Glutathione and Thyroid Autoimmunity
Published November 27 2017
The autoimmune thyroid conditions Graves’ Disease and Hashimoto’s Thyroiditis involve damage to the cells of the thyroid gland. Think of it as a war. There is a one-sided war going on between your immune system and thyroid gland, and the battlefield is wrought with damaged or dead tissue and cells. We want to clean up this battleground, repair the war zone, get rid of the bad guys that contributed to the condition in the first place, and glutathione can be a key player to tipping the scales in your favor. In this article I’ll discuss why a glutathione deficiency is common, some of the methods of testing for a glutathione deficiency, and how to increase glutathione levels through diet and supplementation.
What Exactly Is Glutathione?
It probably is best to start off by briefly discussing what glutathione is. Glutathione is a master antioxidant which neutralizes and scavenges free radicals, detoxifies harmful compounds from the body, promotes cellular repair, and it is used in DNA synthesis and repair. Glutathione is made and recycled mainly in the liver, but it is found in every cell in the body.
Glutathione is a tri-peptide, and due to the sulfur groups it consists of, glutathione is actually sticky. It travels around the body like a Swiffer mop, and it sticks to all the bad things floating around in your body. Not only does glutathione mop up the battleground in your thyroid gland, but glutathione is everywhere else in your body, sticking to harmful chemicals, and eliminating them before they can do further damage to your thyroid. In more scientific terms, glutathione helps to protect the thyroid cells from oxidative damage from free radicals.
In addition, glutathione maintains healthy cellular mitochondria, and it has been found that damaged mitochondria is a big factor in many different health conditions. When dealing with glutathione levels and thyroid autoimmunity, studies show that thyroid disease involves oxidative damage systemically, and it especially affects the mitochondrial membranes (1) (2).
Another thing that is fascinating about glutathione is that it knows exactly what to do when it arrives on the scene of the battle. It has diverse effects on the immune system because it either stimulates it or inhibits the immunological response in order to control inflammation (3). That is a very smart molecule.
What Causes Glutathione To Be Depleted?
There are numerous factors that can cause a glutathione deficiency, and here are five common ones:
1) Environmental toxins. This includes pesticides, herbicides, heavy metals, and even mycotoxins.
2) Acetaminophen. This depletes glutathione in the liver very quickly, and is a common cause of liver toxicity, and in some cases can cause liver failure.
3) Other prescription and over the counter drugs. In addition to acetaminophen, other medications can have a negative effect on glutathione levels, including NSAIDS (4) and statins (5).
4) Alcohol. Not surprisingly, drinking alcohol on a regular basis can cause or contribute to a glutathione deficiency (6) (7).
5) Nutrient deficiencies. Since certain nutrients are essential for glutathione formation, it makes sense that being deficient in one or more of these can lead to lower glutathione levels. For example, being deficient in one of the amino acids necessary for the formation of glutathione can lead to low glutathione levels. In addition, since selenium is a cofactor of glutathione, having a selenium deficiency is likely to lead to a glutathione deficiency.
Glutathione and Thyroid Autoimmunity
There are a few studies which show the relationship between glutathione and thyroid autoimmunity. One cross-sectional study looked at glutathione status and the activities of its recycling enzymes in 44 females with Hashimoto’s Thyroiditis (8). The study demonstrated a substantial reduction in glutathione status in those people with Hashimoto’s. The authors also concluded that decreased glutathione is a major factor in the development of oxidative stress and the loss of immune tolerance in Hashimoto’s.
And for those who have Graves’ Disease, the research shows that this condition is also characterized by increased oxidative stress and that increased free radicals might be responsible for some symptoms and signs of hyperthyroidism (9). The study goes onto say that antioxidant treatment may improve some of the clinical manifestations of hyperthyroidism. In other words, taking antioxidants such as glutathione can help to decrease the hyperthyroid symptoms. Since selenium is a cofactor of glutathione it shouldn’t be surprising that studies show that selenium can specifically be helpful in the treatment of Graves’ Disease (10).
