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Understanding Hashimoto's Thyroiditis

Updated: Feb 14



Autoimmune conditions are on the rise, affecting a significant portion of the population. A striking statistic reveals that one in two Americans suffers from some form of immune disorder, with nearly half classified as autoimmune. Among these conditions is Hashimoto's thyroiditis, an autoimmune disorder where the immune system mistakenly attacks the thyroid gland, leading to various health challenges.


Did you know? Genetics account for only 1/3 of the risk of developing an autoimmune disease; the other 2/3 comes from your environment, exposures, diet, and lifestyle.


The Role of the Immune System

The immune system plays a powerful role in protecting us from harmful pathogens and keeping us well. Part of how the immune system does this is through differentiation: being able to differentiate between self and other and between friend and foe. When this ability to discern goes awry, and the immune system attacks the body's healthy cells, tissues, and organs, we have autoimmunity, which translates to "immunity against self." The immune system mistakenly attacks healthy tissues, so autoimmune disorders often involve chronic inflammation, pain, and fatigue.


In autoimmunity, what defines the disease is the tissue, organ, or body system the immune system is attacking. There is also a category of autoimmune disease called systemic autoimmune disease, where the immune system can attack multiple tissues and systems in the body. In the case of this article, I am sticking to thyroid-related autoimmune conditions.


Regardless of the target of the immune attack, all autoimmune conditions

are connected by one central biochemical process: a runaway immune response involving chronic systemic inflammation that results in the body attacking itself. Autoimmune conditions are some of the most challenging and complex health issues today.


Stages of Autoimmunity:

Stage 1- silent autoimmunity: This initial stage is detectable only via labwork through the presence of elevated antibodies, often symptom-free, and there isn't any loss of tissue or function. An example of this regarding the thyroid is when elevated thyroid antibodies are showing up in lab work. Still, all other thyroid hormone markers are within the functional range. The client feels fine, with no noticeable symptoms of thyroid dysfunction. People can stay in stage 1 for a long time, as autoantibodies can present long (years) before symptoms appear clinically.


Stage 2- Autoimmune Reactivity: At this stage, symptoms are presenting, but there is no clinically noticeable tissue loss. Going back to the thyroid example, this is when there are elevated thyroid antibodies, and the rest of the thyroid hormones are within the lab range but outside of the functional lab range. In this stage, people complain of feeling miserable and have often been told by their doctor that they're OK because, other than the antibodies, their thyroid panel is" normal." The conventional thought process here is "wait-and-see"; there's nothing to do but wait until it develops into a full-blown disease state.


Stage 3: When the autoimmune condition progresses to a later stage, it is typically when the formal diagnosis of autoimmune disease occurs. At this point, we see elevated antibodies in the lab results, the client has significant symptoms, and there is measurable tissue destruction, often an enlarged thyroid gland on physical examination, and loss of function.


What Happens in Hashimoto's Thyroiditis? 

Autoimmune thyroid disease is increasingly common and often co-occurs with other autoimmune conditions. Two common autoimmune conditions that affect the thyroid are Graves disease (hyperthyroidism) (an overactive thyroid) and Hashimotos (hypothyroidism) (an underactive thyroid).


With Hashimoto's Hypothyroid, there is a cascade of symptoms in the body;

  • Slower Metabolism

  • Hard time regulating body temperature

  • Constipation tendency

  • Weight gain

  • Fatigue

  • A feeling of tightness around the throat

  • Dry hair

  • Hormonal imbalances (adrenal, thyroid, sex hormones)

  • Nutrient deficiencies


With Hashimoto's, there is an immune system attack on the thyroid, which directly impacts metabolism, hormones, and energy levels in ways that require a nuanced, functional medicine approach.


Functional lab markers:

In my practice, I always order a complete thyroid lab panel that includes antibodies when patients exhibit symptoms of thyroid dysfunction. I also consider anti-thyroid antibody testing when a client has other diagnosed autoimmune conditions. When one autoimmune condition is often at play, other autoimmune conditions are likely also going on. A comprehensive thyroid panel is not the norm in a conventional medical model or even in specialty practices such as endocrinology. When assessing thyroid function, I look at the following labs to get a clearer picture of what's happening: TSH, T4 Total and Free, T3 Total and Free, T3 uptake, Reverse T3 and Anti-Thyroid Antibodies.


The presence of thyroid antibodies helps diagnose autoimmune thyroid conditions like Hashimoto's thyroiditis or Graves disease.  



Understanding Anti-Thyroid Antibodies: 

Anti-thyroid antibodies play a pivotal role in diagnosing autoimmune thyroid conditions. Here are three significant types:

  • Thyroid Peroxidase (TPO) Antibodies:  target thyroid peroxidase, an enzyme essential for producing thyroid hormones. Elevated levels indicate an autoimmune attack on the thyroid, commonly leading to hypothyroidism in Hashimoto's or hyperthyroidism in Graves.

