This is the first mini-blog in a series on autoimmune and inflammatory diseases. The goal is to highlight the causes, risk factors and symptoms, and discuss common approaches to treatment and how Naturopathic care can support patients to alleviate symptoms and improve their quality of life.
Hashimoto’s disease is the most common type of thyroid condition in Australia. It is also the number one autoimmune disease I see in clinic, with patients who have been diagnosed or who I strongly suspect may have it.
Hashimoto’s is an autoimmune disease that involves the destruction of thyroid tissue as well as reduced synthesis of thyroid hormones. Autoantibodies cause oxidative stress and inflammation that impact on a number of body systems and contribute to many common symptoms.
Sadly, thyroid conditions are poorly diagnosed and many people are unaware they have one. I commonly see women who have gone to their GP with significant fatigue amongst a range of other symptoms, who have been dismissed and told they are ‘fine’ when they absolutely are not, or have been prescribed anti-depressants. If this is you, read on.
The Thyroid Gland
The thyroid is a butterfly-shaped gland located at the base of you neck that produces your thyroid hormones. Every single cell in your body contains thyroid receptors, which is why your thyroid hormones impact all major organs and body systems including the gut, brain, gall bladder, liver, cardiovascular system, blood glucose and body temperature regulation, to name just a few.
The thyroid is known as your master metabolic regulator for a reason!
Low thyroid function slows down your metabolism, which explains many of the common symptoms including:
- a drop in body temperature and increased sensitivity to cold
- hair loss
- brain fog, memory issues
- depression, anxiety
- sleep disturbance, insomnia
- gut issues, constipation
- weight gain
- hoarse voice, difficulty swallowing (with enlarged thyroid)
- changes to your period including heavy bleeding and pain
- unexplained infertility
- dry coarse skin
- slowed heart rate
- fluid retention
- muscle stiffness and pain
- carpel tunnel syndrome
It is important to note that many people can experience these symptoms of hypothyroidism and not have autoantibody production. In most cases, recovery is quicker as the degree of immune dysfunction is not as extensive.
Causes and Risk Factors
Genetics play a key role in the development of autoimmune thyroid disorders including HLA-DQ, HLA-DR, FOXE1 and other thyroid specific genes. A family history is the number one risk factor due to the likely genetic component, but there are other contributing factors including hormones. For example, women are affected significantly more than men, and onset often occurs at times of significant hormonal change such as post-birth and menopause. Furthermore, symptoms can disappear during pregnancy (this is common for all autoimmune diseases), likely due to the body’s protective mechanisms against for the foetus – the immune response is quietened. Fascinating stuff hey?
Other risk factors include smoking, vitamin D deficiency (significant risk), dysbiosis (imbalance in gut bacteria), and infection including Yersinia enterocolitica, hepatitis, and Helicobacter pylori. Viruses activate both arms of the immune system, so may be a causative factor in disease onset and I regularly find my thyroid patients have had glandular fever/Epstein Barr virus or herpes simplex virus. Pesticide and chemical exposure as well as heavy metal toxicity can also play a key role.
If you have frequently used corticosteroids, know that they reduce active T3 and increase rT3 levels. Accordingly, acute illness, stress and starvation has the same effect, which is why a traumatic event can often be the trigger for disease onset.
Important note: all autoimmune diseases have a common driver – a loss of the gut-immune interface; therefore restoring this is a key component of treatment.
Diagnosis of hypothyroidism requires an elevated TSH with low T4 levels. For a diagnosis of Hashimoto’s, autoantibodies must also be present.
Unfortunately many people fall through the cracks with insufficient/inadequate testing and not being appropriately diagnosed.
See my blog post on thyroid madness to understand the different types of thyroid and signalling hormones and to take a deeper dive into testing.
Conventional Medical Treatment
The standard approach to treating low thyroid function is synthetic thyroid hormone replacement therapy. Thyroxine replaces T4, the storage form of your thyroid hormone, and does nothing to address the conversion of T4 to T3 or reduce autoantibody production. This is why so many men and women fail to see a significant improvement in their symptoms with medication.
Natural desiccated thyroid is an alternative to thyroxine, however it is rarely prescribed in Australia. It is a much better choice and most patients will feel significantly better on it as it contains T4, T3, T2, T1 and calcitonin.
In the majority of cases, long-term thyroxine use is required due to the irreversible damage to the thyroid, however Naturopathic care can help improve the effectiveness of medication, support the conversion of T4 to T3 and most importantly, reduce autoantibody levels and reduce inflammation and oxidative stress, resulting in a dramatic improvement in symptoms.
I have worked with a number of patients at diagnosis who have been able to avoid medication entirely, with the support of their endocrinologist, using Naturopathic care only. I can’t even begin to tell you how rewarding this is!
Naturopathic treatment focuses on diet and lifestyle interventions, alongside nutrients and herbs that are scientifically proven to exert an anti-inflammatory action and modulate (or balance) the immune system. There are many dietary approaches including the autoimmune paleo diet (AIP), however I have found much better results (and better compliance) using an anti-inflammatory, high fibre Mediterranean style diet that is 100% gluten free (non-negotiable due to the increased risk of Coeliac disease). Other dietary advice is unique to the individual and depends on many factors including case history, family history, gut health and pathology test results.
Working with patients with Hashimoto’s disease is one of the most rewarding things I do. There is literally nothing better than seeing someone get their mojo back!
If you (or someone you love) has Hashimoto’s disease or hypothyroidism and you need support to better manage your condition, I’d love to work with you. I am a qualified and experienced Naturopath who specialises in autoimmune and inflammatory diseases. Book a discovery call today to find out how I can help you.