Тиреоидит на Хашимото. Първопричината

by Izabella Wentz

Тиреоидитът на Хашимото не е просто хипотиреоидизъм. Повечето пациенти с хашимото страдат от киселинен рефлукс, недостиг на хранителни вещества, анемия, чревна пропускливост, чувствителност към храни, проблеми с венците и хипогликемия в допълнение към „типичните” симптоми на хипофункция на щитовидната жлеза като напълняване, непоносимост към студ, косопад, умора и запек.

Тялото се оказва заклещено в един порочен цикъл от претоварване на имунната система, недостатъчност на надбъбречните жлези, чревна дисбиоза, нарушено храносмилане, възпаление и аномалии в освобождаването на тиреоидни хормони. Този кръговрат се самоподдържа и ще продължи да причинява нови и нови симптоми, докато не се намеси външен фактор, който да го прекъсне.

Промените в начина на живот, описани в тази книга, целят да прекъснат този цикъл на части. Започваме с най-простите модификации, като отстраняваме причинителите, и продължаваме с поправяне на другите нарушени системи, за да върнем равновесието и да позволим на тялото да се възстанови.

Изабела Уенц, доктор по фармация, FASCP, е фармацевт, пациент с Хашимото и пионер в областта на промените в начина на живот, необходими при тиреоидит на Хашимото. Тя обобщава три години проучвания в книгата си „Тиреоидит на Хашимото: промени в начина на живот за откриване и отстраняване на първопричината”. Д-р Уенц живее в Чикаго, Илинойс, заедно със съпруга си Майкъл и работи като фармацевт, отговарящ за безопасното изписване на медикаменти.

Genres: Health, Nonfiction, Self Help, Science, Medical, Medicine, Nutrition

374 pages, Paperback

First published May 31, 2013

About the author

Dr. Izabella Wentz, PharmD, FASCP is an internationally acclaimed thyroid specialist and licensed pharmacist who has dedicated her career to addressing the root causes of autoimmune thyroid disease after being diagnosed with Hashimoto’s Thyroiditis in 2009.

Dr. Wentz is the author of the New York Times bestselling patient guide Hashimoto’s Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause and the new #1 New York Times bestselling protocol-based book Hashimoto’s Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting Your Life Back.

As a patient advocate, researcher, clinician and educator, Dr. Wentz is committed to raising awareness on how to overcome autoimmune thyroid disease through The Thyroid Secret Documentary Series, the Hashimoto’s Institute Practitioner Training, and her international consulting and speaking services offered to both patients and healthcare professionals.

Reviews

[Saraelizabeth · Rating 3 out of 5]

I have mixed feelings about this book. It is extremely informative and well-researched. I totally appreciate that the author herself struggled with Hashimotos and stubbornly worked to put it in remission. I actually think that's paramount. In my mind, that gives her writing more weight and sympathy.
However, all that being said, I found the advice to be contradictory and overwhelming. I understand that part of that is the nature of the disease. It is extremely difficult to pin down solutions, and any solutions cannot be applied to everyone.
But one page she'd be recommending a certain diet; the next page she'd be admitting that a lot of hashimotos-ers would have difficulty with that diet. That happened repeatedly and made it hard for me to feel empowered to find a solution.
Thankfully, I have a good doctor that has brought me halfway down her recommended path of healing. I think it would be even more difficult for someone just starting out to swallow all the options.
Overall it's a good resource, but a little overwhelming.

[Tami · Rating 5 out of 5]

EDIT 9.17.2017: people keep seeing this and liking it. So I feel that I need to address here, not just in the comments, that this was all crap. What I wrote was true--that I found myself and my symptoms on page after page of Wentz's book. And it was true that her story of health in response to her measured actions as detailed on the pages of her book gave me hope.

The problem, however, is that after following all of the protocol it didn't work. At all. I spent hundreds and hundreds of extra dollars on her special vitamin requirements and followed the diet regimen; basically I did all the things to no avail.

So maybe this will work for some people, but it didn't for me. What I know is that my body carries massive amounts of inflammation due to severe childhood trauma, and my body is simply incredibly unresponsive to attempts at treatment. What I eat or don't eat doesn't much matter. Supplements and exercise and prescriptions, while I keep trying and I listen to doctors, never help me feel better nor lose weight. So that is my experience, and maybe this helps you.

***

As someone who was told by a nutritionist that I had severe adrenal fatigue in January 2014, I thought I just had to figure out how to manage. The primary source of my stress is managing the exhausting therapy schedule of two special needs children, and I can't stop being their mom (not would I ever want to). I was diagnosed with Hashimoto's in October 2014, despite eating a mostly paleo and low carb diet, and thought I just won the unlucky genetic lottery.

But I had no idea that things like an average body temperature of mid-96 to low-97, or my constant lower back pain, or my seemingly random thyroid issues during pregnancy, or the fact that I follow every weight loss rule to a at and I never works like it is "supposed" to, or the fact that my sex drive went to -1000% post kids, or that I haven't woken up feeling rested since pre-puberty (I'm 33) and no amount of sleep is EVER enough, not even when sleep monitors say my quality was 100%, or that I can't stay asleep without Unisom, or that I feel exhausted all day but cannot sleep until 2-3am no matter what I do (including no screens for 3 hours before attempting to sleep), or that if I don't get enough sleep (more than 7 hours) I don't digest my dinner and will throw up, or only having BM every 2-3 days despite eating very healthy, or that raw vegetables never seem to digest and feel like a rotten rock in my stomach, or never feeling energy from food (not even when doing a strict Whole 30), or that 1 bagel will literally shoot the scale up 3-4 pounds and they don't just come back off as water weight after a few days, or INTENSE PMS, or incessant headaches, or sensitivity to bright lights, or that I am constantly on the verge of yelling-out-loud anger and I cannot figure out why (and am generally annoyingly optimistic and pleasant-minded), or myriad other symptoms are all interconnected.

