There are numerous factors that can trigger an autoimmune response, and lead to the development of a condition such as Graves’ Disease and Hashimoto’s Thyroidits. Infections are one of these factors, and in this blog post I am going to discuss four specific gut infections that can lead to the development of an autoimmune thyroid condition. While there are other infections that can trigger thyroid autoimmunity, the ones I will be discussing are some of the more common ones.
If you’re wondering how infections can cause an autoimmune thyroid condition, I spoke about this in greater detail in a past article I wrote on viruses and thyroid autoimmunity [1]. In this article I discussed three different mechanisms in which an infection can ultimately lead to a condition such as Graves’ Disease or Hashimoto’s Thyroiditis. I realize that most people reading this won’t be interested in learning these mechanisms, but for those who are interested I’d check out this article.
Speaking of viruses, for those wondering why I don’t talk about certain viruses in this blog post such as Epstein Barr, the reason is because I’m focusing specifically on gut infections. However, I should mention that certain viruses can affect the health of the gastrointestinal tract as well. In fact, although Epstein Barr isn’t considered to be a “gut infection”, this virus can affect the gastrointestinal tract. In addition, cytomegalovirus and herpes simplex virus can potentially cause ulcerative disease of the gastrointestinal tract (1) [2].
With that being said, let’s go ahead and discuss these four gut infections:
1. Yersinia enterocolitica. Yersinia enterocolitica is a gram negative bacteria that is a common cause of human gastroenteritis (2) [3]. Some of the common symptoms include diarrhea, abdominal pain, fever, and sometimes vomiting (3) [4]. Complications are rare and can include a skin rash, joint pain, or the spreading of bacteria to the bloodstream (4) [5]. As for how this bacteria is transmitted, the most common method is by eating contaminated food, such as raw or undercooked pork, although sometimes drinking contaminated milk or water can be a cause. A few studies show a correlation between this pathogenic bacteria and thyroid autoimmunity (5) [6] (6) [7] (7) [8].
How Is Yersinia Enterocolitica Detected?
An infection of this pathogen is usually diagnosed through the stool, although the antibodies can be tested through the blood.
Treatment For Yersinia Enterocolitica
The conventional medical approach usually involves prescription antibiotics. These are usually effective, although the obvious downside is that these antibiotics also eradicate beneficial bacteria as well. Natural agents which can be effective against Yersinia include oregano oil, berberine, and garlic.
2. Helicobacter Pylori. Helicobacter pylori is a gram-negative bacteria that infects the stomachs of humans, and it is associated with peptic ulcer disease, gastric carcinoma, and gastric lymphoma (8) [9]. Keep in mind that while some people will experience symptoms such as heartburn, indigestion, and nausea, the absence of symptoms doesn’t rule out H. Pylori. As for how it is transmitted, the most common method is the oral-oral route (i.e. kissing), and the fecal-oral route (i.e. contaminated water) (9) [10]. A few studies show a correlation between H. Pylori and thyroid autoimmunity (10) [11] (11) [12].
How Is An H. Pylori Infection Diagnosed?
H. Pylori can be tested for through the blood, saliva, stool, and through a urea breath test. Blood and saliva testing measure the H. Pylori antibodies, while stool testing and the urea breath test can detect the actual presence of this bacteria. If someone has recently tested positive for H. Pylori then the antibodies can remain detectable for months after eradication, and as a result they should test for H. Pylori through the stool or the breath test.
Treatment for H. Pylori
Conventional treatment usually involves triple therapy consisting of two antibiotics and a proton-pump inhibitor (12) [13]. Sometimes quadruple therapy is used, as this also involves bismuth, a heavy metal that has antimicrobial activity against H. Pylori (12) [13]. With regards to natural treatment methods, a few studies show that mastic gum can eradicate H. Pylori (13) [14] (14) [15], and this is something I have used in my practice. Other natural agents I have used include berberine, black cumin seed, garlic, and matula tea. H. Pylori can form biofilms [16], and N-acetylcysteine [16] (NAC) can be an effective biofilm disruptor in those with an H. Pylori infection (15) [17] (16) [18].
3. Blastocystis hominis. Blastocystis hominis is an enteric parasite [19], and some of the symptoms commonly associated with Blastocystis hominis include abdominal pain, pruritus, flatulence, malaise, anorexia and diarrhea (17) [20]. How Blastocystis is transmitted is not known for certain, although a fecal-oral route through contaminated food or water is the most likely cause (18) [21].
In the past there has been some controversy over whether this is a harmful parasite, or if it is commensal. But more recently it has been recognized that this is indeed a pathogenic parasite, and in addition to increasing proinflammatory cytokines, Blastocystis hominis can also cause a leaky gut [22], which is a factor in autoimmune conditions such as Graves’ Disease and Hashimoto’s Thyroiditis. With regards to thyroid autoimmunity, there is one case report that shows that someone with Hashimoto’s went into remission upon eradicating Blastocystis hominis (19) [23]. Of course this is only a single case report, but over the years I have worked with a few autoimmune thyroid patients who tested positive for this parasite and went into remission upon eradicating it.
