Choosing a Probiotic, Goiter-Gut Connection, Food Sensitivities

Welcome to Healthy Gut Healthy Thyroid!

This is your weekly roundup of the BEST actionable steps for those people with thyroid and autoimmune thyroid conditions who want to restore their health…by healing their gut. Whether you have hyperthyroidism or Hashimoto’s you will benefit from the content in this newsletter.

In today's issue:

• Main Topic: Choosing a Probiotic: 6 Key Factors to Consider

• Podcast Review: 3 Concerns with Sea Salt and Thyroid Health

• Understand Your Tests: Why test the Immunoglobulins?

• Ask Dr. Eric:
  ✔️Is there a goiter-gut connection?

  ✔️How can I address food sensitivities?

Choosing a Probiotic: 6 Key Factors to Consider

With so many probiotic supplements available, it can be challenging to determine which one is best for those with hyperthyroidism and Hashimoto’s. Here are six key factors to consider when making your selection:

Factor #1: Potency. I recommend choosing a probiotic with a potency of at least 25 billion CFU (colony-forming units). However, a higher CFU count does not necessarily mean a superior product. A probiotic with 80 billion CFU is not automatically better than one with 25 or 50 billion CFU.

While there are high-quality probiotics with lower CFU counts, aiming for at least 25 billion CFU is ideal for general gut health support.

Factor #2: Clearly Listed Strains. It’s important to choose a probiotic that specifies the exact bacterial strains it contains. I first learned the significance of strain-specific probiotics from Dr. Jason Hawrelak, a leading probiotic expert and one of my instructors while trying to obtain my Master's in Nutrition degree at the University of Western States.

Dr. Hawrelak explains in his article, The Importance of Strain:

"Strains of bacteria within the same species can have significantly different actions, properties, and characteristics, as many of these characteristics are strain-specific qualities."

For example, Lactobacillus plantarum Lp-115 has been shown to inhibit H. pylori colonization (in an animal model)¹, but other strains of Lactobacillus plantarum may not offer the same benefit.

My private-label probiotic, SMT-Probio, contains 18 different strains, including Lactobacillus plantarum Lp-115. And there are other good quality probiotic supplements that list the specific strains, and not just the species.

Factor #3: A Variety of Strains. While you don’t need a probiotic with 18 different strains, I recommend choosing one with at least five strains, with eight to ten strains being even more beneficial.

That said, there are cases where a probiotic with just one or two strains may be warranted. For example, Lactobacillus rhamnosus GG has been shown to help with antibiotic-associated diarrhea.

Factor #4: Third-Party Tested. Independent lab testing has shown that some probiotic supplements do not contain the strains or CFU counts listed on their labels. To ensure quality and accuracy, look for third-party verified probiotics.

I personally rotate my probiotics, and besides SMT-Probio, any other probiotics I take are also third-party verified. While not every non-probiotic supplement I use or recommend is third-party tested, those that aren’t have a strong reputation for quality.

Factor #5: Rotating Probiotics. Rotating probiotics can be beneficial for gut health, as different supplements contain different strains, which can help diversify the gut microbiome. This is why I like to switch between different high-quality probiotic formulas.

Factor #6: Get Some Probiotics from Food. While this article focuses on probiotic supplements, it’s worth mentioning that fermented foods are another excellent source of probiotics. If you enjoy fermented foods such as sauerkraut, kimchi, fermented pickles, or kombucha, consider incorporating them into your diet regularly.

Conclusion: many people take probiotic supplements, and unfortunately a lot of these aren't potent enough and/or don't list specific strains on the label. So to receive optimal benefits from any probiotic supplement you take make sure you follow the advice given in this article.

Find Your Hashimoto’s Triggers

If you have Hashimoto’s thyroiditis, visiting an endocrinologist is likely to result in a prescription for thyroid hormone replacement. And while there is a time and place for thyroid hormone replacement, the problem is that it doesn’t do anything for the autoimmune component of Hashimoto’s.

