The amount of women affected by Hashimoto’s is staggering. You are likely one of these women or know someone near and dear who suffer the symptoms.
In our last post we disclosed that an estimated 40 million Americans are affected by thyroid disease and nearly 90% of them are women. That means 1 in 8 women can expect to develop hypothyroidism in their lifetime.
Did you know that on average it takes up to five years for a woman struggling with the symptoms of an autoimmune disease to get an accurate diagnosis?
The current medical model has been statistically shown to dismiss and ignore women’s voices and create an environment in which we feel uncomfortable speaking up about our symptoms and health concerns.
Many women have stories of not just being medically dismissed, but medically mistreated.
In fact, we have seen many struggling with fatigue, anxiety, and depression, with no clear understanding of why. They’ve tried anti-depressants and anti-anxiety medications, but nothing helped.
Even worse, these women have been dismissed by their doctors after have gotten an incomplete thyroid test showing that everything is normal. It isn’t until we really dig into the symptoms, lifestyle, diet, and then follow up with the proper blood tests that we find out that Hashimoto’s is to blame.
If your energy and mood are so low that your quality of life is affected, or if you’re always bloated and your skin always dry, then perhaps this post will shed some light into WHY.
It’s time to take back our own responsibility for our own health. You CAN improve your symptoms despite what your conventional doctor might say. We’ve witnessed it time and time again. You too can discover this for your self, so let’s do it.
What is Hashimoto’s Disease?
According to the Mayo clinic, “Hashimoto’s disease is a condition in which your immune system attacks your thyroid, a small gland at the base of your neck below your Adam’s apple.”
The thyroid gland is part of your endocrine system, which produces hormones that coordinate many of your body’s functions like digestion, reproduction, and metabolism to name a few.
“Hashimoto’s disease is the most common cause of hypothyroidism in the United States. It primarily affects middle-aged women but also can occur in men and women of any age and in children.”
What Are Thyroid Antibodies?
One of the ways the immune system protects us is through a second line of immune defense called the adaptive immune system, which produces antibodies (the first line of defense is called the innate immune system and it includes white blood cells and other cells).
Antibodies are proteins that circulate in our blood and neutralize and destroy viruses, bacteria, and other organisms or allergens. When we’re fighting off a cold or flu, we WANT our immune system to produce antibodies.
But when it comes to our own tissue, we don’t want those antibodies attacking our own self, which is exactly what happens in autoimmune disease.
“Autoimmune diseases are cases of mistaken identity,” writes Dr. Aviva Romm. “A variety of triggers can lead the body’s immune system to gets confused and start to attack our own, otherwise healthy tissue.”
With autoimmune thyroid disease, or Hashimoto’s, the immune system attacks the thyroid gland. The antibodies that attack the thyroid, or affect thyroid function, are called thyroid antibodies and in Hashimoto’s including anti-thyroid peroxidase (TPO) antibody and anti-thyroglobulin (Tg) antibody.
Thyroid peroxidase oxidizes iodide ions to form iodine atoms for addition onto tyrosine residues on thyroglobulin for the production of thyroxine (T4) or triiodothyronine(T3), the thyroid hormones.
Dr. Aviva Romm continues her explanation, “Large numbers of white blood cells called lymphocytes (these are innate immune system cells) accumulate in the thyroid and make antibodies that start to damage the thyroid, interfering with its ability to produce thyroid hormones or function properly.
Without adequate thyroid hormone, many of the body’s functions slow down, sometimes drastically. When cells in the thyroid become inflamed, TPO, an enzyme involved in thyroid hormone production, is released from the cells, and the body reacts by creating what are called anti-TPO antibodies. Anti-Tg antibodies increased in response to thyrobulin, being released from damaged thyroid cells.”
What To Do If Your Antibodies Are Elevated
If you’re struggling with hypothyroid symptoms: anxiety, fatigue, brain fog, digestive issues, insomnia, weight gain, hormone imbalances, fertility challenges, miscarriages — then it could definitely be your thyroid.
You’ll want to consider scheduling an appointment with a functional medicine doctor to get some blood tests run (check out our post for a comprehensive list to consider).
According to Dr. Romm, “doctors are taught to check test for TSH, and only add in additional tests, including thyroid antibodies, if the TSH is abnormal. The problem with this is that the while the TSH, or thyroid stimulating hormone, gives you some information about how your brain is communicating with your thyroid, it gives you no information about whether your immune system is attacking your thyroid.”
You can have high auto-antibodies for as long as 8 years before other thyroid labs show abnormalities. That’s almost a decade of attack on your tissue before bigger problems manifest and potentially become even more difficult to address.
