Reader Adam Kadela has begun intermittent fasting and wonders how it might affect his hypothyroidism:

I have a question pertaining to the section at the end of the book covering extended fasts. I regularly practice the 16-8 fast/feast protocol (breakfast at noon, last meal before eight), and plan to throw in a 36 hour fast once a month per your book. however, I am hypothyroid (hashimoto’s) and take synthetic T4 and T3 (unithroid and cytomel), so I’m wondering if an extended fast could affect my thyroid function negatively.

This is a great question. I think the daily 16-hour fast should be therapeutic for hypothyroidism, but I’m not sure about the 36-hour fast.

In today’s post I want to talk about why daily intermittent fasting may be therapeutic for Hashimoto’s, which is an autoimmune hypothyroidism.

Food Sets The Circadian Clock

The circadian clock is strongly influenced by diet: indeed, food intake dominates light in setting the circadian clock. If you regularly eat at night and fast during the day, the body will start treating night as day and day as night. [1]

(Alcohol consumption at night will also tend to reset the clock, which may explain why college students are often night owls!)

This suggests that controlling the timing of food consumption can help to maintain circadian rhythms.

The Circadian Clock and Hypothyroidism

The thyroid follows circadian rhythms. there is a circadian pattern to TSH levels:  high at night, low during the day.

The thyroid’s circadian pattern is diminished in autoimmune hypothyroidism. in a study of hypothyroid children, the night-time surge of TSH averaged 22%, compared to 124% in normal children. Only one of 13 hypothyroid children had a night-time TSH surge in the normal range. [2]

The study authors concluded:

We suggest that the nocturnal surge of TSH is important for maintenance of thyroid function and conclude that the nocturnal TSH surge is a much more sensitive test than the TSH response to TRH for the diagnosis of central hypothyroidism. [2]

Shift Work and Hypothyroidism

If circadian rhythms are important for thyroid function, we would expect shift workers to have high rates of hypothyroidism. Shift workers sleep during the day and eat at night, which disrupts circadian rhythms.

It turns out that shift work doubles the risk of autoimmune hypothyroidism:

Stress induces autoimmune disorders by affecting the immune response modulation. recent studies have shown that shift work stress may enhance the onset of the autoimmune Graves hyperthyroidism. On the other hand, the possible association between occupational stress and autoimmune hypothyroidism has not yet been investigated…. Subclinical autoimmune hypothyroidism was diagnosed in 7.7 percent shift workers and in 3.8 percent day-time workers with a statistically significant difference: Odds Ratio (OR) 2.12, 95 percent Confidence Interval (CI) 1.05 to 4.29; p=0.03…. Our data show a significant association between shift work and autoimmune hypothyroidism. This finding may have implications in the health surveillance programs. [3]

Shift Work Affected Adam Too

In a follow up email, Adam told me that night shift work may have helped cause his hypothyroidism:

[T]he paper about thyroid and fasting … is particularly interesting to me due to my experience with night shift work for 10 months last year. my circadian rhythm was all out of whack due to experimenting with different sleep schedules and trying to workout around midnight before going into work at two a.m. I also played around with different diet strategies (grazing method w/ small meals, warrior diet, and ultimately settling on the 16-8, which is by far superior imo). my thyroid, along with other hormones, did not enjoy these trials.

Intermittent Fasting May Be Therapeutic

Since the circadian rhythm is affected by both food and light exposure, lifestyle practices can enhance natural circadian rhythms. These practices should optimize the circadian cycle:

• Light entrainment:  Get daytime sun exposure, and sleep in a totally darkened room.
• Daytime feeding: Eat during daylight hours, so that food rhythms and light rhythms are in synch.
• Intermittent fasting: Concentrate food intake during an 8-hour window during daylight hours, preferably the afternoon. A 16-hour fast leading to lower blood sugar and insulin levels, and the more intense hormonal response to food that results from concentration of daily calories into a short 8-hour time window, will accentuate the diurnal rhythm.
• Adequate carb intake:  Eat at least 400 “safe starch” carbohydrate calories daily during the afternoon feeding window. Relative to a very low-carb diet, this will increase daytime insulin release and, by increasing insulin sensitivity, may reduce fasting insulin levels. it will thus enhance diurnal insulin rhythm.

