Hashimoto's Thyroiditis: Everything you need to know
WHAT IS HASHIMOTO’S?
Hashimoto’s Thyroiditis is an autoimmune condition in which antibodies (antithyroid peroxidase and anti-thyroglobulin antibodies) attack the thyroid gland tissue, a small gland at the base of your neck below your Adam's apple leading to chronic inflammation. The term “Thyroiditis” refers to “inflammation of the thyroid gland”. To be clear, Hashimoto’s thyroiditis is an autoimmune condition that triggers a thyroid issue, NOT the other way around. As a result of this inflammation, the immune system will attack itself.
Women are 10 times more likely to have Hashimoto's thyroiditis than men. It can occur in teens and young women, but more commonly shows up in middle age.
Antibodies fight against thyroid peroxidase and/or thyroglobulin which slowly destroys follicles in the thyroid gland. It also invades the thyroid tissue by leukocytes, mainly T-lymphocytes. As a result, the thyroid gland can become enlarged.
The resulting decrease in thyroid hormones impacts cells throughout the body, causing symptoms such as:
Fatigue
Weight gain
Headaches and migraines
Thinning or dry hair, nails, and skin
Feeling cold all the time
Irregular periods
Puffiness or fluid retention
Fertility problems
Slow digestion and constipation
Brain fog
Depression
Aching muscles and joints
Loss of muscle strength and tone
These symptoms may be vague early on, but the inflammation can result in an enlarged thyroid (goiter) and thyroid nodules over time.
It can also accompany other autoimmune diseases (lupus, RA) or hormonal disorders such as diabetes, Addison’s disease, Graves’ disease, Pernicious anemia, and Vitiligo.
Hashimoto's thyroiditis is a progressive disease
In the early stages of thyroid tissue destruction, when your TPO antibodies are borderline positive, the body compensates, producing more hormones to keep normal hormone levels. In this stage, your thyroid is still close to fully functional.
Even though TPO antibodies may be present in the blood, it could take many years before symptoms appear.
Progressively, as immune cells destroy more thyroid tissue, the gland loses the ability to compensate, and thyroid hormone production drops. You might start to feel symptoms as antibodies continue to attack your thyroid gland over time.
Eventually, the gland loses its ability to produce thyroid hormones.
Often, thyroid antibodies can be the first indicator of a thyroid problem. While the presence of thyroid antibodies does not necessarily mean that you have hypothyroidism, it does indicate an ongoing attack against the thyroid, increasing your risk for future thyroid disorders.
TESTING & LABS
Thyroid Function and Autoantibodies
A Complete Thyroid Panel including thyroid-stimulating hormone (TSH), T3 (free and total), T4 (free and total), and reverse T3 should be assessed using functional medicine ranges.
TSH measures how the pituitary gland in the brain communicates with the thyroid, indicating hypothyroidism when elevated. A normal TSH does not rule out thyroid issues on its own since it is an indirect measure of function.
Free T4 measures bioavailable unbound thyroid hormone and is a marker of low thyroid function when decreased.
In the peripheral tissues, T4 is converted to T3. Low T3 indicates decreased thyroid function or a problem with conversion, which often occurs with chronic stress, inflammation, or high toxic burden.
Some T4 is also converted to reverse T3, which serves as a “brake” by competing with free T3 for cell receptors. High reverse T3 can cause hypothyroidism and usually reflects a systemic issue like chronic inflammation.
In addition, testing for thyroid peroxidase (TPO) and anti-thyroglobulin (TG) antibodieshelp diagnose Hashimoto’s. Elevated TPO antibodies are typical, and thyroglobulin antibodies may also be elevated and are associated with symptom burden.
A Functional Medicine approach to Hashimoto's includes screening for a comprehensive thyroid panel, and assessing supportive thyroid nutrients, markers of gut health, food sensitivities, and detoxification capacity.
HASHIMOTO’S DISEASE POSSIBLE CAUSES
HASHIMOTO’S & GUT HEALTH: THE CONECTION
All disease starts in the gut. Digestive issues are a common connection in those who suffer from Hasmioto’s Thyroiditis.
