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The Functional Approach to the Management of Hashimoto’s Disease

Written by

Deborah Freudenmann BHSc

Hashimoto’s Disease is a common thyroid disorder known to cause disturbances in thyroid functions. It can disrupt the hypothalamic-pituitary-thyroid axis (HPT axis) and affect critical mechanisms linked to the thyroid homeostasis or the thyrotropic feedback control.

Here is a brief discussion about what Hashimoto’s Disease is, and the functional approach to the management of this condition.

What is Hashimoto’s disease?

Hashimoto’s disease is a thyroid condition that occurs due to the abnormal response of the immune cells to the thyroid gland.

The thyroid is a small gland located at the base of the neck. The thyroid gland is a part of the neuroendocrine system responsible for regulating metabolic processes and the body’s response to stress.

The primary function of this gland is to secrete thyroid hormones including T3 and T4 and plays a critical role in regulating the functions of the endocrine system.

The secretion of hormones in the thyroid gland is dependent on the levels of another hormone called TSH (thyroid stimulating hormone) secreted in the pituitary gland. The THS levels are, in turn, dependant on the amount of TRH (thyrotropin releasing hormone) secreted in the hypothalamus.

This is how the secretions of T3, T4, TSH, and TRH are interdependent.

The abnormal levels of any of these hormones due to conditions like Hashimoto’s disease can cause disruptions on the HPT axis and endocrinal functions.

Hashimoto’s disease is characterized by inflammation in the thyroid tissues due to the damage caused by immune cells. Hashimoto’s disease is also one of the common causes of hypothyroidism.

What are the different stages of Hashimoto’s disease?

Stage 1: Genetic predisposition

In the first stage, the patient has a genetic predisposition to develop Hashimoto’s disease even in the absence of any other risk factor. The levels TSH, T4, and T3 are usually normal in these patients.

The laboratory tests may not reveal the presence of thyroid antibodies or any abnormality in the functions of the thyroid.

Stage 2: Infiltration by immune cells

This stage is characterized by an infiltration of lymphocytes in the thyroid. When in small amounts, these immune cells help in removing toxins and unwanted foreign bodies from the healthy tissues.

However, an excessive infiltration of lymphocytes in the tissues can trigger an abnormal immune system response due to which the immune cells begin to attack the healthy thyroid tissues resulting in inflammation and destruction.

At this stage, the laboratory findings may reveal elevated levels of thyroid antibodies, though the levels of TSH, T3, and T4 may be normal.

Patients may experience symptoms like anxiety, miscarriage, infertility, fatigue, mood swings, weight gain, or weight loss. Impairment of gut functions is another characteristic feature of this stage of Hashimoto’s thyroiditis.

These symptoms could be attributed to the abnormal functions of the immune system such as damage to the thyroid cells due to food sensitivities to gluten and dairy, increased intestinal permeability, nutritional deficiencies, adrenal dysfunctions, trauma, infections, or toxins.

Damage to the thyroid cells due to these factors may lead to abnormal stimulation of the immune cells that infiltrate the thyroid gland in an attempt to protect it against invaders. However, these immune cells also attack the healthy thyroid tissues causing damage to the gland.

Since the body cannot regenerate the thyroid cells efficiently, the damage to the gland reduces its ability to produce adequate amounts of thyroid hormones thus disrupting the HPT axis.

Stage 3: Subclinical hypothyroidism

This is the third stage of Hashimoto’s disease, also called subclinical hypothyroidism.
During this stage, the levels of TSH may be slightly elevated while the levels of T3 and T4 may be normal.

Appropriate treatment and lifestyle interventions to eliminate the root cause of the disease can be effective to relieve the symptoms, prevent complications, and reverse the damage.

Stage 4: Overt hypothyroidism

During this stage, the patient starts to exhibit evident signs of thyroid failure. It occurs when the thyroid gland is destroyed to the point it is no longer able to make its own thyroid hormones.

Management of Hashimoto’s diseases

> Nutritional depletion and deficiencies

The deficiency of minerals, especially iodine, is linked to abnormal thyroid functions. Including foods rich in iodine or the use of iodine supplements is recommended to promote the secretion of thyroid hormones and restore healthy functioning of the HPT axis.
Often, even when someone is eating a nutrient dense, low inflammatory diet there is still the risk of nutritional deficiencies. Factors such as low stomach acid, fat malabsorption and a lack of digestive enzymes will impair the ability to absorb/breakdown nutrients. Common deficiencies include: magnesium, zinc, B vitamins, iron, vitamin D and selenium.

> Inflammation

Chronic inflammation can trigger damage to the healthy tissues of the thyroid and contribute to the faster worsening of the condition. Limiting the consumption of foods containing sugars, sugar substitutes, and unhealthy processed foods is recommended to control inflammation and minimise damage to the gland.