Adam tells me that intermittent fasting seems to be improving his hypothyroidism:

I think you’re correct in that I’ve experienced some curative effects. however, with the improved nutrient absorption and gut health from healthier eating and fasting, I think I fluctuate a lot b/w slightly hypo, normal, and hyper, since my medication is constant. I’m still in the process of finding a balance, but it’s a bigger improvement than my past state.

Conclusion

Many doctors mistakenly assume that little can be done to cure autoimmune disorders. in fact, however, autoimmune conditions commonly disappear once the chronic infections, food toxins, or poor health practices that cause them are eliminated.

Circadian rhythms have powerful influences on many biological processes, and disrupted circadian rhythms are a common feature of disease. Without clinical trials it’s impossible to be sure, but efforts to enhance circadian rhythms may be therapeutic for diseases such as hypothyroidism.

Intermittent fasting, daytime light exposure, excluding light from the bedroom, night fasting and daytime feeding are simple practices. but they may be underappreciated keys to good health.

References

[1] Fuller PM et al. Differential rescue of light- and food-entrainable circadian rhythms. Science. 2008 May 23;320(5879):1074-7. pmid.us/18497298.

[2] Rose SR et al. Hypothyroidism and deficiency of the nocturnal thyrotropin surge in children with hypothalamic-pituitary disorders. J Clin Endocrinol Metab. 1990 Jun;70(6):1750-5. pmid.us/2112153.

[3] Magrini A et al. Shift work and autoimmune thyroid disorders. Int J Immunopathol Pharmacol. 2006 Oct-Dec;19(4 Suppl):31-6. pmid.us/17291404.

Tagged as: Fasting, Hypothyroidism • Comments (30)

Hypochondriacs unite.

Welcome back to Club Medical where misery loves company and those who think they’re sick, but really aren’t can gather together to discuss their symptoms. during your fun-filled weekend, we are pleased to offer you the opportunity to complain to your heart’s content about all those little aches and pains everyone else is fed up listening to.

This season we are offering a special Thanksgiving package where you can talk turkey with our gourmet experts, sharing their gastronomic secrets on how to prepare the quintessential feast without fowl play. Weekend package includes Thanksgiving dinner on the Turkey Trot Terrace, hosted by Sam and Ella — experts on how to have a safe holiday without fear of being poisoned to death by an undercooked bird or tainted stuffing. Learn to baste with wild abandon, and take the worry out of Thanksgiving by being cranberry cool and sweet potato savvy.

You will join in discussions with other hypochondriacs to talk about your latest twinges and tingles that plague you every day. we want you to vent your symptoms that your doctors have been telling you for years are stress-related, but which we know otherwise. we take your complaints seriously.your organs are our main concern. we encourage you to use your time wisely by signing up for seminars that pertain to your particular symptom agenda.

This year, our 30th organ recital keynote speaker is the renowned Belle E. Acher, an expert on the G.I. tract including the appendix, diverticulum and her all-time favorite: the belly button. Dr. Acher does not take indigestion lightly. this woman has guts and gall. she is available for personal consultations, and provides free maps outlining your complete abdominal cavity. Sign up today. it will be a gas.

Colonoscopies can be arranged for an additional fee, and the registration list is already as long as your intestines. These are performed by the world-renown circus performer, and inventor of the latest tube passing techniques, Dr. Samuel Sigmoid, and his team of trained live-wire acrobats who can navigate the colon without the use of a net.

For those whose problems manifest themselves in the cardiovascular area, take heart. Dr. Angie O’Plasty, a cardiologist, has flown all the way from Ireland to assist you in getting the most out of your arteries. In her book: Arteries: how to get rid of Plaque by Daily Aorta Flossing, she explains how to tell if your chest pains are due to 1) an unresolved adolescence, 2) a nagging spouse or 3) a corned beef and jalapeno pepper sandwich on seeded rye.