This book had me constantly going, "Wait--what? That, too?" So many things just felt normal to me. I assumed everyone never feels rested or energetic. Or that I am just lazy. Some things I know aren't normal--being constantly dizzy and seeing black spots--but I thought that I just can't heal. Nothing has worked. NOTHING.

The fact that Wentz and so many others have been able to put all of this into remission gives me hope. I am not assured that I'll get to the root of my autoimmune illnesses and magically heal, but fur the first time I have more tools in my belt than "eat better, move more, sleep more, and take thyroid meds." Once my thyroid is gone it's GONE. I refuse to accept that. So thank you, Isabella Wentz, for writing this book so I have a falsity concise bit of information to meet with my naturopath and lay out exactly how I need her assistance in attacking this, from strict Autoimmune Paleo diet, pursuing gut health, testing for food sensitivities, parasites, and genetic mutations, to what supplements to take and not take, etc. THANK YOU.

I hope that one day people are able to read my story of going from sickness to health, from simply being alive to LIVING, and are inspired that they, too, can find a way out from under disease that makes simply waking up and keeping your eyes open feel like a burden to great to bear. This book will always be a huge catalyst in that journey; Lord, that it may come to pass.

[Averyl · Rating 5 out of 5]

This book may have just given me my life back!

[Mischenko · Rating 5 out of 5]

Hashimotos Thyroiditis: Lifestyles Interventions for Finding and Treating the Root Cause by Izabella Wentz is a book to help people who are suffering from Hashimoto's thyroid disease, an autoimmune disorder that destroys the thyroid gland.

I definitely learned a few more things, but in a nutshell, it always seems to boil down to diet and stress. Supplements and probiotics are also important. Find out what you're sensitive to, like gluten and dairy, etc.

The absolute hardest part to me is the diet. Food to many is the last good drug and if you need to heal, you'll have to give a lot of it up, probably most of what you're used to eating and enjoying.

Overall, the book is worth reading and keeping for reference.

5*****

[Wench · Rating 1 out of 5]

I was diagnosed with Hashimoto's a few years ago. Since then, it's been a roller-coaster, as I continually work to feel better. I'm also a scientist by training, and the idea of finding and treating a root cause of a disease, rather than just the symptoms, is really, really attractive to me. Hence, buying and reading this book.

Aaaaaaand... I have a lot of problems with it. I fully respect that Dr. Wentz knows her own life, process, and body, and I completely believe that what she did worked for her. I have problems when she tries to generalize it to everyone, saying that she really recommends this and it is so sure to work, and then in the next paragraph contradicting her own recommendation and saying that everyone is different and will respond differently.

I respect that there isn't a lot of solid research being done with autoimmune diseases, specifically Hashi's, and especially not with the therapeutic modalities she recommends, but I have problems when she gets *basic science* wrong. For example: I promise you are not vaporizing the mercury in your dental fillings as you chew, because the vaporization temperature of mercury is over 600 degrees Fahrenheit. Your body temperature is about 98 degrees Fahrenheit. Even with chewing, your mouth is maybe 100 degrees Fahrenheit? It's just not happening.

I respect that changing her diet worked for her, and that what we eat can affect how we feel, but I have problems with the fact that she recommends what are outright starvation diets as a way of healing. First off, starving is not good for you. Second off, that is incredibly triggering just to read about for anyone with a history of disordered eating, like anorexia, and would be virtually impossible for anyone with that history to actually implement.

As for the very short section at the end where she actually discusses what to do to get better, one, it doesn't actually walk you through half of what was promised in the introduction, and two, it's mostly those starvation diets and contradictions and errors in basic science again. Contradictions are kind of the nature of the beast, but there are ways to make this more clear. Perhaps a chart, with recommendations of what to try first, and then what to try if that doesn't work? I know some of this information exists, because I have seen it.

At any rate, I did discuss this with my doctor - a functional medicine specialist, so she's also all about treating root causes - and she also agrees that it may very well work for some people, but not for me. I'm returning this, and hey, if Amazon is going to give me nearly the full price back on it, so much the better.

[Hashimotos Husband · Rating 5 out of 5]

Normally, I'm not one to write reviews, but this is the book I've been waiting for! I have been searching and searching and I feel like I just stumbled onto a gold mine. I was just diagnosed with Hashimoto's in May 2014 not knowing anything about this disease and I ordered this book. It is my go-to reference book. I have highlighted, put notations in margins, stuck sticky notes on pages, and copied quotes.

Following all of the advice on nutrition and supplements from her book on Hashimoto's has completely transformed my life for the better. I feel clear headed, no longer suffer debilitating aches and pains in muscles and joints, my headaches and jaw-clenching have lifted, my lymph nodes are no longer swollen, my hair is healthy, and I have lost so many pounds that my grown-up children tell me I look more and more like myself, when they were young.

I started with antibodies at 1854 and a TSH of 78.7. I am now current at 2.6 TSH and antibodies at 504. I owe this to this amazing book. This book has saved my life. I cannot begin to express my gratitude.

