After reviewing the new book Thyroid
Power, I've said that one of the strongest chapters is Richard
and Karilee Shames' discussion of mind-body aspects of
autoimmune hypothyroidism. Their interesting theories about
autoimmune hypothyroidism, combined with Karilee's findings
from her in-person thyroid support group, offer some
interesting ideas that may resonate with some thyroid
patients.
Mary Shomon: Most people
have a vague sense that the immune system is involved with
thyroid illness. Some even know that the brain is involved
with immune function. Can you explain briefly that important
connection?
Drs. Shames: It turns
out that the cause of virtually all cases of low thyroid is
not so much a faulty thyroid gland, as it is an over-zealous
immune system. As strange as it might seem, common low thyroid
is a mild immune system illness in which the immune system
wrongly attacks the innocent thyroid gland. The illness is
called Hashimoto's Thyroiditis in honor of the Japanese doctor
who first identified it.
Of course, there are other kinds of thyroid problems:
infections, injuries, benign nodules, and cancer, for
instance. But, most simple low thyroid disease is
immune-caused.
Normally, the immune system is poised and waiting to defend
the body against foreign invaders such as virus or bacteria.
Part of this job involves constant search-and-destroy missions
by certain white blood cells. These neutrophils and monocytes
are always in motion, hunting down a hiding germ or cleaning
up cellular debris. On a good day, they can even direct a
killer lymphocyte into eliminating a previously normal body
cell that has recently turned cancerous.
All this normal immune function is, of course, to our benefit.
We live in a veritable sea of bacteria and other
creepy-crawlies that are nicely held at bay by this relentless
vigilant system. However, some of us pay a price for this
pervasive vigilance. Without warning and for no good reason,
our immune system can sometimes start attacking our normal
cells and tissues.
It is clearly a mistake for the body to be attacking itself,
but it does happen. The name for this seemingly bizarre event
is autoimmune illness. Once thought to be rare, it is now
known to be surprisingly common.
For the moment, let us say that recent research is suggesting
runaway environmental pollutants, among others, as likely
culprits.
These deleterious influences appear to be assaulting our
sensitive and delicately balanced immune systems, causing
mixed messages within the body. Some of the new chemicals our
immune system tries to fend off are hormone mimics. Others are
hormone blockers. Still others are immune disrupters. Many of
the thousands of these new chemicals dumped into the
environment are simply low-level poisons.
In a desperate attempt to ward off an apparent assault from
all sides, our confused antibodies are increasingly attacking
our own glands and hormones. No one knows the exact mechanism,
but the results are becoming obvious.
Mary Shomon: There is
compelling recent information that bacterial infection might
be involved in the underlying cause of triggering the
autoimmune effect. What are your thoughts about this?
Drs. Shames: Yes, in
fact you reported in your newsletter that there has been an
interesting research study in Greece regarding the bacteria
Yersinia Enterocolitica. The researchers in the Journal of
Clinical Microbiology and Infection reported that the
prevalance of antibodies to this bacteria was fourteen times
higher in people with Hashimoto's Thyroiditis than in the
control groups. They concluded that there is strong evidence
for an immunopathic causative relationship between this
bacteria and Hashimoto's.
This is just one further example of what we are calling the
multifactorial theory of Hashimoto's Thyroiditis etiology. In
other words, various non-chemical factors might be combining
with the chemical siege to cause our immune systems to make
antibodies against our own thyroid glands. If you have a
family history of low thyroid, diabetes, or other
rheumatic/autoimmune illness, then almost any serious physical
or mental stress might trigger the primed immune system into
mischievous action against the thyroid, one of its favorite
body targets.
Thus, the cause of low thyroid disease may be viewed as
multi-factorial, just as heart disease is multi-factorial. A
person may have multiple risk factors, each of which can add
to that individual's likelihood of acquiring the syndrome.
Most people know that the risk factors combining to yield
heart disease include family history, smoking, high blood
pressure, high blood fats, stress, lack of exercise, and high
levels of homocysteine.
