What to do to balance thyroid dysfunction from lipoic acid + ALCAR?

There have been studies showing that both lipoic acid and ALCAR impedes thyroid function in the bodies (Google ncbi articles with lipoic acid/ALCAR and thyroid).
I am using ALA for heavy metal chelation and ALCAR for cholesterol and antioxidant benefits. However, my energy level has been gradually declining, which I think is due to thyroid dysfunction.

I cannot take iodine supplements even at low dose (50 mcg or less) because I get an autoimmune response from iodine. Also, taking too much iodine impairs thyroid gland, which I do not feel comfortable with. I also cannot take methylation protocol to enhance DNA production because I have a genetic profile that makes me sensitive to methyl donors. Lastly, I react negatively to fat-soluble vitamins/supplements because my fat metabolism pathway is impaired due to gut dysbiosis. Gut protocols such as glutamine, slippery elm, probiotics, and soil-based probiotics are out because of histamine intolerance and ammonia metabolism malfunction.

I personally think all the problems are rising from gut dysbiosis, but anything that intervenes gut health results in serious side effects and even more hair loss. I have tried organic sauerkraut, bifido probiotics, S. boulardii, Miyarisan (Clostridium butyricum), resistant starch (potato starch), and other gut lining rebuilding supplements like DGL, slippery elm, and glutamine. I know that gut dysbiosis is the root cause because I have been on antibiotics many times due to four surgeries I had to go through so far. I am a bit lost what else I can do to boost my thyroid function. My test result shows low free T3, low total T3, low free T4, and low T4. In addition, I have low free testosterone (below reference range) while my total T level is in the middle. I would sincerely appreciate recommendations. Thanks.

if they don't work for you, don't take them

they don't work for everyone

the average person will try maybe 3 or 4 regimens before they find one that works for them

there are things that will always beneficial though, such as low level laser therapy and red light therapy
niacinamide
vitamin D
etc

Changeexpert,

I am wondering whether you could post links to the studies you mentioned. If this was a real conclusion that was drawn, I have to believe there was some very important detail about something like dosage or some other aspect of the treatment that was important. I just am not keen on these types of statements because they have the effect of causing people to shy away from a couple of great supplements due to misinterpretations of data.

I also do not agree with your sentiments on iodine. If the reaction is autoimmune, it is not to the iodine itself, but to thyroglobulin. A proper thyroid test would show elevated antibodies. Did you find these were elevated? And can you be certain its due to the iodine?

I am just overall a bit confused by your post and exactly what you are dealing with. It seems a bit rife with speculation and self-diagnosis (aka problem seeking and finding). Its a tendency I see many times in the do-it-yourself-health circles, which is to self-diagnose with multiple chronic and broad-spectrum health conditions that are catch-alls for hundreds of symptoms. "My fart smelled weird yesterday and it seems to be due to a dysfunction in my DNA repair mechanisms and possibly because my gut bacteria have voted in favor of building a casino near my appendix."

If you spend long enough on the internet researching your own symptoms, you'll find everyone has gluten intolerance, histamine intolerance, has decided they either under or over methylate, have gut dysbiosis, a thyroid abnormality, adrenal fatigue, intestinal parasites, heavy metal toxicity, and autoimmune disease. And they're all throwing a different cocktail of spice oils and silver at themselves to correct the problem while also over-hyping (making a mountain out of a molehill) these minute choices such as whether to ditch lemons for oranges because they heard this or that about certain citrus fruits for candida.

You aren't sensitive to fat-soluble vitamins. You need them to survive, let alone for good health. And you are metabolizing fat or you'd be dead. (Although you can under-metabolize fat in the diet for several reasons) Gut dysbiosis can be contributed to by this excess fat in the distal gut, so taking a supplement to help digest the fat and some bile stimulants might be beneficial, along with taking your fat-soluble vitamins which you are probably not getting enough of.

First solution, stay off the internet health boards/blogs/forums for a few months. Take some simple measures to help you start digesting food better (betaine hcl, digetsive enzymes, bile salts), get on a diet like the Perfect Health diet, get on an exercise regimen, stay hydrated, sleep, and try not to think about any of this stuff too hard for a few months. Bet you come back feeling much better.

If your thyroid panel really is showing something problematic, get further testing to establish what's going on. Is it autoimmune? Are there nodes? Thyroid medication is a viable solution for a real clinical thyroid problem, and its just a matter of whether you want to go synthetic versus the real-deal (I prefer the latter), and establishing what dose you feel best at.

Your avoidance of fat-soluble vitamins could be causing your issue as well. Low vitamin D levels are linked to hypothyroidism and Hashimotos. I'd recommend iodine, selenium, vitamin D (along with A), sufficient dietary carbohydrate (35-45% of total calories), and avoidance of soy (also cook your cruciferous vegetables if you eat them).

