I wanted to explore a very important element of autoimmune disease that most researchers have not figured out—I think I cracked the code!!
Most autoimmune conditions have a higher incidence rate in women compared to men. This includes systemic lupus erythematosus (SLE), Sjogren’s syndrome, primary biliary cirrhosis, Hashimoto’s, rheumatoid arthritis, and multiple sclerosis. In Hashimoto’s, 5-8 women are affected for every one man.
Conservative estimates state that one in five women will be affected with Hashimoto’s or another thyroid disorder at some point in their lives!
I often get questions from my readers about why women have higher rates of Hashimoto’s and autoimmune disease. After all, I teach that Hashimoto’s is an environmental condition triggered by our environment, and men and women live in the same world, right?
Female hormones are thought to play a role, as pregnancy, puberty, and perimenopause are three of the most common times in a woman’s life for the onset of thyroid disease. Sex hormones, especially estrogen and prolactin, have an important role in modulating the immune system and may impact autoimmune disease. Estrogen can also change the requirements for thyroid hormone, and this may result in an autoimmune condition, especially in the presence of nutrient deficiencies. Prolactin, released by breastfeeding women to promote milk production, may also become elevated in women with Hashimoto’s (even when they’re not supposed to be breastfeeding) and has been tied to increasing thyroid antibodies and infertility.
Women have a higher risk of developing Hashimoto’s and Graves disease in the years following giving birth. One theory known as “fetal microchimerism” proposed that this is due to fetal cells that may remain in the mother’s thyroid gland and can cause an immune system response. A study of women with Hashimoto’s revealed that 50% of them had fetal cells in her thyroid gland. Luckily, a 2015 study found that fetal cells in the thyroid gland postpartum were actually more common in women without autoimmune thyroid disease, and that they seemed to serve a protective role from developing Hashimoto’s and Graves. Isn’t that sweet; it’s like our babies are trying to help mama out—even in utero. But I digress.
The hormones and pregnancy don’t fully explain the higher rates.
Another theory that has been suggested is the use of personal care items. Sadly, conventional personal care products are laced with toxins, and on average, women use 12 personal care products, while most men use just six. Here’s an article I wrote about personal care products for more information.
But I don’t think personal care products fully explain the higher rates either…
Genetics also do not fully explain the increased reason.
A study of children exposed to Chernobyl found that 80% had thyroid antibodies compared to genetically similar children in a Ukranian village that was at a further distance from Chernobyl. These antibodies were found in boys and girls alike.
Through my research and work with people with Hashimoto’s, I have found that nutrient depletions, food sensitivities, an impaired stress response, an impaired ability to get rid of toxins, intestinal permeability, and infections can trigger Hashimoto’s.
What do all of these things have in common?
All of these factors send a message to our body that the world we are living in is not a safe place and that the body should go into an energy-conservation mode.
In 2014, I attended a lecture by Erica Peirson, ND, who specializes in thyroid disorders in children with Down Syndrome. She explained that more people in Ireland have Hashimoto’s because the lower metabolic rate helped them survived the potato famine.
Imagine that—thyroid disorders are advantageous in times of famine! This is because in time of famine, it’s really important for us to conserve our resources.
What is the best way to conserve resources? Slow metabolism of course! That way, a person can survive with eating fewer calories. How do you slow down metabolism? One great way is to slow down thyroid function. How do we achieve slowing down thyroid function? Why not send some inflammatory cells into the thyroid to attack it so that it doesn’t produce as much hormone.
In a way, hypothyroidism puts us in a quasi-hibernation mode so that we are more likely to retreat to our caves, survive on fewer calories, and conserve energy by sleeping a lot. While I haven’t found any studies of thyroid antibodies in bears, thyroid hormone activity has been measured to be significantly lower in bears when they hibernate compared to when they are out and about catching fish and doing other bear things that bears do during warm months. This mechanism has helped them survive harsh winters when food and resources are scarce.
Now, we are not bears, but we have also made our own adaptations to survive difficult times.
Let me explain a bit further….
The immune system has an important job: to sense our environment and to determine what is safe and what isn’t.
The thyroid gland is also a part of this sensing pattern. In fact, a 2013 study found that the thyroid gland can sense danger and initiate the autoimmune response.
The innate immune response is known to be triggered when the thyroid gland becomes infected by a pathogen, like the Epstein-Barr virus, or when it is damaged by radiation or another toxin. The damage to the tissue releases molecules that call out to the immune system to help clear the pathogens, damaged cells, and begin cell repair.
These molecules are called danger-associated molecular patterns or damage-associated molecular patterns (DAMPs), and they can initiate and perpetuate an inflammatory response within a tissue or an organ as the cells that are sent in may further damage thyroid cells. This theory explains why toxins like fluoride or even excess iodine, which can initially damage the thyroid (especially in the presence of nutrient depletions), can contribute to an autoimmune response.
Many of my friends and readers know that I am a big evolution buff, and from an evolutionary perspective, it makes perfect sense to me that our immune system and thyroid gland are sending a message to our body in times that are not safe.
