What Is Hashimoto’s Thyroiditis? Symptoms, Treatment and Diet Explained
Somewhere between 15 and 21 million people have Hashimoto’s thyroiditis, an autoimmune form of hypothyroidism that results in glandular damage when the immune system mistakenly attacks the thyroid. It is the most common cause of thyroiditis in the United States (1).
Seven out of eight victims of thyroid disease are women, so while there are certainly men who are battling this relatively common autoimmune disorder, it is primarily a women’s health issue (2).
Even more people are probably walking around in the early stages, undiagnosed or misdiagnosed, and they may remain that way for years — even after symptoms have started to significantly interfere with their lives.
Because of all the misinformation out there on Hashimoto’s, we devoted this post to explaining each detail of the disease and discussing the importance of thyroid function. You’ll come away with a clear understanding of Hashimoto’s thyroiditis, and a better knowledge of symptoms, treatment methods and diet restrictions. Let’s dive in.
Hashimoto’s Thyroiditis Symptoms
Because of the individual nature of Hashimoto’s, your own genetic landscape, lifestyle, environmental factors, age and overall health will impact what symptoms you have. It’s difficult to create a universal list of symptoms. However, the following seem to be common and are in many cases the ones that can lead to an official diagnosis when viewed collectively by a practitioner who is well-versed in the disease (3):
- Fatigue, often chronic and debilitating
- Weight gain or inability to lose weight
- Constipation, usually chronic and long-term
- Sensitivity to cold, especially in the hands and feet
- Dry skin that usually worsens significantly in the winter months
- Depression and feelings of sadness or hopelessness
- Muscular aches, pains and cramps that can sometimes be misdiagnosed as fibromyalgia or rheumatoid arthritis (or can exist alongside these two related autoimmune disorders)
- Reduced ability to tolerate exertion, i.e. fatigue on walking even short distances, inability to exercise or feelings of lightheadedness when standing for too long
- Irregular or extremely heavy menstrual periods
- Infertility or recurrent pregnancy loss
- Dry, brittle and dull hair, skin and nails
- Low basal body temperature
- Elevated LDL cholesterol
- Insomnia or fatigue, even after sleeping normal hours
- Anxiety, mood swings and mood disorders (sometimes misdiagnosed as a major depressive disorder or bipolar disorder, but can exist alongside these conditions, too)
- Tenderness or pain in the lower throat where the thyroid sits, frequent sore throats not associated with sickness, or swelling of the throat, known as a “goiter” or enlarged thyroid gland
- Increased susceptibility to viral or bacterial infections; feeling of always being sick or picking up every bug that’s going around
- Increased incidence of diabetes
How Do You Get Hashimoto’s?
You might be wondering how you get Hashimoto’s. The sad but true fact is that there are a number of triggers, risk factors and causes, and many who develop this disease often have more than one. While this list isn’t exhaustive, these are some of the factors that may make it more likely to develop Hashimoto’s thyroiditis (4):
- Family history of any thyroid disease or hypothyroidism (in parents, grandparents or siblings) and genetic susceptibility
- Having a current autoimmune disorder of a different kind. Once the immune system goes rogue, it will sometimes continue to target various parts of the body unless all autoimmune disorders are in remission.
- Pregnancy or postpartum (up to 12 months) can be a risk factor, trigger or cause since the thyroid is susceptible to hormone changes and there are no greater hormone shifts than during and after pregnancy.
- Excessive iodine intake, which is why it’s vital to not supplement with such a volatile element. Unfortunately, an iodine deficiency can also contribute to hypothyroid problems, and some practitioners actually recommend supplementing with high doses of it.
- Viral or bacterial infections that become chronic can trigger an immune attack on the thyroid. This is most commonly seen with Epstein-Barr, the virus that is associated with mononucleosis.
- Menopause can also trigger Hashimoto’s, which, second to pregnancy and postpartum, is the next largest shift of a woman’s hormone equilibrium. Women of this age are usually screened for hypothyroidism but most doctors stop short of running the full battery of testing, and simply prescribe medication.
Can You Prevent Hashimoto’s?
Now you know about all of the risk factors, triggers and causes of Hashimoto’s. But is it possible to prevent it, even if you have many of the uncontrollable factors, or you aren’t willing to forego having a baby just to avoid possibly developing a thyroid disease?
The answer is, technically, no —there is no known way to absolutely prevent Hashimoto’s. However, if you’re aware of symptoms, family history and risk factors, you can get a much faster diagnosis and actually stop the progression of the disease before the thyroid is damaged. The only way this can happen is with proactive testing, like testing antibodies to determine if they’re a factor before the symptoms become chronic, and a preventive lifestyle.
Testing for Hashimoto’s
The only way to diagnose Hashimoto’s is by a series of blood tests (5). Most doctors will only run TSH, which stands for thyroid stimulating hormone. Unfortunately, this is not even a thyroid hormone, but is produced by the pituitary gland in the brain to tell the thyroid to make more hormones (6). The assumption is that if your TSH is high, meaning that your brain is shouting louder and louder at your thyroid to do its job, there must be a problem with the thyroid.
This is where things get complicated. While that can be true, there may be other factors at play. The thyroid may in fact not be producing the right levels of thyroid hormone because it is under attack from the immune system. The only way to deduce this is to test for thyroid antibodies — thyroid peroxidase antibody and thyroglobulin antibody.
