Hashimoto’s thyroiditis is one of the most common autoimmune diseases that affects women. In fact, autoimmune disease is the fourth leading cause of disability in women. I was diagnosed at the age of 29 after my doctor noticed a lump in my throat. This lump was a goiter. The thyroid, located at the front of your neck, produces hormones that regulate metabolism and energy in your body and is the organ most commonly affected by autoimmune disease. A goiter is formed as your thyroid gland becomes more damaged, and then the pituitary gland senses a low thyroid hormone level and secretes more TSH to stimulate the thyroid, which causes the thyroid to grow. This is a goiter.
There are two types of autoimmune disease that affect the thyroid. The most common is Hashimoto’s thyroiditis, the most frequent cause of hypothyroidism. Grave’s disease (autoimmune hyperthyroidism) is less common. In both cases, the immune system becomes confused and begins producing antibodies against the thyroid. These antibodies cause inflammation and tissue destruction and, ultimately, symptoms of thyroid hormone imbalance.
Symptoms of Hashimoto’s include:
- Weight gain
- Increased sensitivity to cold
- Joint/muscle pain
- Dry skin
- Dry, thinning hair/hair loss
- Brain fog/memory problems
- Premenstrual syndrome (PMS)/irregular periods
There are many theories behind the underlying causes of Hashimoto's. As numbers increase, some theories include changes in our exposure to bacteria through a focus on hygiene and antibacterial products, as well as an increased burden of environmental chemicals that overwhelm and confuse our immune system.
Nutritional deficiencies, notably vitamin D, iron and selenium, have also been implicated in the development of autoimmune thyroid disease, as have viral infections and other assaults on our immune system. Studies have also begun to explore the relationship of stress and exercise with a diagnosis of autoimmune disease.
While the conventional approach to treating all hypothyroidism is to regulate TSH levels with a levothyroxine (Synthroid) prescription, the autoimmune nature of Hashimoto’s may need a more holistic approach – one that includes this standard prescription, but also takes a look at environment, nutritional deficiencies and diet. Before taking any supplement, please consult with your primary care physician to ensure there are no interactions with other medications or conditions you may have.
An essential micronutrient, a lack of dietary selenium can worsen Hashimoto’s. Selenium modifies immune and inflammatory responses in the body and may reduce autoimmune antibodies in Hashimoto’s. Foods rich in selenium are Brazil nuts, sunflower seeds, crustaceans, tuna, mushrooms, and most meats.
Across all ages, low levels of vitamin D are associated with an increased incidence of Hashimoto’s. Vitamin D is a vital regulator of the immune system, and low levels are seen in many autoimmune conditions. Everyone with autoimmune disease should have their vitamin D tested, and supplement if levels are low.
People with Hashimoto’s have a higher risk of celiac disease, and research has found everyone with Hashimoto’s can benefit from a gluten-free diet. Avoiding gluten may reduce progression of Hashimoto’s and may reduce autoimmune antibodies. Fortunately we live in an age where gluten-free foods are more readily available.
The microbiome, the population of bacteria in our bodies, is a powerful regulator of the immune system. Imbalances in the microbiome, known as dysbiosis, have been found in many autoimmune conditions. Probiotics and fermented foods, which support microbial diversity, may be helpful in treating, and preventing, autoimmune diseases.
Myo-inositol is involved in regulating the activities of hormones, including TSH. When combined with selenium, myo-inositol may reduce autoimmune antibodies in Hashimoto’s, increase thyroid hormones, and decrease TSH. While it is found in some fruits, beans, grains and nuts, benefits of myo-inositol have only been found with supplementation.
What should you do if you suspect or have been diagnosed with Hashimoto's?
Testing: Ask for thyroid panel including TSH, free T3, T4, and thyroid antibodies, plus iron and vitamin D.
Lifestyle: Avoid chemicals in personal care products. Check out the Environmental Working Group's Skin Deep database to see if you what you are putting on your body is clean. Exercise regularly and try to reduce stress.
Diet: Incorporate fermented foods for a healthy microbiome. Try a gluten-free diet.
Supplements: Add vitamin D and iron, if you are deficient. Selenium, if your diet is inadequate and myo-inositol may also be helpful. Photo from here, with thanks.