> Food sensitivities

The incidence of Hashimoto’s diseases is higher in patients who suffer from food sensitivities to gluten and dairy. Identifying the specific food sensitivity, you are suffering from and eliminating these foods from the diet could provide faster relief from the symptoms of this disease.

It would also help to reverse damage to the thyroid gland and enable its efficient functioning thereby improving the levels of T3, T4, and TSH.

> Stress and trauma

Mental stress and trauma can not only trigger inflammation but also contribute to adrenal dysfunctions and hormonal disturbances. The stress hormone, cortisol, can directly interfere with thyroid hormone production.

It is advisable to adopt healthy strategies such as meditation and breathing exercises to reduce the effects of mental stress and emotional trauma. It would restore the normal balance of hormones in the nervous system and prevent disruptions in the functions of the hypothalamus, pituitary gland, and thyroid gland.

> Poor sleep and circadian rhythm

Men and women who suffer from insomnia or disturbed sleep due to sleep apnea or restless leg syndrome are more likely to develop Hashimoto’s diseases.

Poor sleep can disrupt the body’s circadian rhythm and worsen hormonal imbalances.

Adopting strategies to improve sleep patterns is expected to improve hormonal balance, reduce mental stress, relieve chronic inflammation, boost immunity, and thus, reverse the damage caused due to Hashimoto’s diseases.

Patients can maintain a fixed sleep-wake routine to improve their circadian rhythm in order to derive relief from thyroid diseases.

> Previous or co-existing infections

Previous or coexisting infections may contribute to inflammation and damage to the thyroid gland. Appropriate treatment of infections, such as ozone therapy can restore the functions of the thyroid within a shorter period.

> Impaired gut health

Impairment of digestive functions due to leaky gut syndrome or poor gut flora can affect immune system functions and trigger the development of autoimmune disorders like Hashimoto’s disease. The most common food sensitives that people react to include certain grains, gluten, dairy and sugar.

Food sensitives are a silent contributor which can exacerbate autoimmune disease, including Hashimoto’s disease.

To support the healing of the gut lining integrity, it is important to remove food sensitivities or food allergens. The use of probiotics could improve gut functions and help to restore healthy activities of the thyroid gland.

> Mitochondrial dysfunctions

Mitochondrial dysfunctions can worsen the symptoms of Hashimoto’s disease by reducing your energy levels and cellular functions.

Improving mitochondrial functions through a nutritious diet is highly recommend to reduce the risk of complications linked to this condition.

> Methylation issue

Analysis of the DNA methylation status in blood cells can provide clues about the possible factors responsible for the development of Hashimoto’s diseases.

Addressing issues related to abnormal methylation can reverse the pathogenesis of this condition and help patients derive relief from the symptoms.

> Obesity and metabolic dysfunctions

Obesity and metabolic dysfunctions like diabetes are known to co-exist in patients with thyroid problems. Blood sugar balance is pivotal for healthy thyroid function (thus often a second autoimmune disease). Individuals who suffer from Hashimoto’s don’t tolerate high sugar/carbs very well as it causes an insulin surge to help clear the extra sugar from the bloodstream. Any major fluctuations or swings in blood sugar levels can actually magnify the symptoms of Hashimoto’s disease.

Maintaining a normal weight, adopting healthy dietary habits, and regular exercises can control these factors and prevent the development of Hashimoto’s disease.

> Toxins & poor detoxification 

Exposure to toxins and impaired detoxification pathways can contribute to the accumulation of toxic substances in healthy tissues. Adopting strategies to promote detoxification such as drinking plenty of water every day, taking nutrients to support phase 1 and 2 detox would help to eliminate toxins from your body and restore normal thyroid activities. There are a few environmental toxins found to play a role in Hashimoto’s including but not limited to; synthetic pesticides, polychlorinated biphenyl’s, bisphenol-A, heavy metals, radiotherapy etc.

Red Light Therapy 

The symptoms of Hashimoto’s hypothyroidism can be relieved more effectively by undergoing red light and near-infrared light therapies. This treatment would work by destroying autoantibodies, supporting regeneration of the damaged tissues, and improving thyroid functions.

A Russian study conducted in 2014 conduded red and near infrared light therapy for 10 sessions with 347 women who suffered from subclinical hypothyroidism. Their baseline TSH averaged at 9.1 mlIU/L, but after 10 sessions the TSH was normalised in 227 (97%) of women. Their TSH averaged 2.2 mlU/L after the red and infrared light therapies.

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The treatment of Hashimoto’s disease through the functional approach aimed at identifying and eliminating the root causes can help to reverse the damage and restore healthy functions of the gland.

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  • 3 Responses

    1. Where can one buy one of those red light things for Thyroid problems; also prices if available
      Do you have instructions on useage too? THANKS for helping me.

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