Hep C Low Carb Diet

Hep C Low Carb Diet

  • Thyroid Antibodies|
  • Healthy Level of TPO Antibodies|
  • How to Reduce Thyroid Antibodies|
  • Diet|
  • Gut Health|
  • Supplements|
  • Optimize Iodine|
  • The Bottom Line|
  • Recommended Products|
Thyroid Autoimmunity – What Are Healthy Levels for Thyroid Antibodies - auto

You must reduce elevated TPO antibodies down to the normal reference range to prevent hypothyroidism.

If a recent lab test has shown that you have elevated thyroid antibodies, your next question might be, "How can I bring them down to normal levels?"

When it comes to thyroid antibodies, striving for perfection may be overrated. Let's talk about what level of antibodies you should aim for and how to reduce them.

What are Thyroid Antibodies?

Sometimes the immune system mistakenly attacks your thyroid gland with antibodies. This damages your thyroid and can lead to inflammation of the thyroid gland (thyroiditis), symptoms of hypothyroidism or hyperthyroidism, and if left unchecked, autoimmune thyroid disease.

By far, the most common cause of hypothyroidism and elevated thyroid antibodies is the autoimmune disorder Hashimoto's thyroiditis. Elevated thyroid antibodies are also found in Graves' Disease.

Hashimoto's is diagnosed by blood tests looking for:

  • Elevated thyroid peroxidase (TPO) antibodies
  • Elevated thyroglobulin (TG) antibodies (although these are less reliable)

You have autoimmune hypothyroidism if you have elevated thyroid antibodies and also have:

  • Low T4
  • Elevated thyroid stimulating hormone (TSH) levels.

Not everyone who has thyroid antibodies is hypothyroid, but some people with elevated TPO or TG antibodies will eventually become hypothyroid. The question is, how likely is it you will become hypothyroid if your antibodies are elevated?

How Important are Thyroid Antibodies?

The "normal" reference range for TPO antibodies is less than 35 IU/mL. But a 2016 study published in the Journal of Hormone and Metabolic Research [1 Trusted Source PubMed Go to source ] found:

  • Those who had TPO antibodies below 500 IU/mL had a low risk of future progression to hypothyroidism.
  • Those who were above 500 IU/mL still only had a moderate risk.

The Tehran Thyroid Study, which followed the course of thyroid disease in a large cohort of people over nine years, showed similar results: those with elevated TPO antibodies only had a 9-19% chance of becoming hypothyroid after 6 years of follow up [2 Trusted Source PubMed Go to source , 3 Trusted Source PubMed Go to source ].

If we consider this, elevated thyroid antibodies are not as consequential as many thyroid experts would suggest.

I've commonly seen people with Hashimoto's disease or elevated thyroid antibodies become hyper focused on reducing their antibody test results to the "normal" reference range, and becoming unnecessarily stressed. The research suggests this isn't necessary.

Instead, it implies that only a minority of patients with elevated TPO antibodies will progress to full hypothyroidism. What this means for you is that you don't have to continuously pursue lower and lower levels of antibodies with strict diets or supplements, especially if your thyroid symptoms are under control.

If you're a patient, or a doctor working with patients, it's important to understand that reducing TPO antibodies to under 500 IU/mL—or getting your thyroid symptoms under control through other means—is a clinical win.

Very High Thyroid Antibodies

Thyroid Autoimmunity – What Are Healthy Levels for Thyroid Antibodies - AdobeStock 170166574 L

All that said, if your TPO antibodies are very high, reducing your antibody count is definitely a worthwhile goal. The higher the antibodies, the more likely you are to develop hypothyroidism.

The farther you reduce your antibodies, even if you can't get them down to 500 IU/mL, the less damage to your thyroid gland. Just don't feel discouraged by failing to get them down to the "normal" reference range.

4 Ways to Reduce Thyroid Antibodies

There are several ways you can reduce your thyroid antibodies and improve your thyroid function, using diet and lifestyle.

1. Improve Your Gut Health

Preliminary evidence suggests that gut health is closely linked to thyroid health, and that improving gut health can decrease thyroid antibodies and balance your  thyroid hormones. Here are several ways you can work on improving your gut health.

  • Anti-Inflammatory Diet: A low-quality diet is typically the single biggest source of inflammation that can impair your thyroid and immune function. But encouragingly, early evidence shows that changing your diet can lower thyroid antibodies.