Dr.Angie O’Plasty, trained in affairs of the heart, will attack your chest with a vengeance. put your heart in her hands and join her for an informative few hours.

Our weekend also includes the hypochondriac’s favorite symptom: the headache. Dr. Mya Graine, the leading headache authority, will teach you bio-feedback techniques that apply to your particular complaint. Men, if your headache is caused by a spouse who asks you to perform unspeakable acts like taking out the garbage or sitting through your kid’s soccer games in the rain, you can learn how to use the headache as a viable tool for avoiding such outrageous demands. Women: when your man expects you to cook dinner or cater to his every need, we’ll show you how to develop a headache at a moments’ notice. Remember, the headache, if utilized properly, can become a couple’s best friend.

In between our seminars, Club Medical is pleased to offer you fine dining on either our open-air restaurant, The Ledge, open to all hypochondriacs except acrophobics. These folks might prefer eating in their rooms with two staff members close by who are proficient in performing the Heimlich maneuver. Or, if indoor dining is your pleasure, The Cave, which received a 4-Star rating in Hypochondria Health magazine but might be just a tad too stuffy for some of our guests who don’t like enclosed spaces. For those phobic-free individuals, the choice is yours.

Those who consider the brain to be your favorite organ, may we suggest our après-dinner event in the Gray Room presented by our guest lecturer, Dr. Sara Bellum. those who were with us last year may recall her erudite dissertation: Quieting the Nervous System through Meditation and Regular Jerry Springer Viewing. Dr. Bellum knows the brain like the back of her hand. this years’ topic will be: how to Increase your I.Q. by Drinking Purified Placenta Extract from African Jungle Apes. Seating is available in right Brain and Left Brain areas, but come early.

What would our Club Medical Thanksgiving weekend be without barely-live entertainment? this week, the rock group, Acid Reflux, will be performing on the Gall Stone Patio. those who like slow dancing can glide the night away in the Liposuction Lounge while our 12-piece orchestra plays golden-oldie favorites: my Aching Heart, Smoke gets in your Eyes, and I’ve got you Under my Skin. For those who enjoy the lighter side of life, our group of comedians: The Stitches will make you laugh so hard, you’ll split your sides.

Thanksgiving is one of our busiest seasons, and the reservations are pouring in, proving that there are more hypochondriacs than ever before. Is it any wonder? with the rising cost of medical care in this country, people would rather live with their illnesses than see a doctor. Here at Club Medical, we give your symptoms the respect they deserve. If you’re hurting, we want to know about it. There is always a dislocated shoulder to cry on. Unlike your friends and family who are fed up, we at Club Medical never tire of listening to your complaints no matter how boring they are.

This year, we are dividing our guests into specific groups according to their symptoms. All those with ailing extremities, hairline fractures and osteoporosis, will go immediately to central casting

People with earaches, scratchy throats and postnasal drips will meet in our newly-appointed ENT auditorium where your ailments will never fall on deaf ears.

Those afflicted with eye disorders including styes, floaters and pink eye resulting from wearing rose-colored glasses, will congregate in the Site for Sore Eyes.

Our guests who believe they suffer from infectious diseases or fevers of unknown origin will assemble in the hermetically-sealed building in the adjacent building until a definitive diagnosis can be determined.

Let’s give a rousing hand (except for those with carpal tunnel syndrome) to our staff of advisors, all leaders in hypochondriacal behavior, for making your Thanksgiving Club Medical weekend possible. Remember: you don’t have to take your symptoms lying down. have fun, be careful and keep in mind the Club Medical motto: just because you’re a hypochondriac doesn’t mean you’re not really sick.

Westporter Judith Marks-White shares her humorous views every Wednesday in the Westport News. she can be reached via e-mail at or at judithmarks-white.com