Hashimoto’s thyroiditis is an autoimmune disease affecting the thyroid. As is the case with all autoimmune diseases, antibodies and sensitized T-cells are produced against one’s own tissues. Types of autoimmune conditions include lupus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and more. In the case of Hashimoto’s, the body turns on itself to attack and destroy its own thyroid gland.
Hashimoto’s is one of the leading causes of hypothyroidism (underactive thyroid), but hypothyroidism is one of the most undiagnosed, misdiagnosed and unrecognized health problems. The Thyroid Federation International estimates that up to 300 million people suffer from a thyroid dysfunction worldwide, but over half are likely unaware of their condition.
What is Hypothyroidism?
Hypothyroidism is a condition of decreased thyroid hormones (specifically T3 and T4), resulting from the inability of the thyroid gland to 1) produce T4 hormone or 2) to convert T4 to T3 (the active form of thyroid hormone – most of the conversion of T4 to T3 occurs in the digestive tract and liver), or both of the above. Regardless of the cause, hypothyroidism symptoms include, but are not limited to, fatigue due to a slowed metabolism, mental dullness, physical slowness, dry skin and hair, inability to tolerate the cold, muscle weakness and cramps, recurrent infection, yellow bumps on the eyelids, and depression.
What Causes Hashimoto’s Thyroiditis?
Hashimoto’s Thyroiditis can be described as an inflammatory disease, because essentially what is happening is that the immune system is responding to some sort of inflammatory stimulus, by attacking the thyroid. Your body is fighting something that you may not even be aware of, such as an underlying infection or toxin. The immune system gets confused with all this stimulus and and as a result, it goes awry, and your own tissues get caught in the crossfire – for example the thyroid in the case of Hashimoto’s, your joints in the case of Rheumatoid Arthritis, your gut in the case of inflammatory bowel disease etc.
What are the underlying causes of this inflammatory stimulus? It could be any of the following: hidden allergens in food (with dairy and gluten being common culprits), environmental toxins (such as having high levels of mercury in the body), underlying viruses or bacteria (such as Epstein Barr virus), poor diet and of course, stress. . At one time all of these underlying issues applied to me. I was diagnosed in 1994 with Hashimoto’s, a few months after my second child was born – often a shift in hormones can also trigger an attack of Hashimoto’s. I also have had chronic and rampant inflammation –I used to hurt just getting out of bed every morning. I have been on prescribed thyroid medication for 23 years. Over all this time doctors still do not know the underlying cause of autoimmune disease. Typically they are trained to treat symptoms with anti-inflammatories (such as Advil), and sometimes more powerful immune suppressing medication. In the case of Hashimoto’s Thyroiditis, physicians are trained to prescribe thyroid medication – whereas the truth of the matter is, it is not the thyroid that is malfunctioning, but rather the immune system causing the issue.
The Role Of Functional Medicine In Autoimmune Conditions
Functional medicine teaches that it is paramount to find the root cause of an issue and not to treat only the symptoms. Therefore, if you suspect you have an autoimmune condition, I highly recommend that you consult with a functional practitioner to identify the root causes from your environment and your food. Once identified, steps can be put in place to reverse these underlying imbalances, which will leave you feeling a whole lot better.
Given that hypothyroidism can be caused by low levels of T3, T4, or both, accurate diagnosing through bloodwork requires examination of both free T4 and T3 serum levels, in addition to TSH levels. However, some provincial health plans only support serum TSH testing for routine screening of the thyroid and most doctors don’t run a full thyroid blood panel. Unfortunately, testing for just TSH does not provide the complete picture. Because of this, many cases of hypothyroidism go undiagnosed, especially if they involve normal T4 levels but inadequate free T3 levels (or vice versa). Additionally, depending on the medical laboratory, reference ranges may vary. In general, an ideal serum TSH level should be below 2.0 mIU/L, but many labs indicate an upper limit of 5.0 mIU/L.
A full thyroid panel for hypothyroidism should test:
- Free T4
- Free T3
- Reverse T3
- Thyroid Peroxidase Antibodies (TPOAb)
- Thyroglobulin Antibodies (TgAb)
If your doctor is unwilling to run these tests, you can get yourself a second medical opinion or order your own thyroid lab test without your doctor. You could also see a Functional Medicine Doctor or Naturopathic Doctor, both of which are more likely to order a full thyroid panel.
A lack of thyroid hormone has many physiological effects, therefore someone with hypothyroidism or Hashimoto’s will likely have hypochlorhydia (underactive stomach), an iron deficiency, mineral deficiencies, a vitamin B12 deficiency, high total cholesterol and constipation. Additionally, they will be unable to convert beta carotene to vitamin A, are at risk for osteoporosis, are prone to insulin resistance and are at risk for diabetes. Watch for an upcoming article on the many steps that you can take to treat your autoimmune disease.
Nutritional Pathology – Brenda Lessard-Rhead, BSc, ND