Understanding leaky gut and how it leads to thyroid autoimmunity

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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: Understanding leaky gut and how it leads to thyroid autoimmunity

• Podcast Review: Reverse Hyperthyroidism Step by Step

• Ask Dr. Eric: Do I have to avoid gluten and dairy forever?

Understanding Leaky Gut and How it Leads to Thyroid Autoimmunity

These days, many people have heard of the term "leaky gut," but unless you’re a healthcare practitioner, you might not know exactly what it means. So, in this article, my goal is to explain what leaky gut is, how it can play a role in the development of Graves’ disease and Hashimoto’s, and some of the main causes behind it.

And then in the next newsletter I'll discuss the "leaky gut triggers" in greater detail, along with gut healing strategies.

Some of what I’ll cover may get a little technical—but by the time you’re done reading this newsletter and the next one, you’ll have a much better understanding of what a leaky gut actually is, why it’s so common, and what you can do to protect and heal your gut.

What Is the Intestinal Barrier?

The gastrointestinal epithelial barrier is designed to protect you. It prevents harmful substances like foreign antigens and microbes from entering your bloodstream, while still allowing the absorption of essential nutrients, water, and electrolytes.¹

There are four key components of this barrier:^2,3

1. Microbial Barrier. This consists of beneficial bacteria in your gut that protect against pathogenic microbes. These good microbes help digest certain fibers, compete with harmful organisms, and produce substances that keep pathogens in check.
   

2. Biochemical Barrier. Mainly made of mucus, this layer contains antimicrobial compounds, proteins, and antibodies that protect the intestinal lining from pathogens and toxins.
   

3. Physical Barrier. The physical barrier is the single-cell lining of the gut. These cells absorb nutrients, produce antimicrobial compounds, and regenerate every 3–5 days. Tight junctions between these cells regulate what enters the bloodstream.
   

4. Immune Barrier. Located just below the gut lining, this part of the immune system identifies threats and defends against infection. It also produces IgA, an antibody that plays a major role in gut immunity.

The Role of Tight Junctions

Tight junctions are protein complexes that seal the spaces between intestinal cells, controlling what can pass through. When these junctions are disrupted, they become “loose,” allowing substances like toxins, food particles, and bacteria to enter the bloodstream—this is what we refer to as increased intestinal permeability, or leaky gut .

Once this happens, the immune system mounts a response. Over time, this chronic immune activation and inflammation can contribute to the development of autoimmune conditions—including Graves’ disease and Hashimoto’s thyroiditis.

What Causes a Leaky Gut?

Many factors can disrupt the intestinal barrier. A recent review article listed several common “barrier disruptors”:⁴

✅ Air, water, and food pollution

✅ Chemical compounds

✅ Unhealthy diets

✅ Alcohol

✅ Tobacco & e-cigarettes

✅ Microplastic particles

✅ Nanoparticles

✅ Household chemicals

Some of these are clearly easier to avoid than others. For example, you can choose to avoid alcohol, gluten, and processed foods. But microplastics, air pollution, and nanoparticles? Those are a bit harder to escape, no matter how clean your lifestyle is.

That’s why leaky gut is so common—even in people who are trying to be healthy. The good news is that you can take steps to support and repair your gut barrier by minimizing your exposure to these triggers, improving your diet, and addressing underlying infections or inflammation.

I’ll go deeper into the most effective strategies for healing a leaky gut in the next article.

Final Thoughts

Leaky gut isn’t just a buzzword. It’s a real phenomenon with real consequences—especially for those with autoimmune conditions like Graves’ disease and Hashimoto’s.

The more you understand the different components of your gut barrier and the various triggers that compromise it, the more empowered you’ll be to take action. While you may not be able to avoid all of the environmental and dietary threats, the goal isn’t perfection—it’s progress.

And healing your gut is one of the most powerful steps you can take toward restoring thyroid balance.

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, 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 the 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 podcast episode I discussed the framework I use to help people with hyperthyroidism restore their health. Hyperthyroidism can feel chaotic until you understand the system behind your symptoms. Are you recognizing them?

This episode walks through the five (5) parts of the SAVED Thyroid Method, a healing framework that I recommend to my patients. SAVED serves as an acronym for each step, detailing how every component can gently influence antibody activity in hyperthyroidism. 

If you’ve been trying to make sense of your hyperthyroidism and want a grounded, root-cause roadmap, this is a conversation you won’t want to miss.

Ask Dr. Eric

During every issue I'll answer a question or two 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: DO I HAVE TO AVOID GLUTEN AND DAIRY FOREVER?

Dr. Eric, do I have to give up gluten and dairy forever?

Thanks for your question! This is actually something I get asked quite often, as I recommend avoiding gluten and dairy during the healing process. Some natural healthcare practitioners go even further and advise people with autoimmune conditions to permanently avoid both gluten and dairy.

Others take a more moderate approach—recommending long-term avoidance of gluten, but allowing the reintroduction of dairy once health has been restored.

Let’s Talk About Dairy First

I don’t believe that everyone needs to give up dairy forever. In fact, many of my patients are able to successfully reintroduce dairy after healing. Of course, everyone is different. Some people continue to do best avoiding dairy entirely, while others tolerate it well in moderation.

The type and quality of dairy also makes a difference. When reintroducing dairy, I usually recommend opting for healthier forms—such as raw dairy, or dairy from goats or sheep, and ideally organic. That said, some people can also tolerate good-quality dairy from cows, especially when it's grass-fed and minimally processed.

Personally, I minimized my dairy intake for many years. But more recently, I’ve been drinking goat milk kefir as an additional source of calcium. And I’ve joked elsewhere that when I eat a cauliflower crust pizza, I skip the vegan cheese and go with the mozzarella!

What About Gluten?

Now here’s where things get more controversial. There’s much more debate surrounding gluten—and more practitioners recommending permanent avoidance of it, especially for those with autoimmunity.

Unlike dairy, gluten doesn’t offer any nutritional benefits. And as I’ve mentioned in previous articles, gluten has been shown to increase intestinal permeability (aka “leaky gut”)—even in those who aren’t sensitive to it.

So, while you might not feel like you react to gluten, it still could be harming your gut. And since a leaky gut plays a key role in autoimmunity, this is a good reason to consider avoiding it long term.

Now, I’ll be honest—I’m one of those people who doesn’t feel bad when I consume gluten. And I’d be lying if I said I’ve completely avoided it since going into remission from Graves’ disease back in 2009. But overall, I’ve done a good job of minimizing my exposure.

And of course there are plenty of gluten free options to choose from these days, although remember that just because something is gluten free doesn't mean it's healthy.

And while ancient grains like Ezekiel bread or traditionally fermented sourdough might be better options than modern refined wheat, I still encourage most people to limit gluten as much as possible, and ideally avoid it completely while healing.

Additional Thyroid-Related Resources

Click Here for Reverse Hyperthyroidism Step by Step (episode 227)

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:

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That’s a wrap