iThyroid.com

LATEST IDEAS

   Last Updated: February 11, 2001

On this page I would like to present my latest thinking on the origin and correction of thyroid disease.

It seems to me that thyroid disease is caused by deficiencies of key minerals and that there are critical steps of mineral metabolism that need to be working for normal thyroid metabolism.

The thyroid gland produces the thyroid hormone T4, which is really a pro-hormone, and T4 must be converted by a deiodinase enzyme in the liver and kidneys to T3, which is the cellularly active thyroid hormone which controls metabolic rate.

The key steps in mineral metabolism which are necessary for normal thyroid metabolism are these:

1. Several minerals are necessary for the production of thyroid hormone, T4. These minerals include iodine, iron, manganese, zinc, copper, chromium, selenium, cobalt, and possibly other ultratrace minerals. These minerals and other nutrients which work with these minerals must be in the diet or supplemented.
2. One mineral, selenium, is necessary for formation of the deiodinase enzyme which converts T4 into T3. 
3. Another mineral, copper, seems to be necessary for suppressing the production of immune system malfunctions which cause autoimmune Graves' disease, and appears to have other critical functions in preventing hyperthyroidism.
4. Several minerals, including potassium, sodium, lithium, calcium, and magnesium, regulate the passage of minerals, other nutrients, and T3, through cell membranes. Imbalances of these "gateway minerals" can limit T4 production by interfering with the transport of minerals into the thyroid cells and can also limit the amount of T3 which gets into the body's cells, thereby limiting the rate of metabolism.
5. Other nutrients including vitamins, proteins, and fats which work with the minerals need to be present for the minerals to work properly to perform normal endocrine functions.

Of all these steps, perhaps the critical step is passage of key nutrients into the cells. Even if adequate minerals are in the diet, if they don't get into the cells, there will be a functional deficiency.

We have seen that balance is a key concept in understanding nutrition and the nutritional correction of disease. This seems most true when we talk about the minerals which regulate the intercellular passage of nutrients. The sodium-potassium channels, the lithium-sodium counter transport system, and the calcium channels all depend upon the ratios of minerals rather than their absolute concentrations.

In the years that I've been studying this disease I have still not seen one bit of information that suggests that hyperthyroidism and Graves' are the result of anything other than nutritional deficiencies and imbalances. When you get the right nutrients, you can feel better in hours or days.

My latest thinking is that hyperT results when there are imbalances in two key mineral relationships: 
(1) zinc/cadmium/iron/copper 
(2) sodium/potassium/calcium/magnesium

(1) Copper gets depleted by various methods: excess zinc or cadmium can deplete copper; various vitamin deficiencies, such as biotin, PABA, pantothenic acid, B-2, niacin, or B-1, can prevent copper from being utilized correctly. Therefore copper has to get replenished by supplementation (5-8 mgs per day); removing excess cadmium (smoking, chocolate, coffee, excess green leafy vegetables, etc.); removing excess zinc (stop taking multiple vitamin/mineral supplements, limit high zinc/low copper meats, limit B-6 which assists zinc metabolism), and by limiting iron and the nutrients that help iron metabolism (B-12, manganese, folic acid).

(2) Correct the imbalances in sodium/potassium/calcium/magnesium minerals. The balance of these minerals is critical since this balance controls the transport of water, other minerals, and other nutrients through the cell walls. 

It appears that in hyperthyroidism, excess sodium and calcium deplete potassium and magnesium. Deficiencies of these two minerals causes wide-ranging problems. Among other problems, magnesium deficiency causes rapid heart rate and potassium deficiency causes weak or irregular heart rate.

Either potassium or magnesium will be more depleted and it's necessary to correct the deficiencies without upsetting the critical potassium/magnesium balance. To determine which mineral is more depleted, look at your symptoms. Magnesium deficiency seems to cause rapid heart rate since magnesium is involved in muscular relaxation. Magnesium deficiency prevents the heart muscles from going through a complete relaxation phase so the heart rate accelerates. 

Potassium depletion not only causes irregular heart rate, but it seems to cause water to enter the cells and stay there, causing the body to swell up with edema. This is the reason why many hypers (and hypos) gain weight--it's all water retention. If you are swelling up, then you are probably potassium deficient, so take more potassium than magnesium. If you are losing weight, then probably magnesium is more deficient than potassium, so take more magnesium than potassium.

The deficiencies of potassium and magnesium explain why sodium and calcium (dairy products, etc.) aggravate hyper symptoms, since sodium especially depletes potassium and calcium especially depletes magnesium. 

There is also an interaction between the metals in group (1) and the minerals in group (2). Zinc depletes potassium and cadmium depletes magnesium. Copper assists magnesium metabolism and potassium seems essential to enable copper to get into the cells. 

The interactions are probably more complex than described, but the important message is that a deficiency of one mineral has wide-ranging repercussions on the balances of other minerals. The key deficiencies are copper and its large collection of assisting nutrients, magnesium, and potassium. 

Potassium is the strangest to replenish because all the supplements available are limited to 99 mgs. Our daily requirement is about 3000 mgs, so taking one or two tablets doesn't do much. You'll probably have to take 800 mgs or more a day to effect any change. It also helps to increase high potassium foods like bananas (400 mgs in one) and potatoes (500 mgs in one).

Keep in mind that excess potassium can deplete magnesium (and increase heart rate), while excess magnesium can deplete potassium (and cause irregular heart rate). Strive for a balance between these two minerals as you experiment to determine appropriate supplementation amounts. Start with small amounts and don't take a lot of one without the other. Remember that foods are the primary source of these minerals so use supplements as needed to create balance.

There are a lot more complexities involved, but this is a good summary of my present thinking about how to correct hyperthyroidism. Once the hyper phase is controlled, many people go back hypo and at this point, other nutrients may need to be added (iron, selenium, chromium, zinc, B-12, etc.) to boost thyroid production up to normal. That's a whole other story.

POTASSIUM

I have a theory that a potassium deficiency is a critical precursor of thyroid disease. The reason that it's been undetected is that both the causative and corrective process occurs so slowly that it's difficult to perceive. The theory is this:

Of the five minerals involved in the cellular transport of nutrients, potassium seems to be the most likely to be deficient in thyroid disease. The initial effects of long-term potassium deficiency cause hypothyroidism but when the deficiency gets severe, hyperthyroidism results.

Deficiencies of potassium decrease the ability of nutrients and hormones to enter the cells by disrupting the sodium/potassium transport system. This results in mineral deficiencies which then cause abnormal thyroid function, and can cause other symptoms like causing the cells to accumulate water, resulting in cellular and bodily edema. This edema or weight gain is seen in both hypothyroidism and hyperthyroidism.

Low potassium can contribute to hypothyroidism by not only preventing nutrients from getting into the thyroid cells thereby limiting production of T4, but also by limiting how much T3 can get into the cells, thereby lowering the metabolic rate of the cells and body.

It's possible that very low potassium levels are the beginning trigger of hyperthyroidism. Copper and magnesium transport into the cells decreases and this combination causes the various symptoms associated with hyperthyroidism. Magnesium deficiency decreases the ability of the heart and muscles to fully enter a relaxation phase resulting in muscular cramps and tics. These effects are seen in the heart as rapid heart rate, since the relaxation phase of the heart beat is shortened. This magnesium deficiency makes the person very intolerant of calcium intake since calcium is a natural antagonist of magnesium and is the promoter of muscular contraction.

Potassium deficiency also decreases copper transport into the cells and this results in copper-deficiency anemia, since the iron no longer has enough copper to form an adequate amount of hemoglobin. Intake of iron further depresses copper levels resulting in more hyper symptoms when iron, manganese, or cobalt are ingested.

Both hypers and hypos report that magnesium supplementation can relieve many of the symptoms of thyroid disease. Hypers in particular report that magnesium reduces episodes of rapid heart rate, which are referred to as "thyroid storms." One possibility is that the magnesium deficiency experienced in hyperT is actually a result of potassium deficiency. A high ratio of sodium to potassium may favor the transport of calcium into the cells at the expense of magnesium. This pushes the heart rate higher because of the subsequent high calcium/magnesium ratio. Magnesium supplementation helps, but perhaps the key to increasing magnesium is the use of potassium supplements along with magnesium supplements.

In my experience I've found that magnesium decreases the rapid heart rate of hyperT for a short period of time, but does not cause any progress in the long-term goal of correcting hyperT. What does control hyperT in the long run, is supplementation with copper and the nutrients which help copper metabolism.

I've wondered what causes the copper deficiency in the first place. One possibility is that thyroid disease begins with potassium deficiency, or rather a too high a ratio of sodium to potassium over a long period of time. This results in the gradual increase in copper and magnesium deficiencies, and the serious symptoms of hyperT are the result of problems created when these nutrients get deficient.

What evidence is there that potassium deficiency is a key precursor to thyroid disease?

