What is autoimmunity? Leaky gut, the immune system, and gut bacteria. Episode 28.

Welcome to episode 28. I kind of feel like I left you in the dust last week by cutting things off at intestinal permeability. I’m still working on getting my TSH in normal range and my brain had had enough. It felt like too much work to dive deeper and so I ask you to have patience with me as my brain and body get back up to speed with all that I want to share with you. I had some kind of bug last week where my body ached which didn’t help me feel like doing much but lounging around. I did some research for a client and that was about it. I am fighting fatigue for a number of reasons, and am honoring my body’s need for rest. 

I want to say something about medication. It is not a bad thing to have to take thyroid hormones. Sometimes the damage done to the thyroid is so great that the gland just can’t make enough hormone for your cells. Some of us will need lifelong hormone replacement even after all the diet and lifestyle changes we have made and that is okay. It doesn’t mean you are a failure. It’s okay to need medication. All the diet and lifestyle stuff will help. It might even help you need less medication- just don’t feel bad if you still need to take it. 

Ok so lets dive more in to Hashimoto’s and the things that can affect it. You know you need to heal your gut if you listened last week. How do you do that? You have to lower inflammation. This starts with changing your diet and your lifestyle. An elimination diet or autoimmune protocol diet - AIP- can be very helpful. I’ll cover that more in detail in another podcast. 

Before I talk about the gut let’s talk a little bit about the immune system. When you have an autoimmune disease such as Hashimoto’s, your immune system is attacking self. It is attacking proteins in your body that are part of you. Our immune system is supposed to protect us from invaders like bacteria and viruses. In autoimmune disease it is attacking our tissues, like the thyroid. This means that autoantibodies have been created. Antibodies against our own tissue. 

Antibodies are important parts of our immune system where they recognize proteins in things like bacteria, viruses or parasites. The autoantibodies or antibodies hang on to the invader and signal the immune cells to launch an attack. In autoimmune disease, your body mistakenly makes antibodies to our own tissue as well as to the things that don’t belong like the virus or some bacteria.  

When your body creates antibodies against proteins in your own tissue this is called molecular mimicry or being cross reactive. This is the beginning of how you develop an autoimmune disease. 

Your genes will predict the probability of your immune system creating the autoantibodies and it will be your environment (diet and lifestyle) that cause the immune system to actually create them. How many genes you have that say you have susceptibility to autoimmunity will determine how quickly your autoimmune disease is triggered by your environment and how severe it will be. 

Your autoimmune disease likely happened or manifested because the autoantibodies formed and your body wasn’t able to determine the difference between the antibodies formed against your own tissue and the antibodies that formed against foreign invaders. Then your immune system launches the attack against both the foreign invader and your own tissues which eventually causes enough damage to your own tissue that will result in you having symptoms of disease. In the case of Hashimoto’s the symptoms result in what would look like hypothyroidism or a slow thyroid or it could trigger Graves disease which is a hyperthyroid state. 

You don’t have any control over your genes but you have a lot of control over your diet and lifestyle or what would be referred to as your environment. In order for you to understand why your body has essentially began an attack on you it might be a good idea to understand how your immune system works. 

We are all made up of various types of proteins. They are what are called the building blocks of the body. The bricks your house is made of so to speak. Proteins are broken down in to amino acids which form all kinds of things in the body. Some amino acids are essential, building everything we are made from. When some of these amino acids get strung together, they create proteins.  Our DNA is made from proteins and so is pretty much everything else in our body.

Antibodies created by our immune system are also a protein and they are called immunoglobulins. You may have been tested for IgA, IgE or IgG antibodies. What these immunoglobulins do is look for certain amino acids that are strung together a certain way in some proteins. They then attach themselves to these amino acids strung together and keep the protein from working properly. Once it binds to this protein and basically deactivates it, it lets the immune system know that this protein does not belong and should be attacked. 

Your immune system will then attack the whole thing, not just that little protein that was recognized. So if it is bacteria, the whole bacteria gets attacked. The same thing happens to our thyroid when there is a case of mistaken identity. The thyroid tissue gets attacked and the immune system remembers that the proteins in our thyroid are something that need to be attacked just like it would remember to attack the same bacteria if it invaded our system. So when you have an inflammation in your body, your immune system may be on constant high alert and attacking thyroid tissue because its protein structure is similar to something else being attacked. One common issue is foods that have similar protein structure like the protein in wheat or gluten- called gliadin. 

There is so much more to this- this is a vey simplified version of what is going on in our body. 70-80% or so of our immune system lies in our gut and the lining in our gut being in tact is crucial in the prevention of autoimmune disease. 

The small intestine also is where about 90% of absorption of nutrients happens through the microvilli. The microvilli are little fingerlike projections that line the small intestine also called the brush border. The microvilli  take up the nutrients from the food we eat and helps to transport those nutrients into the blood stream.  This is how your cells get the nutrients they need to work well. 

The adult small intestine is about 16 feet with a diameter of about 1 inch but the microvilli increase the surface area to be 500 times greater than that.

