27 February 2020

When Your Health Turns On You: #Hypothyroidism –– 4: Vitamin Co-Factors and the Microbiome

The backstory for those just joining me:

During 2017 I was suffering lots of weird health symptoms, the most concerning being that my brain refused to function properly – hardly a useful trait in a novelist. April 2018 a lump developed on my neck: a swelling on my thyroid. A GP’s blood tests indicated I might develop Hypothyroidism, whereas symptoms and antibodies emphasised that I was suffering Hashimoto’s Hypothyroidism, an autoimmune disorder. I’m writing this series of daily posts because if you don’t recognise the signs your health could turn on you. I don’t recommend it. Read Post-1, Post-2 and Post-3.

Note: I’m British and live in the UK. We have a National Health Service, free at the point of access, paid for via our taxes. Your mileage may differ, even if you live in the UK. 

October 2019. After accepting that the National Health Service was going to step up only if and when I hit crisis point, I knew I’d have to do my own legwork, not merely table a bit of proof – in this case a below range Vitamin D reading.

Unlike many health disorders, there doesn’t seem to be a UK charity dedicated to Vitamin D, except for children (diagnosis of Rickets is on the increase; Osteomalacia is the term used in adults). Canada isn’t so reticent. Its The VitaminD Society states: 97 percent of Canadians are vitamin D deficient at some point in the year… Its short intro page makes interesting reading. Bear in mind that London is further north than the main cities of Canada.

The UK might not have a dedicated Vitamin D charity, but Vitamin D insufficiency and deficiency scores highly among other health charities: lupus, multiple sclerosis, rheumatoid arthritis, fibromyalgia… yes, all the ones I noted in Post-3 as autoimmune disorders. That smoking gun continued to smoke.

While I trawled through the many blood tests available on Medichecks, I kept in mind my original considerations:

  • If my body was missing Selenium, and now Vitamin D, what other minerals and vitamins is it missing?
  • As I eat the recommended “good balanced diet”, why was my body missing any?

Vitamins and minerals are mostly drawn from our food in the stomach via Intrinsic Factor – most notably Vitamin B12 – and during transit through the small intestines. Did I have an absorption problem? There might also be a question over Cortisol, the fight or flight hormonal system. It plays a significant part in a person’s metabolism and when it isn’t functioning properly it puts stress on the thyroid. I added an Essential Fatty Acids Omega 6:3 ratio test to my choices. These are called ‘Essential’ because they have active roles in a person’s metabolism yet can’t be produced in the body.

I wasn’t looking for a smoking gun this time, but eliminating other possibilities. Most of these tests are not available on the NHS via a GP, only via a Consultant Endocrinologist. I didn’t want to wait months for a referral, even if I was allowed one. If I paid for a private consultation the fee would likely be more than for the tests, and I’d still have to pay for those.

The basic Cortisol – four saliva tests in a day – returned well within ranges (good); there were no Intrinsic Factor antibodies (brilliant); Zinc, which had been included in a test bundle, was low in its range so I needed to bear this in mind; Essential Fatty Acid Omega 3:6 ratio was 1:12 despite my good balanced diet (oh dear); and the Thyroid tests were all pulling back (fantastic).

Yet again, the big one was Vitamin D. Despite my being on 40mcg (about 1600iu – international units) a day for the previous three months, its test number had risen only five points bringing the result just inside the edge of the lower range. Something was definitely wrong. Time to find a support group specialising in Vitamin D deficiency and learn from the experience of members.

January 2020. With Christmas-3 behind me I got down to it. Facebook again provided a choice. I looked at a few but it was 'Vitamin D and Co-Factors UK' which drew my attention, initially due to ‘co-factors’ being in its title.

I’d learned a bit about co-factors. The absorption potential (bioavailability) of Iron is enhanced by Vitamin C, even a glass of orange juice will do. Vitamin B12 has a symbiotic relationship with Folate. If they are out of balance neither work as they should. The body is a complex organism and these explanations highly generalised, but they illustrate the concept.

