By Dr. Shawna Darou, ND
What is Hashimoto’s Thyroiditis?
Hashimoto’s is a very common autoimmune condition that causes hypothyroidism or under-active thyroid. Your immune system attacks the thyroid gland causing inflammation called chronic lymphocytic thyroiditis, which then leads to under-production of thyroid hormones and a slower metabolism. Hashimoto’s is most common in women, and is the most common cause of hypothyroidism. If you have hypothyroidism and are on medication, it is most likely that you have Hashimoto’s, even if you were never told this at diagnosis.
How do you know if your hypothyroidism is Hashimoto’s?
The presence of antibodies to your thyroid will clarify whether your hypothyroidism is Hashimoto’s or not. There are two antibody levels that can be easily tested for with standard bloodwork:
- Thyroid peroxidase antibodies (TPO-antibodies)
- Thyroglobulin antibodies (TG-antibodies)
If either of these levels are high on your bloodwork, this confirms that presence of Hashimoto’s.
If you are beginning to get low thyroid function symptoms (see below), and yet your basic thyroid tests are still normal, it could be the start of Hashimoto’s where antibody levels rise before we notice any other changes in the numbers. You would be more likely to experience the inflammatory signs.
Symptoms of Hashimoto’s Thyroiditis:
- Tiredness, even with sufficient sleep
- Cold hands or feet
- Hair thinning
- Weight gain or difficulty losing weight
- Dry skin
- Mood changes, especially depression
- Change in your menstrual cycle – longer cycles, heavier flow, more
- Sensation of a lump in the throat or a change in your voice
- Slower heart rate
- Difficulty concentrating or brain fog
- More frequent colds and viruses
What drives autoimmunity?
According to the doctors in functional medicine, autoimmunity (of all types) results from the following:
GENETIC SUSCEPTIBILITY + ENVIRONMENTAL TRIGGER + LEAKY GUT
The genetic susceptibility explains why many people can be exposed to the same environmental stressors, and not all end up with the same disease or diagnosis. Thyroid issues however are extremely common, and if you ask in your family you will likely find other family members who are on thyroid medication.
Here are the most common environmental triggers that we look for with Hashimoto’s:
- Food triggers – Hashimoto’s is especially associated with gluten sensitivity and celiac disease
- Infections – Epstein Barr virus, H. Pylori, bacteria Herpes viruses and Yersinia eterocolitica (a gut bacteria) are the most commonly associated with Hashimoto’s
- Toxins – Mercury, perchlorates, and nitrates – are all toxins that are similar to iodine and can cause havoc with the thyroid
And leaky gut (also called intestinal permeability) is often the route where infections, bacteria or foods reach your blood and lymphatic system leading to inflammation and immune system confusion. This process of immune system confusion is called molecular mimickry, where for example part of the gluten molecule appears similar to part of the thyroid gland or receptor.
Steps to reverse Hashimoto’s
STEP 1: Start with the gut
Naturopath’s are known to say – start with the gut! This applies to Hashimoto’s for several reasons, the most imporant being leaky gut or intestinal permeability. What happens here is that food or microorganism pass through the permeable gut lining into your blood and lymphatic system and stimulate an imimune response.
The steps when starting with the gut can include several steps, and these are personalized: removing inflammatory foods, clear pathogens and opportunistic organisms in the gut, replenish with healthy microorganims (probiotics), restore optiomal digestive function and repair the intestinal tract lining.
STEP 2: Nutrient-dense nutrition
Nutrient-dense nutrition means to include foods that provide an extra burst of nutrition, rather than empty calories. This includes plenty of vegetables, healthy fats such as avocado, olive oil, coconut oil and nuts, organic / grass-fed / pastured meats and poultry, wild fish, bone broth, collagen, and anti-inflammatory herbs and spices such as tumeric, ginger, rosemary, oregano, garlic and onions.
It is commonly recommended to remove gluten from the diet, especially if thyroperoxidase (TPO) antibodies are raised. Simply going gluten-free can often make a very big difference. Gluten- containing grains contain a compound called zonulin that increases intestinal permeability, and gluten is also assocated with ‘molecular mimickry’, where the gluten-molecule has a similar protein strcuture to the thyroid and your immune system attacks both.
In some cases, there are other food sensitivities to address, especially when there are significant gut symptoms and intestinal permeability. Next on the list is dairy products (because the casein component is inflammatory), and may also include eggs, nuts, soy, corn, citrus and nightshades. These foods may be temporary sensitivities that clear as the leaky gut is repaired.
STEP 3: Look for hidden infections
Several infections are associated with Hashimoto’s, and interestingly they can be silent. These include: Epstein-Barr virus, Helicobactor pylori (H. pylori), Yersinia enterocolitica and herpes viruses. The good news is that we can test for these viruses and infections, and treat them, and this often results in a significant drop in thyroid antibody levels and inflammation.
STEP 4: Are you pushing yourself too hard?
When your body is overly stressed, your body produces hormones that actually slow down thyroid function and also the conversion of T4 to T3, the active form of thyroid hormone. What this means, is that if you’re still very stressed, and even if you are addressing your diet, gut function, reducing toxins and supporting your thyroid with optimal nutrients, your thyroid does not have a chance to heal.
Also remember that stress isn’t only emotional stress. It includes unstable blood sugar levels, over-exercising, sedentary lifestyle, lack of sleep, shift-work, and more.
Remember: your body only heals in a state of rest. Build in some rest time into your week, your day and add some truly restorative activities to your life such as meditation, yoga, time in nature, breathing exercises, journaling, or simply gaps in your day to breathe.
STEP 5: Clear toxins
There are several chemicals that are molecularly similar to iodine, and can be absorbed by the thyroid gland causing a loss of function. A few of these include mercury, perchlorate and nitrates. Other chemicals associated with Hashmoto’s are polychlorinated biphenyls (PCBs), dioxin, organochlorine pesticides, polybrominated diphenyl ethers (PBDEs) – flame retardants, BPA and phthalates, and other heavy metals like cadmium, lead and aluminim. Your thyroid gland is the most metabolically active organ in the body – it’s no wonder that our chemical and toxin exposure affects it.
Suggestions to reduce your load of toxins include: drinking filtered water; using an air purifier at home; choosing organic foods; minimizing the use of plastics; safely replacing metal amalgam dental fillings; and choosing natural personal care products.
Expectations and timeline
True healing often takes longer than we expect, but if we’re on the right track you should notice some positive changes in your wellbeing first, meaning that you’re feeling more energized, clear-headed before we see changes in your blood results.
There is often a question about using medications or not, especially in early diagnosis where the numbers are not so bad. There is not a clear answer here, and it really depends on your current quality of life, severity of symptoms, stress levels and commitment to your treatment plan. In some cases, a low dose medication can assist in your ability to make lifestyle changes to heal. If however you have been on medication for many years, and the dose is fairly high (ex. more than 75mcg Levothyroxine daily), the thyroid gland itself may be irreversible damaged and getting off medication completely is not realistic. Lowering inflammation and reducing thyroid antibodies in all cases however, will improve wellbeing and should clear all of the lingering symptoms you are experiencing even while on medication.
With Hashimoto’s, treating the underlying causes of your condition will invariably result in positive changes to all areas of your health.
I hope this short article has given your hope if you have Hashimoto’s to dig deeper in order to improve your health and energy levels. This is a condition where antibody levels can be reduced and reversed, meaning you are restoring function to your thyroid gland and removing inflammation.
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