There is a mucosal layer- and that is just what it sounds like. A layer of mucous that lines the cell wall of the intestines keeping the outside contained to this area. What that means is, like I stated last week, our digestive tract is exposed to the outside and it protects the rest of our body (the inside) from harm. 

The wall of the intestines can become damaged in a number of ways- toxins, bacteria or pathogens and even from proteins found in grains, beans and even nightshades like tomatoes and potatoes. They can actually cause microscopic holes to be formed in the small intestines which allows undigested food particles, proteins and toxins to leak in to the blood stream causing inflammation and immune system reactions. 

The tight junctions formed in the wall of the intestine are one of the lines of defense that keep the inside protected from the outside. They are supposed to open up to our insides for certain nutrients to get absorbed properly.  Zonulin is a protein in our gut that acts like a gate keeper and will monitor the opening and closing of the tight junctions. 

One study describes the workings of zonulin quite well. The study done by Alessio Fasano in 2012 found that zonulin played a role in increased intestinal permeability (leaky gut) which “may be influenced by the composition of the gut microbiota” which contributes to autoimmune disease when antigens are present. Zonulin is a protein in our intestines that regulates the tight junctions in the small intestine which means it basically controls when or if there will be openings created/permeability in the small intestines where things from the outside can have access to our insides. 

The biggest triggers for zonulin to cause the small intestine to loosen the tight junctions (again, giving access to our insides) are exposure to bacteria and gluten. The bacteria discussed in the study were infections that trigger an immune response.  The protein gliadin which is in wheat was the other big trigger for zonulin to cause the tight junctions to open or create intestinal permeability/leaky gut. 

This may be partially why a gluten free diet is so helpful for people with autoimmune disease. There is some thought that all of us with autoimmune disease may have a gluten sensitivity.  Once the immune system recognizes a protein in a food, it can recognize similar proteins in other foods which can lead to multiple food intolerances. Gluten and proteins in dairy, oats, yeasts used in baking and in brewing as well as in many other grains are all similar enough that there can be a likelihood that you may be sensitive to one or more of these foods in addition to gluten. 

It doesn’t mean that you are but that there could be a likelihood of developing additional sensitivities to those foods. 

Hopefully I have established that the health and or integrity of the small intestine is important for your health when dealing with autoimmune disease. Diets like the autoimmune protocol are very helpful in determining which foods are giving you trouble and are cheaper than food sensitivity testing which isn’t always the most reliable.

Other things that can affect intestinal permeability are things like NSAIDS- ibuprofen or acetaminophen, hot peppers like cayenne, alcohol, the wrong types of bacteria in your gut, stress, exercising too hard, surgeries and food allergies. 

If it is not clear to you yet, you need to fix your gut in order to calm your immune system. It starts with digestion. You need to have good digestion, you need to have regular bowel movements that are about a 3 or 4 on the bristol stool chart. Your eliminations should be daily, 1-2 times a day. Your stool should be about the length of your forearm from your wrist to your elbow. It should come out with ease, and there should be little to nothing on the toilet paper when you are done. 

Eliminations should be about 16-24 hours after you eat- that means that what you ate should come out of you about 16-24 hours later. You also want to have a good balance of bacteria in your gut. You can feed the “good” guys by consuming lots of vegetables and fermented foods. 

We have more bacteria living in our digestive tract that we are made of cells. There are trillions of them and there are hundreds of different species of bacteria that make up those trillions. Usually though, you have a portion of bacteria that dominate your gut- these guys kind of run the show.

They help us digest sugars, starches and fiber in our food so we can absorb the nutrients from them. These bacteria provide us with certain chemicals that help us with energy production and help regulate our metabolism. They also make B vitamins and vitamin K and increase our ability to absorb our fat soluble vitamins A, D, E and K. 

A good or healthy gut bacteria help our immune system operate properly or keep it operating as it should. When we experience what is called gut dysbiosis or having the bacteria out of balance, we start to see dis-ease or symptoms of digestive upset. 

Feeding the bacteria the proper foods helps keep in balance the good and bad bacteria  which keeps your immune system operating properly. What you put in your mouth directly affects the amount and type of bacteria living in your gut. This is why diet changes are so important when you are looking to heal your gut or bring your body back in to balance. 

I will cover the diet changes needed in a future episode so please stay tuned for that. Do you have any questions about this episode? Go to helpforhashimotos.com and look up Episode 29 on the blog. You can read the transcript there and you can leave a comment or question under the blog post. 

Be sure to sign up for my newsletter there and get your free ebook 5 Things Your Doctor Won’t Tell You About Hypothyroidism. 

Join me on facebook in the Help For Hashimoto’s facebook group and on Instagram at @StephanieEwalsNTP. 

If you like what you are hearing I would appreciate it if you left a review on iTunes so more people can find the show and be helped. 

Look for information coming soon about a live group coaching program for those of you who don’t even know where to begin with the diet and lifestyle changes. The program will be live video calls and I will walk you through how to make the changes you need in order to feel your best. You will get nutrition and thyroid education as well as support from the group. Please let me know if this is something you would be interested in. 

Thanks so much for listening. See you next week. 

Looking for a way to exercise with chronic illness? Check out Autoimmune Strong