Hashimoto's Thyroiditis

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Autoimmune disease diagnoses have increased dramatically over the past several decades, and no autoimmune disease is more prevalent than Hashimoto’s Thyroiditis. Over 35 million Americans suffer from Hashimoto’s, it is 5-8x more prevalent in women than men, and it is commonly worse around puberty, pregnancy, and perimenopause.

Autoimmune disease is when your immune system begins to attack a particular tissue in your body and create inflammation and eventual tissue damage and destruction. When the immune system attacks the gut we call it Crohn’s Disease, when it attacks the joints we call it Rheumatoid Arthritis, when it attacks the nervous system we call it Multiple Sclerosis, and when it attacks the thyroid gland we call it Hashimoto’s (or Graves’) Disease. If the attack on the thyroid persists the thyroid will suffer tissue damage and will begin to function suboptimally, leading to hypothyroidism (see stages of Hashimoto’s below). It is estimated that 90% of hypothyroidism is Hashimoto’s. This immune system attack will also lead to an increased risk for developing other autoimmune conditions.

The symptoms of Hashimoto’s can vary from minor to debilitating, including but not limited to:

  • fatigue

  • weight gain

  • brain fog

  • constipation

  • poor sleep

  • low energy

  • hair loss

  • dry skin

  • chronic cough

  • Irritable Bowel Syndrome

  • sensitivity to cold

  • infertility

  • depression

  • anxiety

A great book that I reference several times in this podcast episode is called The Hashimoto’s Protocol by Dr. Izabella Wentz, and her previous book is also a great resource  Hashimoto's Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause.

Hashimoto’s is diagnosed by the presence of antibodies (immune cells) against certain parts of the thyroid, specifically Anti-Thyroglobulin Antibody (TG) and Anti-Thyroid Peroxidase Antibody (TPO), with TPO being the most prevalent.

Estimated prevalence of Antithyroid Antibodies.png

I mention in the podcast that TPO antibodies are the most reliable marker and I discuss the values - below is a chart showing what values I discuss in the podcast episode.

 

TPO Antibodies

0 - 10 = desired number of antibodies

0-35 = normal on laboratory reference range

< 300 = often “sub-clinical” but still very relevant - will still cause damage but more slowly

> 300 = this will quickly lead to thyroid damage and clinical symptoms

Numbers can be as high as 10,000!!!!

 

Sample Thyroid Panel #1

 

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Sample Thyroid Panel #2

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Hashimoto’s progresses in 5 stages which I have borrowed and adapted slightly from Dr. Wentz.

 

Stage 1 - Leaky Gut - Intestinal permeability is the gateway to autoimmune disease. In this stage someone may have a genetic predisposition to Hashimoto’s but their immune system has not begun creating any antibodies. Perhaps in this stage a person’s immune system will begin attacking gluten, which can often lead to an attack on the thyroid later.

Stage 2 - Breakdown of Immune Tolerance - This is when the body begins to have trouble distinguishing “self” from “non-self”, meaning it begins attacking the own body’s tissues instead of foreign invaders. This is when antibodies begin to show up. This stage can last for years before a person moves on to stage 3.

Stage 3 - Subclinical Hypothyroidism - The antibodies will still be present and the Thyroid Stimulating Hormone (TSH) will be elevated (Listen to our last podcast episode “Could It Be Your Thyroid?”) but the T4 from the thyroid will still be normal. This is often when symptoms show up or begin to progress rapidly.

Stage 4 - Overt Hypothyroidism - By this point the thyroid has suffered enough inflammation and damage that it is functioning suboptimally. TSH will be elevated and T4 and T3 will be low, indicating a need for thyroid hormone replacement in the medical system.

Stage 5 - Other Autoimmune Diseases - When you have one autoimmune disease your risk of developing others goes up dramatically, so if Hashimoto’s continues to progress unchecked it can absolutely lead to other autoimmune diagnoses.

At the end of the podcast I briefly discuss a THEA score, which is outlined below. Basically it gives you an indication of your Hashimoto’s Risk Category

THEA Score.png