    A low-carbohydrate diet was shown in one study to reduce thyroid antibodies by 44% in people with Hashimoto's thyroiditis, but not celiac disease [4 Trusted Source PubMed Go to source ], while a gluten-free diet was shown to reduce thyroid antibodies in a group of women with Hashimoto's thyroiditis [5 Trusted Source PubMed Go to source ]. Other studies have shown that eliminating dairy or gluten may help improve thyroid function [6 Trusted Source PubMed Go to source , 7 Trusted Source PubMed Go to source ]. A Paleo diet template is low carb, diary free, and gluten free, and may be a good place to start.

    You may have heard of the Autoimmune Paleo diet, which has been shown in one small study to reduce thyroid symptoms and inflammatory markers [8 Trusted Source PubMed Go to source ]. Many clinicians have seen their autoimmune patients respond well to the Autoimmune Paleo diet. However, the diet has yet to be shown to reduce thyroid antibodies. This doesn't mean it's not useful, but it may not be necessary to follow such a restricted diet to reduce thyroid antibodies.

  • Gut Infections: Gut infections, such as H.pylori, SIBO (small intestinal bacterial overgrowth), and Blastocystis hominis are associated with elevated thyroid antibodies. Treating these infections may reduce thyroid antibodies [9 Trusted Source PubMed Go to source , 10 Trusted Source PubMed Go to source , 11, 12 Trusted Source PubMed Go to source , 13 Trusted Source PubMed Go to source ].
  • Probiotics: Probiotics have been shown in multiple studies to improve the gut infections that are associated with elevated thyroid antibodies, including H. pylori infection and SIBO (see above) [14 Trusted Source PubMed Go to source , 15 Trusted Source PubMed Go to source ]. In another study, probiotics didn't appear to improve thyroid antibodies, however, they did reduce the need for thyroid medication [16 Trusted Source PubMed Go to source ]. More research is needed to confirm this effect, but probiotics appear to improve thyroid function.
  • Digestive Support: Research shows that up to 40% of hypothyroid patients also have stomach autoimmunity, resulting in low stomach acid [17 Trusted Source PubMed Go to source , 18 Trusted Source PubMed Go to source ]. Basic digestive supports such as digestive enzymes or stomach acid support may help thyroid function [19].
Thyroid Autoimmunity – What Are Healthy Levels for Thyroid Antibodies - auto

2. Supplements

  • Selenium: Several studies, including a meta-analysis (the highest quality science) show selenium improves thyroid antibodies for hypothyroid patients [20 Trusted Source PubMed Go to source , 21 Trusted Source PubMed Go to source , 22 Trusted Source PubMed Go to source ]. However, not all research agrees, and more studies need to be done.
  • Vitamin D: Research suggests that vitamin D deficiency is associated with higher levels of thyroid antibodies [23 Trusted Source PubMed Go to source ], and that supplementation may decrease thyroid antibodies [24 Trusted Source PubMed Go to source ].
  • CoQ10 & Magnesium: Some evidence suggests CoQ10 and Magnesium supplementation may reduce thyroid antibodies. CoQ10 has been shown to "improve thyroid vascularity," and magnesium supports iodine uptake [25 Trusted Source PubMed Go to source ]. One small study demonstrated supplementation with magnesium, CoQ10, and selenium along with additional supports reduced thyroid antibodies [26 Trusted Source PubMed Go to source ], while one additional study showed an association between low serum magnesium and thyroid antibodies [27 Trusted Source PubMed Go to source ].
  • For more on supplements to support thyroid function, see How Should I Use Thyroid Supplements?

3. Light Therapy

There are some encouraging data showing that low-level laser therapy can improve thyroid function and decrease TPO antibodies. The therapy also reduced the amount of levothyroxine medication the patients needed, even after 9 months of follow up [28 Trusted Source PubMed Go to source , 29 Trusted Source PubMed Go to source ].

4. Optimize Iodine Levels

Iodine is an important nutrient for the thyroid gland, but must be used cautiously. Supplemental dietary iodine has been shown in several population-based studies to increase the incidence of autoimmune thyroid diseases [30 Trusted Source PubMed Go to source , 31 Trusted Source PubMed Go to source ]. On the other hand, too little iodine can also cause thyroid symptoms. Optimizing your iodine levels may reduce thyroid antibodies.

For more on how to optimize your iodine, including how to test, see How Should I Use Thyroid Supplements?

The Bottom Line

Unless your TPO antibodies are very high, it's not necessary to be hyper-focused on reducing your thyroid antibodies to the lab reference range. Reducing elevated thyroid antibodies to below 500 IU/mL, and improving your thyroid function with diet and lifestyle changes significantly reduces your risk of developing hypothyroidism.

If you want help with reducing high antibody levels or reducing thyroid symptoms, schedule an appointment at our center for functional medicine.