Other than genetics and chemicals, are there other risk
factors that could account for the energy epidemic that grips
us? Could radiation, for example, be another cause? We know
how deleterious this can be on sensitive immune balance. With
the depletion of the ozone layer, our exposure to the sun’s
ultraviolet radiation is increasing. What about our exposure
to whatever radiation is emitted by cell phones, computer
screens, or counter-top microwave ovens?
Not only is the neck a likely place to receive much of this
added new radiation, but the thyroid gland is particularly
sensitive to it. Even more directly sensitizing to the
delicate thyroid is the increased irrigation of food crops
with brackish water containing significant amounts of
radioactive iodine 131. This potentially toxic isotope is
known to head straight for the thyroid gland and become
concentrated there.
One non-chemical immune irritant on the increase is intestinal
parasites. Once thought to be a problem confined to third
world populations, a wide variety of mild parasitic conditions
now affect the average city dweller in the United States.
Sometimes, without causing any particular distress, their
presence is like a thorn in the side of the immune system,
which makes increased levels of antibody against them.
Increased antibody production against the parasites has a
subtle way of spilling over into increased antibody production
against the thyroid.
Still another possibly suspicious trend on the increase is the
widespread fluoridation of municipal water supplies. This
well-intended activity has been so widely accepted in today's
society that it is shocking to read the mounting research
casting doubt on its safety. The short-range goal of reducing
tooth decay seems to have blinded many to the long-range risks
to sensitive immune balance posed by fluoridation. We discuss
this in Thyroid Power.
The high stress of daily life may be as big a factor in
thyroid disease as it is in heart disease. Anxiety and
depression are known to have deleterious effects on immune
balance. Also, the increasingly rapid pace of life may leave
little time for immune-restoring activities like aerobic
exercise, muscle building, or slow stretching. Keep in mind
that what is disruptive to the immune system now, may be
disruptive to a thyroid gland later.
Mary Shomon: How are
these causative factors related to the mind-body connection?
Drs. Shames: Although it
was once thought that the immune system functioned fairly
autonomously, it is now known that this body system is in
constant two-way dialogue with the brain. The control centers
in the brain are continually feeding information to thte
immune system, and the immune system is continously feeding
information back to the brain. Our emotions, our stress level,
and the very fabric of our inner life are directly related to
the quality of this brain-immune conversation.
Current medical science does not provide easy solutions for
people with autoimmune low energy. It is not simply that the
underlying reason for the low energy is missed, though this is
often the case. Even when the problem is diagnosed properly,
the treatment frequently falls short.
In autoimmune conditions, the whole body is involved, rather
than just the organ that has been attacked. The damaged organ,
in this case the thyroid, is referred to as the
"target-organ." This is medical lingo for the part that
displays the symptoms of the total body autoimmune situation.
Interventions are generally directed only at the target-organ,
and not the source of the problem, which is the entire immune
system.
People need to know that taking hormones and vitamins for
autoimmune low thyroid is similar to taking nose drops or eye
drops for hay fever. The drops can help the symptoms, but can
never fully address the root cause of the problem.
Thyroid doctors do not generally address the immune system
problem because almost every standard medicine in the
conventional medical arsenal is ineffective for autoimmunity.
Recently developed immune-boosting medicines are not
appropriate when the immune system is already in autoimmune
overdrive. Even the new immune-modulator drugs like Paxone and
Avonex are not used for thyroiditis. Unfortunately, doctors
simply do not have a pill to prescribe that will directly
reduce the autoimmune component of low thyroid.
However, many non-drug approaches offer substantial promise.
Before using them, you first need a clear sense of what is
causing your particular version of the illness.
Mary Shomon: Do you feel
then, that stress and emotions might be an autoimmune trigger
in the same way that chemical pollution and/or Yersinia
bacteria are autoimmune triggers?
Drs. Shames: Yes. The
triggering of the autoimmune phenomenon resulting in common
low thyroid (Hashimoto's Autoimmune Thyroiditis) is indeed
possible from stress alone.
The tendency for the autoimmune reaction is in part genetic.
