Probiotics are live, beneficial bacteria and yeasts.  They are usually dairy-based and are found in foods like yogurt and kefir and in dietary supplements.  Taking the right probiotics and taking them at the right times (if antibiotics are being used) can be enormously helpful to anyone with Hashimoto’s Hypothyroidism.

The intestinal tract contains trillions of bacteria, yeasts, and other microbes, with the great majority of those being in the large intestine.  The small intestine should be fairly sterile. An unhealthy balance of flora, known as “dysbiosis,” can be caused by antibiotics and by both physical and psychological stress.

Most Hashimoto’s patients have dysbiosis when they begin seeing me for treatment. Dysbiosis worsens hypothyroid symptoms, even when patients are on the correct dose of thyroid hormone and have normal thyroid results on lab tests.  The overgrowth of pathogenic flora must be corrected to reduce inflammation in Hashimoto’s Disease.  For help, schedule a free, 15-minute phone consultation with me, Dr. Steven Roach, on our Contact Us page or by calling (704) 853-8000.

Not All Probiotics Are Equal

Intestinal flora are measured in terms of CFUs (colony-forming units), which means that they can multiply.  The probiotic doses sold in most heath-food stores (5-10 billion beneficial flora) are meant for people who already have a healthy balance of bacteria and just need to maintain that balance. Unfortunately, 10 billion helpful bacteria are not enough to heal dysbiosis.  Therapeutic doses should be at least 60 billion CFUs of beneficial bacteria daily.

For years, Functional Medicine doctors like myself (see our Functional Medicine page) have been using therapeutic doses of probiotics, obtained from labs with more stringent purity standards, to heal dysbiosis.  Although more than 60 billion CFUs daily is important, I do not use that dose initially.

Start Probiotics Slowly

Bacteria have a natural life-cycle; therefore, some of the many billions present in the body will be dying every day, without any probiotic influence.  As these commensal (non-harmful) and pathogenic (harmful) flora die, they release endotoxin (also called LPS—lipopolysaccharide) from the cell wall, which produces damaging inflammation for anyone with Hashimoto’s Hypothyroidism.  Healing an imbalance in gut flora is itself a balancing act.  Starting a probiotic regimen slowly is essential, because the death of large numbers of bacteria results in an avalanche of inflammatory endotoxins, which worsen autoimmune symptoms.

The good news is that the body has a weapon to combat this problem: intestinal alkaline phosphatase.  Alkaline phosphatase is an enzyme that removes phosphorous from the cell wall of bacteria, which “detoxifies” the endotoxin.  Hashimoto’s patients, however, often have low levels of intestinal alkaline phosphatase, because thyroid hormone is needed to induce its production.   

Other causes of low alkaline phosphatase are a zinc deficiency and malnutrition (nutrient deficiency). Nutrient deficiency is common with Hashimoto’s patients, because they often have both low stomach acid and intestinal problems because of gluten intolerance.

Probiotics Have Many Benefits

In addition to limiting non-beneficial bacteria, probiotics play a role in the conversion of T4 (the inactive form of thyroid hormone) to the active form (T3) that can be used by the body.  About 20% of this conversion happens in the gastrointestinal tract, and it is dependent upon beneficial bacteria.

Zonulin, a protein made in the body, has a destructive effect on the lining of the intestinal wall, producing a condition known as “leaky gut” (allowing food particles to enter the bloodstream). Hashimoto’s patients have worsening autoimmune symptoms when they have a high amount of zonulin, and probiotics help to lower it.

My previous blog mentioned that fact that helpful flora (as well as harmful flora) travel to the brain by the vagus nerve that connects the “gut” to the brain, and the good bacteria have a positive effect on cognitive ability and memory.  Pathogenic bacteria, however, have the effect of inflaming the brain, which can lead to dementia; so dysbiosis is an important thing to avoid.

Also, some strains of beneficial flora actually improve the way immune cells are made, and treating autoimmunity is the key to managing Hashimoto’s Disease.  Even more amazing is research that shows that probiotics can actually turn harmful genes “off” and helpful genes “on.”

Finally, taking probiotics while taking antibiotics is necessary; however, it is important to take beneficial flora at a time far enough away from the antibiotic to improve chances of survival.  At Carolinas Thyroid Institute, we use probiotics and other effective, natural treatments for the symptoms of Hashimoto’s Hypothyroidism.  For more information, see our Questions and Answers page.