What the test results mean
The antibody test results will likely determine if you have Hashimotos. For example if TSH is high, Free T3 or Free T4 could be low, and thyroid antibodies (TPOAb and/or TgAb) are positive, then your doctor will likely make a diagnosis.T
Another scenario pointing towards Hashimoto’s is that other thyroid labs are within a normal range, but it’s just the thyroid antibodies that are high. In this case many doctors have been taught to dismiss this as ‘no big deal, your body seems to be handling it’ – but in fact, elevated antibodies may indicate an elevated risk for developing Hashimoto’s later on. And wouldn’t you like to prevent that from happening?
Maybe you’ve already gotten a diagnosis of Hashimoto’s and are even already on thyroid hormone replacement medication, but you’re still not feeling better – and your thyroid antibodies are still not coming down. Their presence may cause continuous damage to the thyroid tissue, leading to a decrease in thyroid hormone production. Which leads us to our next point…
You’re determined to bring those thyroid antibodies down! But is that possible?
In response to your diagnosis, perhaps the doctor said, ‘it’s just something you have to live with – nothing can be done. But here is some thyroid hormone to keep the lights on upstairs…’ This is a true disservice too your health.
“If you know your antibody levels and they’re high, but your other thyroid tests are within a normal range, it isn’t time for thyroid hormone medication,’ states Dr. Romm, “but it doesn’t mean the thyroid should be ignored, either.”
There is scientific and anecdotal evidence that we actually can bring thyroid antibodies down, and we can do it naturally. To understand how we first need to know WHY our immune system backfires on us in the first place…
What Causes the Immune System to Produce Anti-Thyroid Antibodies in Hashimoto’s Disease?
There are several Root Causes that can lead the body to start to attack the thyroid, and a couple of basic ‘mechanisms’ that are responsible.
Though your genes are just a blueprint and aren’t necessarily your destiny, genetics can play a role in susceptibility to Hashimoto’s. But more importantly, it’s the environment and lifestyle factors – like nutrition, chronic stress, and gut health – that may determine whether those genes lead you on a path of disease – this is called epigenetics.
Three root causes leading to an increased risk of Hashimoto’s:
1. Gut health
Gut health is at the top of the list for many reasons. Dr. Aviva Romm explains, “the intestinal microbiome, the community of bacteria that live in your gut, play a major role in regulating the immune system, and when gut flora get out of balance, the immune system can lose its balance too, and through a series of unfortunate events, triggers the immune system to becomes more apt to mistake the thyroid for a “bad guy” that needs to be attacked.”
Leaky gut also influences immune function. This is when the tight junctions of the enterocytes in the gut lining are damaged allowing food particles, bacterial fragments, and other organisms into circulation. In a healthy gut, only nutrients should be able to cross this barrier.
What causes leaky gut?Zonulin, a protein that modulates the permeability of tight junctions between cells of the wall of the digestive tract, normally allows for nutrients and other molecules to get in and out of the intestine. However, when leaky gut is present, the spaces between the cells open up too much allowing larger protein molecules to get into the bloodstream where an immunologic reaction can take place.
We know that the 2 most powerful triggers to open the zonulin door include:
- Overgrowth of harmful organisms, like bacteria or yeast in the intestine
- SIBO = small intestinal bacterial overgrowth
- Fungal dysbiosis or candida overgrowth
- Parasite infections
- Gliadin in the diet (gluten containing foods)
Gliadin is a protein in wheat, that like gluten, is a trigger for people with celiac disease (an autoimmune condition). There is evidence of a strong link between celiac disease and Hashimoto’s. This is likely a result of the inflammatory gluten protein causing leaky gut.
Dr. Aviva Romm adds, “studies have also demonstrated considerable improvements in – and even resolution of – subclinical hypothyroidism and Hashimoto’s with a strict gluten-free diet. Historically, it was thought that consuming gluten was only a problem for people with celiac disease; however, gluten sensitivity, though not an autoimmune condition, can also cause significant chronic inflammation and symptoms for millions of suffering people.”
Improve Gut Health:
- Try an elimination diet (with the supervision of a trusted functional medicine doctor) to identify and remove foods causing inflammation and immune reactions. Read more here
- Consider removing inflammatory foods like alcohol, gluten (and gluten cross-reactants), cow’s milk dairy products, sugar, caffeine, GMO corn, GMO soy, food additives, and artificial sugars
- Work with your doctor to reduce or eliminate the use of NSAIDs (like ibuprofen) that can damage the gut lining
- Aim for a BM once per day and compare stool to the Bristol stool chart to rule out any physiological issues.
