Hashimoto’s disease, or Hashimoto’s thyroiditis, is one of the most common autoimmune disorders. It affects about five percent of the population, with rates five to 10 times higher in women versus men. Yet, this condition tends to be underdiagnosed and many women who undergo conventional treatment, may not find the recovery they desire. 

In this two-part series on Hashimoto’s, I will cover Hashimoto’s in detail. Today, we will dive into:

• What is Hashimoto’s?
• Hashimoto’s disease symptoms
• What causes Hashimoto’s disease?

Then, in Part 2, we will cover a functional medicine approach to Hashimoto’s healing. This is such an important topic, let’s jump in! 

What Is Hashimoto’s Disease?

Hashimoto’s is an immune disease that affects the thyroid, a butterfly shaped gland in the throat that produces thyroid hormones necessary for metabolic function in every cell of the body. 

Hashimoto’s is characterized by thyroid-specific antibodies that causes damage to the thyroid gland and ultimately hypothyroidism, or underactive thyroid. Hashimoto’s may also cause subclinical hypothyroidism, where lab tests are within the conventional ranges, but hypothyroidism symptoms are still present. 

Out of all cases of hypothyroidism, about ninety percent are autoimmune Hashimoto’s. Diagnosis relies on positive blood tests for thyroid peroxidase antibodies and/or thyroglobulin antibodies. Women are more likely to be diagnosed with Hashimoto’s between the ages of 45 and 60, yet the disease process often begins much earlier. 

Those with Hashimoto’s thyroiditis have a higher risk of developing other autoimmune disease, such as Celiac disease and rheumatoid arthritis. 

Hashimoto’s Thyroiditis Symptoms

Unlike hyperthyroidism symptoms, where everything speeds up, Hashimoto’s symptoms are symptoms of low thyroid hormone, where everything is slowed down. 

Symptoms of hypothyroidism and Hashimoto’s may include: 

• Weight gain or weight loss resistance
• Constipation and other digestive symptoms
• Depression or anxiety 
• Dry skin
• Cold hands and feet
• Hair loss or thinning
• Brittle nails
• Irregular menstrual cycles or PMS
• Infertility or miscarriage
• Brain fog or poor memory
• Fatigue
• Low libido
• High cholesterol 
• Blood sugar imbalances
• Muscle or joint pain

Hashimoto’s And Thyroid Disease

From the functional medicine perspective, we want to go beyond diagnosis and understand the why behind a disease. A root cause understanding allows for personalized treatment that optimizes thyroid function for each individual. 

To understand Hashimoto’s, we must understand the root causes of autoimmunity. Autoimmune disease results from an interaction between genetics and environmental factors. In autoimmune disease, there are three factors that must be present for disease to develop. 

1. A genetic predisposition
2. Leaky gut, or intestinal permeability
3. A trigger

Please read Part 1 and Part 2 of my series on autoimmunity to learn more about this science. (Add links) 

In the case of Hashimoto’s thyroid disease, common triggers and underlying contributors include:

• Exposure to gluten. Through a process called molecular mimicry, the immune system may mistake thyroid tissue for a part of the gluten protein called gliadin. Because of leaky gut, other food sensitivities are also common with autoimmunity

• Nutrient deficiencies. Deficiencies or imbalances in important thyroid and immune nutrients including iodine, selenium, iron, magnesium, zinc, vitamin A and vitamin D may contribute thyroid or immune dysfunction contributing to symptoms and disease.

• Dysbiosis. Imbalances in the microbiome including pathogenic infections, low beneficial bacteria and other imbalances may lead to inflammation and contribute to immune system dysfunction. 

• Viral infections.  Viral infections, including Epstein barr virus, are another trigger for autoimmunity. Functional medicine clinicians are now questioning whether COVID-19 may be a viral trigger for autoimmunity and an explanation for those suffering from long COVID. (add link to covid article Part 2)

• Toxin exposures. Environmental toxins coupled with poor detoxification may drive autoimmune disease for some. This is another highly individual area worth exploring. 

While we might think of Hashimoto’s thyroiditis as a thyroid problem, it is really an immune problem and requires a deep dive into contributing factors and root causes. With a functional medicine approach, time and dedication to lifestyle change, Hashimoto’s can be halted and, in some cases, even reversed. 

I’ll dive more into the functional medicine approach to Hashimoto’s in Part 2 of this series. If this article gave you a lightbulb moment regarding the symptoms you experience, please contact me to work together. 

References

1. Pyzik, A., Grywalska, E., Matyjaszek-Matuszek, B., & Roliński, J. (2015). Immune disorders in Hashimoto's thyroiditis: what do we know so far?. Journal of immunology research, 2015, 979167. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4426893/ 
2. Biondi, B., Cappola, A. R., & Cooper, D. S. (2019). Subclinical Hypothyroidism: A Review. JAMA, 322(2), 153–160. Abstract: https://pubmed.ncbi.nlm.nih.gov/31287527/ 
3. Nobuyuki, A. (1988). 4 Autoimmunity and hypothyroidism. Baillière's Clinical Endocrinology and Metabolism, 2(3), 591-617. Full text: https://www.sciencedirect.com/science/article/abs/pii/S0950351X88800557 
4. Mori, K., Nakagawa, Y., & Ozaki, H. (2012). Does the gut microbiota trigger Hashimoto's thyroiditis?. Discovery medicine, 14(78), 321–326. Full text: https://www.discoverymedicine.com/Kouki-Mori/2012/11/27/does-the-gut-microbiota-trigger-hashimotos-thyroiditis/ 
5. Ihnatowicz, P., Drywień, M., Wątor, P., & Wojsiat, J. (2020). The importance of nutritional factors and dietary management of Hashimoto's thyroiditis. Annals of agricultural and environmental medicine : AAEM, 27(2), 184–193. Full text: http://www.aaem.pl/The-importance-of-nutritional-factors-and-dietary-management-of-Hashimoto-s-thyroiditis,112331,0,2.html