Chris Kresser on his wife, Graves' disease and LDN

[Deb]

http://chriskresser.com/rhr-testing-for ... out-anemia

Chris Kresser: Steve, did we miss the Graves’ disease question or did I not put that in there?

Steve Wright: I don’t see a Graves’ disease…

Chris Kresser: Scroll down a little bit. It’s in there somewhere. If you can’t see it, we’ll come back to it in a different episode.

Steve Wright: I copied down to the intermittent fasting one. I don’t see it in there.

Chris Kresser: Well, let me just kind of paraphrase it. The question, I think, was essentially we’ve talked a lot about hypothyroidism and Hashimoto’s but haven’t talked much about Graves’ disease and how would I recommend approaching Graves’ disease. Graves’ disease is certainly more rare than Hashimoto’s and hypothyroidism. That’s one of the reasons I haven’t talked about it as much, but I do know quite a bit about it because my wife was diagnosed with Graves’ disease, and this was back when we were still trying to get pregnant with Sylvie and we were having some difficulty, and I was doing some investigation figuring out what was going on, and we discovered that she had Graves’. And shortly after discovering that and treating her for that, she got pregnant with Sylvie. So it’s something that I’ve done quite a bit of research into and I have obviously a personal motivation to stay up with it.

So for us, for my wife, the number one thing by far in terms of turning her health around was low-dose naltrexone, which we’ve discussed a few different times. Low-dose naltrexone is a low dose of a medication called naltrexone, of course. Naltrexone, if you look it up, you’ll find that it’s used for some things that have nothing to do with autoimmune disease and Graves’ disease. Naltrexone at 50 mg is used for opiate and alcohol withdrawal. You know, so basically it blocks the endogenous opiate receptors at that dose, which are our natural feel-good chemicals, so that if a heroin addict that was on 50 mg of naltrexone shot heroin, they wouldn’t feel a thing. The problem at that dose was that not only did they not feel any pleasure from shooting heroin, they felt no pleasure at all at any other time in their life because their pleasure-producing chemicals were completely blocked. So naltrexone was not very successful from that perspective, but a doctor in the ‘80s named Dr. Bihari found that if you used a lower dose of naltrexone and created a temporary blockade of the opiate receptors overnight, you could basically trick the body into producing more endogenous opiates.

And if you’re wondering how this relates to autoimmune disease, we know now that white blood cells have receptors for these endogenous endorphins, and that suggests that the endorphins have an immunoregulatory effect. And sure enough, later research showed that low-dose naltrexone stimulates T regulatory cell function. The T regulatory cells balance the immune system, and they turn off the inflammatory response once it’s turned on, and that’s a characteristic of autoimmune disease, is they’re often runaway inflammatory responses. They’re basically inflammatory conditions run amok, where you get an inflammatory process and it just goes on and on and doesn’t get turned off. So low-dose naltrexone, there are studies examining it in multiple sclerosis, in fibromyalgia, Crohn’s disease, probably the most well-known and best-designed trials, and it was remarkably effective for Crohn’s disease. There was something like a 77% remission rate, which is just unheard of for a Crohn’s disease treatment, and with no side effects compared to placebo, which again, is unheard of because most of the drugs that are used to treat Crohn’s are pretty potent and can cause some pretty nasty side effects, like prednisone and Imuran and Remicade and some immunosuppressive drugs.

So low-dose naltrexone has not been clinically studied specifically for autoimmune thyroid disease, but many autoimmune diseases share common mechanisms, so it’s not that much of a stretch to think that if it works for MS and IBD and fibromyalgia that it could work for Hashimoto’s and Graves’, and sure enough, it does work very well for those conditions in my anecdotal experience and then the experience of a lot of other practitioners that use it and have hundreds of patients that are taking it for autoimmune thyroid disease. So that would be absolutely my number one priority if I had Graves’ disease, is trying low-dose naltrexone. There’s little risk to doing it. There are no known long-term complications or risk associated with it at such a low dose, and especially when you compare it to the other treatment options in Graves’, which are basically having your thyroid radioactively ablated, or nuked, in layperson’s terms, or taking radioactive drugs like PTU or methimazole that have pretty nasty side effects including liver failure and death, I think low-dose naltrexone is a pretty attractive alternative. I actually have a friend or a friend, or a friend’s mom, who had had Graves’ for 30, 40 years and had been taking medication, I think, PTU for that length of time, was extremely skeptical that LDN could help her because she had been on medication for so long. But she heard about Elanne’s experience, and she decided to give it a shot, and now she’s off of those toxic drugs and she’s just taking LDN. So it works even after that length of time in some people.

The next thing is that there are some studies, a couple studies, that suggest that L-tyrosine at pretty high doses can suppress the conversion of T4 to T3. Graves’ disease is a hyperthyroid condition, and reducing the conversion of T4 to T3 can be helpful in those situations. So the dosage that was observed in those studies to do that was around 1000 mg two to three times a day.

There’s some research that suggests that lithium orotate can help because it blocks the release of iodine and thyroid hormones, and in fact, it’s often used after radioactive ablation of the thyroid gland in Graves’ disease, when patients can experience a transitory increase in thyroid hormone after that ablation, and lithium is used to bring the levels down to prevent a thyroid storm or thyrotoxicosis. So the dose, though, for that with lithium orotate is very low. Some of you might be familiar with lithium as a treatment for bipolar disorder. In the case of bipolar disorder, it’s used at a dose of, like, 800 to 2400 mg, but the way it’s used to bring levels down of thyroid hormone is a lot lower. It’s about 120 mg. I would not do this without supervision of a clinician who knows what they’re doing because lithium, if it’s not dosed properly, can have probably some undesirable effects, so it’s good to get some support there.

Those are the main ones. Again, for us, I did some other things, like a custom herbal formula for my wife, but it’s difficult to give general recommendations for that because it’s really tailored to each person’s particular presentation. But what happened is after she went on LDN, within two months she was pregnant, and then we had a very healthy baby girl who’s actually turning 1 in two days, three days. This weekend we’re having her 1-year birthday party, which is gonna be fun. So it can be quite remarkable, and really she’s been euthyroid the entire time since she’s been on LDN. She’s never had to take any other drug. And she’s healthy and doing great, so it’s definitely an exciting treatment for people who have that condition.

[humbird753]

Hi Deb,
Thank you for sharing this. I receive Chris Kresser's reports via emails, but was having trouble getting this one copied here. Interesting read for sure.

Paula

[tex]

Deb,

Thank you so much for posting that. It turned on my light blub.

First off, I'd like to point out that Chris Kressor's endorsement of any treatment carries a lot of weight, as far as I'm concerned. He does his homework.

But to get back to my epiphany: His discussion about how LDN stimulates regulatory T cell function to suppress inflammation, suddenly made it clear to me why LDN doesn't work very well for controlling MC. Rather than to side-track this thread, I'll start a new topic about my thoughts.

Thanks for the information.

Tex