BY TIME February 20, 2022
People commonly fixate on diet, supplements, and medication when it comes to managing a chronic health condition such as Hashimoto’s hypothyroidism or other autoimmune disease. But these approaches fall short if you don’t also address the impact of the mind on health, or “psychoneuroimmunology.”
Autoimmunity is a disorder in which the immune system attacks and destroys body tissue. In the case of Hashimoto’s, one of the most common autoimmune diseases, it targets the thyroid gland, causing hypothyroidism. Hashimoto’s accounts for more than 90 percent of cases of hypothyroidism, affecting more than 20 million Americans.
After extensive research and clinical practice, I published a book in 2010 on Hashimoto’s called, “Why do I Still Have Thyroid Symptoms When My Lab Tests are Normal?” At the time, the autoimmune mechanisms of hypothyroidism were little understood.
My book explained how autoimmunity, an incurable condition, can be driven into remission through evidence-based non-pharmaceutical models. The book sparked a new culture of blogs, websites, social media platforms, and recipe books dedicated to managing Hashimoto’s and other autoimmune diseases.
It Takes More Than Diet
However, I witnessed a disturbing trend in this evolution: a rigid fixation on the “autoimmune paleo diet,” previously known as the elimination-provocation diet. True, many people with Hashimoto’s found certain foods triggered their symptoms, the most common being gluten and dairy. Soy, corn, eggs, grains, nightshades, and legumes are other common immune triggers in people with autoimmunity.
In our diet-obsessed, food-purity culture, people began to promote the autoimmune diet as the pillar of treatment. While it’s important to identify dietary triggers and customize an anti-inflammatory diet unique to your needs, diet is only one piece of the bigger autoimmune puzzle.
In fact, if you eat the perfect autoimmune diet, take all the right supplements, and are on the right medication, your success at managing your autoimmune Hashimoto’s may nevertheless fall short if you also work in a job you hate, are in an unhappy relationship, have a constant stream of negative thoughts running through your head, or are mired in some other chronically negative situation.
This concept is called psychoneuroimmunology, and it’s well established in the scientific literature. Tending to your mental and emotional well-being is just as important as addressing other inflammatory triggers.
The Lessons of Psychoneuroimmunology
Psychoneuroimmunology is a newer field that looks at the connections between your nervous system and your immune system.
In more than 20 years of working with complex autoimmune patient cases, I can tell you that unless you tend to your emotional and mental well-being, your success managing your Hashimoto’s or other autoimmune condition may fall short.
That’s because your physiology changes with your emotional state, and your emotional state is often driven by how you think about yourself and your circumstances. Sometimes you can change your circumstances to drive changes in your thoughts and feelings; sometimes the work is all internal.
Here are some ways I commonly see the psychoneuroimmune response sabotage a patient’s efforts at improving their health:
Lack of Support: Autoimmunity is an invisible disease. Patients often don’t look sick, though they may appear “lazy” due to fatigue and malaise. It takes the average autoimmune patient many years and multiple doctors’ visits before receiving a diagnosis, because the condition is so poorly understood. As a result, they grapple with lack of support or validation, including from their doctors, their partner, and their family. My patients with a good support system have better outcomes than those whose inner circles belittle their condition.
Unhealthy Relationships: Being in a chronically toxic relationship—whether it’s at work or at home—is stressful and inflammatory, which can sabotage your efforts to drive your Hashimoto’s into remission.
Professional Unease: If you dread going to work every day and you hate your job, this produces chronic stress and inflammation that hinders autoimmune management.
Chronic Negativity: Granted, it’s difficult to be positive when you feel ill all the time. However, the patients who are generally more optimistic fare better than chronically negative patients. Positivity is a practice like learning a new instrument or language that can improve with consistent effort.
Isolation: Online interactions are no substitute for real in-person interactions with other humans, which studies show are health-protective. Few things calm us and make us feel as secure as a friendly, sympathetic face-to-face interaction.
Lack of Mental Stimulation: Although fatigue may have you down when you’re chronically ill, it’s important to find ways to regularly challenge your brain to avoid depression and inflammation.
Psychoneuroimmunity for Thyroid Health
I understand it’s not always possible to simply quit your job or leave a relationship, however it’s vital that you understand the impact these situations can have on your health. Awareness is often the first step in many journeys.
Often it’s not simply the situation itself that affects us, but how we think about the situation. If we can’t change our circumstances, maybe we can change our internal reaction.
The key is to understand the role of brain plasticity in your autoimmune condition. Brain plasticity means the brain’s ability to learn new things. When you do something over and over, your brain becomes more efficient at it, whether it’s golf or gratitude.
The bad news is we can develop negative plasticity through chronically negative thoughts and habits.
The good news is we can use plasticity to boost psychoneuroimmune health, even if many of our life circumstances are less than ideal.
One of the easiest and most profound ways to improve psychoneuroimmune health is through a regular gratitude practice. This can be as simple as writing down five things you’re grateful for just a few times a week, or doing a gratitude meditation, which you can find on Spotify, YouTube, or on meditation apps. Just keep it consistent to build positive brain plasticity that improves your immune health.
Laughter and Play
Children intuitively know what we forget as adults—laughter and play are inherent to well-being. In fact, wildlife research shows intelligent animal species play throughout adulthood except, perhaps, the beleaguered adult human. Laughter, too, elevates mood. Watch shows that make you laugh and find ways to engage your inner child in light, playful activities.
Being a keyboard socialite doesn’t count—join regular social gatherings. Ideas include Meetup groups, hobby and craft groups, book clubs, and dog parks.
Meditation and mindfulness practices are game-changers in affecting the psychoneuroimmune response. I personally do transcendental meditation twice a day for 20 minutes and it profoundly impacts my performance, brain function, and mood.
Meditation is especially important if you’re suffering from brain-based symptoms common in Hashimoto’s hypothyroid patients, such as depression, poor focus and concentration, anxiety, and chronic pain.
Meditation is so effective it actually changes the shape of the brain for the better. Just two months of daily meditation increases the thickness of the hippocampus, the center of learning and memory. Meditation also decreases the volume of the amygdala, the brain’s center for fear, anxiety, and stress. Subjects reported feeling less stressed as well.
Meditation also dampens inflammation and helps regulate the immune system.
A 2017 literature review suggests meditation downregulates nuclear factor kappa B, a major inflammatory pathway, and a 2021 review suggests Mindfulness Based Stress Reduction (MBSR) reduces the activity of immune pathways that promote autoimmunity.
Tend to Your Psychoneuroimmunity
While diet and lifestyle strategies underpin successful Hashimoto’s and autoimmune management, don’t forget to tend to your social, psychological, and even spiritual health through daily practices that bring you joy and relieve stress.
If you’d like to learn more about how to manage your Hashimoto’s condition through a personalized approach unique to your needs, please visit my course Hashimoto’s: Solving the Puzzle, available through my site at drknews.com.
Datis Kharrazian, Ph.D., DHSc, DC, MS, MMSc, FACN is a Harvard Medical School trained, award-winning clinical research scientist, academic professor, and world-renowned functional medicine health care provider. He develops patient and practitioner education and resources in the areas of autoimmune, neurological, and unidentified chronic diseases using non-pharmaceutical applications.