Glutathione and Thyroid Eye Disease
Some of my patients with Graves’ Disease have thyroid eye disease, which is also known as Graves’ ophthalmopathy. And the research shows that in Graves’ ophthalmopathy patients, glutathione levels are significantly diminished in tissue samples, which supports the value of antioxidant treatment such as glutathione supplementation (11). In other words, if you have thyroid eye disease then it is a good idea to do things to increase glutathione levels, which I’ll discuss in greater detail towards the end of this article.
Which Environmental Toxins Does Glutathione Remove From The Body?
There are many different environmental factors that can be potential autoimmune triggers for those with Grave’s Disease and Hashimoto’s Thyroiditis. Let’s go ahead and take a look at some of the more common harmful substances that are effectively removed by glutathione:
Phthalates and Parabens. These are two of the most widespread and commonly found group of chemicals in our environment. They are typically found in many bath and beauty products such as shampoos and conditioners, cosmetics and perfumes, and they are also found in pharmaceuticals and insect repellants. They can also be found in adhesives, inks, and varnishes. Phthalates have been found to increase the risk of allergic diseases such as asthma and eczema (12). They have also been associated with a number of serious health problems, including infertility, testicular dysgenesis, obesity, asthma, and allergies, as well as leiomyomas and breast cancer (13). I always recommend to read labels and look for products that are phthalate and paraben-free.
Benzene. These and other volatile organic compounds (VOCs) are carcinogenic substances present in products and industry (14). You can find benzene and other VOCs in paint, gasoline, glues, detergents, motor vehicle exhaust, burning coal and oil, and dry cleaning. Benzene is an extremely toxic chemical that is mutagenic and carcinogenic.
Pesticides & Herbicides. 2,4-D is a very common pesticide that was a part of Agent Orange, which was used by the United States in the Vietnam War. These types of pesticides are commonly applied to genetically modified crops, and used as a weed killer for lawns. 2,4-D is a known endocrine disruptor, and can block hormone distribution and cause glandular breakdown (15). Glyphosate is the active ingredient in the herbicide Roundup, and besides recently being classified by the World Health Organization as a probable carcinogen, the research does show that it can cause oxidative stress (16). I have written an article you might want to check out entitled “Does Glyphosate Have A Negative Effect On Thyroid Health?”
Flame Retardants. Flame retardants are endocrine-disrupting compounds that are used to inhibit the production of flames. Not only are they included in products such as furniture, but in clothing as well, such as children’s pajamas (17). You heard me right, some children’s pajamas are soaked in flame retardants. Next time you are visiting a Target or an Old Navy, take a look at some of the children’s pajamas. They come with a large warning tag stating that they are treated to be fire-resistant. This means they are soaked in toxic chemicals in the very remote off-chance that children will be engulfed in flames in their sleep. Avoid pajamas with these tags. There are other, less-toxic choices out there. New furniture is also commonly treated with flame retardants, so make sure to research your furniture prior to purchasing.
PCB’s. Polychlorinated biphenyls are a group of industrial chemicals which were banned in the United States in 1979 because of their known adverse effects on human health. They are still found in the environment however, and the most common cause of exposure is eating contaminated fish. PCBs are shown to upset the balance of thyroid hormones (18).
Fluoride. This harmful chemical is of course added to the water supply and is commonly found in toothpastes. Fluoride can potentially cause hypothyroidism (19), and it can lead to other health issues as well. In the past, hyperthyroid patients were treated with fluoride to lower their thyroid hormone levels. If you are already hypothyroid, fluoride could potentially make your condition worse. I recommend for those with hyperthyroidism and hypothyroidism (along with everyone else) to avoid fluoride.
Heavy metals. These include lead, cadmium, mercury, arsenic, and aluminum, and are all toxic to your health and should be avoided, and removed if exposure has already occurred. Common exposure avenues for these are environmental. For example, arsenic is commonly found in pesticides, and even certain foods such as brown rice. Other heavy metals including aluminum and mercury are found in some vaccines, although many people still have mercury amalgams. Aluminum in particular can lead to permanent negative alterations of the brain and immune function.