There is presently no way to do much about that, except to
choose your ancestors more carefully! We can, however, learn
ways to reduce the factors that trigger the autoimmune
tendency into a full-blown autoimmune attack.
One trigger is age. Some people's internal time clock goes
off, and their autoimmune thyroiditis gets triggered. This can
occur at any age, for no apparent reason, without another
precipitating event. On the other hand, some women's
thyroiditis is triggered by fluctuations in their female
hormone levels, specifically at the unsettled times of puberty
or menopause.
Other women find that the end of pregnancy is a trigger. This
response is named post-partum thyroiditis. Many women who are
diagnosed with postpartum depression, or postpartum low
energy, actually have autoimmune inflammation of the thyroid
gland.
Other triggers that have been described range from accidents,
operations, and severe infections, to bulimia, crash dieting,
and major changes in lifestyle. A few of our patients suffered
from specific trauma to the neck (especially whiplash), which
apparently triggered their long-term thyroid inflammation.
Scientists believe that the antibody inflammation gets started
secondary to cell destruction from some other mechanism. This
other mechanism can cause irritation and damage to the thyroid
cells through the effects of outside chemicals, free radicals,
food allergy, and perhaps other irritants.
It is even possible for severe stress alone to be a trigger.
This should not be totally surprising, when considering the
number of documented incidents in which stress has been shown
to affect immune function. It may be part of the genetic
makeup of certain individuals to be anxious and worried, which
in itself predisposes them to this kind of triggering effect.
Fortunately, this is one genetic tendency where intervention
has been successful. You might not be able to change your
genetic makeup, but you can learn to be less stressed by life
events, reducing the likelihood of triggering further
autoimmune difficulty. In fact, keeping your mental state in
optimal health will reduce the likelihood that Yersinia,
chemical pollution, and perhaps a host of other external
factors will be able to trigger you into thyroiditis.
Stress does affect your immune function. It is certainly known
and accepted in medical circles that severe stress can trigger
hyperthyroidism, and perhaps Hashimoto's thyroiditis. The
exact causal mechanism for this is not clear, but it is
tempting to speculate.
Mary Shomon: So what
does it mean to handle extra stress properly?
Drs. Shames: We've all
heard about stress-reduction activities. When you are going
through difficult situations, this is definitely the time to
utilize any stress-reduction training you've had. You could
choose meditation, self-hypnosis, or specific relaxation
exercises from biofeedback or yoga. It is certainly the time
to begin getting some exercise or to increase your exercise
program, if you already have one. Ideally, you would initiate
such a stress-reduction program before you were in the midst
of big changes.
This could also be a good time for increased interactions with
friends, or a time for some counseling sessions with a
professional. Many people have found that biofeedback sessions
can be very useful during stressful times. The act of quieting
the mind using meditation techniques helps relieve the
biochemical difficulties caused by the stress.
A combination of several of these techniques is known as
imagery. Imagery involves imagining yourself in a relaxing
locale. It's like a mental vacation. In addition, you can
"see" a positive outcome to a problematic situation, or can
mentally envision your world getting better. Some call the
process "visualization", but we find that people are very
diverse in the ways they perceive. Instead we use "imagery",
as imagination can take many forms, including sensations,
smells, and feelings.
Mary Shomon: What
practical things would you suggest someone with autoimmune
hypothyroidism can start doing right now in their path toward
better wellness?
Drs. Shames:
For sufferers of autoimmune thyroiditis, why not visualize
your immune system getting smarter, and leaving your thyroid
alone? Just imagine it getting the point that its best job
will be to protect you from outside invaders, like bacteria
and viruses. Picture it leaving your glandular system,
especially your thyroid, completely free to do its job,
unencumbered.
The medical field specializing in the mind's effect on
immunity is called neuro-immunology. Its practitioners and
researchers tell us that the brain is constantly talking to
the immune system, and that the immune system constantly
provides vital information to the brain. Knowing this, you
might therefore want to employ the above, or similar, imagery
exercises on a regular basis. You might also want to consider
more advanced forms of self-hypnosis and enhanced affirmation
strategies. Our own books on this topic are Healing With Mind
Power and Creative Imagery in Nursing.