Thanks for the response Gates. Hopefully I can clarify all doubts you had.

Gates wrote: I also do not agree with your sentiments on iodine. If the reaction is autoimmune, it is not to the iodine itself, but to thyroglobulin. A proper thyroid test would show elevated antibodies. Did you find these were elevated? And can you be certain its due to the iodine?

My TgAb and TPO levels were elevated after taking Lugol's iodine for just two times (1 drop of 2% Lugol's solution per day).

Gates wrote: I am just overall a bit confused by your post and exactly what you are dealing with. It seems a bit rife with speculation and self-diagnosis (aka problem seeking and finding).

All my diagnosis were confirmed by several physicians, even though they were not sure how to treat them.

Gates wrote:
If you spend long enough on the internet researching your own symptoms, you'll find everyone has gluten intolerance, histamine intolerance, has decided they either under or over methylate, have gut dysbiosis, a thyroid abnormality, adrenal fatigue, intestinal parasites, heavy metal toxicity, and autoimmune disease.

Gluten intolerance -> Lab work proved it.
Histamine intolerance -> I have had body rashes ever since I was a child.
Methylation -> Combination of MAO homozygous condition along with COMT heterozygous conditions, defects in GABA pathway, dopamine receptors make me unable to break down neurotransmitters easily, which was confirmed by 24 hour neurotransmitter urine test.
Gut dysbiosis -> I had rounds of antibiotics for several surgeries I had, along with accutane and doxycyclin I ingested for acne. Stool test confirmed gut dysbiosis.
Heavy metal toxicity -> Hair test revealed very high level of mercury, barium, and aluminum. This agrees with the fact that I have consumed at least 4 canned tunas weekly for 15 years of my life.

Gates wrote:
You aren't sensitive to fat-soluble vitamins. You need them to survive, let alone for good health. And you are metabolizing fat or you'd be dead. (Although you can under-metabolize fat in the diet for several reasons) Gut dysbiosis can be contributed to by this excess fat in the distal gut, so taking a supplement to help digest the fat and some bile stimulants might be beneficial, along with taking your fat-soluble vitamins which you are probably not getting enough of.

I have been losing weight since the last surgery, which happened last March, which makes me suspect that I cannot digest food properly. My stool test confirmed that my c. butyricum level is very low, which is used for metabolizing fat. I was not sensitive to fat soluble vitamins until I had the last surgery, which again confirms that everything stemmed from gut.

Gates wrote:
First solution, stay off the internet health boards/blogs/forums for a few months. Take some simple measures to help you start digesting food better (betaine hcl, digetsive enzymes, bile salts), get on a diet like the Perfect Health diet, get on an exercise regimen, stay hydrated, sleep, and try not to think about any of this stuff too hard for a few months. Bet you come back feeling much better.

I have tried everything you have mentioned. I had severe dysphagia along with heartburn in the early this year. Betaine HCL and digestive enzymes definitely helped me. I still got bile salts in the drawer and only take it when I eat heavy meals.

Gates wrote:
Your avoidance of fat-soluble vitamins could be causing your issue as well. Low vitamin D levels are linked to hypothyroidism and Hashimotos.

My vitamin 25-OH level is on the low end, even though it's within reference range. On the other hand, vitamin 1,25 level is above the reference range. This pattern is seen very commonly in people with autoimmune condition (whether it be mild or strong).

I am already avoiding soy as my serum estrogen level was higher than reference range without help of aromatase inhibitors.

I will post the studies later.

Changeexpert,

Thank you for the clarification. Without that information, it was difficult to get a picture of whether you were self-diagnosing - as I wrongly assumed, my apology is warranted - or not.

I'm now more curious, however, as to what your current physician is thinking. Is he/she in agreement that this issue arises from your gut? Or is this what you're feeling based on your
antibiotic use. I am in agreement that autoimmune issues can begin with the gut. This could also be precipitating the thyroid autoimmunity, and perhaps the hampered metal excretion.

Did your stool test show any yeast problems?

Also, have you removed entirely from your diet either wheat or dairy?

Are you taking ALA as part of Cutler's protocol? Cutler doesn't seem to think ALA is a problem for the thyroid, and if anyone is familiar with lipoic acid it would be him.

http://onibasu.com/archives/fdc/19177.html
http://onibasu.com/archives/fdc/62736.html

If the energy has declined alongside chelating, perhaps your schedule is too aggressive, inadequate supportive nutrients, or you could still be in the 'dump phase'...?

There is another post where he dismisses a carnitine thyroid study, but it wasn't any more illuminating than the above. Not surprising people find Cutler's persona a little alienating somtimes.

http://www.ncbi.nlm.nih.gov/pubmed/1815532

This study above was the only one I was able to find showing a direct correlation between LA and T3 from coadministration.