[Denica · Rating 5 out of 5]

Изключително полезна книга ако искате да разберете сложния механизъм на Хашимото и взаимодействията между отделните жлези в човешкия организъм и щитовидната жлеза. Едно задълбочено изследване, подтикнато от желанието за излекуване на тази хронична, според алопатичната медицина, болест. Книгата дава чудесни насоки на какви изследвания, добавки и хранителни режими да обърнем внимание, за да потушим това автоимунно състояние. В страниците е вплетена и личната история на авторката(фармацевт по образование) с Хашимото, без това да заема ненужно място и да ни просълзява, а по-скоро като допълнение към научните факти, които пък са поднесени много разбираемо.
Като човек, който страда лично от диагнозата, успях да намеря информация, която не бях срещала досега и която смятам, че ще ми помогне в холистичния подход към състоянието ми.

[Raquel · Rating 5 out of 5]

Completely indispensible when it comes to understanding the thyroid and how to care for it, as well as how to determine the root cause(s) of your own autoimmune disorder so you can address those and help put your disease into remission.

The author is a Hashimoto's patient herself as well as a pharmacist, so the book is full of science and data. Rather than finding this boring, I find it incredibly helpful, because I now understand exactly how the thyroid works and exactly how to read bloodwork levels and understand medication dosages. (For example, Dr. Wentz includes a handy conversion chart that compares dosages of all the thyroid medications that I think will be extremely helpful on doctor's visits.) There are numerous chapters devoted to determining what is causing your own autoimmune disease to flare, include adrenal fatigue/insufficiency, hormonal imbalance, and digestive/gut issues. I'm weirdly geekily excited to delve further into this and figure out what's going on in my own body.

It may take you a while to read this one, simply because it's so full of valuable information. I could see this book being extremely valuable to doctors and clinicians.

[Nicole · Rating 5 out of 5]

What a great book! Highly recommend it to any one who suspects they may have thyroid disease. There is so much information packed into this book and it is very well organized and easy to read. This is a book worth owning, as I will probably keep referring back to it.

[Elyse Walters · Rating 5 out of 5]

Easy to read (not too techie)

- Isabella herself is an inspiration --

- Several possible 'good' plans for healing.

In 'real' life ---its still not simple making many life changes --yet this book is a very helpful resource.

[Linda Schiller · Rating 5 out of 5]

Finally, a book that explains Thyroiditis and what you can do to help it besides just pills.

[Sarah · Rating 5 out of 5]

Full of valuable information. My highlights:
-------
Well-established environmental triggers for developing Hashimoto's in those who are genetically predisposed include iodine intake, bacterial and viral infections, hormonal imbalances, toxins, and therapy with certain types of medications.

In people with Hashimoto's, only 50 percent of their identical twins presented with thyroid antibodies, meaning genes alone are not the single defining factor and environmental triggers play a critical role.
- - -
When scientists set the "normal" ranges of TSH for healthy individuals, they inadvertently included elderly patients and others with compromised thyroid function in the calculations, leading to an overly lax reference range. (see more regarding this on page 23)
- - -
Some clinicians may only test for T4, but it is also important to test T3 as some individuals may not be properly converting T4 to the active T3. Some people may have a normal T4 but a low T3 level.
-more on this on p24
- - -
High concentration of TPO antibodies has been associated with distress, obsessive-compulsive symptoms, and anxiety. This is like due to the increased amount of thyroid hormone being rushed into the bloodstream, causing a transient hyperthyroidism. Anyone who has experienced symptoms of hyperthyroidism can describe how agitating this feels. People with anxiety, depression, or other mood disorders should have their thyroid function checked, especially for TPO antibodies. Some individuals with lifelong psychiatric diagnoses have been able to recover after receiving proper thyroid care.
---
Lifestyle interventions can also help with reducing TPO antibodies, reversing hypothyroidism and Hashimoto's, and preventing other diseases - and they make most people feel better. Some may be able to reduce and eliminate the need for thyroid medications when the autoimmune attack ceases and the thyroid gland is able to regenerate.
- - -
"Autoimmune disease: because the only thing tough enough to kick my ass is me." - Unknown (header to chapter 4)
- - -
The theory goes like this:
1) Thyroid cells are damaged by a trigger such as a toxin or an infection.
2) Dying thyroid cells send out a stress signal.
3) Immune cells rush in to "save" the thyroid from attackers.
4) Immune cells attack the thyroid instead.
5) More thyroid cell damage occurs.
6) Body runs out of resources to regenerate thyroid cells.
7) Thyroid is no longer able to produce enough hormone.
- - -
When the intestinal wall becomes permeable, the body loses its ability to recognize benign substances such as our own cells and the foods we eat, instead treating them as though they were foreign invaders such as bacteria and viruses.

Zonulin is a recently discovered human protein that reversibly increases intestinal permeability. This protein in measured in excessive amounts in individuals with autoimmune conditions such as rheumatoid arthritis, Hashimoto's, multiple sclerosis, type 1 diabetes, and celiac disease.
p39
- - -
Hashimoto's has been classified as a type IV hypersensitivity, which is called a delayed type hypersensitivity ("self-allergy"). Unlike other types of immune reactions, the damage to the thyroid tissue is not antibody-mediated; instead, the antibodies "mark" the thyroid cells, and then antigen-specific cytoxic T-lymphocytes (lymph cells) attack the targeted thyroid cells.
- - -
However, examples of autoimmune recovery have discredited the "irreversible" aspect of this theory. It has been shown that continuous environmental triggers are necessary to perpetuate the process. This means the autoimmune process can be stopped and reversed when the triggers are eliminated. One example of this is celiac disease, an auto-immune condition in which gluten, and environmental trigger, has been identified. In most cases of classical celiac disease, all symptoms resolve when the environmental trigger (gluten) is removed.
- - -
As we cannot change our genes, our approach to addressing the root cause of Hashimoto's is threefold:
1. Reducing triggers
2. Eliminating intestinal permeability
3. Providing the body with nutrients to regenerate