  • Thyroglobulin (TG) Antibodies: these antibodies attack thyroglobulin, a protein used by the thyroid gland to produce hormones. Elevated TG antibody levels suggest thyroid tissue damage due to autoimmune conditions, especially Hashimoto's

  • Thyroid-stimulating immunoglobulin (TSI): These antibodies mimic the action of Thyroid-Stimulating Hormone (TSH), stimulating the thyroid gland to produce excess thyroid hormone. Elevated TSI levels reveal overactive thyroid function, which leads to hyperthyroidism.


Factors that affect thyroid function:

  • Inflammation

  • Impaired methylation

  • Liver health/ function

  • Low-lying chronic infections

  • Stress

  • Toxins

  • Trauma


As mentioned previously, two-thirds of the risk of developing autoimmune conditions comes from environment, exposures, diet, and lifestyle. This means that autoimmune disease can be directly linked to food choices and lifestyle. It also means we can manage it simply by changing how we eat and making more informed choices about sleep, activity, and stress.


A Holistic Approach:

In the conventional medical model, the goal with autoimmune conditions is to suppress the immune system's overactive response, aggressively anti-inflame, and, if needed, replace organ function lost due to the autoimmune attack.


The approach is much different from a functional and holistic view. When we understand that autoimmune conditions are, at their core, caused by an immune system that is chronically engaged, like any of us who are overworked and under-rested, it starts to make bad decisions. If this continues over time, autoimmunity can develop.


There are many underlying reasons to consider, one of which may be keeping the immune system constantly engaged. A functional approach to healing aims to identify and remove what drains the immune system so that recovery and remission can occur.



Diet and Lifestyle Plan for Hashimoto's:

When working with an autoimmune client, no matter their level of autoimmunity or the target of their immune system, I address several diet and lifestyle recommendations with every client.


  • Consume an Autoimmune Paleo (AIP)-based diet full of nutrient-dense foods, prioritizing healthy fats, high-quality protein, and organic produce.

  • Consider incorporating intermittent fasting.

  • Hydrate adequately with clean water. My best recommendation is distilled water, as it is the only water purification process that removes radioactive elements that are not removed with filtration.

  • A Paleo diet already removes gluten, grains, and dairy, but this is a VERY IMPORTANT part of the deal. Gluten and dairy are a no-no. There's a strong link between gluten sensitivity and Hashimoto's. Oftentimes, there is an overlap between Hashimoto's and Celiac disease (also an autoimmune disease). You see, gluten and the thyroid tissue are almost identical at a molecular level. So, every time a susceptible individual consumes gluten, not only does the immune system mount a response to the gluten, but it can also mount a parallel response to thyroid tissue, exacerbating the autoimmune response. So, undetected gluten sensitivity may contribute to the development of thyroid autoimmunity in some people. 

  • Reduce exposure to toxins. Toxins, for example, two common toxins, Fluorine and Chlorine, are elements in the Halogen family. Fluorine is a highly toxic gas and is sourced from the mineral fluorite. You know this more commonly as fluoride, used in many toothpaste and city water. It is also used in "Teflon cookware. Chlorine is most commonly found in table salt and bleach for disinfectant use. The issue with these toxins is they leave the body very slowly after being processed through the liver, but also, at a cellular level, they compete with and displace iodine, a key nutrient for proper thyroid function.

  • Get regular physical activity.

  • Reduce stress: Stress is a significant factor for many people in triggering their autoimmunity. Stress can worsen autoimmunity and thyroid disease and block the conversion of the thyroid hormone T4 to the active thyroid hormone T3. Stress" is an all-encompassing term that includes stressors of all kinds: physiological, environmental, emotional, psychological, etc. Stress is cumulative, and the body does not know the difference between the types of stress and responds in the same way. When there is an ongoing, chronic stress situation, cortisol (our primary stress hormone) can either over-activate the immune system or suppress it over time and cause the immune system to fall out of balance. Stress can challenge the immune system and trigger an autoimmune flare; it can trigger an infection (particularly viral infections; think of the herpes virus responsible for cold sores, for example, or a low-lying EBV infection.

  • Stress can also come with a significant lack of sleep, which burdens the body. This leads to another area of focus: adequate sleep.


When you work with me to address Hashimotos (or any other Autoimmune Condition)

We will start with the foundations to create the right environment for your body to find its balance, such as diet, gut health, ensuring drainage pathways are open and detoxification processes are optimized, removing exposures from toxins, supporting nutrient deficiencies (i.e., vitamin D3, iodine, selenium, omega 3's), ensuring you are engaging in self-compassion and mind-body practices and getting regular exercise/ movement.


Understanding the journey of Hashimoto's thyroiditis can help you recognize symptoms early, seek appropriate testing, and engage in strategies for health optimization.



Working with a functional nutritionist can provide support and guidance tailored to individual needs for those navigating this complex autoimmune condition. My goal is to guide you through comprehensive testing, provide you with education and tools to help you understand your body, build a protocol tailored to your individual needs, help you take control of your health, and keep your autoimmunity in remission. That is empowering!

 

Book a call with me, Eli, and let’s explore a treatment plan tailored to your needs and designed to restore balance and wellness.




 
 
 

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