A discussion with my wife's nurse at a Remicade infusion clinic revealed that almost every patient had some sort of a thyroid problem - they are both autoimmune diseases- but that there was little written about it. Then a quick perusal of online forums revealed a surprisingly intense discussion concerning this possible association between Crohn’s disease and thyroid problems. Much like the case of looking for a cause by examining correlations between cigarette smoking and lung cancer, however, associations between Crohn's and Thyroid disorders, while suspected, are debated.
The Debate: Associations between Crohn's and Thyroid Diseases.
In a 2003 study by N. Pooran et al entitled ‘Crohn’s disease and risk of fracture: does thyroid disease play a role?’, it was stated that “Thyroid disorder was not found to be associated with Crohn's disease and was not found to increase the risk for fractures. Therefore, screening for thyroid disease is not a necessary component in the management of Crohn's disease.”
On the other hand, a 1990 study by G. Messina et al, ‘The clinical and echographic assessment of thyroid function and structure in patients with a chronic inflammatory intestinal disease’ and a 2005 study by T. Inokuchi et al, ‘Autoimmune thyroid disease (Graves' disease and hashimoto's thyroiditis) in two patients with Crohn's disease: case reports and literature review,’ concluded that “thyroid dysfunction is associated with ulcerative colitis as well as (2 cases) Crohns disease”. Furthermore, a study by JK Triantafillidis et al in 1992, as quoted in a 2007 article by R.N. Bankar et al entitled 'Thyroid Disorder and IBD' in ispub.com, concluded that "thyroid dysfunction can occur simultaneously, precede or appear after the manifestations of IBD”.
The Function of the Thyroid
The butterfly-shaped thyroid sits in the neck and regulates the whole body by combining iodine with the amino acid tyrosine to produce thyroid hormones. As the Thyroid Foundation of Canada points out, these hormones “are essential for life and have many effects on body metabolism, growth, and development”.
As the TFC also states, “autoimmune disorders of the thyroid gland are the most common cause of thyroid dysfunction. These autoimmune disorders are caused by abnormal proteins, (called antibodies), and the white blood cells which act together to stimulate or damage the thyroid gland. Graves’ disease (hyperthyroidism) and Hashimoto’s thyroiditis, are diseases of this type. Graves’ disease affects about 1 in 100 of the population, whereas Hashimoto’s thyroiditis is even more common."
Low Thyroid and Crohn’s
In the Crohn’s online forum, a frustrated Crohn’s patient spoke up:
“Yes, I am another Crohn's and Colitis sufferer with hypothyroidism. I take Synthroid 08.8 along with Remicade, Lilalda, Pamine, Opium, migraine meds, Lipitor, Vit B12 monthly shots and a ton of other vitamins. I haven't connected my thryoid to the Crohn's because my Mom had thyroid problems for most of her life so I just figured it is genetic like the migraines I have had since age 16. I am 25 and was diagnosed with Crohn's Disease last summer. It's been an awful year of very little remission, despite completely changing dietary habits. Lately, every time I have an attack I gain a ton of weight. I am always swollen and tired. I feel cold in 80 degree weather and my skin is terrible. Lately, I've been waking with joint pain in the night and it lasts until I take 800mg of ibuprofen. I am so sad. I work out constantly and very carefully watch diet and calories. I am always hungry.”
Symptoms of Low Thyroid
There are many symptoms that suggest a low thyroid. In Canada, if a TSH test reads 5 or over medication is available but if not, the following can still happen and steps need to be taken. In her book, ‘A Smart Woman’s Guide to Weight Loss’, Lorna Vanderhaeghe outlines the symptoms and what to do about it.
Symptoms for Women:
- Weight gain, particularly belly fat
- Hair loss, particularly at the part
- Constipation (not a particularly useful symptom for most Crohn's patients)
- Infertility: a string of miscarriages. Note: children of hypothyroid mothers, even with treatment, have a higher than normal incidence of difficulties with spatial perception, memory, language and other skills
- A never-ending menopause
- No sex drive
- Cold hands and feet
- Adrenal fatigue. Note: cortisol, a corticosteroid hormone- it helps reduce inflammation and stress- works with your cell receptors to receive thyroid hormones from the blood to the cells and can become fatigued from stress, certainly a reality with Crohn’s
Symptoms for Men:
- constipation
- elevated cholesterol
What to do about Low Thyroid
Since medication is not an option if a TSH test reads under 5, a natural alternative is needed. There is another debate, however, regarding thyroid-suppressing cruciferous vegetables that block iodine uptake (goitrogens). For instance, Tess Thompson, writing in NativeRemedies.com, states that “cabbage, cauliflower and broccoli are… considered to contain goitrogens and inhibit production of thyroid hormones.” Lorna Vanderhaeghe on the other hand, suggests the positives outweigh the negatives. Certainly, if a Crohn’s patient decides to eat these vegetables they should be well cooked to enable digestion.
Supplements:
- Vitamin D (helps in the natural production of tyrosine)
- L-Tyrosine
- Protein powders: pumpkin (put into shakes or organic yogurt)
Exercise:
- Walk 30 minutes a day
Food recommendations:
- Lots of broccoli
- Replace butter with coconut butter: helps to burn fat
Foods to avoid because they block iodine:
- Soy products: tofu, edamame soy beans
- Water with fluoride
- Kelp
- Gluten
According to Lorna Vanderhaeghe, "30 percent of the population does not know they have a thyroid problem". Furthermore, when you are under stress with active Crohn's, it is probably the last thing you want to worry about. However, from what I've read and heard it's worth looking into. You be the judge.
Sources:
- Poornan, N. et al. ‘‘Crohn’s disease and risk of fracture: does thyroid disease play a role?’ Long Island Jewish Medical Center. New Hyde Park, NY
- Messini, G., Viceconti N, Trinti B. The clinical and echographic assessment of thyroid function and structure in patients with a chronic inflammatory intestinal disease. Recenti Prog Med 1999;90:13-6
- Triantafillidis, JK, Cherakakis P, Zervakakis A, Theodorou M. Coexistence of hyperthyroidism and ulcerative colitis: report of 4 cases and a review of the literature. Ital J Gastroenterol 1992;24:494-7
- Inokuchi, T, Moriwaki Y, Takahashi S, Tsutsumi Z, KA T, Yamamoto T. Autoimmune thyroid disease (Graves' disease and hashimoto's thyroiditis) in two patients with Crohn's disease: case reports and literature review. Inter Med.2005;44:303-6
- Vanderhaeghe, Lorna. ‘A Smart Woman’s Guide to Weight Loss’. Health Solutions, Vancouver. May 2010
- Nativeremedies.com
- thyroid.ca
- crohnsforum.com
- ispub.com
- R.N. Bankar, M. Jones & K. Hine: Thyroid Disorder And Inflammatory Bowel Disease . The Internet Journal of Gastroenterology. 2007 Volume 5 Number 2
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
James Gibson - James Gibson is a retired teacher and small business owner. He is a published writer and has a wide spectrum of interests.
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