Mary Shomon: I find it
interesting to consider how being more mentally in control of
the immune system might enable patients to better cope with
their autoimmune thyroid problems. But are there specific
practical things to focus on?
Drs. Shames: That is
certainly a fair question. Here are some of our best tips for
doing exactly that, based upon over 20 years of clinical
experience each, both with thyroid individuals and thyroid
recovery groups.Tip 1:
Carefully consider all sources of input into your life, and
screen out those that may be draining your energy, or making
you feel worse.
Anyone newly embarking on combining
physical and psychological thyroid treatment should not be
surprised to experience an initial exacerbation of symptoms,
prior to stabilizing and fine-tuning. Many thyroid patients
with longstanding histories have found they required a
complete program for achieving optimal health, including
nutritional advice, exercise coaching, and psychological
counseling.
Tip 2: Emotions are a normal, healthy
response to being diagnosed with any condition, including that
of low thyroid, and most people will benefit from having
support for resolution of these issues.
Some never get beyond this stage,
but many proceed to acceptance, and to a sense of needing to
empower themselves and others. An important overriding theme
emerged in our recovery groups. All the members were all
able to identify what seemed to be a similar disorder in
their approach to life. They all felt "hyper-vigilant,"
guarded against the world and its stressors.
Another commonality they uncovered was that almost everyone
in the groups described herself as hypersensitive, and
feeling like the proverbial "canary in a coal mine." (Long
ago, coal miners kept canaries in cages down in the mines
because the birds were more sensitive to the deadly, but
odorless, gases that would sometimes escape into a mine
shaft. When the canaries died, that signaled the miners to
evacuate immediately).
Modern day "canaries" are people who seem to be more
sensitive than others to the hazards of modern life. Their
resulting illness can serve as a warning to the population
at large, signaling that impending environmental hazards are
worsening. It is both a blessing and a curse to be the
canaries for our society. Karilee chooses to consider it an
honor to serve in such an important role. This is not to
diminish the incredible hardships she must often face,
however, in being so very sensitively attuned.
Tip 3: Often those with autoimmune
thyroid are extremely sensitive people, perhaps reacting more
quickly or strongly to an external threat that may eventually
affect everyone.
On the other hand, however, they
found that their overly watchful immune systems were, at
times, protecting them from the wrong things, i.e. attacking
their own tissues. Those who are challenged in this
particular way need to make better friends with themselves.
They need to boost self-esteem while rebuilding their
defenses into something more healthy and discriminating.
And, they often need to practice self-forgiveness, as a
regular mantra, in order to make room for more peace and
harmony in their lives.
Remember, people with autoimmune challenges may be on
"hyper-alert," and can benefit from rebuilding their
defenses into something more healthy and discriminating.
Ideally, we might suggest that those challenged by this
condition learn to regard the thyroid disease as an
experience, a journey about "surrendering," and "opening up
to the process". This stance allows for greater ease,
physically, mentally, emotionally, and spiritually.
Tip 4: For many people with
autoimmune thyroid, benefit may be derived from considering
the meaning of "protection" and "rejection" in their lives.
In a very popular book from the
early 1990's, Women Who Run with the Wolves by Clarissa
Pinkola Estes, Dr. Estes shares the story of "The Mistaken
Zygote." This tale seems to describe how many of us
similarly challenged may have felt about our family of
origin. In this ethnic folk tale, espousing a common theme
in many cultures, a fertilized egg was supposed to be
"delivered" to the home of a certain family, but the bird
became confused and dropped it elsewhere. The individual
grew up with a very different family, and felt puzzled and
uncomfortable.
In Karilee's thyroid recovery groups, many of the
participants felt that their own characteristics were not
consistent with those of their family. They often didn't fit
into their family of origin well, and occasionally
fantasized about having been adopted. Some considered that
feeling like an outsider in their "clan" could have been a
factor in the development or triggering of the tendency
toward autoimmune thyroid.
Tip 5: Since the mind and body are
intricately interconnected, for optimal recovery one must
carefully guard one's thoughts, weeding out those which are
immune- disruptive.