- - -
Most antibiotics do not know the difference between the bad bacteria causing your infection and the good bacteria helping you with digestion and vitamin extraction as well as keeping peace within your intestinal track. . . . Since beneficial bacteria make up our immune system, antibiotic use is a suspected cause of increasing cases of allergies, chronic disease, autoimmune conditions, digestive issues, and even cancer.
- - -
People with Hashimoto's are also five times more likely to be diagnosed with celiac disease. Recently, gluten intolerance has been described as a spectrum, with only the most severe cases of damage being diagnosed with celiac disease.

Additionally, some people with Hashimoto's may present with a celiac-like intolerance to milk proteins (whey and/or casein), egg proteins (ovalbumin), or soy proteins.

Many of these cases are undiagnosed, and when people continue to east foods they are sensitive to, they damage their intestines.
- - -
The co-occurrence of Hashimoto's and celiac disease has been clearly established. I would even venture to say one does not need to have full-blown celiac to have impaired absorption of selenium.

Selenium plays a crucial role in thyroid function:
1. Acting as a catalyst to convert the inactive T4 to the biologically active T3
2. Protecting thyroid cells from oxidative damage from hydrogen peroxide by forming selnoproteins
p68
- - -
One in four individuals in the general population may be zinc-deficient, and most people with hypothyroidism are. Zinc deficiency prevents the conversion of T4 into the active T3 version. This results in a slowed metabolism of proteins. Zinc is also needed to form TSH and may become depleted in those with hypothyroidism who are constantly producing more TSH.
- - -
Genetic Causes of Nutrient Depletions

Some individuals with Hashimoto's may have a gene variation that prevents them from properly activating folic acid. This gene variation is present in up to 55 percent of the European populations and appears more commonly in those with hypothyroidism.

The gene involved in the MTHFR (methylenetetrahydrofolate reductase) gene, and genetic testing is available to show whether someone has this gene variation. The MTHFR gene codes for the MTHFR enzyme, which converts the amino acid homocysteine to methionine, a building block for proteins.
- - -
Soy is one particular goitrogen that is especially detrimental for Hashimoto's patients. The isoflavones genistein, daidzein, and glycitein in soy reduce thyroid output by blocking activity of the TPO enzyme.

Soy has been linked with the development of autoimmune thyroid conditions, and children fed soy formula were almost three times more likely to develop anti-thyroid antibodies as compared with breast-fed children.
- - -
Hashimoto's was not recognized in the United States before the nationwide salt iodization program began in 1924. In many other countries, studies have shown rates of autoimmune thyroiditis increased drastically after salt iodization programs.
- - -
Researchers in Iran were able to document the rates of thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb) before and after a national salt iodization program started in 1994. In 1983-84, postiive TPOAb and positive TgAb were found in 3.2 percent and 4 percent of the 465 adults selected for random sampling in Tehran.

This sampling was repeated with 1,426 adults in Tehran in 1999-2000, this time showing 12.5 percent positive for TPOAb and 16.8 percent positive for TgAb. The addition of iodine quadrupled the rate of Hashimoto's within a six-year span!

Studies in Greece, China, Sri Lanka and Italy reported similar increases in Hashimoto's after the addition of iodine to salt.
- - -
Considering that iodine increases the rate of Hashimoto's incidences - and even small doses of iodine can lead to the progression of thyroid abnormalities over a short period of time - it is no surprise that one in five women will have a thyroid dysfunction at some time in her life in the presence of iodized salt.
- - -
The Standard American Diet exceeds the threshold of safe iodine consumption for those with autoimmune thyroid conditions.
- - -
Many vegetable oils are made from genetically modified crops and contain large amounts of pesticides. When diets high in polyunsaturated fats were tested on animals, it was concluded that they can cause problems with learning, are toxic to the liver, trigger immune system malfunction, slow mental and physical growth, cause chromosomal damage, and induce premature aging. In addition, diets high in polyunsaturated fats are responsible for increased rates of cancer, heart disease, and weight gain.
- - -
A variety of bacterial infections have been implicated in triggering autoimmune thyroiditis, including Helicobacter pylori (the same bacteria that causes ulcers), Borrelia burgdorferi (associated with Lyme disease), and Yersinia enterocolitica.
- - -
Researchers have identified Mycoplasma, Candida, and Epstein-Barr virus as the infections most commonly associated with Hashimoto's.
- - -
In the case of infections, once the infection is removed, TPO should cease to be a trigger when the immune system recognizes the infection is gone. Thus, treating infections may help heal Hashimoto's. In other cases, the infection may already be gone, but the immune system may need a reboot.
- - -
Th1 and Th17 were both found in the thyroid cells of mice with Hashimoto's, and it is proposed that IL-17 cells are critical to the development of Hashimoto's.