I’d like to introduce you to the Izabella Wentz Safety Theory on autoimmune thyroid disease.
This theory is based on my work and observations with 1000’s of people with Hashimoto’s, a concept known as adaptive physiology, and some of the leading theories of autoimmune disease including the bystander effect, molecular mimicry, thyroid directed autoimmunity, and the three-legged stool of autoimmunity. I also considered another autoimmune theory—the hygiene hypothesis—which states that autoimmune disease develops because the environment we live in is too clean. I address why this theory is not valid in my book Hashimoto’s Protocol.
Adaptive physiology is a concept that suggests that our bodies develop chronic illness to adjust to our environment and that the chronic illness serves a protective role…
Our bodies have evolved, or were brilliantly designed, to achieve two main goals:
1 – to help us survive
2 – to reproduce and perpetuate our species
Basically, our bodies are adapting to our environment that will ensure the best for us as individuals as well as for the future of our species.
Going back to why women get more autoimmune thyroid disease… we know that women carry the primary burden for bringing new life into our world. This means that women will be particularly tuned into sensing the environment to make sure that the time is prime for reproduction. After all, pregnancy is a huge stress on the body that requires resources. If you are in a situation where resources are scarce, it’s generally easier to survive if you’re not pregnant. As infertility is a side effect of thyroid disease, perhaps the immune system attack on the thyroid gland is an effort to help us survive.
Here’s the message our body is hearing: “You’re not safe here. This is not a good time to reproduce. I’m going to help you get through the tough winter by slowing down your metabolism. This will allow you to hold on to more weight to keep you fed when food is scarce. I’m also going to make you cold and tired so you don’t venture out of your cave because that will keep you safe.”
I’ll give you a hypothetical example of how our bodies evolved and were educated to understand the signals we were sending them to ensure our survival. I’ll also include how modern versions of these signals can put us in an adaptive physiology conservation mode.
Back when we were cave women, one of our main sources of stress was a lack of food. When we didn’t eat, ate things that we were not adapted to digest, or had deficiencies in nutrients, this was a message to the body that we needed to conserve resources and reduce calorie burning.
In modern days, we can send the same signal to our body by being on a calorie restricted diet (food is scarce), eating a processed diet (nutrient deficiencies), and eating things that are considered food today but would not be recognized as food by cavewomen (digestive difficulty). For example, humans are not able to eat most grasses in their natural state due to not having the ability to ruminate. However, modern agriculture has found a way to process grasses like wheat to make them “edible” for humans. Of course, I use the word “edible” loosely; even with all of this processing, research is finding that there are still components of these foods that are highly indigestible to humans. Most notably is the protein gluten found in wheat.
The Safety Theory also explains other situations that are correlated with autoimmune thyroid disease.
One glaring reason that I think most women are acutely aware of is that, quite honestly, being a woman in our society is not as safe as being a man.
It’s common knowledge that women are more likely to be physically, emotionally, and sexually abused compared to men, and abuse sends a signal to our bodies that we are not safe. Multiple studies have confirmed that thyroid hormone alterations are present in people who have been abused.
- In 2000, Stein and Barrett-Connor found that past sexual assault was associated with an increased risk of breast cancer, arthritis, and thyroid disease.
- A 2005 study found that altered thyroid activity was found in women with PTSD associated with childhood sexual abuse.
- Two studies found alterations in thyroid hormones in women who were sexually abused and had co-occurring menstrual-related mood disorders.
- Higher rates of Hashimoto’s were found in victims of child abuse, and researchers concluded that: “Severe childhood-trauma-related stress may promote lasting altered thyroid levels.”
- Battered person syndrome (previously called “battered woman syndrome”) is experienced by people who are victims of physical, emotional, and sexual abuse and by definition includes health-related complaints. Health complaints like asthma (an autoimmune disorder) and fibromyalgia (often connected to Hashimoto’s and other thyroid antibodies) are very commonly reported.
- Some PTSD studies have found that people who have undergone traumatic stress events may have alterations in their thyroid hormone release patterns. Some may show higher levels of T3/T4, while others may show lower levels of T4.
- A 1999 study by Wang and Mason reported that former prisoners of war (POWs) with evidence of combat-related posttraumatic stress disorder (PTSD) show decreased levels of free and total T3. These levels of thyroid hormone may be reflective of the ex-POW’s reports of “shutting down” or stonewalling,” which were behaviors that were more life preserving compared to a fight or flight response that may have put their lives in danger.
It may be easy for people to recognize physical abuse, but emotional abuse at the hands of others may also be a factor in you feeling unsafe as can “social defeat situations,” such as being picked on by “mean girls.” After all, back in cavewoman times, if you were rejected by society, your chances of survival were reduced.
Going back to the adaptive part of adaptive physiology of Hashimoto’s…
Here’s how Hashimoto’s can help us with our own survival as well as the survival of our species:
- Hashimoto’s makes us want to sleep and withdraw, be less fertile, and carry more weight which increases our chances of survival.
- Hypothyroidism makes us less fertile, lowers our libido, and makes us potentially less attractive to potential partners and our abusers (losing hair, body weight increased, dull skin, pheromone changes).