Another folk myth is "The Ugly
Duckling" by Hans Christian Andersen. In this story the
mother duck has one egg that takes too long to hatch. When
it finally hatches, it is different, and the other ducks
criticize him. He grows up teased, rejected and feeling
unloved. Once mature, he sees his reflection to find that he
is now a beautiful swan. No one recognized his true self
until this time and he now comes to be honored and
appreciated.
Almost all the group participants described an "ugly
ducking" childhood where they didn't feel safe, or valued.
Some had parents who were verbally abusive, and labeled them
with derogatory words. A child, vulnerable and reliant on a
parent, may learn a variety of coping responses as a result
of this kind of treatment. These often include not
expressing one's inner feelings or truth, not feeling safe
sharing oneself fully in the world, and not knowing how to
relate in a healthy manner to others. All such behaviors
undermine and attack the self.
Since many in the groups were tired so much of the time,
they had to learn ways to conserve energy. They agreed on
the need to limit "energy suckers," people who manipulated
and drained their energies in order to feed their own needs.
They had to learn to identify this type of interaction
immediately when it occurred.
Here is how they did it. Most of them had such people in
their lives: a nosy neighbor, an abusive or ineffectual
boss, a child with temper tantrums, a widowed parent with
learned helplessness, or a chatty friend with less demands
and responsibilities. They came to realize that these people
behave in parasitic ways unconsciously, not necessarily
intending to drain energy from others, but acting
compulsively in a way they learned in their early life to
get attention. Group members who were energetically
deprived, however, could not afford to have energy-suckers
feed off of them!
Tip 6: Certain people may impact your
health in ways that are immuno-disruptive.
Once they learned to respect and
honor themselves, group members learned how to define
boundaries within a loving relationship. They found themselves
redefining their needs and desires, identifying what they
would and would not do, what they expected others to do, and
how the family would reorganize itself around a democratic
pattern rather than an autocratic one. They empowered each
other with the strength and courage to set these limits. They
learned to find a balance, and to recognize when they lost it.
Tip 7: Setting boundaries and avoiding compulsive behaviors
might be very significant ways to conserve energy when
compromised.
Women shared unhealthy coping
patterns they had developed, including other compulsive
behaviors. One pattern was to overindulge, to do something
(eat, spend, talk) compulsively, in an attempt to feel
better, often justifying the behaviors by saying, "I deserve
this," or "I need this in order to cope." In order to
achieve a more positive sense of balance, these women
learned to ask, "What do I really need?" rather than acting
in a driven manner.
They slowed down their behavior, identified the difference
between acting and reacting, and learned to identify
triggers to their reactive behavior. They began to see that
they were pushing to accomplish, to do, to create, to
express, in order to avoid facing their own unpleasant
feelings, including the feeling of exhaustion, deep inside.
Tip 8: Take some time to consider a
positive mental image for your immune system that helps you to
make the best decisions for your health. Research has clearly
demonstrated the health connections between positive mental
imagery and immune/health enhancement.
Tip 9: Anger management can be a key to stabilizing the
thyroid and improving overall health.
The head and heart can often be at
odds, as many of us find in our daily lives. However,
thyroid-compromised individuals cannot afford to have
needless battles. They must choose their battles wisely and
expend energy cautiously and appropriately.
Tip 10: Learning to detach from
negative behavior of family members can be immune-enhancing at
times. In addition, clear communication can be particularly
immune-enhancing.
Tip 11: People with low thyroid need to honor their own pace
and abilities on a day-to-day basis, without judgement or
comparison. Each day we are different, and if we can make
allowances for this continual flux, others are likely to be
more accepting as well.
Tip 12: Speak out, as part of your healing journey.
Consider the lessons from Rachel
Carson in writing her passionate book, Silent Spring,
(1962), which is still popular today. Pay attention to your
body, your feelings and the data, and help your community to
make the best decisions for the largest number of people to
maintain health and wellbeing.
An interview by
Mary Shomon as it
appears on her website
Thyroid-Info.
http://www.thyroid-info.com/articles/shamesautoimm.htm |
