Hashimoto’s Thyroiditis – Yes, but what’s the cause?

I don’t know how many people are aware, but thyroid medication is the 4th most prescribed medication just below pain medication, cholesterol, and blood pressure. I think it’s quite interesting considering that low thyroid is associated with increased pain, elevated cholesterol and high blood pressure.

What’s more is that most cases of hypothyroid are actually caused by Hashimoto’s. I know this may all sound confusing, hypo this, hashi that! It’s simple to quickly get a handle on thyroid disease. Hypo – means low. Most people who suffer with thyroid problems are not producing enough thyroid hormone. The main reason is due to an autoimmune attack on the thyroid, whereby the immune system is creating excessive amounts of antibodies that actually destroy the thyroid gland. This can happen suddenly due to pregnancy or menopause when the immune system can be triggered as a result of hormonal fluctuations. It can also be a response by the immune system to a stressful life event, infection, and commonly exposure to environmental toxins.

The Symptoms May Include

• Fatigue
• Hair loss
• Weight gain
• Puffy face
• Trouble tolerating cold
• Joint and muscle pain
• Constipation
• Dry skin
• Dry, thinning hair
• Decreased sweating or hot flashes
• Heavy or irregular menstrual periods
• Fertility problems
• Depression
• Anxiety
• Slowed or rapid heart rate
• Goiter
• High blood pressure

Lab Findings May Include

• Elevated cholesterol
• Low T3, T4 (thyroid hormones)
• Elevated TSH
• Elevated reverse T3
• Elevated thyroid binding globulin (usually the result of high estrogen or hormone based contraceptives)
• Low Iodine in a 24 hour urine sample or blood test
• Low selenium in a 24 hour urine sample or blood test
• Elevated CRP- inflammatory marker produced in the liver
• Elevated thyroid antibodies (the hallmark sign of Hashimoto’s Thyroiditis)

A Holistic Approach to Low Thyroid and Autoimmune Disease

I have treated many patients with hashimoto’s and what I can assure you regarding treatment is that it’s individual. One of the major sources of frustration for a patient who has been seeing their internist or endocrinologist is that all that happens (generally speaking) is that they are provided with a lab test for TSH and T4, and maybe a thyroid antibody test, based on those results a script for synthroid or levothyroxine (T4) is then prescribed. If your doctor is more aggressive in treatment on rare occasions you will be provided with a different thyroid medication that contains the active thyroid hormone T3. While this can be helpful to you the patient, it is extremely limiting when it comes to resolving the cause of your symptoms and the autoimmune response that remains following medication. Recall, in most cases of low thyroid the person actually is having an immune response that is attacking the thyroid. Do you feel that should be addressed? I certainly do! Well, it’s not conventionally addressed and this leads to a short term benefit when starting thyroid hormone prescriptions, followed by symptoms that seem to nag on or return.

Now, I am going to tell you what the main triggers that I have seen consistently with hypothyroid in my twenty years practicing holistic medicine. These are not in order.

1. Gluten reactions. People who have autoimmune thyroid disease (you would only know if your doctor checked your antibody levels and told you the results were positive) are mildly to severely sensitive to the inflammatory impact of eating gluten. You won’t like this, but they are also mildly to severely sensitive to dairy. Yikes!! How do I know this? Because for twenty years I have helped hypothyroid patients adjust their diets, in part pulling out these foods and each time I have witnessed mild to overwhelmingly positive changes in their symptoms. That said, this is may not need to be a permanent change in diet, maybe just some lifestyle adjustment in the long term is enough to benefit you. This needs to be determined on an individual basis. I caution you not to go at this alone. There are too many variables to consider and careful monitoring of symptoms and labs can make all the difference in the long term with respect to healing and knowing what to do for your best long term outcome. While I was writing this blog post, one of my recent new patients had come in for a follow up due to a previously elevated TSH. At twenty five years old her doctor had prescribed her Synthroid. She reported feeling no different on the medication and stopped taking it. Years later she still had an elevated TSH, the hallmark of hypothyroidism. Three months into holistic treatments and her most recent thyroid test for the first time in years (no thyroid medication prescribed) is now normal! The cause of her hypothryoid was multifactorial and had to due with diet, nutrient deficiencies, stressful life events, and a hidden gut infection.
2. Environmentally acquired illness. Something in your environment has made you sick. The most common culprit is working or living in a water damaged building or home. This could have been years ago or near the time of diagnosis. Thyroid disease can be brewing for many years before full onset. Let’s avoid the thinking that if my environment is good today, what came before does not matter. That is not the case! Environmentally acquired illness may also come from pesticides, herbicides, and other chemicals found in our food supply, heavy metals, mercury, arsenic, cadmium, personal care products and more. Here we need to consider not just one toxicant but the variety of daily exposures over time. The thyroid is very sensitive to chemicals.
3. Nutrient depletion as would be the case with low iodine, selenium, magnesium, zinc or other factors important for normal thyroid and immune support. In the office I test patients for these nutrients among others to make sure we are not missing the details of each person’s case. Remember treatment is required as individualized as are the causes.
4. Hormone imbalances that include estrogen dominance, low progesterone, or excessive cortisol production. Also checked via labs and symptoms. Usually caused by genetic variances and triggered by a stressful life situation or chronically feeling overwhelmed.
5. Infections including EBV, HSV, HPV, GI infections (usually hidden). Lyme or Lyme coinfections. This will lead to chronic GI inflammation, leaky gut, and alterations in the good bacteria in the gut. Often times people with thyroid problems are experiencing GI symptoms of bloating, gas, belching, loose stools or constipation.

Based on the list above, I hope you can see that treating Hashimoto’s or low thyroid requires more time and energy than simply running a TSH and T4 to adjust thyroid hormone. There are also many people who have normal TSH but are still showing signs of Hashimoto’s via elevated antibodies and may at this time have no need for thyroid hormones, but instead focused treatment of the causes. A watch and wait approach will only increase the autoimmune responses.

If you are interested in having comprehensive testing and analysis of the causes performed you can reach me for a phone or in person consultation in my Tampa Bay holistic medicine practice.

Testing will likely include labs for thyroid antibodies, reverse T3, vitamin levels, hormones, and key inflammatory markers. Additional lab testing may include stool testing, heavy metals, or tests for mold exposure.

Initial consultations are one hour and you can schedule a consultation online today.

Dr. Matt

D.C., DACBN, CFMP®

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