Join 60,000 others in my newsletter and get a free ebook! Subscribe to Dr Sircus newletter and receive for free an ebook and introductory articles that will guide you through his protocol and the medicinals that compose it. Thyroid Cancer & Iodine Join 60,000 others in my newsletter and get a free ebook! Subscribe to Dr Sircus newletter and receive for free an ebook and introductory articles that will guide you through his protocol and the medicinals that compose it. The Endocrine System: Thyroid and Parathyroid Gland If you found this article interesting, you will love Jon Barron's newsletter!One thing I have learned from my readers is they are largely on their own. Rarely do conventional or alternative practitioners understand the depth of Hashimoto’s, a complex web that involves the neurological, hormone, and immune systems (we call it the neuroendocrine-immune axis). If you have Hashimoto’s you must think outside of the “thyroid box.” I am in the process of updating the tremendous amount of information I have learned about the thyroid since publishing Why Do I Still Have Thyroid Symptoms?
I am also writing other books that supply additional pieces to the Hashimoto’s puzzle. My recent book Why Isn’t My Brain Working? discusses a big puzzle piece—the brain is always a part of the Hashimoto’s puzzle. My primary goal with the thyroid book was to let readers know most cases of hypothyroidism are autoimmune and to offer some basic solutions. My goal with the new brain book is to educate Hashimoto’s patients that their persistent fatigue, depression, and poor digestion may be brain-based as Hashimoto’s devastates brain health. If you have Hashimoto’s I encourage you to read the following chapters in the brain book: Chapter 8: Gluten Sensitivity and Beyond Chapter 11: What is Neurological Autoimmunity I appreciate the amazing support from my readers and now understand the only way to raise the bar for thyroid care is to create accurate and referenced information not just health care providers but for patients. I like to think my first thyroid book helped evolve thyroid care beyond iodine supplements and natural thyroid hormones to a more complex but well rounded approach.
I admit at times it is hard to see others repackage my years of hard work into their own blog articles and thyroid books with no acknowledgement, but at the end of the day what matters most is the information gets to people who are suffering. I will continue to work very hard the next few years to update and share directly with patients new pieces to the thyroid puzzle. In this newsletter, however, I would like to clarify the concept of goiter and goitrogens. Many people assume any enlargement of the thyroid gland is a goiter and indicates an iodine deficiency. Nothing is further from the truth and I would like to clarify the information. I also want to address the outdated concept of the food goitrogens still embraced by many doctors and patients despite lack of clinical evidence. But first let’s start with thyroid gland enlargement. Enlargement of the thyroid gland is classified as diffuse if the entire thyroid gland is enlarged or solitary if only a small section of the thyroid is enlarged.
The most common causes of solitary enlargements are benign cysts and nodules. However, a nodule should always be evaluated to make sure it is not a malignant growth found with thyroid cancer. Now let’s talk about diffuse enlargement. This means the entire gland has become enlarged. The two main causes of diffuse enlargement are goiter or swelling from thyroiditis (inflammation of thyroid gland). Diffuse enlargements are rarely found with thyroid cancer One of the key ways to differentiate thyroiditis from goiter is to look at whether the size of the thyroid changes. With thyroiditis, the thyroid gland constantly changes size as it goes through various stages of inflammation and swelling. Painless thyroiditis (the thyroid gland is not sensitive to touch) is the hallmark of autoimmune thyroiditis. Painful thyroiditis, on the other hand, is usually associated with viral infection in the thyroid gland and accompanied by fever and signs of infection (bacterial infections are rare due to the thyroid gland’s iodine-rich, anti-bacterial environment).
If you have Hashimoto’s and have noticed painless swelling of your thyroid gland you do not have goiter but instead painless thyroiditis. Factors that may trigger swelling and autoimmunity include iodine, gluten, stress or anything else that activates the immune system. Unfortunately, many people with Hashimoto’s are misdiagnosed with goiter when in fact they have swelling from autoimmune thyroiditis. Remember, the key to diagnosing autoimmune thyroidits (inflammation of the thyroid gland) is painless swelling of thyroid that comes and goes. Now let’s talk about goiter. Goiter is not swelling but instead thick tissue growth of the thyroid that does not change size. The most common cause of goiter in the United States is not iodine deficiency or overconsumption of goitrogenic foods. I know this is widely believed in the natural medicine community, but anyone who tells you this does not know how to read the scientific literature or perform a proper thyroid clinical work-up.