There are a few things though I think are worth considering about this study:

• Study is performed on rats and there didn't appear to be any evidence from human trials.
       
  
• Without access to the full text, we are missing some key information about the doses used. The dose makes the poison, and its likely
     that they were using doses that promoted large testable blood levels, and relatively more than a human would take supplementally.
       
  
• The study used the alpha isomer only. That's not to say this would have an effect, but its possible. CS often recommends the R-isomer.
       
  
• The study is referring to peripheral activity of T3 only. So basically the activity in skeletal muscle. Thyroid hormone has braod and diverse
     activities centrally in the fat tissue, the heart, and the liver. So this study cannot say that the effects of LA are uniform throughout the body.
  

Something else to consider is that lipoic acid - unlike here in the West - has a relatively longer history of use by the medical establishment in Europe. Its likely that if there were significant thyroid effects, they would have been observed and we'd have more data about it. That there isn't is suggestive.

Here's what I'm thinking concerning the relationship between lipoic acid and thyroid hormone. It boils down to the fact that they have similar actions and are synergistic, so much so that coadministration is likely to lower the levels of thyroid hormone.

Here's why. There is a correlation between insulin and active thyroid hormone. This connection seems to be permissive in both directions, meaning both have the potential to increase levels of the other, and vice versa. For example, high doses of T3 (or hyperthyroid states) tend to promote insulin resistance, because of the increased levels of insulin that result. Its my opinion that this has to do with the overall cellular energy expenditure. This is why we can see bilateral causative effects: promoting insulin resistance can suppress thyroid hormone conversion, and also promoting too much thyroid hormone conversion (or just simply too much T3) can promote insulin resistance. It seems to be that both thyroid hormone and insulin hormone have independent feedback inhibition, such that increases above set point for either can lead to a reduction in the other.

This helps to explain why we tend to see that very low carbohydrate diets will lower level of thyroid hormone. Blood sugar is lowered along with insulin levels, and the oxidative energy expenditure by the cell is decreased, and thyroid hormone conversion decreases. Likewise, chronically elevated blood sugar as seen in high carb (or just hypercaloric) diets promotes insulin resistance at the cellular level, and can likewise lower T3. The exact relationship between T3 and insulin is unclear but its certainly there.

Lipoic acid increases cellular energy expenditure and works to lower blood sugar. It *mimics* the effect of insulin and has been shown to increase the transport by GLUT 4. Therefore, it lowers blood sugar and reduces the level of insulin required to deal with a given volume of blood sugar. So over time, taking lipoic acid is going to lower the production of insulin and it will likewise lower the conversion of T4 to T3, but NOT in a pathological way. Its more of an economic principle of supply and demand. And again, that is only at periphery seemingly (we don't have more data) so at the level of skeletal muscle, which is where the better chunk of sugar metabolism occurs.

Taken within reason, I don't believe we have anything to fear about lipoic acid and it effecting thyroid. As it concerns ALL antioxidants, there are people who theorize that taking too many exogenous antioxidants will cause our own systems to become "lazy". I suppose that this could into the same type of conversation where one might say we are making our own tuning to carbohydrate intake less "sensitive", but that is total speculation. There isn't data to support that to my knowledge. So really the only concern I can see with taking *reasonable* doses of lipoic acid would be the same as there might be for ANY other antioxidant, a speculative possibility that we are doing the work for our body and not allowing it to undergo its own adaptive responses.

But most of those types of antioxidant-averse theories ignore some important concepts, in my mind. Mainly by assuming that our bodies have adapted redox-systems calibrated for the level of oxidative stress we experience today. I don't believe that to be the case. We have spent the majority of human existence evolving in a world that was much different than post-industrial Earth. I think its reasonable to say that between the modification of the food supply, chemical exposure, heavy metal exposure, etc. etc., that the stress burden we experience goes above and beyond what our systems were designed for. That is my belief. And that calculated use of antioxidants (within reason) is beneficial to health & longevity. Lipoic acid is a well-researched antioxidant that has shown pretty robust benefits for all kinds of metabolic problems. Given the onslaught our machinery faces every day, I will continue to consider it a useful tool to give my body a hand. That is until better data comes out to show there is something to worry about concerning LA and the thyroid. Right now that study is not enough in and of itself.

TLDR: Thyroid hormone and insulin are sensitive to each other's levels. Lipoic acid lowers insulin levels in skeletal muscle. So lipoic acid lowers thyroid hormone conversion in skeletal muscle. This does not suggest lipoic acid is adversely effect thyroid gland output OR thyroid hormone activity significantly anywhere besides the periphery. The data do not show that lipoic acid is something to worry about, and the larger body of data show that reasonable use of lipoic acid is beneficial for metabolic health.

to keep a long story short

take ALA with sugar/carbs meal