Hashimoto Diary Part 7: The gut plays a big role

At the beginning of the year 2014, on the advice of my family doctor, I took the care of a private clinic in Bonn. There should be a good doctor who knew his way around my illness and could do all further examinations and treatments in the house. That sounded very good at first.

From now on, i had to drive 100km back and 10km twice a week. The first conversation was promising and at least he showed interest on my bowel problem and the light colour of my stool. It was quickly clear to him, that it had to be a problem with the gallbladder.

In my gallbladder several polyps were found and I was advised to get rid of my gallbladder in the near future, as the polyps could degenerate and lead to fatal cancer. I had to let that sink first and did not want to make an rash decision.

Furthermore, my treatment consisted of bioresonance, colon hydrotherapy, ozone treatment and high-dose vitamin infusions. The infusions have brought at least some energy for a short time. Colon Hydrotherapy was very uncomfortable, expensive and without much success.

But he bioresonance surprised me very much. Not only had the practitioner unequivocally diagnosed all my ailments without any hint in advance, but also the fact that she had treated me in relation to my herpes and it has never shown up again for over two years. Although in the years before i have suffered at least 6 times a year with severe herpes on my lips.

The bioresonance also revealed that several (root-dead) teeth cause problems and that mercury is an issue. These topics are very important to me, but there are so many studies going on at the moment that I did not go into it at first.

The gut makes problems

Since I still had massive problems with digestion or the whole digestive system, I had myself tested for food intolerances at the Aachen hospital. At two-week intervals, H2 breath tests were made for possible lactose and fructose intolerance. Both were negative, although I had severe symptoms during the test. Also, a breath test with glucose was performed to exclude a small bowel malady. This test also came back negative, although symptoms were present during the test.

In addition to the breath tests, the intestinal flora was determined again and unfortunately did not turn out very well. There are big differences in intestinal flora status tests, and they are not only linked to the price. The best and most detailed test can be ordered from Medivere (GanzImmun).

Hashimoto intestinal flora
Hashimoto intestinal flora

Overall, too few lactobacilli, bifidobacteria and E. coli bacteria were measured in the stool. But histamine-producing clostridia, and Candida albicans were increasingly present in the stool.

Thus, it was clear that once again I had to start a candida treatment including diet. The treatment should last 2 weeks.

After the classic treatment with nystatin tablets and nystatin suspension, I have added another three weeks with natural anti-fungal remedies. I used candida support, caprylic acid, grapefruit seed extract, lapacho tea and garlic. There were also a lot of probiotics on my list, but my symptoms, especially the fatigue and weakness, have dramatically worsened on probiotics.

This meant that I had to give up the probiotics. However, nobody could explain why taking probiotics worsened my health enormously. Whether this was due to the histamine intolerance and the histamine-forming bacteria in the probiotics, or perhaps more of a leaky gut? Nobody was able to answer this questions, so it was time to learn more about that topic.

The thyroid hormone adjustment does not work

The adjustment with the thyroid hormones did not work that way either. I had tried almost all possible combinations of T3 and T4, but it was not possible to achieve an acceptable state with those synthetic thyroid hormones. As before, a very strong onset about 60 minutes after hormone intake still was a big problem for me.

But also the tiredness, weakness and the bad digestion were very troublesome for me. I would have wanted to switch to natural pigs hormones right away, but my doctor did not like my plan and so she did not want to issue me a prescription for it.

L-thyroxine alone did not work at all. Although the levels increased, the symptoms worsened noticeably. Weight and body fat increased steadily, digestion slowed and fatigue raised beyond measure. With additional intake of Thybon most of the symptoms improved, but I reacted much more extreme to all foods, became very pale with dark eye circles, had circulatory problems and could barely sleep.

The adrenal glands probably still used to play a central role here. For some time, my pulse was very low and sometimes fell under 45 beats per minute. My body temperature was mostly below 36 degrees.

For those who might be interested, here is an overview of my dosages and splittings in 2014:

19.02.2014
About 7 weeks 100 LT and 15 Thybon (50 LT + 5 — 2.5 — 2.5 – – LT 50 + 5)
Total amount of hormones: about 145 LT

TSH (0.4-4.00) — 0.81 μlU / ml
ft3 (2.3-4.2) — 3.5 pg / ml — 63.16%
ft4 (0.8-1.8) — 0.94 ng / dl — 14%
rt3 (<614) — 257 pg / ml

Condition: Moderate … Tired, bad sleep, thrice out at night, shortness of breath and massive reactions to all foods. Tired after eating, circulatory problems etc.

