TSH Receptor Sites Dysfunctional in Fibromyalgia, Depression, and Autoimmune Thyroid Disorders

Monday, January 09, 2017
By: Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

Compromised thyroid function leads to many different symptoms like fatigue, depression, aches and pains, and poor metabolism. Standard labs of TSH, fT4 and fT3 are often normal and leave individuals struggling to find answers. Occasionally, thyroid antibody levels of thyroid peroxidase and thyroglobulin may be tested. Recent findings pertaining to another antibody, called the anti-TSH receptor antibody, may be the key for those struggling to find answers. Anti-TSH antibodies affect autoimmune thyroid concerns like Grave’s disease and Hashimoto’s, but we now see it in a whole new light for those with major depression, fibromyalgia, and even men with autoimmune thyroid concerns. Preventing autoimmune destruction of TSH receptor sites on the thyroid requires key nutrients and greater understanding of the causes of these attacks.

[Jump to: Nutritional Options]

TSH Receptor Site Dysfunction and Autoimmune Thyroid

Thyroid disorders come in many forms and when they go undetected and unsupported, thyroid destruction arises, and numerous symptoms may occur. It is important to protect thyroid stimulating hormone (TSH) receptor site attacks from autoimmune inflammation. This thyroid lab value can be measured and has many different names like Thyrotropin Receptor Antibody, TRAb, TSH Receptor Antibody, and TSH Receptor Blocking Antibody amongst others. There are two more commonly measured antibodies called Thyroid Peroxidase and Thyroglobulin Antibodies, but these are different than the anti-TSH receptor antibody.

TSH receptor site destruction may be present in both Grave’s disease (commonly hyperthyroidism) and in Hashimoto’s thyroiditis (commonly hypothyroidism, but may have a mixture of symptoms). Much of the anti-TSH antibodies medical literature focuses on Grave’s disease, but it impacts more than that. In each of these disorders, the TSH receptor site reacts differently with the autoimmune attack against it. In Hashimoto’s, the TSH receptor site on the outer surface of the thyroid gland is blocked by the antibody attack, which causes hypothyroidism.  In Grave’s disease, the TSH receptor site is stimulated by the antibody attack and causes an overactive thyroid gland and the classic symptom of bulging eyes as seen with former First Lady Barbara Bush. Elevated anti-TSH antibodies and tissue destruction causes the thyroid gland to atrophy, which ultimately leads to hypothyroidism or thyroid failure.

Depression, Fibromyalgia and TSH Receptor Site Dysfunction

Many people with depression often comment that their thyroid feels “off”, yet basic lab results may reveal little information. Indeed, when thyroid function is compromised, depression is a common symptom. The perspective of understanding dysfunctional TSH receptor sites and its effect on mood and depression helps validate this feeling. A recent study showed that women with the higher levels of TSH receptor antibodies had an elevated risk and occurrence of depression. Other thyroid markers including thyroid peroxidase antibodies, thyroglobulin antibodies, free T3 and T4, TSH, and interleukin-17 (IL-17) were tested, but were not associated with depression severity. The more elevated TSH receptor antibodies were, the greater the difficulty with depression. These findings confirm another dimension with depression and autoimmune thyroid and possibility of better treatment and management.

Fibromyalgia patients may also experience a sigh of relief and confirmation about their puzzling symptoms as TSH receptor site destruction is commonly present. Research published last month confirms that anti-TSH antibodies were frequently elevated and the most prominent of the three thyroid antibodies in women with fibromyalgia. Inflammatory attack on the TSH receptor sites impairs thyroid gland and hormone function. Symptoms of poor thyroid function, like fatigue, cold intolerance, muscle stiffness, and joint pain can mimic fibromyalgia-like symptoms. It may be that protecting the TSH receptor sites from autoimmune attack can help ease the challenges of fibromyalgia. 

Men, Estradiol, and TSH Receptor Site Dysfunction

Men are also susceptible to autoimmune thyroid concerns. In a study of 1263 men ages 15-94, it was found that estradiol/E2 was significantly higher in men who tested positive for anti-TSH receptor antibodies. Anti-TSH receptor antibodies were more likely to be elevated in men with autoimmune thyroid disorders than other thyroid antibodies. Lab test levels of TSH or free T4 were not affected, rather E2 or estradiol levels was related with elevated anti-TSH receptors antibodies. Like the depression and fibromyalgia studies, patients may find that other thyroid markers are normal, but thyroid function is decreased.  Elevated anti-TSH receptor antibodies demonstrate active inflammation and autoimmune thyroid disease which impacts the function of the thyroid gland. The goal in this situation is not only to protect the receptor sites from damage, but help the body detoxify estrogen.

TSH Receptor Site Dysfunction Often Passed by Medicine

The Journal of Clinical Endocrinology & Metabolism states that measurement of the TSH receptor site destruction or anti-TSH receptor antibodies  is rarely necessary. Rather, the journal encourages physicians to rely on other tests like TSH, fT4, and fT3 and clinical presentation due to the cost of TSH receptor antibody testing. The general focus with anti-TSH receptor remains on Grave’s disease, but the science clearly states that Hashimoto’s thyroiditis can be included. These studies connecting depression, fibromyalgia, estradiol/E2 and the higher prevalence of anti-TSH receptor antibodies, offers another perspective to patients with troubling thyroid symptoms when other thyroid labs fail to provide evidence. This information can help validate thyroid concerns and make nutritional decisions to protect against TSH receptor antibody destruction.

