rely upon the same essential nutrients. If a nutrient is deficient which causes the endocrine system to be disrupted, then the immune system will also likely be disrupted.
While thyroid diseases sometimes occur without immune involvement, most cases of thyroid disease are thought to the result of immune system dysfunction. These are the autoimmune thyroid diseases, Graves’ Disease and Hashimoto’s Thyroiditis. For example, some people may have what is called primary hypothyroidism which is the result of the lack of an essential mineral such as iodine. However, in most cases of hypothyroidism, immune dysfunction is seen.
Autoimmune diseases are a class of diseases that primarily affect the endocrine system (thyroid diseases, diabetes, adrenal diseases, etc.) and the skin, nerves, and connective tissue (lupus, vitiligo, myasthenia gravis, multiple sclerosis, etc.).
The most interesting clue about the cause or etiology of autoimmune diseases is found in who primarily gets them: women in their child-bearing years, that is from the onset of menstruation at around age 13 to onset of menopause at age 40-50. Women outside this age bracket and men can get autoimmune disease, but it’s much less common.
If the greatest risk factor for autoimmune disease is being a female in the child-bearing years, then what could be the cause for this risk. As far as I can see there is only one reason for this increased risk: estrogen. Estrogen is the one thing which is increased in women in this age bracket.
My theory of the cause of thyroid disease including autoimmune thyroid disease is that it is caused by nutrient deficiencies, primarily of essential trace minerals. However, as I stated above, any good theory must account for all the observed facts. The biggest observed fact in thyroid disease is that it primarily affects women. About 90% of the people who suffer from thyroid disease are women. This is a huge factor.
Role of Estrogen in Thyroid Disease
Estrogen plays a key role in my theory of thyroid disease. However, I don’t see estrogen as a cause of thyroid disease. I see estrogen as an accelerator of the nutritional imbalances that underlie thyroid disease. Let me explain.
First, however, let me add that estrogen is not one hormone, but three: estradiol, estrone, and estriol. Most studies on estrogen use estradiol, which has the most biological function. I use the term estrogen so you’ll know what I’m talking about, but the term estradiol is more accurate.
One of the most fascinating studies that I’ve run across was performed studying cadmium toxicity in rats. I believe that cadmium is principle player in the etiology of thyroid disease, but again, not the real cause.
While being female is the largest risk factor for developing thyroid disease, the second largest risk factor that has been identified, especially for hyperthyroidism, is smoking tobacco.
While many chemicals present in tobacco smoke have been identified which affect thyroid function, I believe that the most important ingredient of tobacco smoke which affects the thyroid is the heavy metal cadmium.
Cadmium is one of the most potent and long-lasting toxic metals known. Cadmium has been shown to kill animals at a concentration lower than any other commonly occurring toxic metal. Cadmium has been demonstrated to damage thyroid cells and this damage can be viewed in in vitro studies of thyroid cells in a culture.
Now to get back to our experimental studies of cadmium toxicity in rats. In this study, both female and male rats were castrated, thereby eliminating the bulk of production of the sex hormones, estrogen and testosterone. In this way estrogen and testosterone administered and the observed effects can be attributed to the administered hormones.
Both the castrated male and castrated female rats were given cadmium labeled with radioactive cadmium. Half of the cadmium administered rats were injected with estrogen and half with testosterone. The course of the cadmium in the body was then able to be followed because it was radioactively labeled.
The amazing result was that estrogen caused the cadmium to be incorporated into and retained by the body, while testosterone caused the cadmium to be excreted from the body. This is extremely significant and to me represents the key to understanding why 90% of the people with thyroid disease are female.
I’ve been thinking for a long time about this result. For a while I thought that females and males had different mechanisms for dealing with toxic metals. In males, testosterone protected the body by causing the rapid excretion of toxic metals into the blood stream and out of the body via urine and the bile system. In females, however, this strategy could have disastrous results because the female might be pregnant. If the toxic metals were put into circulation to be excreted, they would travel in the blood to the fetus and cause the fetus to be possibly damaged.
Now, however, I’ve come up with a different hypothesis, one that I like much better. What estrogen might be doing is causing the female body to absorb and store trace elements. This could be very valuable because the female needs to have a good store of these scarce trace elements in order to pass along a good amount to the offspring. A baby probably needs a good store of essential trace elements to protect it for years from running out. Also, because females lose significant amounts of blood each month during menstruation, and thereby lose essential trace elements like iron and copper, having a hormone like estrogen which increases the accumulation of trace elements would be very advantageous.