For 5 weeks: 125 LT + 10 tybone 4x split

TSH (0.4-4.00) – 0.04 μlU / ml
ft3 (2.3-4.2) – 3.4 pg / ml – 57.9%
ft4 (0.8-1.8) – 1.23 ng / dl – 43%
rt3 (<614) – 232.6 pg / ml

Condition: Not that good …. total UF -Symptoms. Hair loss, low pulse, freezing, brittle nails, fatigue and weakness, bowel problems and so on.

07.07.2014
For 7 weeks: 150 LT (2x split – morning and noon 75)

TSH (0,4-4,00) – 0, 1 μlU / ml
ft3 (2.3-4.2) – 3.26 pg / ml – 50.53%
ft4 (0.8-1.8) – 1.37 ng / dl – 57%
rt3 (<614 ) – 432.9 pg / ml

Condition: Getting better …. after 10 weeks getting worse again. Fatigue, low pulse, freezing, weight gain, massive constipation, resulting in respiratory distress etc.

31.10.2014
150 LT (complete evening intake on bed edge)

TSH (0.27-4.20) – 0.26 μlU / ml
ft3 (2.0 – 4.4) – 2.63 pg / ml – 26.25%
ft4 (0.9 – 1.7) – 1.75 ng / dl – 106%

Condition: At first good then slowly getting worse. At the end total exhaustion, which has been confirmed by the values. Change to nocturnal intake at 4-5 o’clock in the morning / at night.

28.11.2014
150 LT Morning + 2.5 Thybon Afternoon

TSH (0.27-4.20) – 0.02 μlU / ml
ft3 (2.0-4.4) – 3.0 pg / ml – 69%
ft4 (0.9 – 1.7) – 1.72 ng / dl – 102%

Condition: Catastrophic! Tired and destroyed

Gall Bladder, Polyps, and the Intestinal Flora

The bowel continued to cause more and more problems, but it was not just the obvious things like stool colour and texture that worried me more and more, but also the fact that I was reacting to any kind of food. My abdomen was bloated and after each meal I became extremely weak and tired.

Depending on what I had eaten, this condition continued for several days, so I was unable to do my work or fulfill my other responsibilities like family and household. It also was hard to understand what exactly caused the symptoms, as I finally reacted to a spoonful of rice the same way as to a histamine bomb in the form of salami or tomatoes.

I was very confused about what exactly the problem was. Was it food intolerances? Or a wrong thyroid hormone setting which consequently led to such intestinal complaints? Nobody could tell me.

In addition to the thyroid adjustment, I had to continue to pay attention to the intestinal issue and have made several appointments for sonography of the gallbladder again. Finally, I had five gallbladder sonographies at different doctors and got a total of three different opinions or diagnoses. Two of them were sure there were gallstones.

Two other doctors diagnosed me gallbladder polyps. The fifth doctor saw only Gallengries (fat), which should be harmless. Big confusion again, and it did not make it easier for me, to decide what finally should happen with my gallbladder.

But it kept me worried that it might be polyps. These could eventually lead to gallbladder cancer, and because of that I should not wait too long for a decision.

At my insistence, the stool and pancreatic elastase were examined again. The elastase was 110 and thus in the insufficiency area. Another problem: / Why did the pancreas now also quit its job? I could choose between my already low energy level, a serious  problem in the intestine, or the gallbladder.

And once again, no one was able to tell me anything about it, except that it may be for no apparent reason that the pancreas quits its work. I could hardly wonder about such statements and tried to research again. A few days later I got my Intestinal-Flora-Test back, which looked like this:

Gut inflamed intestine flora damaged
Gut inflamed intestine flora damaged

The Candida fungi and also the Clostridien had disappeared apparently, the bifidobacteria were again in the green range. But the number of enterococci had decreased.

Lactobacilli were still missing and the pH-level of my stool was still in the strong alkaline range. Apparently, the Candida treatment and a short candida diet against the Candida seemed to have helped. Why the Clostridia level was back in normal range, was a mystery to me, because I actively had done nothing against it.

The alpha 1-antitrypsin was within normal limits and, against all expectations, did not indicate a leaky gut.

The ß-defensin-2-marker showed an inflammation of the intestinal mucosa, which I noticed quite clearly when I applied pressure on my abdominal left half. But also the fat content showed clearly, that the fat digestion did not work properly.

Intestinal-flora-test, Candida treatment
Intestinal-flora-test after Candida treatment

So definitely anything was not right, although my intestine looked perfect at every colonoscopy according to the doctors. During this time I took a variety of probiotics to rebuild the intestinal flora. However, this did not seem to work quite well and the probiotics made me feel worse, as I still can not tolerate it.

I constantly had that Leaky-Gut syndrome buzzing around in my head, because it is more common with this intestinal disease that the patient does not tolerate probiotics. This is primarily because the intestinal bacteria can pass the intestinal barrier and get into the bloodstream. In this case, the immune system is overwhelmed and it comes to various symptoms.

