Hashimoto’s Hypothyroidism

Hashimoto’s Thyroiditis (aka Chronic Autoimmune Thyroiditis) is the most common cause of Hypothyroidism we see in clinical practice.  It is an autoimmune variant of hypothyroidism, which means that the body’s own immune system is attacking the thyroid. Its name comes from Dr. Hashimoto.  He originally described patients with goiter (enlarged thyroid) and subsequently discovered special types of cells that had infiltrated the cells of their thyroid tissue on microscopic examination.  Further study found that there was a self-driven mechanism by which the body directed the gradual destruction of the thyroid gland (hence, its “autoimmune” nature). In time, this self-attack resulted in the gland no longer functioning optimally.

Risk Factors

Individuals with family histories of autoimmunity have a higher likelihood of exhibiting Hashimoto’s.  Stress, infection, pregnancy, and radiation exposure can increase the risk for the development of an attack on your thyroid.

So, HOW does this happen? A case of infiltration and mistaken identity!

There are a few different hypotheses for how this “attack on self” gets started.  One of these theories is at the foundation of our Integrative Medicine approach: “Molecular Mimicry.”  Molecular Mimicry is just a fancy way of saying that a foreign substance (could be as simple as food!) is exposed to your immune system inadvertently (via a process called Intestinal Permeability or “Leaky Gut”), and this foreign substance just happens to look very similar to your thyroid parts.  The body’s immune system attacks these foreign parts as it should, but it accidentally ALSO attacks the thyroid given they looked so similar. Just a mistake.  

How to Identify It?

In terms of symptoms, you will likely experience similar symptoms to Hypothyroidism: fatigue, cold intolerance, weight gain, constipation, hair loss, dry skin, muscle aches, and menstrual irregularities.

Additionally, on laboratory examination, we find elevations of Autoantibodies (the guys that demonstrate a self-attack is indeed happening) against the thyroid in patients that have Hashimoto’s Thyroid.  You can also see specific findings on ultrasound testing.  

Treatment

The first step is to identify the foreign substance that is permeating the gut and causing the self-attack. Often “gluten” is at least one of the culprits. (Gluten’s ability to permeate the gut and cause mischief is one of the original reasons behind “gluten-free diets” before they just became a fad.)  

After identifying the foreign substance or substances, we can begin working on “resealing” any permeability that resulted in the inadvertent exposure in the first place.  

All other treatment approaches covered under Hypothyroidism would also apply here.

It is possible to halt and even reverse this attack on self, but it requires a comprehensive approach.  We can help!