New research suggests Th17 - rather than TH1 - may be causing the damage involved in the pathogenesis of Hashimoto's. This would explain why some Hashimoto's patients present with a mix of Th1 and Th2 dominance as well as with no clearly defined dominance.
- - -
Dr. Fasano has identified that in the presence of leaky gut, we secrete excess zonulin, a protein that modulates the permeability between the right junctions. An excess of this protein has been found in every autoimmune condition, including Hashimoto's.
- - -
These gram-negative bacteria are normally present in small amounts in the human intestine, but some individuals may have too mnay of them and not enough of the beneficial gram-positive bacteria. This produces and imbalance in bacterial gut flora known as gut dysbiosis.
- - -
According to Elaine Gotschall, the author of Breaking the Viscious Cycle, a diet rich in refined carbohydrates can lead to a compromised GI flora. Anecdotal evidence shows that people who become affected with intestinal disorders are more likely to eat a diet high in simple carbohydrates compared with those who were unaffected.
- - -
Stool tests are available to check microbial balance. These tests can tell us whether there is a lack of beneficial bacteria or an overabundance of pathogenic organisms such as potentially pathogenic gram-negative species or Candida.
p 142
- - -
Symptom improvement in many autoimmune conditions has been reported after the initiation of a gluten-free diet. Length of gluten exposure is positively associated with the development of autoimmune conditions. This means the longer you eat gluten, the more likely you are to develop an autoimmune condition!
- - -
Glutamine dosed daily (orally) at 0.5 grams/kg ideal* body weight for two months was shown to reduce intestinal permeability in subjects with Crohn's diease. Dr. Maes used a more conservative does of 7 grams a day.
- - -
N-Acetyl Cysteine (NAC)

Hashimoto's patients are deficient in the antioxidant glutathione. It helps prevent free radical damage to the thyroid but isn't well-absorbed if taken orally. N-acetyl cysteine (NAC) is a precuror to glutathione and can be taken orally. NAC has been used for healing intestinal permeability. Be aware it can cause stomach upset if taken on an empty stomach and thus should be taken with food. Dr. Maes used a dose of 1.8 grams a day with chronic fatigue patients.
- - -
Saccharomyces Boulardii

IgA levels can be increased by taking the beneficial yeast Saccharomyces boulardii, which helps clean up the intestines. S. boulardii does not take up residence in the intestines, but it does a lot of great work while passing through. S. boulardii can also help with clearing out yeasts, pathogenic bacteria, and parasites.
- - -
Endotoxin from gram-negative bacteria can promote inflammation through the stimulation of Th1 pro-inflammatory cytokines (TNFa) in the intestine as well as in the rest of the body, especially in those with intestinal permeability. . . . Pro-inflammatory cytokines are seen with many autoimmune conditions, including Hashimoto's, type 1 diabetes, inflammatory bowel disease, and celiac disease. Endotoxin is thus being considered a promoter of autoimmune conditions.
p 157
- - -
Intestinal damage due to gluten and other intolerances; low stomach acid; and other conditions commonly present in Hashimoto's put people at risk for malnutrition because of poor protein assimilation.
- - -
Glycemic Burden

Researchers in Poland have found that up to 50 percent of patients with Hashimoto's have an impaired tolerance to carbohydrates. This means that after consuming carbohydrate-rich foods, their blood sugar levels spike, causing a substantial insulin release. The role of insulin is to clear blood sugar out of our cells, so a large insulin release is followed by a rapid blood sugar drop (hypoglycemia). . . Hypoglycemia necessitates the release of cortisol to help maintain the glucose supply to the brain and counteracts insulin, causing insulin resistance (this is also linked to the type 2 diabetes epidemic).
p171
- - -
Inflammation

Chronic inflammation may result from joint pain, obesity, toxic burden, GI tract inflammation, irritable bowel disorder, pathogens in the GI tract, or food allergies. These conditions signal cortisol for its anti-inflammatory effect.

HPA Dysfunction and Autoimmunity

Some researchers believe HPA axis dysfunction and prolong cortisol elevation may be the cause, rather than the consequence, of autoimmune diseases. A natural steroid, cortisol suppresses cellular immunity (Th1), preventing tissue damage from excessive inflammation.
[See more on page 172]
- - -
Subclinical Addison's

People with Hashimoto's and other autoimmune conditions are more likely to develop Addison's.

Co-occurring Addison's and Hashimoto's is known as Schmidt's disease, and any person with Hashimoto's who has anti-adrenal antibodies should be considered to have both conditions.
p 177-8
- - -
It is unclear whether the cause of adrenal insufficiency or subclinical Addison's is due to depletion, down-regulation, or autoimmune origin, but it is evident adrenal and thyroid function have an impact on one another.
p178
- - -
Chronic Viral Infections
Western Lifestyle and Autoimmune Coniditions
The "old friends" hypothesis proposes that Treg cells do not develop correctly because they are not exposed to parasites and other benign organisms that have coexisted with humans and coevolved with us to "teach" our immune system how to respond to threats.

In our modern-day world, where we receive vaccines, use antibacterial soaps, and take antibiotics, we are exposed to far fewer forms of bacteria, viruses and parasites. This, of course, has many benefits, especially in the case of becoming affected with serious infection. It appears, however, that we may also be missing out on exposure to organisms that may perhaps have had a beneficial effect on our immune system.
-read more on page 212
- - -
Animal fat, broths, soups and stews support the body's ability to suppress the viruses. Monolaurin/lauric acid, one of the components of coconut oil, hasbeen found to be active against the Epstein-Barr virus. Replication of many viruses, including Epstein-Barr, is inhibited by glycyrrhizic acid, an active component of licorice root. Quercetin, co-enzyme Q10, n-acetyl cysteine, and glutathione were also reported to help fight chronic fatigue syndrome because of their antiviral properties.
- - -
The most accurate test for allergies is a skin test in which an allergist scratches the surface of the skin with the allergen and observes for rashes to see if the person is reactive to the substance. Blood tests are also available but are less sensitive. This type of allergy is often called a "true allergy" by medical professionals.

