Raphael Kellman, M.D., Contributor
Thyroid Nation
The Real Reason Your Gut won’t Heal 

GI issues are common, disruptive and painful. Millions of people suffer from chronic digestive disorders, going from doctor to doctor unable to find true relief. Trips to mainstream and even holistic physicians frequently end the same way-symptoms get a little better but there is never a true resolution. So what’s being missed?

More often than not, there is a constellation of health problems co-existing and contributing to the ongoing issues patients endure.

Body systems that may seem unrelated work together to create the state of health.

Imbalances in the thyroid and microbiome are frequently missed or inadequately addressed and play a huge role in digestive health. Without accurately identifying and treating these underlying causes, patients become trapped in never-ending cycles of symptoms.

The Thyroid – GI tract Connection

A very large percentage of patients that come in for intestinal and digestive disorders have some level of thyroid dysfunction. Either there is a problem with the thyroid gland itself, an autoimmune condition, the brain’s signaling system is off, there is a problem activating the thyroid hormone produced or all of that is working but the body’s tissues are unable to take in and use the hormone. When I approach the subject, nearly all patients tell me they have already been tested and their thyroid checked out just fine. For the majority of them, we find they actually do have a thyroid problem once very deep and accurate testing is performed.

Truly understanding the thyroid and the ways it can be impacted is very complicated and multi-layered. So too are the ways thyroid health can affect the whole body. The hormones it produces are critical and if there are inadequate levels, metabolism slows down and nothing will work at full capacity. In the GI tract, this could have grave consequences that cannot be corrected until the underlying thyroid issue is accurately diagnosed. Until then it’s like trying to extinguish a blowtorch with an eyedropper. Unless the fuel for the fire is removed, that flame will keep burning unchecked.

This is a very common scenario mainly due to the inadequacy of the routine thyroid test that can only pick up on some cases of hypothyroidism. Many of the conditions I just spoke of are impossible to see unless more in-depth and precise testing is performed. Unfortunately, most mainstream doctors today use the standard TSH test to diagnose. Some holistic physicians look at a few additional markers which can increase the odds of finding these problems but even that isn’t deep enough. The deepest most accurate testing available is a full thyroid panel (see other recommended tests) combined with the TRH stimulation test. I have used this method for almost 20 years and have been able to pick up on literally thousands of cases of low thyroid that would otherwise go undiagnosed leaving patients stuck with their never-ending symptoms.

In the GI tract, this could mean the stomach is unable to produce enough gastric acid. Without it, foods are unable to be broken down properly and pathogens remain alive making it into the small intestine. These patients may suffer from candida, bacterial and parasitic infections, malnutrition, vitamin deficiencies, leaky gut syndrome, food allergies, osteoporosis, and even chronic heartburn. In these cases, antacids will be ineffective because the problem is actually low stomach acid, not too much. Correcting the underlying thyroid imbalance allows patients to overcome the antacid/heartburn trap.

The intestine can also be affected. Wavelike contractions are generated to mix and push food forward so usable nutrients can be absorbed while waste products and bacteria are swept into the large intestine. This process slows down due to low thyroid, leading to many chronic conditions like constipation, malabsorption, bloating, exhaustion, brain fog, and overgrowth of bacteria known as SIBO (related SIBO test). Colitis and Crohn’s are two chronic inflammatory diseases of the intestine both of which are also highly linked to low thyroid function. It’s essential to increase the chances of healing by doing the appropriate testing.


Microbiome health leads to gastrointestinal health

The intestine is host to trillions of bacteria creating an ecosystem deeply connected to our health. One of the most effective ways to heal the digestive tract is by bringing balance to the colonies of microbes. When friendly populations dominate, these bacteria help regulate immune function and strengthen the connections between intestinal cells called tight junctions, stopping leaky gut. They can also promote gut wall healing, crowd out pathogens and promote cellular turnover.

Bacteria even have a hand in making nutrients and internal antibiotics our bodies use. They are responsible for the fermentation of indigestible fibers that we eat, creating short-chain fatty acids like butyrate which is actually a fuel source for the cells of the large intestine. Additionally, butyrate has the amazing ability to inhibit inflammatory cytokines TNF alpha, IL 6 and NF-kB which drive many chronic inflammatory diseases.

Useful Test: Comprehensive Stool Analysis with Microbiome

If the microbiome is unhealthy, it will be that much harder to heal and put an end to intestinal dysfunction. Long-standing imbalance causes inflammation and can even spark thyroid conditions and issues converting thyroid hormone to its active form. NTIS or non-thyroidal illness Syndrome is characterized by a decrease in regulation of hypothalamus and pituitary function due to high levels of inflammation. Over time, it can affect the thyroid itself creating confusing results on blood tests making it more elusive. People suffer endlessly and remain chronic without proper care.

True healing requires a multi-level approach. Systems that seem unrelated often work together to create dysfunction but can also be turned around to reclaim good health. That is why true holist medicine and comprehensive testing is so important, as well as having a practitioner who understands the deeper causes and methods.

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About the Author

kellman_cropped-2Dr. Kellman is a pioneer in functional medicine who has a holistic and visionary approach to healing. He is a graduate of Albert Einstein Colleg of Medicine in New York and did his post-graduate training in internal medicine at Beth Israel Hospital, Lenox Hill Hospital, and St. John’s Hospital. As a doctor trained in internal medicine Dr. Kellman uses the latest drugs and technology to treat specific diseases but his approach to medicine is patient-centered and holistic. He focuses on the complex interaction of systems — not just the disease but on you as a whole person who is greater than the sum of your parts. Check out his website. Please follow him on Facebook and Twitter.

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