Do you have Hashimoto's?
Hashimoto's disease is the leading cause of thyroid malfunction
Although the name sounds somewhat exotic, Hashimoto’s disease is not rare at all.
In fact, it’s the most common cause of thyroid malfunction in the developed world and it’s responsible for 90% of under-active thyroid cases! Sadly, it usually takes years to get the diagnosis. Years during which you may be suffering from mysterious symptoms that come and go while the results of your thyroid tests remain normal. Keep reading to understand what’s the disease all about, why it’s so hard to detect (seemingly) & what to do to get better.
First of all, let’s have a look at how Hashi may manifest itself.
You may have Hashimoto’s aka Hashi if you’re struggling with a combination of the following symptoms:
- Weight gaining for no reason
- Feeling cold (deep to the bone, when everyone else is just fine)
- Muscle weakness (no power to work out), cramps
- Joint pain
- Hair loss
- Dry, pale, dull skin
- Loss of outer part of eyebrows (and a serious loss of self confidence!)
- Problems with balance
- Feeling not present, spaced out
- Low mood, depression
- No motivation
- Low libido
- PMS & period problem
- Fertility issues, miscarriages
All of these symptoms are part of the hypothyroidism landscape, associated with Hashi.
Additionally, you may be going through spells of anxiety, heart palpitations and insomnia, which are typical of hyperthyroidism. If you have Hashi, you get to taste it all! 😭
It can feel like you’re on a rollercoaster – sluggish one day and hyper-active the next. The spells can be longer, lasting weeks or months and can be intercepted with (blissful) periods when you feel relatively well.
Hashimoto's develops over many years & stays under the radar
Hashi develops in genetically predisposed individuals under the influence of environmental factors, such as bad food choices, stress and an unhealthy lifestyle, hidden infections, pollutants and toxins.
This means that even if you do have the predisposing genes, the disease will not manifest unless the right (or, share we say, wrong) combination of environmental factors is present.
We could say that the genes load the gun but the environment pulls the trigger. In the case of Hashi, the gun’s aimed at your thyroid but other bits of your body can get hit as well (eg. your brain).
In the early stages of the disease, your immune system starts making antibodies to your thyroid gland (they’re the squiggly things around the thyroid in the image on the top) but typically you experience no symptoms. Something has triggered things off and you’re sliding down a slope without realising what is happening.
As the disease progresses, you start showing symptoms associated with hypothyroidism, but you have normal TSH levels so your doctor tells you there is nothing wrong with you. In fact, most people tend to think there is nothing wrong with you.
Your fatigue may be seen as laziness, your depression as being antisocial, your weight gain may be pinned down on secret overeating. You may feel isolated, hopeless and helpless and you may even doubt yourself. ‘Maybe there is nothing wrong with me? Maybe it is all in my head?’
Hashimoto’s is an ‘invisible’ disease but your symptoms are real even if no one seems to think that and your blood test results look normal.
You may experience decades of fatigue and poor physical endurance, poor brain function causing brain fog or depression, as well as chronic gut issues, including chronic constipation.
You may experience spells when you feel better as the disease does not develop in a linear way but is characterised by periods of remission and relapse.
You may experience periods when you feel anxious and overstimulated due to excess thyroid hormones spilling from the thyroid cells as they get attacked and destroyed by your immune system.
The TSH on a blood test may not only be normal but can even be low. A test is only a snapshot in time and you can be anywhere between hypo and hyperthyroid.
As the destruction of your thyroid progresses, your symptoms become more severe and consistent with hypothyroidism. When a significant part of your thyroid gland has been destroyed, your TSH increases and stays high. You’re finally diagnosed with hypothyroidism. However, typically no test are run to rule out or confirm autoimmunity.
The reason these tests are not routinely run is that the results do not change the standard medical treatment.
Hashimoto's can not be treated with thyroid medication
Thyroid hormone replacement therapy (levothyroxine) is the standard medical treatment for hypothyroidism and it does what it says on the box. It replaces the T4 that your body cannot produce on its own. It does not address the underlying immune imbalances and does not stop the progression of autoimmunity. It does not put out the inflammation raging throughout your body.
Apart from causing your thyroid to become unable to produce sufficient levels of hormones, the inflammation disrupts the activation of these hormones as well as the function of the cellular receptors the hormones bind to.
This is why you feel you’re not really getting better despite taking the medication. It’s also because Hashi is far more than a thyroid disease.
Hashimoto's affects more than your thyroid
Multiple other organs and body systems are involved and a treatment plan must recognise and address all of the aspects of the disease.
Apart from the thyroid and the immune system, the brain, the gut, the liver and detox mechanisms, energy metabolism and the female reproductive system are affected.
You may be given different medications to help manage different symptoms – anti-acids for acid reflux, metformin for insulin resistance, contraceptive pill for irregular periods, anti-anxiety medication or antidepressants for low mood.
While these may help to a degree, the underlying autoimmunity and inflammation are still not being addressed. Neither are the multiple mechanisms gone out of balance, such as blood sugar regulation, detoxification or digestion and nutrient absorption. This leads to the development of more and more seemingly unrelated symptoms alongside the progressive destruction of your thyroid gland and impaired thyroid hormone function.
Hashimoto's can be managed & you can be symptom-free
Unlike the drugs alone, a holistic, integrative approach, including bespoke diet and lifestyle interventions and carefully chosen supplements alongside the right medication, can put the disease into remission.
Each person with Hashi has their own, individual set of issues and requires a slightly different therapeutic approach.
In terms of diet, most studies suggest following a gluten-free & dairy-free diet based on a variety of whole foods. As hidden food sensitivities are a factor for most people, identifying your personal dietary triggers using the elimination/reintroduction diet can be hugely helpful. Typically, the problematic foods include grains, nuts & seeds, eggs and a group of vegetables called nightshades (tomatoes, peppers, aubergines, potatoes). Foods of particular benefit include green leafy vegetables (spinach, kale, rocket salad, cabbages, etc) & cruciferous vegetables (yes, despite what you might have heard about their negative effect on thyroid!). Having some good quality protein and fat with every meal helps to stabilise balance sugar levels and prevent blood sugar spikes & dips, which are an important trigger in most people with Hashi.
There are a number of supplements that can be helpful in getting the disease under control, including glutathione, NAC, vitamin D & B12, magnesium, digestive enzymes & HCl, probiotics, adaptogens, etc. Ideally, these should be carefully selected by an experienced professional based on a thorough heath evaluation & the results of appropriate tests. Self medicating can be a bit of a hit and miss – it can help but it can also do some harm.
In terms of lifestyle, sleep is the key ingredient in a recovery plan. Poor quality or insufficient sleep can prevent healing so having a good sleep hygiene is a must. This includes going to bad at a decent time, avoiding screens right before bed time & making your bedroom as dark as possible. Engaging in regular physical activity, without pushing yourself too much, is also crucial to recovery for a number of reasons, including the fact that it helps to achieve better sleep quality. Identifying and avoiding your chemical triggers, such as BPA from plastic water bottles is another step you need to take to start feeling better.
If you’re a proactive individual, who likes to DIY things, there are plenty of great resources to help you with healing, such as the amazing book by Dr Datis Kharrazian titled ‘Why do I still have thyroid symptoms when my lab tests are normal’ – I couldn’t recommend it more!
If you’d like some help figuring things out, hit the button below to book a quick chat. I’m always happy to help!