How Does the Gut Affect Thyroid Autoimmunity?

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How does the Gut affect Thyroid Autoimmunity? This is JJ Virgin, four time New York Times bestselling author, celebrity nutrition expert, and Fitness hall of Famer. I've been on a lifelong quest for answers to the toughest health questions and now I'm sharing what I found with you. Welcome to Ask the Health Expert. Maria from Instagram asks, how does the gut affect thyroid autoimmunity? Hey, it's JJ and I've got Dr. Michael Ruscio with me to answer this question. Now you might know him from his great podcast Dr. Ruscio Radio, or as the author of the best selling book Healthy Gut, Healthy you. I happen to know he's also an adventure junkie who's a musician in his spare time with a secret dream to paraglide. We'll be right back to answer the question. Hey, it's J.J. here. Now let's be honest. The holidays are basically a financial ambush. Travel, hosting gifts, surprise holiday school things. Suddenly you're wondering how December turned into a spirit spending spree. If you want to keep your finances under control this holiday season, you need to be using Monarch. It's rated the Wall Street Journal's best budgeting app of 2025. Monarch is the all in one personal finance tool that brings your entire financial life together in one clean interface on your laptop or your phone. What really grabbed my attention is how fast those little holiday expenses pile up. With Monarch. Seeing everything in one place makes it a lot harder to accidentally overspend. And honestly, I appreciate anything that keeps me from starting January with a money hangover. You'll love exploring the holiday spending category. Imagine how good it will feel to actually see what's happening before your credit card statement does that whole dramatic reveal thing. Monarch basically shows you exactly where the money is going in real time, and that level of clarity could change everything, right? Don't let financial opportunity slip through the cracks. Use the code virgin@monarch.com in your browser for half off your first year. That's 50% off your first year@monarch.com with code Virgin.

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Great question. How does the gut affect thyroid autoimmunity? Just as a quick refresher, the primary cause of hypothyroidism is thyroid autoimmunity. So this is definitely something to consider and for us to be cognizant of. And the best way to assess or quantify thyroid autoimmunity is through a marker known as TPO or thyroid peroxidase antibodies available at any big box lab. Now, what's the connection between the gut and the thyroid? Well, we have some preliminary data here that connects these two. It's also important to be careful not to oversell a case. So we have some evidence connecting these two. We don't have irrefutable and highly compelling evidence. And I think that's very important for people to understand what we do know. The best model we have that looks at this connection is looking at H. Pylori, which is the stomach that resides in the stomach and can cause hyperacidity and ulcers and Hashimoto's and also graves. So thyroid autoimmunity in general, and the research does show, and the research here is meta analyses of several trials has demonstrated that there is an increased prevalence of thyroid autoimmunity in those with H. Pylori. However, here's the important caveat that functional and integrative medical enthusiasts often don't disclose when we drill deeper down into this. That association seems to only be present for hyperthyroidism or graves and not so much for hypothyroidism. So from a high level, thyroid autoimmunity as a whole has been tied to H. Pylori. When we drill down to the details, it seems to only, at least according to the preliminary evidence, be present for those with graves or hyperthyroidism and not for those with hypothyroidism. Why does that matter? Because we don't want to send a hypothyroid Hashimoto's patient on a crusade against H. Pylori unless there's good evidence to support that connection. Now, there's other preliminary evidence that also has shown, and this comes out of some research in Poland, that those who have SIBO actually have higher levels of thyroid antibodies for Hashimoto's or hypothyroid than do healthy controls, but we still don't know if treatment there is going to have any benefit. Now, it's also likely that part of what expresses one's underlying genetic risk in terms of will they become hypothyroid if they're genetically predisposed, is a multitude of factors in their gut and how the gut impacts the immune system, which start in formation from while you're in utero in mom. And that has to do with how many animals mom has contact with, how many animals you have contact with as a kid. Some research is looking at this association how kind of non hygienic your environment is. All these things help to tune and calibrate your immune system. And so this multitude of environmental exposures to healthy dirt, germs and bacteria through the gut immune connection likely will steer you in a riskier or less risky direction for autoimmunity globally. So there definitely is a connection here. However, it's important not to oversell it because we don't want to lay all the blame at one organism like H. Pylori. The other thing that's slipping here really quick, and this is where I think the brunt of the clinical effect comes from. If you're suffering with symptoms, thyroid symptoms, a very overlooked cause, and there is very good documentation of those symptoms. Fatigue and depression, as two examples, can be caused by your gut health, but it's not the gut causing autoimmunity. It's the gut directly causing those symptoms like fatigue and depression, or the gut causing malabsorption of the medication. And so you can't get your levels normal because you're not consistently absorbing whatever medication that you're taking. So the gut's definitely involved. The minimal mechanism is likely the gut to the autoimmune, but definitely through the gut impacting symptoms and medication absorption. We want to incorporate that into any thyroid care health plan.

This is JJ with Ask the Health Expert. I do this five times a week, so make sure you never miss a show by going to subscribetojay.com.

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