1. Adrenal hormones cortisol and aldosterone, which are increased during stress stimulate potassium excretion.
2. Hypokalemic periodic paralysis, a condition caused by potassium deficiency in which the body becomes rigid, is associated with hyperthyroidism.
3. The synthesis of muscle protein requires potassium and we see muscle wasting in hyperthyroidism.
4. The excessive use of salt depletes potassium and we see that hypers often have an intolerance for salt.
5. Coffee and sugar increase the excretion of potassium from the body and we've seen that decreasing or eliminating coffee and sugars, including fruits, helps hyperthyroidism recovery.
6. Physical activity increases potassium excretion and we've seen that many hypers have been exercising extensively before developing hyperT. "Extensive physical exertion for 3 hours a day can dissipate from 700 to 800 milligrams of potassium, which radiates out from sweat." (Nutrition Almanac)
7. An early symptom of potassium deficiency is decreased heart rate as you would experience in hypothyroidism. (In my experience a slow, pounding heart rate indicates potassium deficiency, while a fast heart rate indicates magnesium deficiency.)

If potassium deficiency is a causal factor in thyroid disease, then why hasn't it been discovered before now? When I had hyperthyroidism, I experimented with potassium and never experienced any effect one way or the other. However, I've recently learned that I was ignorant of some key bits of information about potassium.

First, the Nutrition Almanac states that "Potassium constitutes 5% of the total mineral content of the body." Potassium is not a trace mineral, but a major mineral. The body normally has a lot of it and requires a large intake each day to maintain adequate levels. The amount of potassium in the average person's daily diet is estimated at 2000 to 6000 milligrams, with an estimated minimum requirement of 2500 mgs. A banana contains about 450 mgs. and a potato about 600 mgs.

Second, there appears to be a law which limits the amount of potassium which can be put into a supplement at 99 mgs. This means that to satisfy your daily requirement of potassium by supplementation would require 25 capsules. When I had hyperT and experimented with potassium I was taking 1 or 2 capsules a day. This was an insignificant amount and it's no wonder that I felt no effects. If you became deficient and needed to replenish your body stores, you might have to take 10-20 capsules a day to have any significant effect.

I don't know the reason for limiting supplemental amounts of potassium to 99 mgs, but the result is that few people will ever experiment with adequate amounts to affect their conditions. If hypothyroidism is the result of long-term potassium deficiency and hyperthyroidism is the result of severe long-term potassium deficiency, who would ever find out? You would have to take what would appear to be huge amounts of potassium, and you'd also have to replenish all the nutrients that became deficient while you were potassium deficient. Experiments of this complexity just don't get done.

I think that it's worthwhile experimenting with potassium to see what effects it might have. Remember, that potassium itself is not going to relieve the major symptoms of thyroid disease--it just opens the cellular door for the important minerals to get in so they can perform their duties. Used in conjunction with the other recommended nutrients, additional potassium from supplementation or eating extra amounts of high potassium foods like potatoes and bananas may be a key in recovery.

For those who have experienced weight gain or edema, watch your weight and other symptoms. I found that when I was potassium deficient, at night when I removed my socks I saw noticeable indentation marks where my socks were. Above the sock line, my legs seemed swollen. So far, getting extra potassium has significantly reduced that symptom.

My latest hair analysis showed very low potassium levels but I ignored this evidence. While my high heart rate days of hyperthyroidism have been long gone, I started experiencing periods of very slow pounding heart rate at night. I attempted to use magnesium and copper to try to control this, and sometimes it would help. However, I reached a point where magnesium and copper only made the situation worse. In fact everything made it worse and I was at a complete loss about what might be causing those symptoms.

Finally, the symptoms got so severe that I was getting that "maybe I'm going to die feeling." One night about 3 am when I awoke with muscle cramping, severe heart problems, and I could hardly walk, I decided I had to try something that I wasn't supplementing. For some reason I tried potassium and within 20 minutes the symptoms were substantially less and within an hour I was comfortably back to sleep. Over the next two weeks, continuing potassium supplementation completely eliminated all of those heart symptoms. Another reminder that no matter how bleak a health situation might seem, when you get the right nutrient you can recover in minutes.

As I've experimented with potassium I have developed a first rule that you may want to check out for yourself: If you feel your heart rate pounding at a high rate, reach for magnesium first. If you feel your heart rate pounding at a low rate, reach for potassium first.

The ratio of potassium to magnesium seems to be important. If we need a minimum daily intake of 2500 mgs of potassium and 400 mgs of magnesium to maintain health, then perhaps a ratio of 6:1 might be appropriate. This seems high to me, but I have very little information to go by. My gut feeling is that for supplementation, it might be best to take between a 1:1 and a 2:1 ratio of potassium to magnesium. For example, try 400-800 mgs of potassium and 400 mgs of magnesium if you're experiencing pounding heart rate problems (adjust the ratio depending on whether it's a high or low heart rate). Remember to factor in your dietary intake of these minerals since the potassium content of foods can be high (450 mgs for a banana).

Persons with hyperthyroidism who want to try potassium supplementation should proceed with caution. Try a small amount and increase very gradually, making sure to take copper and magnesium as needed.

Let me know if you have any information that might be pertinent to these ideas. Thanks, John