The single most common cause of goiter in the United States is from chronically undiagnosed autoimmune Hashimoto’s completely unrelated to iodine deficiency. Let’s talk about what actually causes a goiter. Goiter is excessive tissue growth of the thyroid and occurs when the thyroid gland has been exposed to too much thyroid-stimulating hormone (TSH) or human chorionic gonadotropin (HCG). And yes, HCG shots for weight loss can cause goiter, but it typically occurs due to pregnancy. Please understand thyroid tissue does not magically grow in the absence of sufficient iodine. It grows when thyroid cells are stimulated by chronic or aggressive thyroid-stimulating hormone (TSH) exposure. This may occur from iodine deficiency, but more often results from chronic undiagnosed Hashimoto’s or pregnancy. Goiter due to iodine deficiency is rare in the United States. Unfortunately, however, many naïve and unskilled educators, doctors, thyroid book authors, and health care practitioners still make the claim.
So what do you do if you have goiter? First you objectively confirm the diagnosis with a thyroid ultrasound. Second, you must find out if you still have an ongoing goiter mechanism as evidenced by an elevated TSH or HCG level. If those are not elevated, chances are you developed the goiter in the past and it is no longer being stimulated to grow. Most people don’t even know they have a goiter until a doctor examines them, at which point TSH needs to be checked to see if it’s still an ongoing mechanism. If TSH is elevated, the possibilities are Hashimoto’s (most common and confirmed with elevated thyroid antibodies), iodine deficiency, or a goitrogenic compound that blocks iodine uptake of the thyroid gland. If it’s iodine-based then taking iodine supplements should immediately correct all thyroid symptoms and normalize TSH. If that doesn’t happen then it’s due to either a goitrogen or Hashimoto’s. You can identify Hashimoto’s through elevated serum thyroid peroxidase (TPO) or thyroglobulin (TGB) antibodies.
You need to check both. Also, sometimes the test will come back negative despite having Hashimoto’s, so if that happens it’s important to repeat the test. Although the most common cause of goiter is Hashimoto’s, let’s talk about goitrogens. Goitrogens are substances (whether in drugs, chemicals, or foods) that disrupt the production of thyroid hormones by interfering with iodine uptake in the thyroid gland. This triggers the pituitary to release TSH, which then promotes the growth of thyroid tissue, eventually leading to goiter. Although iodine is important for thyroid function, it only takes a pinhead of iodine a day and a teaspoon of iodine over a lifetime to avoid thyroid goiter. Let’s shatter another myth about the thyroid. Normal consumption of goitrogenic foods do NOT cause goiter (consuming large amounts of juiced goitrogens, such as cabbage juice, would not be considered normal consumption). Examples of goitrogenic foods include broccoli, cabbage, kale, cauliflower, Brussels sprouts, soy, and a variety of other fruits and vegetables.
The fear of goitrogenic foods is another example of how people have taken in vitro (test tube) studies using unbelievably excessive amounts of a dietary goitrogens and concluded eating any small amount of these foods can cause a goiter. For those who don’t believe me, please go on a goitrogen diet loaded with strawberries, kale, peaches, broccoli, cauliflower, and spinach and see if you develop a goiter. I promise you will not. As a matter of fact, these phytochemical-rich foods are essential for health when you have autoimmunity, except for soy, which is immune reactive for many Hashimoto’s patients. I have seen several patients develop thyroiditis swelling with soy and conclude the soy caused a goiter. In those cases the thyroid swelling reduced when they removed the soy from their diet, confirming that the swelling was due to an inflammatory response and not goiter. Although dietary goitrogens are not clinically relevant there is not doubt that environmental compounds and medications may cause goiter.