And so what happens is that many people will take thyroid hormone without doing anything to improve the health of their immune system, which means that over time further damage to their thyroid gland will take place.

The good news is that you can do things to reverse the autoimmune component of Hashimoto’s. And the best way to accomplish this is by finding and removing your triggers.

My book “Hashimoto’s Triggers” will show you how to do this. By reading this book you will discover the following:

• More than one dozen triggers of Hashimoto’s thyroiditis

• The different diet options, and how to detect your specific food triggers

• Everything you need to know to heal your gut

• How to reduce fatigue, brain fog, hair loss, lose weight, and address other common symptoms

• Strategies to lower thyroid antibodies when nothing else has worked

• Nutritional supplements and herbs for Hashimoto’s

• A comprehensive list of the blood tests you should get, along with other specific tests that can help detect your triggers

• What you need to do to achieve optimal adrenal health

• Natural treatment options for viruses, pathogenic bacteria, parasites, Candida, and SIBO

Click Here to order my book “Hashimoto’s Triggers”

Save My Thyroid Podcast Review

I have a podcast called "Save My Thyroid", where I discuss how people with hyperthyroidism and Hashimoto's can save their thyroid and regain their health. And during each edition of this newsletter I'll briefly discuss a recent podcast episode.

In a recent Q & A podcast episode I answered the question “Is sea salt beneficial or harmful to thyroid health?”

Like many people, I’ve added sea salt to my food for years. Although sea salt is often praised for its trace minerals, there are a number of concerns to think about when considering whether switching to sea salt would contribute positively to overall health.

In this episode I explore the three main concerns about sea salt and thyroid health. One of the main concerns is exposure to microplastics.

The truth is that while I continue to add sea salt to my food as I write this edition of the newsletter, that very well may change in the future. While sea salt is a great source of minerals, I'm not sure if the benefits outweigh the potential risks.

To learn about the three concerns with sea salt make sure you check out the episode.

Understand Your Tests

Why Test For Immunoglobulins?

Immunoglobulins G, A, and M are three primary types of antibodies produced by the immune system. While the test results shown above are from one of my patients, I don’t routinely recommend testing immunoglobulins for every individual. However, in certain cases, it can provide valuable insights into immune function.

Understanding the Three Main Immunoglobulins

IgG: The most abundant immunoglobulin, IgG plays a crucial role in long-term immunity against infections. It is also commonly measured in food sensitivity testing, whereas IgE antibodies are associated with food allergies.

IgM: This serves as the body’s first line of defense against new infections. For example, if someone tests positive for Lyme disease IgM antibodies, this typically indicates an acute Lyme infection.

Conversely, if someone tests for Lyme disease IgG antibodies and it's positive, this usually indicates a chronic Lyme infection. This was the case with me in 2018, when I tested positive for Lyme IgG antibodies but negative for IgM antibodies.

IgA: While the image above represents a blood test, IgA antibodies are primarily found in bodily secretions such as saliva and mucus, providing protection in the respiratory and gastrointestinal tracts.

In my very first newsletter, I discussed secretory IgA (sIgA)—the mucosal form of IgA—which, when low, is often associated with leaky gut.

In my patient’s test shown above, IgA is low. While this does not relate to a leaky gut like secretory IgA can, a deficiency in serum IgA may increase susceptibility to infections.

In some cases, low IgA levels are genetic, meaning they cannot be normalized. However, supporting overall immune health can still help reduce infection risk.

The Impact of ELEVATED Immunoglobulins

While low immunoglobulin levels can increase susceptibility to infections, elevated levels can sometimes indicate an active infection or food sensitivity. In these cases, further testing may be necessary to determine the underlying cause.

It’s also important to note that many people with abnormal immunoglobulin levels do not experience noticeable symptoms. In many cases, the only way to detect an imbalance is through testing.