This terminology is a misnomer, however, and suggests only IgE allergies exist and that reactions mediated by different parts of the immune system are nonexistent. Challenge any medical professional to review their Immunology course notes, and they will find that there are additional types of hypersensitivies just as "true" and "real" as IgE anaphylactic reactions. The two relevant hypersensitivies are mediated by immunoglobulins A and G, IgA and IgG respectively.
-read more on page 218
- - -
IgA food intolerances may be asymptomatic, or they may present with the following symptoms: diarrhea, loose stools, constipation, acid reflux, malabsorption of nutrients from foods, and increased intestinal permeability.

They may cause IBS, gas, nausea, skin rashes (including eczema), acne, respiratory conditions such as asthma, nasal congestion, headache, irritability, and vitamin or mineral deficiencies.
- - -
Accounting for 90 percent of food reactions, the most common food antigens are milk, eggs, peanuts, tree nuts (e.g. almonds, cashews, walnuts), fish, shellfish, soy and wheat.

Nightshades (e.g tomatoes, potatoes, peppers and eggplant), beef, citrus, corn, and pork may also be problematic.
p 222
- - -
Starting in 1945, most American communities began adding fluoride to drinking water in an effort to prevent tooth decay. While various studies show fluoride reduces the incidence of dental cavities and tooth decay, fluoride is an endocrine disruptor. Studies confirm fluoride is directly toxic to thyroid cells and causes thyroid cell death, suppressing thyroid activity.

In fact, fluoride was actually used to treat hyperthyroidism up until the 1950s, prior to the development of other thyroid-suppressing medications. Fluoride is effective as a thyroid suppressor at doses of 0.9 to 4.2 mg per day for hyperthyroidism. Most adults in fluoridated communities are ingesting between 1.6 and 6.6 mg of fluoride per day from water, inadvertently suppressing their thyroid function.
- - -
Fluoridation partially began as a collaborative effort between dental associations, the US government, and sugar lobbyists who wanted to find a solution that would allow people to have fewer cavities while continuing to consume the same amount of sugar.
- - -
The United States is one of the only countries that adds fluoride to its water system. Almost all (97 percent) European countries have rejected water fluoridation due to the toxicity associated with it. Austria, France, Germany, Spain, and Switzerland, however, do allow the addition of fluoride to salt.
- - -
Acid-Alkaline Food Balance

Creating a more alkaline environment in the body may help with the detoxification process and can improve alkaline phosphatase function. While this initially seems to contradict the previous recommendation to increase stomach acidity, it does not. Keeping the stomach acidic and the rest of the body alkaline is the key to optimal health and can be achieved through diet and digestive enzymes.
p 246
- - -
One thing to remember about overcoming Hashimoto's is it takes years to develop the perfect storm to produce Hashimoto's thyroiditis. In the same way, healing won't happen overnight.

[Emily Kestrel · Rating 4 out of 5]

More like three and a half stars, really. I loved the first half of this book, where she explains what's going on with Hashimoto's and the different tests for it, and why so many doctors don't diagnosis it correctly. She could have been writing about my situation exactly.

The next part of this review is more of a personal rant, but it is relevant to this book and why the information is so necessary. I recently went to the doctor complaining of the following:

1. Experiencing many hypothyroid symptoms: extreme fatigue, hair loss, cold sensitivity, depression and anxiety, constipation, severe PMS and heavy, irregular periods, and a weird tingling/pressure feeling at the bottom of my neck;
2. Personal history of elevated TSH labs--the only thyroid lab ever ordered for me--despite being on levothyroxine;
3. Family history of thyroid problems, probably Hashimoto's;
4. Low alkaline phosphotase lab results two years in a row;
5. Swollen thyroid on physical exam which turned out, with ultrasound, to be heterogenous with nodules and rough texture.

And what did the doctor do? He told me my TSH levels, though elevated, were never high enough to show a real problem and that he didn't think I was truly hypothyroid--when I asked why I had symptoms in that case he said it was "controversial"--and he recommended I stop taking the levothyroxine and start antidepressants instead. When I told him I did not wish to do that, he suggested counseling. "To talk about what?" I spluttered in disbelief. "My thyroid symptoms??"Suffice to say that my next course of action was to "fire" him as my doctor and start reading everything I can on the subject in preparation for my visit to a new practitioner.

As I said at the beginning of this review, I found the first half of this book to be extremely helpful, explaining things like why TSH isn't the end-all be-all of thyroid testing, which other labs I should request, and there's even a whole chapter about the low alkaline phosphotase and what that means. I've been reading a lot on the topic, but this was one of the better explanations, and the only one that got into the low AP result.

Unfortunately, the second half of the book was an overwhelming presentation of all the possible variables that could influence Hashimoto's--none of which will be true for everyone, and some of which were so controversial that even the author admitted they were kind of sketch, but I guess she just included them in order to be as thorough as possible. A lot of this second half was contradictory--a supplement that one protocol recommends might be damaging for someone else, etc. Also a chapter on why parasites might be causing gut problems that impact the thyroid, but then in another chapter she mentions that underdeveloped countries where people are exposed to more parasites don't have these autoimmune problems.... This part wasn't especially useful to me, at least not at this time. I would still recommend the book to anyone with hypothyroid symptoms. I wish I could say just believe your doctor, but as I have found out, it's really better to get all the information you can.