➕ References

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  2. Amouzegar A, Gharibzadeh S, Kazemian E, Mehran L, Tohidi M, Azizi F. The Prevalence, Incidence and Natural Course of Positive Antithyroperoxidase Antibodies in a Population-Based Study: Tehran Thyroid Study.PLoS One. 2017;12(1):e0169283. Published 2017 Jan 4. doi:10.1371/journal.pone.0169283 Trusted Source PubMed Go to source

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  4. Esposito T, Lobaccaro JM, Esposito MG, et al. Effects of low-carbohydrate diet therapy in overweight subjects with autoimmune thyroiditis: possible synergism with ChREBP.Drug Des Devel Ther. 2016;10:2939-2946. Published 2016 Sep 14. doi:10.2147/DDDT.S106440 Trusted Source PubMed Go to source

  5. Krysiak R, Szkróbka W, Okopień B. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto's Thyroiditis: A Pilot Study.Exp Clin Endocrinol Diabetes. 2019;127(7):417-422. doi:10.1055/a-0653-7108 Trusted Source PubMed Go to source

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  9. Brechmann T, Sperlbaum A, Schmiegel W. Levothyroxine therapy and impaired clearance are the strongest contributors to small intestinal bacterial overgrowth: Results of a retrospective cohort study.World J Gastroenterol. 2017;23(5):842-852. doi:10.3748/wjg.v23.i5.842 Trusted Source PubMed Go to source

  10. Konrad P, Chojnacki J, Kaczka A, Pawłowicz M, Rudnicki C, Chojnacki C. Ocena czynności tarczycy u osób z zespołem przerostu bakteryjnego jelita cienkiego [Thyroid dysfunction in patients with small intestinal bacterial overgrowth].Pol Merkur Lekarski. 2018;44(259):15-18. Trusted Source PubMed Go to source

  11. Choi YM, Kim TY, Kim EY, et al. Association between thyroid autoimmunity andHelicobacter pylori infection.Korean J Intern Med. 2017;32(2):309-313. doi:10.3904/kjim.2014.369

  12. Bertalot G, Montresor G, Tampieri M, et al. Decrease in thyroid autoantibodies after eradication of Helicobacter pylori infection.Clin Endocrinol (Oxf). 2004;61(5):650-652. doi:10.1111/j.1365-2265.2004.02137.x Trusted Source PubMed Go to source

  13. El-Zawawy HT, Farag HF, Tolba MM, Abdalsamea HA. Improving Hashimoto's thyroiditis by eradicatingBlastocystis hominis: Relation to IL-17.Ther Adv Endocrinol Metab. 2020;11:2042018820907013. Published 2020 Feb 21. doi:10.1177/2042018820907013 Trusted Source PubMed Go to source

  14. Eslami M, Yousefi B, Kokhaei P, et al. Are probiotics useful for therapy of Helicobacter pylori diseases?.Comp Immunol Microbiol Infect Dis. 2019;64:99-108. doi:10.1016/j.cimid.2019.02.010 Trusted Source PubMed Go to source

  15. Zhong C, Qu C, Wang B, Liang S, Zeng B. Probiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence.J Clin Gastroenterol. 2017;51(4):300-311. doi:10.1097/MCG.0000000000000814 Trusted Source PubMed Go to source

  16. Talebi S, Karimifar M, Heidari Z, Mohammadi H, Askari G. The effects of synbiotic supplementation on thyroid function and inflammation in hypothyroid patients: A randomized, double‑blind, placebo‑controlled trial.Complement Ther Med. 2020;48:102234. doi:10.1016/j.ctim.2019.102234 Trusted Source PubMed Go to source

  17. Lahner E, Annibale B. Pernicious anemia: new insights from a gastroenterological point of view.World J Gastroenterol. 2009;15(41):5121-5128. doi:10.3748/wjg.15.5121 Trusted Source PubMed Go to source

  18. Sterzl I, Hrdá P, Matucha P, Cerovská J, Zamrazil V. Anti-Helicobacter Pylori, anti-thyroid peroxidase, anti-thyroglobulin and anti-gastric parietal cells antibodies in Czech population.Physiol Res. 2008;57 Suppl 1:S135-S141. Trusted Source PubMed Go to source

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  20. Wichman J, Winther KH, Bonnema SJ, Hegedüs L. Selenium Supplementation Significantly Reduces Thyroid Autoantibody Levels in Patients with Chronic Autoimmune Thyroiditis: A Systematic Review and Meta-Analysis.Thyroid. 2016;26(12):1681-1692. doi:10.1089/thy.2016.0256 Trusted Source PubMed Go to source

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