Hashimoto’s thyroiditis (named after the Japanese doctor who first described this condition in 1912) is an autoimmune thyroid disease that affects an estimated 14 million people in the United States, but that number may be grossly underestimated, because so few people are tested by their doctors.

Our immune systems are on surveillance all the time to detect viruses and bacteria that need to be fought off to keep us healthy. However, for certain reasons (some of them known and some still unknown), sometimes our immune systems can turn on us and attack our very own tissues. In the case of Hashimoto’s thyroiditis, the body has produced certain antibodies which destroy the thyroid, cell by cell. This process can go on for years, even decades, and can cause a subclinical or overt hypothyroidism. Symptoms may include fatigue, negative mood, depression, dry skin, cold intolerance, puffy eyes, easy weight gain, constipation, slow thinking and poor memory, hair loss or change in hair texture, joint and muscle pain, slow heart rate, infertility and menstrual difficulties. Some people may present with a full and puffy-appearing neck and others will not. Some patients will feel a constriction or tenderness in their neck. Hashimoto’s may be present (rarely, but it does happen) with a transient hyper phase and may be misdiagnosed as Grave’s disease, which is an autoimmune high or hyperthyroid condition.

Proper and thorough testing is the first place to start. The diagnosis is often missed because the only test commonly performed via routine blood work is for TSH, a pituitary hormone that usually rises when the thyroid isn’t producing enough thyroid hormone. In order to diagnose Hashimoto’s thyroiditis, it is important to check for anti-thyroid antibodies and a complete a more in-depth thyroid profile. A thorough battery of thyroid tests includes TSH, thyroid peroxidase antibodies (also known as TPO, or anti-microsomal antibodies), thyroglobulin antibodies, free T3, free T4, serum or urine iodine, and in some cases, reverse T3.

In other parts of the world, iodine deficiency is the biggest cause of hypothyroidism, however, in the United States, it is felt that for the larger percentage of people that have hypothyroidism, the underlying cause is autoimmunity.

There are people that have elevated thyroid antibodies yet despite having all or most of the symptoms mentioned above, they have a normal TSH and they are overlooked because this is the only test that is routinely done by their doctors. That is because it is the quickest, cheapest and easiest way to catch the majority of people with hypothyroidism, but sadly, too many cases are missed with this narrow approach. Anyone that has been diagnosed with hypothyroidism and has to have their doses changed often should be suspicious that they have Hashimoto’s thyroiditis.

There is no drug in conventional medicine that will treat or cure Hashimoto’s thyroiditis other than treating the hypothyroidism with appropriate medication, but this is doing nothing to stop the immune system from ravaging the thyroid further. It is only with diet and lifestyle medicine modifications that the immune system can be tamed and the thyroid can be restored to health. A comprehensive approach to addressing Hashimoto’s thyroiditis after complete evaluation has been done may include dietary changes, vitamin and mineral supplements, and thyroid medications when indicated.

A gluten-free diet (whether or not the person has been diagnosed with celiac or has a gluten intolerance) may prove to be helpful in reversing positive antibodies. One study with celiac patients that had Hashimoto’s thyroiditis reduced or eliminated thyroid antibodies after strictly avoiding gluten for one full year. Correcting vitamin D deficiency and shooting for numbers in the mid- to upper-reference range can calm down autoimmune attack in the body.

Selenium has been well studied in the treatment of Hashimoto’s, and 200 micrograms a day has been shown to be helpful in lowering antibodies. Brazil nuts are wonderful source of selenium, with each averaging approximately 93 mcg per nut. Zinc is another important nutrient for the function of a healthy thyroid. Coconut oil, or pure medium chain triglycerides (MCT oil), can be very beneficial for the thyroid and can calm autoimmunity. LDN therapy or low-dose naltrexone, acting as an immune modulator, has shown some promise in some patients. We need to be informed to be the best self-advocate for our thyroid’s optimal health.

Dr. Judy Gianni is a Naturopathic Physician with NatureMedica Naturopathic Clinic & Detox Spa. Contact her at 520-887-4287, [email protected] or NatureMedica.net.