[Maria Laney · Rating 5 out of 5]

Yay! It's finally here! I read most of it already and it's not even noon on the day it downloaded on my Kindle! That's how good it is. It's easy to read and I see me in it on every page and in every paragraph. Dr. Wentz describes the connection between the gut and the autoimmune condition. It all makes sense! She divides the Protocol into three parts, The Liver Support Protocol, Adrenal Recovery and Gut Balance Protocols. I have been doing my own system based on my own exploration and her first book, Hashimoto's The Root Cause and have made great progress. But I am still so far from normal. It's hard to put it all together with Brain Fog! But now she's got it all laid out in a clear, well written, easy to manage method. I can't wait to get started. Thank you, Dr. Wentz!

[Amy · Rating 2 out of 5]

Well this book has been on my TBR for a long time, as my friend and colleague has told me I should understand all of the permeations of Hashimoto's, and their alternative medicine possibilities for health. Its taken me a long time to get it out of the library. Even when I did, I'm never psyched about dry research, I love a good yarn and character development, plot, growth, and transformation. That's not this book, its dry. But there are possibilities held within.

So here's what I discovered. I think one of my sons has a lot of inexplicable conditions, that I have been thinking about. This book came into my life just at the right time, because I can see now, that there are things I can do, to help him. And that they are interrelated. So I got the book for me, but turns out, its for me to help him. Funny how timing works. and that you can often find what you need right at the time you need it. The book itself? Dry. But possibly a lifesaver, if it should fit.

[Kristin · Rating 4 out of 5]

Incredibly dense and helpful, but also incredibly overwhelming. At times it feels hopeful, at times it leaves me with the feeling that it's so complicated to find a solution, I'd rather stay sick.

[Morgan McGuffee]

I picked this book up when I was 16 and have flipped through it for the last 6 years but this year I decided to actually read it all the way through. I’ve always struggled putting into words how Hashimoto’s affects my life, more often I don’t mention it all. I have treated it with a range of different diets, exercise, medications, and doctors appointments since my first diagnosis. I think there are portions of this book I wholeheartedly find to be true but also so much more to it and like the author states what works for some others might not see any change - if you really want to know more - ask me about it (I’m trying to be more open)

[Doris Jean · Rating 4 out of 5]

The author is a pharmacist who has been diagnosed with Hashimoto's Thyroiditis (HT). She gives lots of technical information with tables and charts and extensive lists of supplements and dosages. On page 324 she gives her personal history of symptoms and and illnesses and ends with her diagnosis of thyroiditis (HT). This book is her personal journey of getting better with HT. She gives lots of interesting recommendations, but never pinpoints much, she just punts to "we are all different and all react differently but some of this might help". I think all her recommendations apply to all illness and not specifically to HT. I would have given only two or three stars but for two things: first, I like biographies, and second, I think health is so important that anything that may help anyone is worth an extra star.

I have a background in science and have recently read quite a few of the newer books on health. It seems to me that HT and many of our modern diseases do not exist as individual diseases, they are just manifestations of symptoms which we cluster into: HT, all the auto-immune diseases, Alzheimer's, diabetes, cancer, autism, heart attacks, allergies, asthma and more. They are all caused by the same elements and all can be healed the same way. All respond to diet, sleep, exercise, sun, relaxation (joy). I think we are genetically programmed for health, but the epigenetic influence of a bad lifestyle (high-sugar diet, sedentary, sleep-deprivation, stress, toxins, etc.) promotes illness and overrides our natural health.

In my opinion, today our food, water and environment is poisoned, and HT overlaps with all the auto-immune diseases, Alzheimer's, diabetes, cancer, autism and all the modern diseases; it's just that different symptoms are more exaggerated in different people. There are several main "toxins" common to all diseases: sugar (insulin), glyphosate, fluorine (in the water), chemicals, drugs, vaccines, stress, sleep deprivation, lack of movement, and lack of outdoor sunshine, inflammation, and infection. Proper diet, sleep, exercise, sun, relaxation (joy), removal of "toxins" have healed many (See Dr. Lorraine Day's work on breast cancer).

It seems to me that sugar is one main toxin. "Sugar" includes alcohol, bread, all grains (rice, wheat, corn, etc.), all beans, all roots (potatoes, carrots, etc.). In other words, all food is sugar except animal flesh (protein-essential amino acids) and except animal fat (the omega 3's and 6's-essential fatty acids). And the body will also convert excess protein into sugar (glycogen) by gluconeogenesis if you eat too much protein. Sugar causes insulin which is aging - it makes the cardiac intraventricular septum friable (heart attacks, and see Dr. Joseph Kraft's research) and insulin shortens telomeres (longevity).

There is no essential carbohydrate, we never have to eat any sugar. We only need to eat a total of maybe three to five ounces a day of animal flesh and fat to survive. Carbohydrates (sugar) can be grouped into starchy plants and non-starchy plants (green leaves, celery, cauliflower, herbs). The starchy (sugar) carbohydrates invoke more life-shortening insulin than the non-starchy plants. Most foods in the produce aisle are poisoned with glyphosate.

Another modern main toxin is glyphosate (RoundUp). Glyphosate is a poison that is in or on all commercial plant harvests and it causes the gut to leak ("leaky gut" and "leaky brain" syndromes) because glyphosate causes holes in the membranes and food particles go outside the gut which sets up diseases. The gut leaks out molecules into the blood and the white blood cells come to the rescue with an immune response. This response can be an allergy, asthma, or beta-amyloid plaques in the brain, for instance. The "leaky gut" explains asthma, allergy, and all the auto-immune diseases and more. Avoiding glyphosate is a good reason to pay extra for "organic"; but beware, there are "fake organic" cheaters out there who want that extra profit. Grow your own?