- Increase lacto-fermented foods in the diet, such as naturally made pickled vegetables, sauerkraut, and goat’s milk kefir
- Increase dietary fiber to at least 35 grams per day by adding ground flaxseed, berries, beans, and cooked vegetables
- Consider a daily probiotic of at least 10 billion CFUs per dose containing Lactobacillus and Bifidobacterium strains. We love Pro 15
- Reduce inflammation by considering ashwaganda (an adaptogenic herb show to help heal the thyroid and a powerful anti-inflammatory) and curcumin (the active ingredient extracted from the curry spice turmeric)
- Consider targeted supplementation to speed gut healing. DGL licorice,
L-glutamine, N-acetyl-glucosamine, MSM, aloe vera, marshmallow root, and turmeric are common in many gut health supplements. We love GI Revive by Designs for Health
2. Nutritional Deficiencies
Another common indicator of thyroid auto-antibodies, nutrient deficiencies affect as many as 8 out of 10 women. Even more, blood work and lab tests don’t always raise red flags for your doctor. Even little deficiencies can lead to big disease. For example, low zinc, vitamin D, vitamin A, and selenium are all associated with the development of Hashimoto’s.
Improve Nutrient Deficiencies:
- Remember to consult with a functional medicine doctor before starting any new diet of supplement plan. The ideas listed here are only for educational purposes.
- Optimize diet to include 8-10 servings of fresh fruit and veggies daily
- There are several key supplements that have been proven very effective for reducing thyroid antibodies. According to Dr. Aviva Romm, she recommends taking all of these at the following daily doses in her practice:
- Selenium (Dose: 200 mcg/day, do not exceed this dose)
- MyoInositol (Dose: 600 mg/day)
- Vitamin D (Typical dose is 2000 to 4000 IU daily)
3. Chronic Stress
Chronic stress can play a tremendous part in an autoimmune attack. In fact, studies show correlation between people who have gone through traumatic childhoods or exposed to chronic stress due to societal’s standards of success.
Chronic stress has been shown to exacerbate inflammation, leaky gut, gut microbiome dysbiosis, immune system depression, and even alter the expression of our genes. Sources of stress can come from obligations, trauma, and your internal and external environment.
External environmental toxins have been linked to increased antibody production. It’s no surprise that there is an increasingly large number of chemicals, plastics, and heavy metals that disrupt both the endocrine system and immune function.
Internal environmental toxins coming from stealth infections, like Epstein-Barr virus, Cytomegalovirus, intestinal parasites, or gum disease have also been linked to increased autoimmunity. Dr. Aviva Romm expalins that “there are several theories about how infections foster autoimmunity. One possibility is the molecular mimicry theory, in which the immune system remembers specific proteins on the viruses that it (appropriately) attacked, but then it starts (inappropriately) attacking other proteins in the body that look similar to the virus protein. Another theory is called the bystander effect, in which the immune system attacks the cells along with the virus, or the virus stimulates the release of specific immune cells that are primed to attach to the body itself.”
- Manage commitments. Understanding first your values and priorities so you know when to say no to people and commitments that don’t align with your happiness. Learn to do that here.
- Morning meditation 5 minutes followed by a journal entry. This works because you are setting aside time for YOU. You are making space to just BE and process your feelings, thoughts, and actions so that you can make sense of your purpose.
- Evening wind-down with a cup of tea and a hot bath or shower. This allows cortisol to come down and melatonin to come up providing a better night’s sleep.
- Avoid screen time from blue light sources 1-2 hours before bed. If this is not possible, consider blue light blocking glasses.
- Cut out caffeine and other stimulants. Read our post on how to do this without nasty side effects.
- Avoid environmental toxins: avoid eating canned food; ditch plastic and teflon-coated kitchen utensils, cookware, and storage containers in favor of glass, stainless steel, and cast iron alternatives; steer clear of soaps that contain chemical antimicrobials (like triclosan); and look for clean health and body care products. Head to The Environmental Working Group for more information and if you’d like a step by step guide to detoxing your home and body, enroll in our course.
- Get tested for infections. If you suspect that a hidden infection is playing a role in your antibody production, work with a trusted practitioner to test for and address chronic underlying infection. Learn more about this from Dr. Aviva Romm here.
“There’s a lot that conventional medicine has yet to learn about thyroid health and disease,” states Dr. Romm, “there are tremendous gaps between the research that’s available and what we’re taught in medical school or our medical continuing education. Just because your doctor doesn’t know about the importance of testing for antibodies or the role of leaky gut, vitamin D, or stress in thyroid health – doesn’t mean the science isn’t there. It is.”
According to her clinical experience, “many women get substantial reduction in thyroid autoantibody levels, are able to reduce thyroid medication dosing, and most importantly, start to feel like themselves again.” We are thrilled that you have been educating yourself on this growing autoimmune condition. We hope that this empowered you to take ownership of your own health!
Brent, Gregory A. Environmental Exposures and Autoimmune Thyroid Disease. Thyroid. 2010 Jul; 20(7): 755–761.
Nordio, M and S Basciani. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. International Journal of Endocrinology. Volume 2017, Article ID 2549491, 6 pp.