Leaky Gut
Leaky Gut

Also, the following stool examination a few months later, shows that the intestinal flora was still quite out of balance.

The enterococci apparently had problems  with settling in the intestine, despite the fact that besides Symbioflor 1, I also took a second product (Arctibiotic Select) at the same time. The Clostridia have grown again in number and the Stool PH still was too alkaline. According to my doctor, the good intestinal bacteria would not be able to settle, as long as the Stool-PH level remained that high. However, she was not able to tell me how to reduce the pH to a normal level.

Calprotectin and elastase
Calprotectin and elastase

The fat content in the stool was even higher in this test than before, even though the pancreatic elastase suddenly was back  in pretty normal range again. It all made quite no sense.

The elastase could not vary that much. And if the elastase was over 400 this time, the question arises why still so much fat was found in the stool. The ß-defensin-2-value was normal again, but calprotectin was significantly increased. My gut seemed to be struggling with some inflammation and unfortunately nobody could figure out, what really was the cause.

In September, my family doctor had referred me again to a gastroenterologist, and for the first time in my long odyssey with physicians I met a young doctor who actually knew his craft very well. He listened carefully, made a few examinations and determined various blood and stool values. My pancreatic elastase level was terrifying again. This time it was at 19.6!

The doctor told me that he had never seen such a low value and could not explain the situation. Subsequently, an MRCP was performed in an X-ray laboratory, to rule out that my bile ducts were not blocked by stones anything like that. Certainly this was not the case.

But it was noticeable, that at each large haemogram in this year, some values ​​were constantly conspicuous. Hemoglobin, hematocrit and erythrocytes always were below the norm. After studying these values ​​for a while, I realized that these values indicated iron deficiency, while my iron and ferritin levels were always unobtrusive and beyond normal range.

Only once  these three values were with​​in the norm. This was after my two-week candida treatment. Coincidence ? Are candida fungi responsible for this deficiency?

What’s up with adrenal fatigue?

Also this year I did not seem to come to a green branch. My health condition was getting worse and worse. The food intolerances were giving me a hard time, but also the constant weakness and fatigue left no room for a halfway normal life.

Cortisol saliva test adrenal insufficiency
Cortisol saliva test adrenal insufficiency

Since I could hardly estimate now, which symptoms were caused by the Hashimoto, the Adrenal weakness, the food intolerance or the Candida mushroom, the search became somewhat difficult. I decided to do a cortisol saliva test again to see if anything had happened to my adrenal fatigue.

Unfortunately the result, as in the last 8 years, was not very pleasing:

My adrenal glands still were producing too little cortisol, to give me even initial energy. At such low cortisol levels, it was not surprising that the thyroid setting proved to be very difficult or nearly impossible.

Something in my body left my adrenal glands so exhausted, and nobody could help me find a way out of this misery. My personal suggestion was, that my condition and all of the symptoms were caused by the gut.

A weird experience with antibiotics

Since I had been racked by recurring tonsillitis for quite some time, in October the time had come to say goodbye to my tonsils. These were actually always red, rugged and caused complaints. Maybe the tonsils were responsible for some kind of long-term stress in the body and weakened the adrenal glands. Possible, but nobody knew exactly.

However, as the tonsils were heavily inflamed right before the surgery,  unfortunately I had to take an antibiotic, because otherwise I would not be able to go through surgery. After taking the second tablet I suddenly felt much better. It was conspicuous that from one moment to another I had almost no more food problems.

I could hardly believe that and began to research again and  once again came  to the bacterial miscolonisation in the small intestine. In a bacterial miscolonisation of the small intestine, colon bacteria have penetrated into the small intestine and cause  a lot of damage there what results in recurring inflammation.

Unfortunately, a few days later I was feeling as bad as before, but this experience could not be a coincidence. So I went to Bochum to the city hospital, to have a lactulose breath test including methane testing done. The hospital was said to be specialized in diagnosing small intestinal malfunctions, but my impression there was very different and I was cared for by unsuspecting students.

This test also came out negative. That negative that it was pretty clear that I was a so-called non-responder. This means that my intestinal flora does not metabolize the sugar to H2 and because of that it would not be possible to detect food intolerances with a breath test. Oh great.

All in all, not a particularly good year, but the upcoming year 2015 will be definitely better …. I can tell you in advance.

Image source:

  • hashimoto-intestinal-flora: © Ghazi-Michael Ayed
  • gut-inflamed-intestine-flora-damaged: © Ghazi-Michael Ayed
  • intestinal-flora-test-candida-treatment: © Ghazi-Michael Ayed
  • calprotectin-and-elastase: © Ghazi-Michael Ayed
  • cortisol-saliva-test-adrenal-insufficiency: © Ghazi-Michael Ayed
  • my-story-part7: © Ghazi-Michael Ayed