Alzheimer's can be linked directly to both glyphosate and sugar. Glyphosate causes a "leaky brain" - a blood-brain barrier leak causing brain inflammation from the leaked molecules which do not belong in the brain. The leak disturbs the balance of molecules in the brain. The Alzheimer's brain is inflamed and imbalanced from the glyphosate and also damaged by insulin (from sugar). Insulin competes with the beta-amyloid plaques for an enzyme which clears plaques BUT which will always go to insulin first, so the plaques do not get cleared, they build up. If the insulin level is high (sugar in the blood) then the enzyme cannot go to clear the plaques.

It seems that the chemical family of the halogens (fluorine in the water, chlorine in cleaners, bromine in plastics) has penetrated our environment (water, clothing, furniture, etc.) to such an extent that all of these ubiquitous halogens can and do block the element iodine. These halogens unbalance the thyroid. Perhaps the thyroid is also disturbed by the mercury in dental amalgams?

As for all illness and especially autism, I see more and more credible proofs that vaccines are destroying the health of many by putting various toxic viruses and toxic adjuvants and toxic metals and unknown DNA directly into the blood.

So my conclusion on all this is avoid sugar, eat a ketogenic or paleo diet, exercise, sleep, sun bathe, replace stress with joy and these epigenetic manipulations will allow your body to heal.

[Fiona · Rating 3 out of 5]

I have Hashimoto for several years but never took the time to get to know it and to get engaged in the whole topic. Doctors also always just prescribed me pills and never talked to me what the effects for my body are or what else can be done to support my thyroid. As the illness is currently affecting my health and daily life immensely I bought this book as a first step to trying understand the illness and to see what I can do, besides taking my pills, to get better and deal with it.
For a starter the book is really good. As everybody (and every body) is different there is no concrete plan saying do this and that and all will be good. There is a lot trial and error in finding the right treatment and what is good for the body. But the book gives good guidance. Sometimes it was a bit too theoretical and in one chapter it says product A is bad for an organ and later it says it is good for another organ. That is probably true, but it was confusing for me and a guide on how to handle this or even a short info like "yes bad for this but good for that, talk about it later and tell pros and cons" would have been really helpful. Also it mostly promotes getting nutrients from eating meat and doesn't offer alternatives for vegetarians and vegans.
Also the author speaks about the US when she speaks about food, medicine, health system etc, this is not relatable to Europe, but the editors made notes on these parts to differentiate how it is in Germany.
I got a lot on my agenda now to tackle my illness and support my body in getting healthier again, and the book was a good start to help me with this.

[Janet Bailey · Rating 5 out of 5]

I would recommend this book for anyone diagnosed with Hashimotos and acid reflux. It is one of the only books I have found that explains the connection between these two conditions. It goes through and summarizes a number of different diets out there and explains what works and what doesn't along with how to adapt them to you. The book's excellent information on dietary supplements may have even saved my life. Previous books on the subject only described what supplements might help but they didn't go through dosage, when to take them, what supplements work well together and what the possible side effects might be like this book does. I had unknowingly been overdosing on magnesium and had been getting sicker and sicker without knowing why until I read this book. I cut my magnesium by a lot and now feel better. There is also an excellent section on the role of iodine where I discovered that your Hashimotos gets worse the more iodine you consume and after reading the list of foods that are high in iodine I discovered soup broth was on that list. I had been eating soup almost everyday making my condition worse and after this book I quit doing that and could see some real improvement. While I probably won't follow every piece of advice in the book there is a lot of good information and it is presented in a way where you feel like here are your possible paths for getting better now you decide which path you want to take.

[Jenni Pankau · Rating 5 out of 5]

Recently diagnosed after I had my first child. The drs just gave my synthroid and sent me on my way, but I was still experiencing chronic fatigue, mood swings, depression, anxiety, dry skin, heart palpitations, weight gain, and hair loss. This book has changed my life. I am gluten free, dairy free, and on supplements. I am starting to feel so much better.

[Cari-lynn Mackie · Rating 4 out of 5]

I got this as a paperback from Amazon and came HIGHLY recommended to me. It was well written and full of good advice, but I found some of it too technical for the layperson. I was lost in the chemistry explanations...maybe I will have to go back and read it again section by section.

[Mackenzie · Rating 5 out of 5]

Really fascinating (at least for a biomedical geek like me) and very encouraging. It might be overwhelming at first but I'd rather have lots of options to try and the reasoning and research behind them. Of course, I hope you never have to read this but I'm glad its around.

[Margaret · Rating 5 out of 5]

Because I read this book, I knew what medication to ask for when I saw my endocrinologist. This is definately a book to keep close by if you have hasimoto's because you will want to refer to it often!

[Rowan · Rating 5 out of 5]

Very helpful with plenty of new information.

[Kim · Rating 5 out of 5]

This is a must-read for anyone with Hashimoto's Thyroiditis!

[Teresa · Rating 5 out of 5]

Great book! Easy to understand, good advice, well-laid out. Highly recommended!

[Ronald · Rating 5 out of 5]

Excellent book for anyone with fatigue, weight issues, or suspected Thyroid issues. Great read!

[Peggy · Rating 5 out of 5]

Easy to read. Very informative.

[Jude Grebeldinger · Rating 5 out of 5]

All I ever wanted to know and then some!