Triggered from an infection which results in an autoimmune response (think ear infections, mono)
Constipation
Chronic immune struggles (think ear infections, mono)
Dysbiosis
Inflammation in the gut
Lack of absorption of nutrients, especially minerals
Lack of animal protein in diet
Eating too much processed and packaged foods
Rancid seeds & nuts and inflammatory processed oils
Diet Suggestions
Since there is a significant gut connection to Hashimoto’s, we want to eliminate anything that can be triggering the inflammation and immune response. The goal is the keep the diet as ANTI inflammatory as possible. That means removing dietary triggers that can cause inflammation.
Avoid:
Gluten- the consumption of gluten products might aggravate the condition and lead to further complications. The connection comes into play when we look at what happens when the body has a sensitive reaction to the consumption of foods that contain gluten.
When gluten is consumed, in some patients, the immune system sees the substance as a pathogenic compound; thus causing the immune system to start attacking gluten.
This reaction of the immune system leads to a number of potential complications. The lining of the stomach is affected firstly, which can lead to the development of gastrointestinal symptoms.
In addition, the immune system may also start to attack other healthy tissue in the body – when Hashimoto’s disease exists together with a gluten sensitivity, it causes the autoimmune reaction that occurs with Hashimoto’s disease to become aggravated.
Diary- Highly allergenic and difficult to digest leaving undigested proteins that can trigger an autoimmune response and promote inflammation and production of mucous. Often over-processed, and poor source of protein with respect to quality. can also be contaminated with antibiotics, hormones, and toxins from the cows.
Grains & legumes- Lectins can specifically trigger thyroid cells to “talk to” immune cells, and attract them to the thyroid gland, a similar process to what happens in the pancreas of a person with diabetes. This is considered one of the early steps in the autoimmune destruction of the thyroid. Lectins have been studied extensively in rheumatoid arthritis (RA), and lectin found in wheat is one of the most common food triggers. Lectins can be toxic to the gut; they stick to and peel off the gut protective layer called mucosa, which then causes bad bacteria to grow uncontrollably and many other food particles to pass through the otherwise tight gut barrier. This is one form of leaky gut.
Lectin activity might be a good explanation of why Hashimoto’s occurs after people have long-term or recurrent infections: lectins block mucosa, which is the natural barrier and protector against bacteria and viruses not only in the intestine but also in the throat (7). This creates a prolonged state of inflammation which can re-program the immune system and lead to an autoimmune condition.
Goitrogen containing foods (raw): Goitrogens are compounds in certain foods that inhibit the uptake of iodine into the thyroid gland stopping the synthesis of T4, and can be neutralized by lightly steaming, fermenting or cooking these foods.Focus on: Clean animal protein sources.
Eat more of:
Protein- Clean animal protein including:
Eggs-organic and free range, wild salmon, mackerel and herring, chicken-organic and free range, grass fed- locally raised beef, grass fed lamb, organic nuts and seeds, particularly almonds, pecans and walnuts)
Healthy Fats- We need fats to maintain cell membrane integrity and function along with brain function. Fatty acids found in coconut products are digested quickly and provide a superior energy source. Vitamin E, which help prevent free radical damage, boosts immunity.
Lifestyle Considerations:
The most important change is going to be removing food allergies/sensitivities.
So ditch the dairy and find gluten-free alternatives.
Here is where you want to pay extra close attention. Making swaps from dairy & gluten products should be to more a more WHOLE foods diet, not packaged and processed. It is easy to get lost in the labels of the products and quickly forget that whole food; the ones we find on the outside of the grocery store, are the ones that will help us heal. Gluten-free & dairy-free products can be accompanied by weird ingredients in them.
Ensure you are cooking all Goitrogenic foods including broccoli, cauliflower, Brussel sprouts, etc.
Consider your nutrition as the holy grail: Proteins, Fats, Fiber- this will help keep blood sugars balanced, support the thyroid gland and help keep your immune system strong.
IN NEED OF EXTRA SUPPORT?
Have you been dealing with symptoms for so long that you’ve adapted to this being your new normal?
We’re here to tell you that digestive distress is not something you need to live with and that it is possible to address the root cause.
You deserve to feel your best.
You can heal.
If you’re interested in further investigating your gut health with functional testing and a 1:1 personalized approach you can learn about our services & programs here.