Ask Dr. Eric

During every issue I'll answer a few questions that I think can benefit most people with a thyroid or autoimmune thyroid condition. If you'd like for me to consider your question for a future edition of this newsletter email your question to [email protected].

QUESTION #1: IS THERE A GOITER-GUT CONNECTION?

Dr. Eric, I have a goiter and would love some tips on how to shrink it, and since this newsletter is related to the gut and thyroid I was wondering if there is a connection between goiters and the gut.

Thank you for your question! When I was dealing with Graves' disease, I developed a mild goiter. In such cases, it is often possible to restore the thyroid to its normal size by addressing the underlying cause. However, larger goiters can be more challenging to shrink.

Common Causes of a Goiter

Several factors can contribute to the development of a goiter, including:

• Hyperthyroidism

• Hypothyroidism

• Inflammation

• Estrogen metabolism issues

• Iodine deficiency

In my case, hyperthyroidism was the primary cause. Once my thyroid function was restored, the goiter gradually decreased in size. For many of my patients, a thyroid hormone imbalance is also the primary cause.

However, if a different underlying factor—such as inflammation, an iodine deficiency, or estrogen metabolism problem—is responsible, then that specific root cause must be addressed for proper resolution.

The Goiter-Gut Connection

While gut dysbiosis or a leaky gut typically do not directly cause a goiter, there can be indirect relationships between thyroid swelling and gut health.

For example, a healthy gut is necessary for properly metabolizing estrogen, and I already mentioned that problems with estrogen metabolism can sometimes play a role in the development of a goiter.

I will explore these connections further in upcoming newsletters, but addressing gut health remains an essential component of thyroid healing and overall wellness.

QUESTION #2: HOW CAN I ADDRESS FOOD SENSITIVITIES?

Dr. Eric, I recently did a food sensitivity test that showed I was allergic to many different foods, and wanted to know what I should do to address this?

Thank you for your question! While I am not a big fan of food sensitivity testing, I do acknowledge that when someone receives test results indicating numerous food reactions, gut health is almost always a contributing factor.

It may be beneficial to temporarily eliminate reactive foods for a few months, but this can be particularly challenging if the test reveals dozens of sensitivities. Regardless of whether you react to a few foods or many, the key focus should be on optimizing gut health.

Food Sensitivities vs. Food Allergies

Many people confuse food allergies with food sensitivities. Here’s the key difference:

Food allergies are IgE-mediated and typically cause an immediate reaction.

A classic example is a peanut allergy, where exposure can trigger a severe reaction within minutes or even seconds. While not all food allergies result in life-threatening symptoms, reactions occur quickly after ingestion.

Food sensitivities, on the other hand, often involve a delayed response—sometimes occurring hours or even days later. Additionally, not everyone with a food sensitivity experiences noticeable symptoms, making it more challenging to identify problem foods without testing.

How to Optimize Gut Health and Reduce Food Sensitivities

So, how can you improve gut health and reduce food sensitivities? This is the core focus of this newsletter, as multiple factors can contribute to gut dysfunction, and the best approach varies for each individual.

While eliminating a few specific foods (e.g., 5 to 10 or fewer) may be helpful, avoiding dozens of foods is often impractical and unnecessary. Simply eliminating trigger foods may not be enough to heal the gut—a comprehensive approach is typically needed for long-term improvement.

By addressing gut imbalances, supporting digestion, and reducing inflammation, many people can tolerate more foods over time.

Additional Thyroid-Related Resources

Click Here for Prebiotics, Probiotics, and the Gut Microbiome (episode 95)

Click Here to learn more about my probiotic supplement SMT-Probio

Click Here to access hundreds of thyroid-related articles and blog posts

Click Here to join the Graves’ disease and Hashimoto’s community

Click Here to purchase one of Dr. Eric’s thyroid-related books

Click Here to work with Dr. Eric and his team

References:

(1) https://pubmed.ncbi.nlm.nih.gov/37621875/

That’s a wrap