How Is A Blastocystis Hominis Infection Diagnosed?
Blastocystis Hominis is typically tested for through the stool.
Treatment for Blastocystis Hominis
From a conventional treatment standpoint, Metronidazole is usually the first drug given, although other prescription drugs that may be given include trimethoprim-sulfamethoxazole, paromomycin, and furazolidone (20) [24]. Some of the natural agents which can be effective in treating Blastocystis hominis include oregano oil, wormwood, clove, garlic [25], black walnut, and saccharomyces boulardii [26]. With regards to S. boulardii, one study involving symptomatic children with Blastocystis hominis showed that this was more effective than Metronidazole (21) [27].
4. Candida. Although Candida [28]is listed here, it’s important to understand that Candida albicans are normal inhabitants of the skin, mucous membranes, gastrointestinal tract, and genitourinary tract. But if something disrupts the gut flora then this can lead to a Candida overgrowth. Many people are aware that taking antibiotics can increase the risk of developing a Candida overgrowth, but there can be other factors as well, including chronic stress [29], glucocorticoids, and even cigarette smoking.
In fact, anything that either suppresses the immune system or disrupts the good bacteria of the gut can lead to a Candida overgrowth. Some of the symptoms associated with a Candida overgrowth include fatigue, brain fog [30], gastrointestinal symptoms, allergies, and joint pain. Those with a moderate to severe Candida overgrowth will also commonly have a thick white coating on their tongue. On the other hand, a thin white coating on the tongue is not an indication of a yeast infection.
There is controversy over whether Candida is a direct trigger of thyroid autoimmunity. There is evidence in the research of Candida causing an increase in autoantibodies, although not specific to Graves’ Disease or Hashimoto’s Thyroiditis. A Candida overgrowth can also cause an increase in proinflammatory cytokines [31], which is associated with autoimmunity. However, an overgrowth of Candida can lead to an increase in intestinal permeability, which can make someone more susceptible to developing Graves’ Disease or Hashimoto’s Thyroiditis.
How Is A Candida Overgrowth Diagnosed?
I have found that the best way to test for a Candida overgrowth is through organic acids testing, which is a urine test that measures different metabolites related to yeast, with arabinose more specific to Candida albicans. Blood and stool testing are also options, although false negatives are common with these methods.
Treatment for a Candida Overgrowth
Conventional treatment methods consist of prescription antifungals such as Nystatin or Diflucan. Natural treatment usually involves a strict “Candida diet”. Like most diets, this involves eating whole foods while avoiding the processed foods, although it also eliminates most sources of sugar, and in some cases all sources, including fruits. It also is advised to minimize or eliminate starchy vegetables such as white potatoes, sweet potatoes, and winter squash. Natural antifungals can also be beneficial, including oregano oil, caprylic acid, olive leaf, garlic, and uva ursi.
Conventional vs. Natural Treatments: Which Should You Choose?
If you test positive for one or more of these pathogens, you might have a difficult time deciding if you should take the conventional medical treatment approach, which usually involves taking prescription drugs, or if you should take a natural treatment approach. Not surprisingly, in most cases I prefer a natural approach, although one has to consider the benefits and advantages of both.
For example, the advantage of taking prescription antibiotics or antifungals is that they usually work much faster than natural agents. Another advantage is that in many cases it is less expensive to take a prescription drug when compared to purchasing nutritional supplements and herbs. This is especially true for those who have health insurance coverage.
Of course one of the big downsides of prescription drugs is the potential side effects. This is especially true with antibiotics, as while there is no question that they are sometimes necessary, they are overused. This is why more and more bacteria are becoming resistant to antibiotics, and it also explains why multiple antibiotics are sometimes needed, which as mentioned earlier is the case with H. Pylori.
The reason why I prefer natural antimicrobials is because they are almost always less harsh on the body when compared to prescription drugs. However, the fact that natural agents usually take longer to eradicate infections can’t be overlooked.
Although I prefer a natural treatment approach, my patients are the ones who ultimately make the decision. For example, while I have recommended a natural treatment approach to many patients with different types of infections, recently I had a patient get diagnosed with H. Pylori, and not surprisingly her medical doctor recommended for her to take prescription antibiotics. I explained the pros and cons, and since she wanted to eradicate H. Pylori quickly she chose to take the antibiotics, even though she realized that this would be harsher on her gut flora. Keep in mind that some natural agents can also have a negative effect on the good bacteria, although they usually aren’t as harmful as prescription drugs.
In summary, infections can be an autoimmune trigger, and in this blog post I discussed four common gut infections in those with Hashimoto’s Thyroiditis. These include Yersinia enterocolitica, H. Pylori, Blastocystis hominis, and a Candida overgrowth. The last one isn’t considered an infectious process, but since it’s so common in people with Graves’ Disease and Hashimoto’s I decided to include it here. When choosing between a conventional and natural treatment approach you need to consider the pros and cons of each, which I discussed in this blog post.