How could estrogen act as an accelerator of mineral accumulation in the body? Perhaps estrogen triggers the production of proteins which bind and store minerals in the body. There is a protein called metallothionein which performs this function in the body. Perhaps estrogen stimulates the body to manufacture more of this or a similar protein.
When I first started studying the effects of the hormones, estrogen and its antagonist, progesterone, on thyroid function it appeared that estrogen caused the body to slow thyroid function like copper does and progesterone caused the body to increase thyroid function, like zinc.
However, this theory was challenged more than once by women who reported that taking supplemental estrogen caused their hyperthyroidism to worsen. I tried to ignore these observations because they didn’t fit into this theory. Now however, these observations make sense.
If estrogen is an accelerator of mineral uptake into the body, it can have opposite effects. Zinc accelerates thyroidal function and copper slows it down. When copper gets deficient, the thyroid produces excessive hormone and hyperthyroidism results. The balance of zinc and copper is important in maintaining normal thyroid function and the proper ratio seems to be about 5:1 for females and 10:1 or higher for males.
If the diet has a zinc/copper ratio which is too high, which is pretty much characteristic of some diets, estrogen can have an accelerative effect of causing this zn/cu imbalance in the body to get too high and causing hyperthyroidism. If the zinc/copper ratio is too low, then estrogen can have the opposite effect, of causing the body to incorporate too much copper and not enough zinc and thereby slowing the thyroid too much. This may be the most prevalent situation since there are more people with hypothyroidism than hyperthyroidism.
The important thing about estrogen is that it probably does not affect the thyroid itself, but only has thyroidal
effects because it influences mineral uptake. Taking estrogen will not cause the correction of thyroid disease but can facilitate correction if the proper minerals in the proper ratios are taken.
Thinking of estrogen as an accelerator of body accumulation of minerals, both essential and toxic, can also shed light on the controversial results seen from consuming foods with estrogen-like substances like tofu. Many reports indicate that tofu promotes hypothyroidism while others report that it promotes hyperthyroidism. If tofu is eaten with a diet high in cadmium, such as from eating large amounts of green leafy vegetables or from smoking, then the estrogen-like substances could accelerate the body’s uptake of cadmium, leading to hyperthyroidism or TED. However, if tofu is consumed along with a diet high in beans and nuts (high in copper), the copper intake could be accelerated and hypothyroidism could result. Tofu is also high in phytates which bind zinc, increasing the possibility of hypothyroidism.
Also, estrogen probably increases the retention of all minerals. Another observation is that females suffer from the effects of mercury toxicity from silver amalgam dental fillings at a much higher rate than males. This is probably another effect of estrogen acting as an accelerator of mercury uptake into the body.
Mercury is one of the metals that cause hypothyroidism since it is a direct antagonist to selenium. Selenium deficiency is known to cause hypothyroidism and goiter and selenium is the trace element that is essential to form the deiodinase enzymes which convert T4 (the hormone our thyroid gland makes) into T3 (the hormone our cells use).
Since many people have mercury dental fillings, those people with high estrogen (women in child-bearing years or supplementing with estrogen) will more likely suffer from hypothyroidism as a result of mercury toxicity from dental fillings.
Cadmium is interesting because the body takes it up and transports it to other places in the body, suggesting that it may be an essential trace element important for certain functions in the body. While it’s difficult to think that our bodies might get a cadmium deficiency, it may happen.
Smoking is also an interesting habit. I’ve often perceived smoking as an antidote to a high-meat diet. Vegetarian smokers are very rare. There seems to be some evidence that this perception might be correct.
Cadmium is directly below zinc in the Periodic Table of Elements. This proximity seems to be the reason that cadmium is a direct zinc antagonist. Cadmium will cause the depletion of zinc. Most meat is high in zinc and low in copper. The effect of a high zinc and low copper intake is that the thyroid increases production and the person gets a little hyper. Smokers report that smoking helps them to relax and perhaps the way this happens is by cadmium in the smoke displacing the zinc and thereby preventing a zinc-induced increase in thyroidal function. This is probably the reason smokers report that their favorite time to smoke is immediately after a high-meat (high-zinc) meal. Another time smokers can’t resist smoking is when drinking beer. Beer is a fairly good source of copper which causes relaxation. Cadmium is also an antagonist of copper (not as strong as of zinc) and this could mean that smoking while drinking can prevent the copper from causing drowsiness.
If you ever want to see the effect of zinc on the metabolic rate, take a large amount of zinc just before you go to bed. I’ve done this several times by mistake and spent the night very restless. This is the reason I always take zinc at breakfast so that I get the energy in the day when I need it and not at night when I don’t want it. And likewise, if you want to relax at night, copper will help.