In this post, I talk about the connection between thyroid and gut health. Bloating, indigestion, and constipation can be caused by a slow thyroid function (hypothyroid). Low stomach enzymes or acid, gut infections, leaky gut, and dysbiosis can lead to hypothyroid issues (both production and activation of thyroid hormones and autoimmune thyroid issue, Hashimoto’s).
One of the things I do and passionate about is connecting the dots. Earlier this week, I was talking to someone on the phone. She has had hypothyroidism (low thyroid hormone) for 7 years and struggling with weight loss, fatigue, and figuring out what to eat to support her thyroid health.
Now, anytime someone tells me they have low or slow thyroid function; I always ask about the gut…
- Do you have indigestion?
- Does it feel that food sits in your stomach like a rock after you eat, even when you don’t eat too much?
- Do you have bloating?
- Do you have acid reflux or heartburn?
- Do you have constipation?
I ALWAYS get a yes for at least one of those, if not more.
It makes me look like some sort of psychic predicting or forecasting their symptoms. While that would be cool, I really don’t have super natural powers. You’ll see as you continue reading or watch the video thatit’s just common sense.
Unfortunately, conventional doctors do not always connect the two. The conventional medical model is that each doctor focuses on their specialty. Your endocrinologist won’t ask you about your gut, and your gastroenterologist won’t bother with your thyroid.
How Does your Thyroid Affect your Gut
Your thyroid gland is like your car’s gas pedal. When cruising properly, you feel great, have energy, burn enough calories to be in a healthy weight, your body is at a good temperature, your cells are getting repaired properly, and so forth.
Everything is great. Life is amazing.
When the thyroid is off, it feels like you hit so hard the brake pedal. Sometimes, it feels like you have one foot on the gas and the other the brake, fluctuating between highs and lows (that can be a sign of Hashimoto’s).
Eventually you run out of steam.
The thyroid gland produces 2 thyroid hormones, 90% T4 and 10% T3. Outside of your thyroid, T4 has to be converted to T3 as T3 is the active form, the one that your cells sense. T3 is the thyroid hormone that lights up every cell of your body. Your cells have a receptor (a lock) for T3 (the key), and it turns things on.
(I talk more about thyroid health here)
Most people know that slow thyroid reduces metabolism and makes you gain weight. But it controls so much more! When you don’t have enough T3, when your cells can’t “see” the T3 you have, or when you have too much of another hormone called reverse T3 (it’s the villain anti-hormone), then many functions slow down:
- You can’t use energy from your food so you feel tired.
- Your body doesn’t generate enough heat so you always feel cold, especially your hands and feet.
- Your hair, nails, and skin don’t regenerate, so they feel brittle, dry, and rusty. You lose hair and doesn’t grow long.
- Your nerves don’t fire up properly, so you may feel brain fog or have difficulty focusing or making decisions quickly.
- The muscle movement that pushes food down the digestive track is slow and weak. And that will disrupt digestion and have a ripple effect on the rest of the gut.
If food can’t exit the stomach fast enough, it will cause heartburn and acid reflux. If you feel bloated or too full even with a small amount of food, or if your stomach feels like a rock, it’s because food is not being broken down and digested properly.
People with hypothyroidism tend to have low stomach acid. I talked about stomach acid in episode 4. When you don’t have enough acid, your stomach enzymes don’t work properly. You can’t digest food properly, and you end up with stomach pain and feeling bloated especially after protein foods. You also end up with nutrient deficiencies. Magnesium is one of those minerals you may have a problem absorbing, and magnesium deficiency is one of the top causes of constipation (watch episode 7 for more info on constipation).
Slow gut motility means bacteria and other microbes have a lot of time to ferment the food you’re eating. More fermentation means bloating, stomach pain, acid reflux, and also diarrhea and constipation. Bacteria fermenting your food, instead of your body absorbing it, leads to more gut inflammation, dysbiosis, SIBO, and leaky gut.
Slow gut motility by itself causes constipation. There’s not enough speed or force to push waste down. Your gut is weak and slow. It takes about 33 to 47 hours for food to pass in the stool from the time you eat. Men are typically closer to 33 hours and women closer to 47 hours. Eat some beets or blueberries and watch the color of your stool to find out how long it takes food to become waste. This is a simple way to see how fast your gut muscle contractions are.
How Does Gut Inflammation Affect your Thyroid?
Remember that your thyroid gland produces 2 types of thyroid hormone: 90% T4 and 10% T3. T3 is the active form (the key), the one that every cell in your body has a receptor (the lock) to and will use. T4 must be converted to T3 for your body to function properly.
Problems in your gut will prevent you from absorbing nutrients that are key to thyroid function and production. When you lack enzymes and stomach acid (from using acid suppressing meds for example), have gut inflammation (from eating sugary fermentable foods), or have gut dysbiosis (from antibiotic use or catching a bug), you’re not going to absorb important vitamins and minerals that your thyroid needs to produce T4 and T3 and to convert T4 to T4. These include magnesium, zinc, selenium, iron, B vitamins, and amino acids.
Problems with absorption also mean that you’re not absorbing your thyroid medication properly, which may one of the reasons you keep needing higher and higher doses to stay afloat.
Gut dysbiosis, chronic gut infections (yeast, H Pylori, SIBO), leaky gut, and food sensitivities are all physiological stress that make your body convert LESS T4 to T3. In this type of stress situation, your body needs to preserve energy for survival. It slows down T3 conversion so you don’t burn calories or refresh your hair! In fact, more of T4 gets converted to the villain reverseT3, which blocks your cells from using the active T3.
Gut dysbiosis interferes directly with the activation of T3. Healthy gut bacteria produce an enzyme called intestinal sulfatase that is responsible for conversing 20% of the inactive T4 in your body to the activeT3.
Leaky gut fires up the immune system and may result in an autoimmune attack on the thyroid (Hashimoto’s). Eighty percent of your immune cells are in the gut, waiting for a foreign invader to attack. When you have leaky gut, more foreign substances pass through the gut barrier and activate the immune system. Over time, the immune cells get out of control and start attacking your own cells, leading to autoimmune conditions. Most of hypothyroid cases are auto-immune, known as Hashimoto’s, where the immune cells attack the thyroid gland. It tries to keep up and produce more and more T4 and T3 to keep their level up, eventually, it gives up and wears out.
What Went Bad First, the Gut or the Thyroid?
The answer is different for each person.
In some cases, the thyroid slows down due to stress, adrenal fatigue, unhealthy diet, genetic predisposition, or any other conditions. And then digestive issues start to show up.
In other people, they started with gut problem like getting food poisoning, taking too many acid suppressing meds, or having to take antibiotics for too long, and then that lead to thyroid-related disruptions.
When I work with my patients, I completely analyze and assess their situation and medical history, to see which one came first. This helps me put a plan to support the thyroid and heal the gut. That also includes proper testing for thyroid hormones and antibodies, gut dysbiosis, leaky gut, gut infections, food sensitivities, and nutrient deficiencies.
When you’re ready to connect the dots so you can fix both your thyroid and your gut so you eliminated your bloating, constipation, weight loss, fatigue, and other related symptoms, I’d love for us to talk. Go to www.nourzibdeh.com/getstarted/ and schedule a time so you can figure out what’s holding you back from your best gut and thyroid health.