Although I can’t say that I do a lot of testing for environmental toxins on my patients, there are a few tests that can evaluate the presence of certain chemicals. For example, hair testing or provoked urine testing are two tests commonly used by natural healthcare practitioners to determine heavy metal exposure. There is also a relatively new test from Great Plains Laboratory called the GPL-TOX, which will reveal non-metal chemical & toxic offenders.
Testing For Glutathione Levels
I don’t typically test for glutathione levels, as there isn’t a reliable test that most people can easily get. If a patient does want to test their glutathione levels, it’s important to note that glutathione testing is not common or mainstream. It is also not 100% reliable because the glutathione levels in the body fluctuate throughout the day and in response to exposure to toxins.
But with that being said, let’s look at some of the different ways of measuring glutathione:
Glutathione blood tests. Both Labcorp and Quest Diagnostics offer a test to measure total glutathione, and while this does have some value, normal levels don’t rule out a glutathione deficiency. RBC glutathione is probably a better way of measuring intracellular levels, although even this isn’t a perfect test.
Gamma glutamyltransferase (GGT). GGT is the enzyme that breaks down glutathione from the blood to allow it’s importation into the cells. This is one marker that I do commonly recommend to my patients, as it can be tested in the blood through most labs, and if this marker is elevated there is usually a deficiency in glutathione. However, normal levels don’t rule out a glutathione deficiency. The research shows that high GGT levels can help to predict the future development of metabolic syndrome (20), and can also lead to an increased risk of developing cancer (21).
Genova Diagnostics Oxidative Stress Analysis 2.0 test. This blood test measures a number of antioxidants including glutathione, antioxidant enzymes, and cellular damage as well.
Organic Acids testing. A few different companies offer organic acids testing, which is tested through the urine, and this can give an idea as to whether someone has decreased glutathione production. For example, the company Great Plains Laboratory has a couple of glutathione markers called Pyroglutamic and 2-Hydroxybutyric. If either of these are elevated then this can be a sign of a glutathione deficiency.
Selenium. Since selenium is a cofactor for glutathione production, if someone has a selenium deficiency there is a pretty good chance that they also are deficient in glutathione. Unfortunately there isn’t a perfect test for measuring selenium levels, although I utilize both hair mineral analysis testing and RBC selenium in my practice.
How To Increase Glutathione Levels
Now that you know how important glutathione is and some methods of determining if you have healthy glutathione levels, let’s talk about how you can raise your glutathione levels.
Eat sulfur-rich foods. This includes garlic, onions, and cruciferous vegetables such as broccoli, cabbage and cauliflower. Some people are concerned about the goitrogenic properties of cruciferous vegetables, but most people do fine with a few servings of these on a daily basis. I spoke more about this in an article entitled “An Update on Goitrogenic Foods and Their Impact on Thyroid Health”. It’s also worth mentioning that some people are sulfur sensitive, and therefore won’t be able to tolerate foods that are high in sulfur, as well as certain supplements that are high in sulfur, including N-acetylcysteine.
Green leafy vegetables such as spinach, kale, collard greens, and parsley are sources of glutathione.
Nondenatured whey protein isolate. A pilot study showed that whey protein isolate improved outcomes for psoriasis patients by increasing glutathione levels (22). Make sure to get the nondenatured protein isolate or bioactive whey, and always aim to buy a product that is high quality, and preferably made from grass-fed animals. Whey is a product that is derived from dairy, so if you are avoiding dairy you may want to avoid whey as well.
Exercise. While there is evidence that exercise can help to increase glutathione levels (23), we also need to keep in mind that physical exercise can cause oxidative stress, and studies show that taking NAC and alpha-lipoic acid can play a role in maintaining healthy glutathione levels upon exercising (24).
