A Deep Dive Into Hashimoto’s Autoimmune Thyroiditis

Hashimoto’s thyroiditis is an autoimmune disease that develops when the immune system creates antibodies against the thyroid gland: the tiny butterfly-shaped endocrine gland located at the front of the neck. This results in an autoimmune attack against the thyroid gland, causing the immune system to mistakenly recognize healthy thyroid cells as harmful foreign invaders. 

When the immune system mistakenly attacks the thyroid gland in Hashimoto’s autoimmune thyroiditis, it damages the cells responsible for producing the thyroid hormones our bodies need to function optimally. Eventually, the thyroid gland may fail to produce and secrete enough of these hormones — slowing down thyroid function and leading to a wide range of symptoms. In many cases (but certainly not all), hypothyroidism can develop. 

Let’s take a closer look at Hashimoto’s thyroiditis, including the symptoms, tests, and therapies that play a role in diagnosing and managing this common yet underdiagnosed autoimmune disease. 

Thyroid Hormones: What Role Do They Play?

Before we talk more about Hashimoto’s disease — an autoimmune condition — let’s take a quick look at the important role our thyroid hormones play in regulating our metabolism, blood pressure, menstrual cycle, and other critical functions. The thyroid gland has a massive job to do, so don’t be fooled by its tiny size! 

Each and every one of our cells, in fact, rely on thyroid hormones in one way or another. This is why Hashimoto’s and thyroid hormone disorders such as hypothyroidism tend to cause widespread symptoms that aren’t just limited to the endocrine system! Thyroid dysfunction affects the digestive, nervous, circulatory, and musculoskeletal systems as well. 

Thyroid & Pituitary Hormones: T3, T4, & TSH

Along with our other endocrine glands (such as the parathyroid, thymus, pituitary, and adrenals), the thyroid is responsible for producing hormones that affect everything from our fertility and digestion to our breathing, mental activity, and heart rate. The thyroid gland, for instance, produces and releases hormones such as thyroxine (T4) and triiodothyronine (T3) — while the pituitary gland produces and secretes thyroid-stimulating hormone (TSH). 

That’s right, TSH is a pituitary hormone rather than a thyroid hormone! This hormone is responsible for triggering the release of thyroxine and triiodothyronine by the thyroid gland. For this reason, T3, T4, and TSH tests are all used to assess thyroid function and diagnose hypothyroidism (an underactive thyroid). 

T3 vs T4: Active & Inactive Hormones

T4 is the inactive thyroid hormone that must be converted to T3 — the active thyroid hormone. T3 is the thyroid hormone that enters the cells and affects our metabolism, energy, and more! 

If the conversion from T4 is inefficient, thyroid function will be suboptimal. Specific nutrients like selenium and zinc are needed to effectively convert T4 to T3.

Hashimoto’s Autoimmune Thyroiditis & Thyroid Hormones

We look at T3, T4, and TSH levels when diagnosing hypothyroidism, but these markers alone cannot tell us whether the immune system is creating antibodies against the thyroid gland (and in turn, slowing down thyroid function). Therefore, T3, T4, and TSH tests are not used on their own to diagnose Hashimoto’s disease. 

Diagnosing Hashimoto’s autoimmune thyroiditis requires antibody testing — and in some cases — a thyroid ultrasound. Additional tests may be necessary when antibody testing is inconclusive or symptoms persist despite completing thyroid hormone replacement therapy. 

What to Know About Hashimoto's Autoimmune Thyroiditis

When the immune system mistakenly attacks the thyroid gland (which is the case in Hashimoto’s thyroiditis), it damages the cells responsible for producing thyroid hormones like T3, T4, and TSH. Over time, this autoimmune attack can damage the thyroid, contribute to the development of other autoimmune conditions such as systemic lupus erythematosus (SLE) and celiac disease, and increase our risk of developing hypothyroidism (an underactive thyroid). 

However, while Hashimoto’s autoimmune thyroiditis is a leading cause of hypothyroidism in developed countries, not everyone with Hashimoto’s develops hypothyroidism. And Hashimoto’s thyroiditis isn’t the only cause of hypothyroidism, either. 

Other potential causes of hypothyroidism include iodine deficiency, congenital hypothyroidism, radiation to the thyroid gland, and surgical removal of the thyroid. Certain medications and inflammation of the thyroid gland (which may or may not be autoimmune) may also cause an underactive thyroid. 

