Hashimoto’s disease, or Hashimoto’s thyroiditis, is an autoimmune disorder that affects the thyroid gland. The thyroid gland is a part of your endocrine system and regulates metabolism and protein synthesis. Located in the neck, the thyroid is responsible for producing many of the hormones your body needs to maintain wellness. In this article, we will look at what Hashimoto’s disease is and steps you can take to treat Hashimoto's disease. Let’s get started. . .
Hashimoto’s is the most common autoimmune disease. It occurs when your body’s immune system mistakenly identifies your own thyroid as harmful. As a result, your natural immune response begins attacking your thyroid gland. This damages your thyroid and can lead to your body being unable to produce healthy levels of thyroid hormones, a condition known as hypothyroidism. Thyroid hormone deficiency can cause serious health problems, affecting your weight, mood, energy levels, and fertility.
There are three other names the condition goes by. They are:
1. Hashimoto’s thyroiditis
2. Chronic lymphocytic thyroiditis
3. Autoimmune thyroiditis
Some might be asking: What does Hashimoto's disease do to the human body? There are many symptoms of Hashimoto’s disease that can be seen in both in female and males who are living with the condition. These symptoms include both physical and mental or emotional manifestations. These can range from mild to severely detrimental to your quality of life.
Some common signs and symptoms of Hashimoto’s are:
• Exhaustion or tiredness
• Gaining weight without explanation
• Sore throat
• Heavy or irregular menstrual periods and problems becoming pregnant
• Joint and muscle pain
• Increased cold sensitivity
• Dry skin and hair
• Hair loss
• Trouble remembering
• Decreased heart rate
Externally, the most common symptom of Hashimoto’s thyroiditis is an enlarged thyroid gland, commonly called a goiter. You can see this on the neck, where it protrudes from the throat. A goiter also puts pressure on the throat, although it is usually not painful.
There are symptoms of Hashimoto’s disease only seen in women. These female only symptoms can be experienced during three times of a woman’s lives. They are:
Menstruation: Heavier than normal bleeding and irregular cycles can be experienced because of hormone levels in the thyroid.
Trying to conceive: Irregularity of cycles can lead to difficulty with fertility and conceiving.
Pregnancy: An unborn baby needs the hormone used by the thyroid to grow and develop both its brain and nervous system. Because the thyroid hormone levels in a woman with Hashimoto’s disease, during pregnancy, symptoms of the disease can be witnessed through miscarriage, birth defects, preeclampsia, anemia, placental abruption, postpartum bleeding, premature birth, low birth weight, or stillbirth.
Now let’s look at conditions that can raise the chances of developing Hashimoto's Disease . . .
Living with one or more of the following nine conditions can put a person both male or female at a higher risk of developing Hashimoto's disease:
• Type 1 diabetes
• Addison’s disease
• Autoimmune hepatitis
• Pernicious anemia
• Rheumatoid arthritis
• Sjögren’s syndrome
• Celiac disease
Here are a few statistics on Hashimoto's disease:
• Percentage of Americans affected: 5%
• Female vs. Male: Ratio of 10:1
• Age of diagnosis: Between the range of 30-50
“Why is Hashimoto’s so common?” Functional Medicine physician Shelly Sethi asks. “Because the root causes, while complex, are very common. Infections, stress, or nutritional deficiencies can all be causing inflammation in the gut, which can lead to leaky gut syndrome. This allows proteins and other agents to leak into the bloodstream, stimulating the immune system to activate or be on guard. If there are any endocrine disruptors or heavy metals that have already come into the system, these can also be taken up by the thyroid itself, stimulating what’s called ‘molecular mimicry,’ causing the immune system to attack and leading to autoimmune disease—a specific cause of Hashimoto’s.”
Now that we know one cause of Hashimoto’s disease, let’s look at what else causes the conditions. . .
There are a number of factors that can play a role in developing Hashimoto’s. There are both environmental and genetic aspects to the why and how someone may develop Hashimoto's disease.
As with any autoimmune disorder, inflammation is a major piece. Inflammation, or the swelling and reddening of tissues in the body, can be caused by diet, infection, allergies, exposure to environmental toxins, life circumstances and stress. Inflammation puts a considerable amount of stress on your immune system, which can lead to the development of an autoimmune disorder like Hashimoto’s. In other words, anything that stresses or strains your body can be a causal factor in the development of Hashimoto’s.