Coffee enemas. Various alternative protocols such as the Gerson Method utilize coffee enemas for their natural ability to detoxify the liver. Coffee enemas enter the portal vein of the liver and stimulate it to produce more bile which is essential in the proper elimination of toxins. And while coffee itself has antioxidants and might actually help to increase glutathione levels, some question whether coffee enemas actually increase intracellular glutathione levels. In fact, one study I came across that looked at the antioxidant effects after single and multiple doses of a coffee enema found that serum glutathione levels weren’t increased (25). Of course this is a single study involving only eleven participants, and one also needs to consider that many healthcare practitioners have successfully used coffee enemas to help their patients.
Glutathione Injections. A common dosage is 600 mg given one time per day.
Intravenous Glutathione Therapy. A common dosage is 2-3 grams per infusion, done by a medical professional. This is a very fast and effective way of quickly raising glutathione levels in the body for those who are severely ill. There are clinics all over the United States that specialize in IV therapy. In our area of Charlotte, NC there are a few facilities which provide IV therapy to patients. There are no referrals needed, as nurses are on staff doing IV drips all day. They do a number of different types of drips, such as high-dose vitamin C, and the Meyer’s Cocktail. They even have drips tailored to alcohol drinkers who want to alleviate their hangovers the next day.
For those who don’t have access to injections or IV drips, supplements are the next best thing to raise glutathione levels, and they are widely available at health food stores and on the internet.
Supplements That Can Increase Glutathione Levels
N-acetylcysteine (NAC). This is a precursor of glutathione, meaning your body converts the substance into glutathione and it tends to be less expensive than glutathione supplements as well, which makes it very popular among my patients. Even mainstream medicine is aware of NAC’s detoxifying abilities, as it is commonly used to treat an overdose of Acetaminophen in hospitals. However, in this case extremely high doses of NAC are recommended, while most natural healthcare professionals recommend between 600 and 1,800 mg/day to their patients.
Acetylated glutathione. I commonly recommended this form of glutathione, which involves the acetyl groups binding to sulfur atoms. This protects glutathione from being broken down within the digestive tract and means more is used by the body.
Liposomal glutathione. A liposome is a tiny phospholipid vesicle, and they help the reduced glutathione to be better absorbed.
L-Glutathione & Reduced Glutathione. These are composed of a single glutathione molecule with the addition of a sulfhydryl group.
Selenium. Selenium supplementation may increase enzymatic antioxidant activity, and the FDA has recently determined that there is sufficient evidence to warrant a qualified health claim for selenium and cancer. The selenoenzyme families of glutathione peroxidases possess powerful antioxidant properties and form a complex defense system that protects the thyroid from oxidative damage (26). Increasing selenium levels can help support the thyroid and it has the added bonus of increasing glutathione levels in the body.
Lactobacillus fermentum ME-3. I recently learned about this strain of bacteria from Ross Pelton, who is a pharmacist who presented at a nutritional conference I attended. Lactobacillus fermentum ME-3 was discovered by Dr. Marika Mikelsaar, and there is research showing that it can increase glutathione levels (27) (28).
Vitamins C and E. These vitamins work together to recycle glutathione.
Milk Thistle (Silymarin). This herb helps to increase glutathione levels and is useful for cleansing, protecting and regenerating the liver. With regards to thyroid health, the liver plays an important role in converting thyroxine (T4) to triiodothyronine (T3). The liver also plays a role in the deactivation of thyroid hormone, along with the transport of thyroid hormone. As a result, problems with the liver are likely to lead to problems with thyroid health.
Alpha lipoic acid. This is a fatty acid found inside all of the cells of the body, and it has the potential to recycle glutathione. Numerous studies show that alpha lipoic acid can reduce proinflammatory cytokines such as TNF-alpha, while downregulating NFkB. There is also evidence that alpha lipoic acid can suppress the number of Th17 cells, while increasing the number of regulatory T cells.
In summary, we know that autoimmune thyroid conditions involve damage to thyroid tissue. For those with Graves’ Disease and Hashimoto’s Thyroiditis, we want to minimize this damage, clean up prior damage and destruction, and we want to support the detoxification of the chemicals we’re exposed to – which very well could have contributed to the condition in the first place. In the war on your thyroid, increasing your glutathione levels could very well tip the scales in your favor.