There is a new exciting paper on the connection between eradicating the intestinal parasite Blasctocystis hominis and improving Hashimoto’s disease. I previously reported this infection connection in a case study which revealed an individual with Hashimoto’s disease getting better after eradicating Blastocystis hominis. Case studies aren’t the strongest scientific proof of a particular therapy but now we have an excellent paper with three research groups including a much-needed control group.
This paper is entitled, “Improving Hashimoto’s thyroiditis by eradicating Blastocystis hominis: Relation to IL-17” published in the journal Therapeutic Advances in Endocrinology and Metabolism by El-Zawawy et al.
The author’s begin by pointing out a very important fact that Hashimoto’s thyroiditis was once thought to be a TH1-mediated disease but once TH17 cells were discovered it became clear that it is a TH17-mediated disease. TH17 cells drive autoimmunity through production of the cytokine IL-17.
Blastocystis hominis is the most common intestinal parasite in humans and most individuals never get any symptoms. This parasite is opportunistic however so if your gut or immune system becomes compromised, it can multiply and cause gut symptoms such as constipation and diarrhea, joint pain, drive autoimmunity and a host of other health problems.
Blastocystis hominis has a prevalence of 1.6% to 16% in developed countries and up to 60% in developing countries. You can get this parasite from contaminated food or water.
How was this study done on Hashimoto’s Thyroiditis and Blastocystis hominis?
60 patients aged 19-57 with 19 females and 1 male in each group.
Group 1: 20 patients recently diagnosed with Hashimoto’s thyroiditis without Blastocystis hominis infection.
Group 2: 20 patients recently diagnosed with Hashimoto’s thyroiditis with confirmed Blastocystis hominis infection.
Group 3: 20 healthy subjects without Hashimoto’s thyroiditis and not infected with Blastocystis hominis infection.
All subjects in group 1 and 2 had a history of fatigue. 9 patients in group 1 and 7 patients in group 2 had a history of constipation. 6 patients in group 2 had a history of diarrhea.
Interestingly, all subjects in group 2 who were infected with Blastocystis hominis had significantly higher blood pressure than the other 2 non-infected groups.
The following tests were done on all subjects:
- Free T4
- Free T3
- Anti TPO antibodies
- Stool analysis
- CBC (complete blood count)
- ALT and AST (liver enzymes)
- BUN (blood urea nitrogen)
Group 2 which was infected with Blastocystis hominis was treated with the medication Nanazoxid for 3 days to eradicate the parasite and then retested 6 weeks later.
What were the study results?
TSH levels were higher in groups 1 and 2 compared to the healthy group 3 as expected.
Free T4 was lower in group 1 compared to group 3 however group 2 did not have lower levels than group 3.
Free T3 was significantly lower in group 2 compared to group 3. Free T3 levels in group 1 were not significantly different than the control group.
TPO antibodies were the same between group 1 and group 2.
Group 1 and group 2 had significantly higher levels of IL-17 compared to the healthy control group. However, group 2 had significantly higher levels of IL-17 compared to group 1 because group 2 was infected with Blastocystis hominis.
They also found that high levels of IL-17 correlated with higher levels of anti-TPO antibodies and lower levels of Free T3.
What happened to the patients treated for Blastocysis hominis?
10 patients in group 2 reported improvement in fatigue and 5 patients had improved constipation. Diarrhea completely resolved in all 6 patients.
Blood pressure in group 2 which was significantly higher before treatment did not change after treatment.
TSH significantly decreased in group 2 after treatment but Free T4 and Free T3 did not change.
IL-17 levels significantly decreased in group 2 after treatment.
The authors thus conclude that eradicating Blastocystis hominis reduced TSH, anti-TPO antibodies, and IL-17.
The authors point out that we have previously known that Blastocystis hominis increases IL-17 levels which are known to trigger autoimmunity and more specifically Hashimoto’s thyroiditis. They also point out that this parasite can increase intestinal permeability resulting in leaky gut which is a major factor in “many, if not all, autoimmune conditions.”
IL-17 inhibits the conversion of T4 to T3 by suppressing the deiodinase enzyme which is required for proper conversion.
The author’s final conclusion is treating Blastocystis hominis infection can improve Hashimoto’s thyroiditis and potentially stop its progression.
What can you do with this information on Blastocystis hominis and Hashimoto’s disease?
The most important thing to do is to get a stool analysis to see if you have this parasite and then successfully eradicate it. If you have it, you can try to get the medication used in this study to get rid of it but I have found that conventional doctors do not believe that Blastocystis hominis is a problematic parasite and will not prescribe medication for it. You may get lucky however.
I use herbal antibiotics and specific probiotics in my practice for this parasite with excellent success so that is another option without drugs. I always test every Hashimoto’s patient I see for intestinal parasites through stool analysis and I do find this parasite quite often. I have found that eradicating it does help patients feel better and now we have some good research to support this connection.
One additional important note is to be sure you have healthy stomach acid levels and a healthy gut in general. Low hydrochloric acid levels can make you more prone to intestinal infections since microbes can more easily pass into the intestine if there isn’t enough acid to kill them. There are many reasons to have low stomach acid including chronic stress, H. pylori, Zinc deficiency, b-vitamin deficiency, food sensitivities, hypothyroidism, anti-parietal cell antibodies, gut dysbiosis and more. Additionally, a healthy gut microbota and gut barrier will provide you with additional defenses against parasites so be sure you work to improve these aspects of your gut.
Some patients with Hashimoto’s disease have positive anti-parietal cell antibodies which are antibodies that destroy acid-producing cells in the stomach. The only real option for these patients is to take plenty of Betaine HCL with meals to overcome the loss of hydrochloric acid production.
If you want to improve your gut health and your Hashimoto’s disease, consider working with a functional medicine practitioner who can help you identify these types of gut imbalances and heal them naturally.