- The anxiety experienced due to thyroid cell breakdown may make a person more hypervigilant to potential dangers.
- Mental health professionals who work with people who are overweight report that those who have been physically abused may inadvertently go on to form a protective barrier around themselves. A person who was abused or felt vulnerable may feel “protected” by the excess weight.
- Being tired, depressed, apathetic, and withdrawn means that we are more likely to stay in our caves and sleep to conserve energy and are less likely to be out in the world where we could be attacked and/or exposed to toxins.
- If our trigger is a stealth infection, thyroid disease makes us withdraw to help focus on healing the infection and prevents the spread of this infection to others.
- During postpartum when prolactin is elevated (in addition to thyroid antibodies), this lowers our likelihood of becoming pregnant again, ensuring that we are conserving resources for ourselves and our newborn.
While I love the Paleo diet, I am not suggesting that if you have thyroid disease that it’s a good thing to just go back to your cave and sleep. Because I’m often writing about lifestyle interventions and weaning off medications, people assume that I am anti-medication, anti-technology, and anti anything that’s not natural.
I consider myself to be more of a problem solver, pattern recognizer, and guinea pig; a person who loves to figure out puzzles through any necessary means. I’m not athletically or artistically gifted, but I do think I have a gift for taking in large amounts of information and seeing patterns. I’ve found that there are universal things that everyone with Hashimoto’s can do to feel better, based on my Safety Theory.
One way to really outsmart autoimmune thyroid disease is to make your body understand that it’s safe!
So, if you have thyroid disease, thank your body for having this genius design that has helped you survive, but also…think about what may be making your body think that you are going through a time of famine, war, toxic crisis, or illness?
Wouldn’t it be great if we could just tell our immune system to stop attacking our thyroid gland and our body and that we are actually relatively safe in this unsafe world?
Rather than doing mantras and telling yourself that you are safe (though I always love those), the key is to communicate to your body in a language that it will understand.
In simple terms, you must eliminate the things that make your immune system believe that you need to conserve your body and resources.
In my work, I’ve found that there is often a combination of triggers that has fueled Hashimoto’s and that a trigger can be anything that has the potential to stress the body or mind, upset the gut barrier, or clog up our detox pathways.
I wrote my book Hashimoto’s Protocol based on my observations with thousands of people with Hashimoto’s that led me to develop my theory and the solutions that support safety and healing. Furthermore, I wanted to give readers an actionable plan to start feeling better right away—regardless of their root cause(s)!
In very broad terms, I teach you how to send those safety signals to your body through reducing your toxic burden, supporting your stress response, and supporting your gut with nutrition and targeted supplements.
This works for every person with autoimmune thyroid disease—regardless of the root cause—to get you on the right path. The second section of the book is focused on advanced protocols. Over the years, I’ve learned about many different root causes such as infections, toxins, and traumatic stressors. The advanced protocols section provides you with assessments to help you determine your root causes and gives you actionable protocols for each root cause, such as my post on H. pylori.
I wrote Hashimoto’s Protocol because I want to empower people with information, so they can stand up for their own health and do what’s best for them, despite what the conventional medical paradigm says. I’d love your support in getting the important message out on how to overcome Hashimoto’s.
In the meantime, here are some things you can do to make your body feel safe today:
Treat your body like your cherished temple. Be nice to it. Feed it nutritious foods when it’s hungry. Don’t skip meals. Don’t subject it to unnecessary stresses like working all day instead of playing or resting. Sleep when you’re tired. Don’t cover it up with harsh makeup and skin creams. Don’t silence its subtle signals. Stop forcing it to have more caffeine when you’re tired. Let it rest. Don’t drench it in antacids when it’s trying to tell you a food you’re eating is not working. Listen to it and care for it like you would care for a dear friend, pet, or child.
I want you and the women you love to live your best lives, and I know it’s possible. If you found this information helpful, please consider paying it forward by sending it to another woman.
Do you think the Safety Theory applies to your condition?
P.S. The Safety Hypothesis is the basis of my book Hashimoto’s Protocol.
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- Bellis M, Burke L, Trickett P, Putnam F. Antinuclear antibodies and thyroid function in sexually abused girls. Journal of Traumatic Stress. 1996;9(2):369-378. doi:10.1007/bf02110669.
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- Haviland M, Sonne J, Anderson D et al. Thyroid hormone levels and psychological symptoms in sexually abused adolescent girls. Child Abuse & Neglect. 2006;30(6):589-598. doi:10.1016/j.chiabu.2005.11.011.
- Kawashima A, Yamazaki K, Hara T et al. Demonstration of Innate Immune Responses in the Thyroid Gland: Potential to Sense Danger and a Possible Trigger for Autoimmune Reactions. Thyroid. 2013;23(4):477-487. doi:10.1089/thy.2011.0480.
- Tomasi T, Hellgren E, Tucker T. Thyroid Hormone Concentrations in Black Bears (Ursus americanus): Hibernation and Pregnancy Effects. General and Comparative Endocrinology. 1998;109(2):192-199. doi:10.1006/gcen.1997.7018.