When I started researching lifestyle interventions for Hashimoto's, this one really irked me. I mean here I was, a non-smoker and being a health conscious person put me at greater risk of developing Hashimoto's. When I decided to write my book, I almost didn't want to reveal that there was indeed a connection, I mean, smoking is terrible for us, and the last thing I wanted to do was to encourage anyone to start smoking or prevent them from quitting. While I tried many interventions in an effort to heal myself, I never did take up smoking! Of course the risks would outweigh the benefits, but I kept this nugget of information in the back of my mind, and wondered what about smoking reduced the incidence of Hashimoto’s... until I came across a new supplement last year.
I came across some research from John Hopkins that showed anatabine reduced the incidence and severity of Hashimoto’s in mice (Caturegli, et.al, July 2012). Mice models for Hashimoto's are often used to learn more about how the condition affects humans, and benefits in mice often translate to benefits in humans.
I came to learn that Anatabine is a naturally occurring alkaloid found in the Nightshade plant family (tomato, tobacco, peppers) that is available as a dietary supplement. Anatabine has anti-inflammatory effects and reduces the expression of cytokines (IL-18, IL-1R2) associated with the development of Th-1 mediated autoimmunity. This makes sense, as Hashi's is often a Th-1 condition, and Graves' is a Th-2 condition.
Hot off the presses, released on October 31st!
A brand new randomized, double-blind and placebo controlled study (this time in humans) followed a total of 146 patients with Hashimoto's for 3 months. Seventy of those patients were treated with Anatabine at a dose of 9-24mg per day, while the rest were treated with placebo.
The results showed a statistically significant reduction in Thyroglobulin antibodies (TgAb's) at weeks 4, 8, and 12. TgAb's reduced by an average of 46 points in the treatment group compared to a reduction by 4 points in the placebo group. 50% of patients reduced their antibodies by at least 25 points, while 25% reduced their TG antibodies by at least 100 points.
All of the patients in the study were euthyroid, meaning their TSH, T4, T3 were within range, either because they were taking levothyroxine or because they were in the early stages of Hashimoto's. Anatabine did not affect the levels of TSH, T4 or T3, but the patients who were taking levothyroxine seemed to have a greater reduction in antibodies that patients that were not.
Dizziness, nausea, tingling and headaches were some of the more common side effects.
The authors suggested that Anatabine may affect Thyroglobulin secretion, resulting in a drop of Thyroglobulin specific antibodies.
Surprisingly, the study did not find a statistically significant reduction in TPO antibodies. The authors of the study noted that TG antibodies are often the first antibodies to come down, followed by TPO antibodies and thought that perhaps more time was needed to see a statistically significant drop in TPO antibodies.
I found the same to be true in my case as well. My TG antibodies completely went away after my first lifestyle changes, but the TPO antibodies were slower to budge and took a longer time to reduce.
Additionally, while this was not shared in the study results, the manufacturer did share some preliminary results on TPO levels last January on their healthcare professional portal. One patient who was studied had an enormous drop in antibody levels after she took a dose of 0.12 mg/kg per day of anatabine for sixteen days. Her TPO antibodies reduced from 3655 IU to 300 IU.
I personally tried Anatabine for three months last year when I was in the middle of my root cause search and it actually lowered my TPO antibodies by about 50% (I didn't have anymore TG antibodies at the time).
What I found particularly interesting is that not everyone responds the same to Anatabine, the study noted that not everyone had a drop in TG antibodies, and some had a greater drop than others did. Of course, this makes sense as not everyone has the same root cause.
How to use it
Doses of 0.12 mg/kg per day to 0.267mg/kg per day have been studied and found to be safe and effective in reducing TPO antibodies. This dose would equal to about 5 mg–12 mg per day for a 100-pound woman. Anatabine has a half-life of about eight hours, and should be dosed six to eight hours apart to ensure a constant level in the body.
Anatabine should be started at a low dose of 1–2 mg per day and gradually increased to the target dose over a week. The onset of action should be seen within a couple of days to a few weeks. Early research suggests that anatabine must be taken continuously to exert its effect on the immune system.
Side effects of headache, nausea, vomiting, and changes in liver function have been observed when doses were started too high. Some individuals with Hashimoto’s may have a nightshade sensitivity, and as anatabine is a tobacco alkoloid there is potential of cross reactivity.
Anatabine lozenges are available from Rock Creek Pharmaceuticals, as Anatabloc®. This supplement can be bought over the counter, however, the manufacturing process and clinical research is pharmaceutical grade. I recommend the non-flavored lozenges for those who may be sensitive to the original minty formulation. The company is currently working on additional hypoallergenic products. Healthcare professionals can request free samples through www.anatabloc.com
When to use it
Anatabine has anti-inflammatory properties, and has been shown to detoxify endotoxin, a toxin produced by our opportunistic gut bacteria (the bad guys that can outnumber the good guys). In my opinion, anatabine may likely be helpful for those with a dysbiosis or low alkaline phosphatase; alkaline phosphatase is an enzyme we all have that helps us detoxify our opportunistic bacteria and is deficient in many with Hashimoto's and some other autoimmune conditions. Smoking, for example, has been found to increase alkaline phosphatase, so while I have not been able to find research on the effects on Anatabine on alkaline phosphatase, perhaps Anatabine works in a similar way?
This supplement may be a helpful tool in reducing inflammation and antibodies while searching for why the immune system is imbalanced. I would recommend it for someone who has already gone through an elimination diet and has already identified their food sensitivites, as the Anatabine may falsely block inflammatory reactions we experience with foods.
It may be of particular benefit for those former smokers who felt their condition got worse after they quit smoking, or for those with particularly high Thyroglobulin antibodies. It may also be something to consider for those who want to quit smoking but are concerned about the impact of smoking cessation on Hashimoto's.
Remember, just as with any supplement, Anatabine is not a cure, but rather a tool to help in your healing journey as you work to discover your root cause(s). Wishing you all the best in your journey and continue to DIG-AT-IT!
PS. You can also download a free Thyroid Diet Guide, 10 Thyroid friendly recipes, and the Nutrient Depletions and Digestion chapter for free by going to www.thyroidpharmacist.com/gift . You will also receive occasional updates about new research, resources, giveaways and helpful information.
For future updates, make sure to follow us on Facebook!
Your Thyroid Pharmacist
Izabella Wentz, PharmD
1. Wiersinga WM. Smoking and Thyroid. Clin Endocrinol (Oxf). 2013;2013 79:145–151.
2. Schmeltz, Lowell R (10/31/2013). "Anatabine supplementation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto's) thyroiditis: A randomized controlled clinical trial". The journal of clinical endocrinology and metabolism (0021-972X)
3. CaturegliP,DeRemigisA,FerlitoM,Landek-SalgadoMA,Iwama S, Tzou SC, Ladenson PW. Anatabine ameliorates experimental autoimmune thyroiditis. Endocrinology. 2012;153:4580–4587
4. www.anatabloc.com healthcare professional portal. Accessed 1/10/13
5. http://jcem.endojournals.org/content/suppl/2013/10/31/jc.2013-2951.DC1/JC-13-2951_4tabs_2Figs.pdf Shows the data that was collected during the trial