Understanding Hashimoto’s Thyroiditis

January is National Thyroid Awareness Month.

This is a topic near and dear to me as many people in my family (including myself) have lived with thyroid dysfunction. However, the true underlying cause rarely gets addressed. I find it frustrating that many Doctors, including endocrinologists do not request the full thyroid lab panel. This is a basic step that gets ignored. Therefore, many people are told their thyroid is “functioning normally.” In reality, it may not be. If you are told your TSH (thyroid stimulating hormone) level is “normal” yet you still suffer from low energy, depression, fatigue, and many more symptoms (symptoms listed here: http://thyroid.about.com/od/symptomsrisks/a/symptomsrisks.htm,  then you may still have issues with the function of your thyroid. Don’t ignore these symptoms!

Symptoms like depression and fatigue often get treated with antidepressants. However, this does not address the root cause of the problem. The thyroid plays a huge role in metabolism and hormone regulation.

The thyroid is a butterfly shaped organ located in front of the neck.

Thyroid

 

Thyroid disease is quite prevalent in the US. Many people suffer from hypothyroidism (under active thyroid). In many cases of hypothyroidism the etiology lies in an autoimmune condition known as Hashimoto’s Thyroiditis. With Hashimoto’s  thyroid the immune system attacks the thyroid gland, gradually destroying it. This results in inflammation, and eventually leads to an under active thyroid gland (hypothyroidism), and may cause an enlarged thyroid, also known as a goiter. Hashimoto’s thyroid is the most common cause of hypothyroidism in the United States.  It primarily affects middle-aged women, but also can occur in men and women of any age and in children.  To determine if one has Hashimoto’s thyroid, a blood test may be done checking for thyroid antibodies.

Dr Richard Herbold who practices at Capitol District Vitality Center in Clifton Park, NY is a Board Certified Clinical Nutritionist and a Board eligible Chiropractic Neurologist. He discussed with me how complicated the thyroid is. “The thyroid hormones need to be manufactured, transported, binded to receptors, and cleared. Everything needs to work together in harmony to have a normal functioning thyroid. Minerals such as zinc, selenium, and Vitamin A are needed in order to make thyroid hormones. Many of us are deficient in these minerals because of our modern diet.” He stated that we need appropriate fuel in order for the thyroid to function efficiently. “We need protein, balanced blood sugars and CLEAN carbohydrates such as those found in starchy vegetables. We also need essential fatty acids to regulate hormones.”  According to Dr. Herbold all nutrition is about balance.  However, the physiological needs are different from person to person.

Here is my story:

I was getting a routine physical exam when my Doctor noticed my thyroid was slightly enlarged on one side. She sent me to an endocrinologist. The endocrinologist checked my antibodies and determined I have Hashimoto’s thyroid. She had her secretary call me, and the conversation went like this: “you have Hashimoto’s thyroid. Right now your thyroid is functioning normally. Once it stops functioning normally, we will put you on medication. You don’t need to worry about it right now.”

So hold on a minute…I should just let my body attack itself? I should just let my thyroid self-destruct, and then just go on thyroid medication? In the meantime, if I gain weight, feel depressed, have low energy…well there are medications for that as well? Right? Why didn’t the Doctor call to explain more thoroughly? I was just diagnosed with a disease that I knew nothing about. Was my thyroid really functioning normally? What were they basing this off of? Because I did not feel “normal.”

The truth is my thyroid was not functioning normally. I believe this is the truth for most of us with thyroid issues. However, we suffer in silence, because after all, the Doctor told us our TSH is “normal.”

One thing I recommend is to ALWAYS be your own advocate when it comes to your health. Always get second, third, and fourth opinions. Ask a ton of questions. Do your research! The thyroid is a very complicated endocrine organ. Don’t just take what your Doctor says at face value. We tend to put Doctors on a pedestal…as if they know everything. Doctors are trained in medicine, and can be a great resource. However, they might not have all the answers.

There were several important factors that this endocrinologist did not even take into consideration. She did not run a full thyroid panel, she only checked for Hashimoto’s antibodies because of the enlargement, and my TSH (thyroid stimulating hormone) level. There are many more blood tests that would give a more accurate understanding of what was going on.

I learned through my own research that (as with other autoimmune conditions) the profound affect that diet has on the function of the thyroid.  For those who are sensitive to gluten, a protein found in wheat and some other grains (many of us are sensitive to gluten and are not even aware that we are) consuming gluten actually tricks the body into destroying your own thyroid, and can trigger Hashimoto’s. According to Dr Herbold, this is known as “molecular mimicry.”  He stated that “Chains of amino acids in gluten share the same molecular structure as thyroid tissue. So when gluten is consumed, the immune system recognizes it as a foreign invader, and attacks the thyroid tissue as well.” It can take several months for the immune system to bounce back and stop attacking the thyroid. I also learned about goitrogenic foods (to avoid) when you have an enlarged thyroid- such as raw cruciferous vegetable (broccoli, cauliflower, kale, cabbage).

This book was life changing for me. Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal? http://www.thyroidbook.com/ The author, Dr. Kharrazian (a colleague of Dr.  Herbold) earned his Bachelor of Science degree with honors from the University of the State of New York and his Doctor of Chiropractic degree from Southern California University of Health Sciences. Graduating cum laude, Kharrazian was distinguished with the Mindlin Honors at Entrance Award, the Dean’s List, and the Delta Sigma Award for Academic Excellence. He also earned a Master of Science degree in Human Nutrition from the University of Bridgeport and a Master of Neurological Sciences degree from the Carrick Institute of Graduate Studies. He received a Doctorate of Health Sciences degree from Nova Southeastern University in Fort Lauderdale, Florida for his work in nutrition and neuroendcrine-immunology.