To put it simply, you can have Hashimoto’s (an autoimmune disease) without developing hypothyroidism (a thyroid disorder). It’s also possible to be diagnosed with hypothyroidism without having Hashimoto’s thyroiditis. The important thing; however, is to know whether your symptoms are the result of autoimmunity, thyroid hormone deficiency, or both!

Diagnosing & Managing Hashimoto's Symptoms

As Hashimoto’s thyroiditis progresses and the thyroid gland sustains more and more damage over time, it’s common to experience a wide range of symptoms that resemble perimenopause, other autoimmune diseases, hormone imbalances, myalgic encephalomyelitis/chronic fatigue syndrome, and various other health conditions. And though many more complaints are reported by patients, some of the more common Hashimoto’s symptoms include the following:

  • Fatigue
  • Brain fog
  • Memory and concentration issues
  • Hair, eyebrow, and eyelash thinning
  • Joint and muscle pain
  • Dry skin
  • Irritable bowel syndrome and SIBO
  • Weight changes
  • Low libido
  • Allergies, rashes, and food sensitivities
  • Menstrual irregularities
  • Thyroid swelling
  • The list goes on!

If you know or suspect you have Hashimoto’s thyroiditis (or perhaps another autoimmune condition altogether), I encourage you to book an appointment with me. We’ll address and identify the root cause(s) behind your symptoms and take steps to restore the natural balance within your body!

Antibody Tests for Diagnosing Hashimoto’s

Since most Hashimoto’s symptoms are nonspecific, diagnosing the autoimmune condition can be quite a challenge unless the correct tests are ordered. Diagnosing Hashimoto’s requires specific antibody testing, a comprehensive patient intake, and occasionally, a thyroid ultrasound. 

Antibody tests for Hashimoto’s thyroiditis include:

  • Thyroid peroxidase antibodies (TPO antibodies).
  • Thyroglobulin antibodies (TG antibodies).

While not everyone with Hashimoto’s autoimmune thyroiditis will have elevated TPO and/or TG levels, most will have an elevation of at least one of these antibodies. Other antibody tests may also be ordered to rule out the presence of additional autoimmune conditions. 

Managing Hashimoto’s Symptoms with Functional Medicine

In conventional medicine, the most commonly used medication for Hashimoto’s thyroiditis is levothyroxine: a synthetic thyroid hormone. This is the same medication used to treat hypothyroidism. 

The naturopathic functional medicine approach to managing Hashimoto’s thyroiditis looks a bit different, however. Prescription medications such as levothyroxine certainly have a place in managing autoimmune conditions like Hashimoto’s, but we also consider other options such as desiccated thyroid extract, low-dose naltrexone/LDN (an immune system modulator), nutrient supplementation, stress management, and dietary and lifestyle changes. 

We also identify and address the root causes of autoimmunity: genetics, environmental triggers, and increased intestinal permeability/leaky gut. Check out last month’s blog to learn more about the functional medicine approach to autoimmunity!

Addressing Potential Nutrient Deficiencies in Hashimoto’s

Testing for vitamin and mineral deficiencies is just as important when diagnosing and managing Hashimoto’s thyroiditis, as nutrient deficiencies and insufficiencies are frequently seen among those with Hashimoto’s and other autoimmune conditions. Common nutrient deficiencies in those with Hashimoto’s thyroiditis include iron, vitamin D, and selenium; however, increasing magnesium and zinc levels can also be helpful in many cases. 

For this reason, a huge part of managing Hashimoto’s symptoms and reducing the risk of developing additional autoimmune diseases in the future comes down to identifying and addressing any nutrient deficiencies or insufficiencies that may be present. If necessary, we then use nutrient supplements, intravenous therapies, dietary modifications, and herbal or botanical remedies to safely and effectively address these insufficiencies. 

Manage Hashimoto’s Disease by Addressing YOUR Root Causes

As a naturopathic functional medicine physician with special interests in autoimmune diseases, hormone disorders, and digestive health, I use in-depth and specialized tests to assess the micronutrient insufficiencies, food sensitivities, environmental triggers, and other potential root causes that may be contributing to your Hashimoto’s symptoms. Connect with me and see for yourself how naturopathic functional medicine can help with managing your autoimmune condition and reversing many of your most troublesome Hashimoto’s symptoms. 

Do you suspect you have Hashimoto’s disease, an underactive thyroid, or another autoimmune condition?

Connect with me to learn how naturopathic functional medicine can help to manage your symptoms and restore balance within your unique body!

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