Some co-factors aren’t so specialised. Magnesium plays a part in 300+ biochemical interactions, including helping regulate calcium and insulin levels, blood pressure and the cardiovascular system, the nervous system, Vitamin D levels... basically, we need it. However, as with Vitamin D, there is considered to be widespread insufficiency, even deficiency, in the population.

During my reading I’d come across various articles suggesting one cause for the lack in the population being that intensive farming was depleting the nutrient, and others, from the land and therefore from food crops, but it was a video from York Cardiology Why Magnesium is So Good For Us which finally made me take notice.

York Cardiology is a YouTube channel run by UK heart specialist Dr Sanjay Gupta who takes time to explain conditions within his remit and the steps people can take to help themselves. If you suffer from any form of cardiovascular problem I suggest you take a look at his playlists. His short video on Hypothyroidism and the Heart is interesting, to say the least.

So did I need to take co-factors with an increased Vitamin D supplement? The answer seemed to be yes, which may come as a surprise to the endocrinologists who gaily prescribe large or even very large amounts of Vitamin D3 alone. (There are various types of Vitamin D; D3 is the easiest to absorb.)

One of the consequences of increasing Vitamin D to an “optimal” level (75-150 nmol/L) as opposed to being just “in range” at 50, is that it enhances absorption of Calcium – the reason it is prescribed to combat osteoporosis. The problem is Calcium and Magnesium work as buddies, so a substantial increase in Calcium needs extra Magnesium as a co-factor to help maintain their balance.

However, unless the rise in Calcium is guided it has a tendency to spread itself into places such as arteries, musculature, joints, and the kidneys. Think of it as limescale in a kettle. Kidney stones, anyone? Having enough to cope with, I’d rather not, thanks.

The co-factors suggested from group experience are Ionic Magnesium to balance the increase in Calcium, Vitamin K2-Mk7 to guide the increase in Calcium to the bones and teeth or the unused to be excreted, and Boron to enhance absorption of both the Vitamin D3 and Magnesium. For these to work optimally together they cannot be taken ad hoc but in a specific ratio. As with all supplementation, as long as no adverse side effects prompt a re-think, results can take three or four months to start to manifest. I’ll post how I get on.

Other Vitamin D support groups will advise slightly differently, dependent on their members’ needs and experiences. Many in my chosen support group also have thyroid disorders, so I feel the match is liable to be good.

Early February 2020. A major aspect coming from my ongoing research has been the importance of a healthy gut system, otherwise known as the Microbiome. Evidently we have between 300 and 1000 different species made up of viruses, fungi, yeasts and organisms. Not only do they help protect us from pathogens, but they aid food digestion, activate freed vitamins and minerals, and interact with the brain and the immune system (oh yes?). We need them all, but in the correct balance.

And herein lies the rub. Even a good balanced diet has a surfeit of sugars (think fresh fruit) and yeasts (think cereal-based carbohydrates). This is the starter kit to any fermenting system.  I find it interesting that sufferers of Irritable Bowel Syndrome, Crohn’s and Coeliac diseases, find respite in gluten-free or even full cereal-free diets. It is a suggestion often made to those with Hashimoto’s Hypothyroidism when options attempting to alleviate symptoms start to run low. All are autoimmune disorders and all show low Magnesium and Vitamin D levels. Add in daily ingested prescription drugs, and over-the-counter medications, to say nothing of the occasional nuclear-blast of antibiotics, and the surprise is that so many of us function well at all.

Can probiotics help? Yes, but three or four strains in a yoghurt-based culture can seem like a drop in the ocean. Multi-strain bacteria in freeze-dried capsule form, which I am currently trying, are available at a price. Kimchi, or unpasteurised Sauerkraut, may well prove a cost-effective alternative if it's available. After all, Hippocrates swore by the stuff. I may be inclined to argue with a modern endocrinologist, but not with the Ancient Greek 'Father of Medicine'.

When Your Health Turns On You #Hypothyroidism series:

1: Symptoms
2: Vitamins & Minerals
3: Blood Tests
4: Vitamin Co-Factors & the Microbiome
5: Functional Medicine & YouTube
6: Covid-19 Coronavirus 
7: Covid-19 and Vitamin D 

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