First, let’s look at the environmental and genetic causes of Hashimoto's disease . . .
Exposure to environmental toxins such as mercury, fluoride, chlorine and pesticides can increase your risk of developing Hashimoto’s. Mercury was commonly used in dental fillings for decades, leading many people to build up significant levels of the poisonous metal in their bodies. Because of its proximity to the mouth, this is especially damaging to the thyroid. Fluoride and chlorine are commonly added to drinking water, and pesticides are found on non-organic fruits and vegetables.
Scientists believe there may be a genetic component to Hashimoto’s thyroiditis, as the disease often runs in families. However, an exact genetic mechanism is not known. Because Hashimoto’s occurs so much more commonly in women, it is also suspected that female sex hormones like estrogen may affect the development of the disease.
As with any autoimmune disorder, emotional stress plays a major role. A study in Autoimmunity Reviews found that up to 80 percent of people diagnosed with an autoimmune disorder experienced high levels of stress prior to developing the disease. Anger, rage, grief, fear, resentment and other painful emotions can place strain on both your psyche and your body, and can manifest as physical health conditions if left unresolved.
This is particularly significant in a disease like Hashimoto’s that affects your thyroid. The thyroid and adrenal glands are part of your body’s stress response system, and can be damaged by chronic exposure to stress. The more stress you experience, the more strain your thyroid experiences.
The actual physical mechanisms that lead to symptoms of Hashimoto’s are simple: your immune system begins attacking your thyroid gland. But what makes this happen in the first place?
Physical causes of Hashimoto’s disease can include anything leading to inflammation—perhaps most often diet or infection in the gut. Some foods can cause significant inflammation and stress on the body and the thyroid gland in particular. One major culprit is gluten, a protein found in wheat, barley and some other grains. Other foods known to frequently cause inflammation include dairy, sugar, corn syrup, artificial sweeteners and many vegetable and seed oils.
Likewise, fungal or bacterial infections in the gut are another major cause of inflammation. These often go hand-in-hand with diet—eating the wrong foods can strain your gut to the point where it becomes easier for harmful bacteria to grow. Antibiotic use can also lead to gut infection. Good gut bacteria are killed off by the antibiotic, which then leaves space for unhealthy microorganisms to colonize.
Diet and infection can also lead to the development of leaky gut syndrome, a condition that is heavily interrelated with inflammation and can be a factor in developing an autoimmune disease.
“Infections, stress, poor diet and nutritional deficiencies can all cause inflammation in the gut,” explains Austin, TX functional medicine doctor, Shelly Sethi, DO “which can lead to leaky gut syndrome. This allows proteins and other agents from the gut to leak into the bloodstream, stimulating the immune system to activate or be on guard.
“If there are endocrine disruptors present in the body,” she continues, “such as PCBs, dioxins, flame retardants, heavy metals, phytoestrogens, phthalates or BPA (bisphenol A), these can also be taken up by the thyroid itself through molecular mimicry, and can turn a defensive immune system response into autoimmunity. This is thought to be a specific cause of Hashimoto’s.”
You can be very successful in treating Hashimoto’s disease. Many people find that by following a holistic treatment plan that focuses on addressing the root causes of the disorder, they can not only reduce or eliminate symptoms but actually recover, reversing the damage that may have been done. However, this generally involves making changes in how you live.
Treating Hashimoto’s can involve a combination of approaches, including:
• Healing inflammation and your gut
• Diet and supplements
• Stress reduction
• Hormone replacement therapy
• Complementary therapies such as acupuncture, chiropractic or yoga
A holistic physician can help you assess whether you have Hashimoto’s. This can include testing your levels of thyroid hormones, as well as examining your symptoms. Your doctor can also help you test for underlying issues like inflammation, leaky gut, infections or food sensitivities, as well as exposure to environmental toxins.
“When it comes to the thyroid gland, there are two potential problems: the autoimmune disease and the functioning of the gland. Once you become hypothyroid,” says functional medicine physician Susan Blum, MD, “the conventional treatment is to give you hormone replacement. This approach treats only the hypothyroid problem, not the autoimmune problem. Wouldn’t it be better to find out you have Hashimoto’s thyroiditis even before your thyroid gland is damaged, causing you to need a prescription for thyroid hormone replacement?”
Because emotional, mental and lifestyle stressors can play such a major role in developing any autoimmune disorder and in causing inflammation, treating Hashimoto’s means encouraging you to lower your stress level and relax. This can include practices such as meditation and yoga, or exercise. Therapies like chiropractic or acupuncture, which can help you release painful emotions trapped in your body, are also effective at lowering your stress. Acupuncture can also help your body reduce your overall autoimmune response.
Working with a clinical therapist or counselor can also be helpful because they can help you identify stress factors in your life, and work to resolve them. Many people with autoimmune disorders find that they benefit from significant lifestyle changes aimed at helping them live a more peaceful life. This can mean anything from letting go of harmful relationships to changing jobs.
Diet and nutrition can be a big part in both causing and treating Hashimoto’s. If you have Hashimoto’s (or any autoimmune disorder) you want to eat a diet that is anti-inflammatory and supports rather than strains your gut. A great place to begin discovering trigger foods is an elimination diet. “Personalizing the diet also involves taking into account your epigenetic makeup and cultural eating patterns as well as lifestyle in order for it to be sustainable,” explains Dr. Shelly Sethi.
When a person is looking to manage Hashimoto’s disease there are many options to find the right fit for your body and needs. A diet designed to help gut challenges and reduce inflammation is likely to include recommendations that certain foods be removed or avoided.
The first step in changing your diet is removing foods that lead to inflammation and gut trouble. Gluten can play a major role in developing Hashimoto’s because it often creates inflammation in your gut and can trigger to an autoimmune response. Many health professionals recommend that you adopt a gluten-free diet if you’ve been diagnosed with Hashimoto’s. Dairy has also been identified as a food for people with Hashimoto’s to avoid. Dairy tends to increase inflammation as well, triggering an autoimmune response similar to that caused by gluten.
Specific foods to avoid for Hashimoto’s disease include:
• Anything with gluten (bread, pasta, etc)
• Starchy vegetables
• Many vegetable or seed oils
• Processed foods (foods from a box)
• Nightshade vegetables (potatoes, bell peppers, eggplants)
A vegetarian or vegan diet has been found to be helpful for some people, although it is important that the diet be rich in greens in order to be effective; and for some people a more paleo type diet. Specific foods for Hashimoto’s disease that are rich in vitamins and minerals or can otherwise help support your thyroid or reduce inflammation include:
• Seaweed and sea vegetables
• Dark leafy greens
• Lean meat
• Healthy fats (olive oil, ghee, coconut oil, avocados)
These are general dietary recommendations, however, everyone is unique. What your body needs might be different. A holistic physician or nutritionist can help you create a custom diet plan to supply your body with the right fuel to function. Switching to the appropriate diet can help heal your gut, reduce inflammation, and improve your symptoms.
Doctors also often recommend a supplement regimen to help treat Hashimoto’s, which can include:
• Vitamin D
• Vitamin A
Your doctor can provide specific suggestions based on your lab tests.
Working with a doctor is usually an important part of healing from Hashimoto’s. A holistic approach to treating Hashimoto’s focuses more on dealing with the root causes of the disease. An appointment with a holistic physician is a good place to start for treating the root causes of Hashimoto’s. They may prescribe treatments such as a plant-based, gluten-free diet to reduce stress on the thyroid, using probiotics to help rebuild healthy gut flora, or a detox protocol to help rid the body of inflammation-causing toxins.
Some doctors treat Hashimoto’s with the synthetic hormone Levothyroxine, which is an artificial version of the T-4 hormone your thyroid produces naturally. Because Hashimoto’s damages the thyroid, many people diagnosed with the disease end up producing lower levels of T-4 than their bodies need to maintain wellness. Taking additional T-4 can help bring your hormone levels back to normal, reducing some symptoms of the disease. There are also natural versions of T-4 available.
Treating a thyroid hormone deficiency with medication and treating the root causes of Hashimoto’s can be complementary approaches. Chiropractic, acupuncture, massage, talk therapy or counseling, and nutrition counseling can also be among the healing modalities that are helpful to some struggling with an autoimmune disorder.
The following expert reviewed and contributed to this article:
Shelly Sethi, DO, Functional Medicine Physician
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