In this book Dr. Kharrazian explains why taking thyroid hormone replacements does not address the cause of hypothyroidism, and why iodine supplements can make you worse. He teaches how to appropriately manage Hashimoto’s thyroid. He explains the six patterns of low thyroid function, only one of which truly can be helped by thyroid hormones. Dr Kharrazian explains how diet affects the health of your thyroid. He discusses what blood tests to ask your Doctor for in order to get real answers. He explains how to talk with your Doctor. I actually had my Doctor read the book!  Dr Kharrazian also explains what foods to avoid based on individual physiological needs, and what minerals/supplements help to support thyroid function.

As I stated above, most endocrinologists/MD’s will only check your TSH level. It is important to request a full thyroid panel, so that you can get the whole picture as to what is going on. I don’t want to get too scientific, and I will link information that I found helpful.

I found this website extremely helpful in learning what types of questions to ask, and what lab tests you might want to request www.stopthethyroidmadness.com.

www.thyroid.about.com is another awesome  web reference. Mary Shomon is an amazing thyroid patient and advocate. She has published numerous informative articles on thyroidabout.com.

RE: medication…Natural porcine (pig) thyroid supplies T1-T4, where as synthetic thyroid only supplies T4 (inactive thyroid hormone). Depending on your individual blood panel, your T3 (active thyroid hormone) may be low as well. T4 needs to be converted to T3. However, there are many factors that can affect this conversion, resulting in low t3. Therefore you might still feel tired/depressed being on synthetic T4 thyroid medication alone. Take home message: If you need medication, know that there are options, and learn about them!

The thyroid is not easy to treat…there are many factors that come into play. There will be ups and downs, especially with Hashimoto’s thyroid. There are many times that the thyroid swings back and forth between hypo and hyperactive. The ups and downs that come along with it are not fun. It’s a balancing act for sure…and each person is different based on their bio-individual needs and the mechanism by which the thyroid is being affected.

At my last visit my thyroid antibodies were lower. I attribute this to the changes I have made in my diet over the past year. I avoid grains. I mainly eat pastured meats and vegetables (including starchy veggies for carbohydrates). I learned that if I get “glutened” even once, my thyroid would be actively attacked for 6 months or more. I’m feeling pretty darn good these days! There are still struggles, and I am learning as I go. I am lucky to have found a Doctor who checks my full thyroid and adrenal panel. She utilizes that information to determine where I am at. I am feeling better than ever and now have a better understand of my past struggles.

If you are experiencing thyroid symptoms, don’t ignore them! Take control, and you will feel so much better!

 

* Please note: This is a personal blog. I am not a Doctor or a Dietician. All data and information provided on this site is for informational/educational purposes only. It is not intended to be a substitution for professional medical advice.

Comments

  1. Laura Midura says:

    I really enjoyed reading this! Very informative! thanks for the post!

  2. Thyroid Geek says:

    I’ve recently read that
    Selenium helps to control antibodies;
    At early onset of Hashimoto’s the small dose of thyroid hormone can reduce antibodies as well (I was actually surprised reading that)
    On the other note, have you had the ultrasound of your thyroid to find why it was swollen on one side only (that could be suggestive of nodular goiter)

    • primalblissnutrition says:

      Yes! I take selenium and magnesium…a small dose can of hormone can reduce antibodies, I was on a small dose for a while. I did have an U/S and it was only slightly enlarged. I am lucky that I nipped things in the bud early on!

  3. TheQuirkyGlutenFreeRunner/Amy says:

    I use to take Selenium and then I stopped, I didn’t know if it was really doing any good or not. I think I’ll go buy some and see if that starts to help. I have been tired/fatigued for several months–before my mom was ill and passed–so I don’t believe my tiredness is from outside factors. I never realized being glutenized would interfere with the thyroid though. I already have one diagnosed auto, plus one undiagnosed (I believe I’m celiac but my specialist wouldn’t test me back in ’06) and so it’s possible to get another one (yeah?).

    Thanks for the information. It is well written and easy to understand.

  4. Wow that was odd. I just wrote an incredibly long comment but
    after I clicked submit my comment didn’t appear. Grrrr… well I’m not writing all that over again.

    Regardless, just wanted to say superb blog!

    • primalblissnutrition says:

      sorry about that…my blog is blocking many of the comments as spam and I have to figure out why. Thanks for reading!

  5. Thank you for one more good article! I love reading them, because you give me a lot of good information!

  6. My primary doctor runs a thyroid profile on me every 6 months now. Last year my TSH was borderline low, so she also sent me for an ultrasound of my thyroid. Apparently my left lobe was full of nodules so on to a Nuclear Scan and everything was good, just need to followup every 6 months with the thyroid profile and ultrasound. Was also told to add real salt back into my diet and take Sea Kelp. I still always feel run down can’t seem to lose weight as hard as I try. Think I will present some of these facts to my primary next month and maybe it’s really time that I seek the help of a endocrinologist. This article was very informative, thanks for sharing.

  7. Carrie Roberts says:

    HI there,
    I also live in the capital district. Our 16 daughter has hashimoto’s and has been gluten and dairy free for about 10 months. She is much better. Her stomach continues to give her inconsistent problems. Have you experienced stomach issues?
    Thank you!

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