Nutrients Required for TSH Receptor Site Protection and Healthy Function

Medical treatment of autoimmune thyroid disease is thyroxine and methimazole (anti-thyroid drug) for Grave’s disease/hyperthyroidism or thyroxine for Hashimoto’s. Thyroxine or T4 is physically a combination of nutritional elements. It contains one molecule of the amino acid tyrosine and four iodine atoms.  Dietary intake and nutritional supplement intake can provide these nutrients and help with thyroid function. Strict vegetarian diets may lack adequate tyrosine as this is found in red meats and dairy.  Even today, many lack adequate iodine intake despite iodized salt. Chemicals such as chlorine, fluoride, and bromide (brominated flours) compete against iodine which contributes to iodine insufficiency.

Vitamin D insufficiency is considered a major risk factor for autoimmune thyroid disorders. The lower the vitamin D level, the higher the risk of autoimmune thyroid disorders. Even if vitamin D levels were not lab level low, increasing levels relates directly to reduction of autoimmune issues. For every 5 nmol/L increase in blood levels into normal vitamin D range, a 1.5 – 1.62 reduction occurred in autoimmune thyroid disorders. An optimal level for vitamin D is between 50-80 nmol/L.

Selenium supplementation is a well-known nutrient essential for protection against autoimmune thyroid disorders. Adequate selenium levels protect the thyroid from inflammation and were shown to drop antibody levels. A recent study showed that individuals who received selenium supplementation were likely to have normalized anti-TSH receptor antibodies levels at six months compared to those who lacked selenium.

Medical dogma says autoimmune thyroid destruction can’t be stopped. This was recently challenged and proven otherwise. The practitioners evaluated supplementation with coenzyme Q 10, magnesium, and selenium in patients with non-cancerous, autoimmune thyroid disease. Patients were also provided musculoskeletal care and stress reduction support. The goal of this small study was to see if this approach could stop autoimmune destruction of the thyroid gland. Over a 2-4 year course of care, the majority of patients were found to have a normalization of their thyroid gland as evidenced by diagnostic ultrasound and reduction of thyroid antibodies. Patients who had a more recent onset of autoimmune thyroid destruction responded more fully and easily than those who had chronic autoimmune thyroid inflammation for 10 years or longer.

Possible Causes of TSH Receptor Site Destruction: Gluten and EBV

In addition to good nutritional support, it is important to understand what causes the autoimmune attack on the TSH receptor sites. Gluten intolerance and celiac disease can trigger and often coexist with autoimmune thyroid concerns. One recent study demonstrated autoimmune thyroid disease was found in at least one in four children who were gluten intolerant. Children are not immune to autoimmune thyroid disorders and must be considered when they are not feeling well. Tummy aches, constipation, poor focus, fatigue, delayed or early growth patterns, skin rash, and dry skin may all be signs of compromised thyroid function and gluten intolerance in children.

Gluten intolerance and celiac disease requires complete removal of this immune challenging food. Each exposure or indulgence triggers immune inflammation and re-activation of autoimmune issues. This applies to autoimmune thyroid concerns or other disorders associated with gluten intolerance like diabetes, osteoporosis, depression, insomnia, migraine headaches and even heart disease. There are many different faces of gluten intolerance and it must be properly diagnosed.

Another trigger for TSH receptor site destruction is associated with the Epstein Barr Virus.  Epstein Barr Virus (EBV) is often casually dismissed by the medical establishment as non-problematic and common benign virus. The research community, on the contrary, has been studying EBV in the context of many different disorders. A trail of studies indicates that EBV infected B-cells, a type of white blood cell that produces antibodies, can possibly trigger dysregulation of anti-TSH receptor sites, and cause autoimmune thyroid disorders.

Those who perhaps had mononucleosis or have struggled with chronic active Epstein Barr Virus, may need to add immune support for this immune challenge. Several nutritional compounds are known to be effective against EBV. These include vitamin C and D, astaxanthin, mangosteen, zinc, laktoferrin, selenium, cordyceps, curcumin, passion flower, lauricidin, ginger, quercetin and others.

Nutritional support should be at the forefront of care and can be used with medical management for elevated anti-TSH receptor antibodies and autoimmune thyroid concerns, fibromyalgia, depression, and estrogen concerns. Selenium, iodine, tyrosine, magnesium, Q10, and vitamin D are top choices. Additional support of coenzyme B vitamins, pantethine, antioxidants, omega-3 fish oil, and quercetin provide another layer of support. Concerns with E2/estrogen dominance may respond to extra fiber, probiotics, chlorella, silymarin, DIM and I3C. These new findings reverse long-held medical dogma and show a new path to managing autoimmune thyroid concerns.  Are you ready for a breakthrough in managing your health?

Nutritional Options

Iodine – This trace mineral is essential for thyroid hormone formation. It works in concert with the amino acid tyrosine to form thyroxine.  Wellness Resources offers water-soluble, non-toxic easy to absorb iodine, free of potassium iodine. Iodine is needed for protecting the thyroid gland and helps support detoxification of estrogen.

Selenium – Selenium is another trace mineral critical to thyroid gland function and antioxidant protection. It also helps support the master antioxidant, glutathione, which is essential for reducing autoimmune challenges. Poor soil and food quality reduces the amount of selenium in our diet.

Tyrosine – Tyrosine is an amino acid found primarily in red meats and cheese.  It is necessary for the formation of thyroid hormone. Diets lacking these foods may compromise the ability to form thyroid hormone and even how it works in the body.

Chlorella – This blue-green super food provides many different benefits. One of its main benefits is detoxification. It can help detoxify estrogen. Chlorella also contains small amounts of B vitamins, amino acids, and trace minerals like iron that are essential for energy, metabolism, detoxification, and thyroid health.

Mangosteen – Mangosteen is a superfruit antioxidant. It is recognized for its support in reducing fat cell inflammation and insulin resistance. It also support the immune system by helping the body keep viral activity, like EBV under control. Wellness Resources provides a standardized extract of mangosteen with an ORAC value of 1500 per gram living up to its name as “queen of the fruits”.

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