TSH is also a faulty barometer for thyroid health because, as previously mentioned, it’s not even produced by the thyroid. In a small number of cases, the thyroid is fine, but there’s a pituitary communication problem. In this case, medicating with thyroid hormone would be a poor move. In patients already on thyroid medication, TSH is a terrible way to monitor medication dosing, but that’s how most practitioners do it.
In order to get an accurate picture of what your thyroid is doing and whether or not you could have early, undiagnosed or late stage Hashimoto’s, you need the following lab tests ordered:
- Free T3 (active form of T3)
- Free T4 (active form of T4)
- Thyroglobulin antibodies
- Thyroid peroxidase antibodies
- Reverse T3 (a storage form of T3)
Hashimoto’s Disease Treatment
Many doctors who properly diagnose Hashimoto’s thyroid disease will still stop short of a full-on treatment of the disorder. They may prescribe hormone replacement and continue testing your thyroid levels until they normalize. But in many cases, while hormone replacement can certainly take the edge off of symptoms, or even totally neutralize them, they don’t actually address the core issue as to why Hashimoto’s started in the first place.
Above all else, Hashimoto’s is an immune problem, and until the immune system calms down, even if Hashimoto’s enters remission, your body will be at risk for further autoimmune attacks.
A full spectrum plan for Hashimoto’s should involve further investigation as to what initially triggered the disorder, as well as hormone replacement when needed. Those with Hashimoto’s should also make dietary and lifestyle changes to remove aggravating stressors that could be perpetuating the immune dysfunction.
Hashimoto’s Thyroiditis Diet
A Hashimoto’s diet should be one that focuses on real, whole foods. Processed food is filled with refined sugars and preservatives that will certainly not help restore balance to the immune system.
Next, and of high importance, is the removal of gluten and dairy. These two foods, when paired with leaky gut, can be enough to keep autoimmunity running for years. Your immune system is intuitive, in that it can produce cells to attack viruses, but it’s not foolproof. When your gut is allowing undigested food particles into your bloodstream, the immune system misreads gluten and dairy in particular as thyroid cells because they’re similar in structure.
Healing the gut lining is imperative in order to reach remission from Hashimoto’s (or any) autoimmune disease. This means plenty of vegetables, high quality protein, high quality omega–3 anti-inflammatory fats and low-glycemic fruits. When you’re under autoimmune attack, it’s best to eat substantially more vegetables than fruits to keep the blood sugar stable. The body will heal best when it is balanced.
Bone Broth for Hashimoto’s
Bone broth, of course, is at the top of every gut healing food list. It helps to repair the lining of the small intestine to keep out foreign invaders that mess with the immune system. It also helps to maintain remission of autoimmunity. It’s safe for every stage of life and wellness, so there’s never a need to stop bone broth.
For a Hashimoto’s plan, we recommend bone broth two or three times daily. You can drink it plain or add it to soups or stews. Not only will it help to heal leaky gut, but it’ll also do wonders for the aches and pains that come along with Hashimoto’s. This is because the gelatin and collagen in bone broth are extremely nourishing and restorative for joints, muscles, hair, skin and nails. It’s like drinking liquid vibrance.
Hashimoto’s Friendly Recipes
Want to get started on some thyroid-friendly recipes? Here’s a round-up of simple, tasty and satisfying foods to help you heal.
- Ginger, Carrot and Sweet Potato Soup by Paleo Plan
- One-Pan Harvest Chicken Dinner with Brussels Sprouts and Butternut Squash by PaleoHacks
- Chili Roasted Pumpkin Seeds by Elana’s Pantry
- Zucchini Pasta Pesto by Cook Eat Paleo
- Slow Cooker Beef Bone Broth by Nom Nom Paleo
- Chicken Stock by Against All Grain
- Butternut Squash Gnocchi with Sage Brown Butter by PaleOMG
- Thai Inspired Turkey Meatball and Coconut Curry by Jo Romero/Comfort Bites
- Baked Sweet Potatoes with Sardines, Green Olives and Kale by Autoimmune Paleo
- Artichoke Mushroom Chicken by Gluten Free Travels
Living With a Thyroid Issue
Thyroid hormone levels are extremely important to living a normal everyday life, so if you or any of your family members have experienced thyroid problems, or are currently struggling with them, it’s essential to seek care. Hypothyroid screenings don’t usually begin until women are in their thirties and sometimes later. Yet it’s becoming increasingly common to see young women in their early twenties developing signs of Hashimoto’s. Like we covered earlier, doctors often misdiagnose and prescribe things that can deal with some symptoms, only to worsen others (such as antidepressants, anti-anxiety medications or steroids).
I know from personal experience because at the age of 20, my health started to decline. I fumbled for years, going from practitioner to practitioner, looking for answers to my debilitating fatigue, hair loss, weight gain, depression and extreme sensitivity to cold. I wore two or three sweatshirts at a time in the spring.
Sadly, it took eight years to receive a proper diagnosis for my underactive thyroid, and by then, the damage was done. While I am in remission from Hashimoto’s, you can never fully undo the progress of an autoimmune disease — you can just stop it from getting worse.
You should now have a better understanding of what Hashimoto’s is and how you can catch it early on.
If you know anyone that might be experiencing Hashimoto’s symptoms, please share this post with them. Reading it could get them on the road to recovery.
Aimee McNew is a certified nutritionist who specializes in women’s health, infertility, and autoimmunity. Her first book, The Everything Guide to Hashimoto’s, releases Oct 2016.