Podcast episode (recorded Feb 12, 2024) in which hosts Wendie Trubow and Ed Levitan interview Dr. Bindiya Gandhi about how chronic stress impairs thyroid function — particularly by reducing peripheral conversion of T4 to active T3 via stressed adrenals and liver — and how this can precede abnormal TSH or autoimmune disease. The discussion links stressors (e.g., medical training, life events) to development of autoimmune conditions (Hashimoto's, celiac) and offers dietary recommendations (notably gluten elimination, sometimes dairy) illustrated by an anecdote of a patient whose TPO antibodies fell from ~170 to ~30 after dietary change. Emphasis is on personalized care with a functional/integrative approach.
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What role does stress play on the thyroid? Because when you think about autoimmune disease and chronic diseases, I always think of stress as a direct toxin for the body. Is that how you think of it in the realm of thyroid?
Yeah. So there's a big direct correlation with stress. I actually see this so often with my patients. People who are difficult, having difficulty losing weight, that have weight loss resistance, but just people that are unwell. This is also one of the precursors, unfortunately, to developing an autoimmune condition. Wendy, you and I both have celiac, but I bet what triggered your Zen mine, if we can pinpoint it, it was stress. Like, hands down, right?
Oh, totally. I mean, it was med school and then residency.
It's exactly same here. Just like that. Yeah, it was back to back. And for me, I developed it in residency. And so same concept with whether it's Hashimoto's or not. Your thyroid is impacted by stress. So let's talk a little bit here specifically of how this is happening, because I think this is important and forgive me if this is overwhelming or too much information for our listeners, but I want people to understand what the reasoning behind this. We have these. We have T4, and T4 is part of the thyroid, and it converts to T3. And when we are exposed to a lot of stress, chronic life stressors, whether it's med school, residency, maybe it's a divorce, maybe it's getting married, maybe it's having a baby, postpartum, parents passing away. Whatever it is, whatever it is, whatever stress you're going through, that conversion from T4 to T3 does not end up happening. Right. And it slows down. And when that slows down, our thyroid becomes sluggish. Right. This is usually one of the precursors or one of the early signs that something awry is going on with our thyroid even before our TSH gets to be problematic.
Let's drill into this video. Because when people. People might not be aware that the thyroid is converted from T4 to T3 in the organs and peripheral tissue, and one of the largest organs is the adrenal glands, that converts the T4 to T3. And when you're stressed, your adrenals are like, dude, I'm busy.
Yeah.
I do not have the bandwidth for doing this right now. And it's not going to do that. Just like when you're in menopause, if you're stressed, you won't make your hormones.
Yes.
So you're not going to make your thyroid hormone into its active form too.
So. Exactly.
This is the direct correlation with stress because you're shutting down the systems that do it.
Yeah. And. And the reason why this is also important, from a toxin or toxic level to Wendy, is, remember, our liver is one of the big organs that we have that really filters all the toxins out. We have phase one and phase two detox, detoxification. But when our thyroid is slowed down, remember, our thyroid is also being converted in our liver. So there's so many different things that are happening all at the same time that we need to pay attention to.
So when you're looking at hypothyroidism and autoimmune disease, which often tracks, by the way, with celiac. So.
Yes.
Like 1 and 2 go together.
Yes.
What are you. So it's definitely avoidance of gluten. What are the other types of things for, from food that you would say to people, hey, if you are heading towards Hashimoto's or if you have a history of it in your family, these are. These are foods you want to avoid or these are foods you'd want to increase. Yeah.
Oh, I'm so glad we're talking about this. So one of the things I am a huge fan of, and, you know, there's like 50 billion diets out there these days. Right. And a lot of people come to you, they've tried everything, they don't know it works. You know, one of the things I really encourage people do is, number one, work with an integrative and functional medicine practitioner because you want to get the right protocol. Anybody listening today? I can definitely make generalized statements, but I don't know if that's going to be the best protocol and diet approach for you. So I just want to get that out there. That being said, if you have an autoimmune thyroid issue like Hashimoto's, I highly would recommend just eliminating gluten. Now, when you eliminate gluten, let's talk about dairy. Dairy is not problematic for everybody, but for some people, if they have celiac like you and I do, which often is gets associated with Hashimoto's, they usually go hand in hand. We tend to see that there's also a problem with casein? Same thing. The body can't tell the difference between casein and gluten and the proteins look very alike. So it can just be problematic. So for some people, they actually get some better relief when they're eliminating gluten and dairy. Does that mean everybody has to eliminate gluten and dairy? No, no, that's not the case. This is why it needs to be more of a personalized approach. But we tend to see. And again, I was just sharing this information with my nurse yesterday because I was so excited. My mom's antibody. Since I've been tracking her antibodies and I changed her diet up five years ago, her thyroid antibodies, Wende went from 170, I think it was TPO antibodies and now it's 30 and all she did was change up her diet. And I mean, it's a big deal. Don't get me wrong, for my mom, it's a big deal. But we literally just cut out gluten. We literally cut out gluten. And I'll be honest, my mom is not as strict as I am. So she's going to cheat occasionally and her antibodies have still come down. Do you know what I mean? So there's direct data, statistics and correlation. By just eliminating gluten and seeing the numbers in the antibody improve.
