Hashimoto’s disease is an autoimmune condition where the body’s immune system attacks it’s own thyroid gland. Just like so many other autoimmune conditions, Hashimoto’s is an immune system “mistake”, where the body thinks that its self is the enemy.
Thyroid disease… is more common than diabetes or heart disease. ~ American College of Endocrinology
Hashimoto’s typically presents itself symptomatically, as an underactive thyroid. However, sometimes depending on the damage done to the thyroid gland, Hashimoto’s can present as fluctuating between an underperforming thyroid and an overactive thyroid. It’s not always easy to determine if your thyroid is the problem, but some things to look for are:
Typical Underactive Thyroid Symptoms:
- Feeling cold
- Excessive sleeping
- Dry skin
- Weight gain/difficulty losing weight
- Thinning hair
- Waking with a headache
- Mental sluggishness
Overactive Thyroid Symptoms:
- Night Sweats
- Heart palpitation
- Difficulty gaining weight
Diagnosis – How Does Functional Medicine Differ from Mainstream Medicine
Most traditional doctors don’t test for Hashimoto’s because the diagnosis doesn’t change the outcome of conventional treatment. The mainstream method of testing, unfortunately, relies just on TSH tests to make their prognosis.
The mainstream, allopathic approach of diagnosis is the following:
- Thyroid-stimulating hormone (TSH) levels. The problem with just testing TSH is that in Hashimoto’s, they can be all over the board! Low, High, or just right. As mentioned, the TSH levels can often fluctuate, depending on the disease progression. Because of this, it is necessary to test for thyroid antibodies to really see what is going on.
- Thyroid antibodies – anti-thyroid peroxidase (anti-TPO) and also anti-thyroglobulin (anti-Tg) antibodies.
But there are additional tests that are needed in order to truly rule other issues out, like the following:
- Total T4
- T3 Uptake
- Total T3
- Free T4
- Free T3
- Reverse T3
- Microbiome tests
- Immune system tests
- Heavy Metal tests
- Mold tests
- Other hormone tests
The Mainstream Approach to Hashimoto’s:
Currently, the mainstream treatment of choice is to give patients thyroid hormone, and monitor levels, adjusting the dosage as you go. However, the problem with this approach is that the thyroid continues to degrade over time because the underlying issues haven’t been addressed. In addition, other medications might be prescribed which further cover up the real root cause.
Hashimoto’s As Seen From A Functional Medicine Perspective
Functional Medicine acknowledges that with Hashimoto’s, there are many, many factors that go into creating the condition. There is no clear answer for why one person will be triggered and another won’t. This is why it is so important that each person is taken as a unique situation, and a plan of care tailored to them specifically. However, there are a few commonalities to look for in what creates a favorable environment for Hashimoto’s to emerge.
- Fluctuations in estrogen
- Pregnancy and peri-menopause
- Insulin resistance – (typically due to a high-carbohydrate diet)
- Heavy metals like mercury
- Other environmental toxins
It is well known that Vitamin D is deficient in well over 60% of the people in the U.S. There seems to be a link toward Vitamin D deficiency and Hashimoto’s. This is no surprise because Vitamin D controls approximately 2000 of the bodies 30,000 genes, and has scientifically been established as a major contributor to the bodies ability to withstand inflammation.
Chronic infections (viral or bacterial)
Hashimoto’s has been associated with a variety of infections including:
- Epstein-Barr virus
- Influenza B virus
Lab testing is sometimes appropriate to determine if a patient has an underlying condition which is causing Hashimoto’s.
Stress and Hashimoto’s
Stress might be the big one here! It is believed that the impact that stress has on the immune system might be one of the main contributor’s to Hashimoto’s. Stress suppresses the immune system, promotes inflammation, causes hormones to be imbalanced, and disturbs the intestinal lining.
Addressing stress should be a HUGE part of ANY plan to treat Hashimoto’s.
Gluten and Hashimoto’s.
There are now tons of studies showing that people with gluten sensitivity also are prone to be diagnosed with Hashimoto’s. The idea is that the body mistakes the thyroid tissue for gluten, attacking what it perceives as a threat. For some people, removing gluten starts to help almost immediately.
Functional Medicine’s Approach to Hashimoto’s.
While all Functional Medicine doctors have a slightly different approach, in general, there are some characteristics that are shared…
To start, no two people with Hashimoto’s are the same. Treatment varies from person to person, and it is based on lab results.
Every new patient always receives a detailed medical and health history.
Then, appropriate labwork is performed to address things like inflammation, hormone issues or infection.
Some common goals for Functional Medicine practitioners working with patients are the following:
- Remove Gluten and Dairy (and potentially many other foods) from the diet, often with an “elimination diet”, in order to assess undiagnosed food sensitivities or allergies.
- Establish a diet with key nutrients that heal the thyroid itself.
- Heal the gut. There are many patients who are dealing with a ‘leaky’ gut, where undigested food and protein pass through the intestinal walls, get into the blood and cause an immune response.
- Identify possible nutrient deficiencies like vitamin D.
Add powerful adaptogens like turmeric, Astralagus, Rhodiola and Ashwagandha
- Investigate infections.
- Handle Stress.
- Modulate the Immune System.
Hashimoto’s and the Immune System
Ultimately, Hashimoto’s is the result of the immune system gone wrong. So any plan must diligently do everything it can to bring balance back. In general, a base foundation of health needs to be established, which would include things like blood sugar regulation, healing underlying infections, restoring gut health and teaching mind-body techniques for stress management.
The immune system is a very complex mechanism, and often when we take an approach with addresses the whole person and their lifestyle, we can make very good progress.
For more on how Functional Medicine approaches Hashimoto’s, check out the following links: