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The Most Important Thing You May Not Know about Hypothyroidism


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Reviewed by Christina Graham, MSN, APRN, AGPCNP-BC


This article is part of a special report on Thyroid Disorders. To see a comprehensive eBook on thyroid health, click here.

An estimated 20 million Americans have some form of thyroid disease. Up to 60 percent of these people are unaware of their condition. One in eight women will develop a thyroid disorder during her lifetime. The number of people suffering from thyroid disorders continues to rise each year. (1)

Hypothyroidism is one of the most common thyroid disorders. It’s estimated that nearly 5 percent of Americans age 12 and up have hypothyroidism. (2) It is characterized by mental slowing, depression, dementia, weight gain, constipation, dry skin, hair loss, cold intolerance, hoarse voice, irregular menstruation, infertility, muscle stiffness and pain, and a wide range of other not-so-fun symptoms.

Every cell in the body has receptors for thyroid hormone. These hormones are responsible for the most basic aspects of body function, impacting all major systems of the body.

Thyroid hormone directly acts on the brain, the G.I. tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gall bladder and liver function, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism and body temperature regulation. For starters.

You can think of the thyroid as the central gear in a sophisticated engine. If that gear breaks, the entire engine goes down with it.

That’s why people with hypothyroidism experience everything from weight gain and depression to infertility, bone fractures and hair loss.

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One of the biggest challenges facing those with hypothyroidism is that the standard of care for thyroid disorders in both conventional and alternative medicine is hopelessly inadequate.

The dream of patients with thyroid disorders and the practitioners who treat them is to find that single substance that will magically reverse the course of the disease. For doctors, this is either synthetic or bio-identical thyroid hormone. For the alternative types, this is iodine.

Unfortunately, in the vast majority of cases neither approach is effective. Patients may get relief for a short period of time, but inevitably symptoms return or the disease progresses.

So what’s the problem? Why have replacement hormones and supplemental iodine been such dismal failures?

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Because Hypothyroidism Is Caused by an Autoimmune Disease

Studies show that 90 percent of people with hypothyroidism are producing antibodies to thyroid tissue. (3) This causes the immune system to attack and destroy the thyroid, which over time causes a decline in thyroid hormone levels.

This autoimmune form of hypothyroidism is called Hashimoto’s disease. Hashimoto’s is the most common autoimmune disorder in the United States. (4) While not all people with Hashimoto’s have hypothyroid symptoms, thyroid antibodies have been found to be a marker for future thyroid disease.

Most doctors know hypothyroidism is an autoimmune disease. But most patients don’t. The reason doctors don’t tell their patients is simple: it doesn’t affect their treatment plan.

Conventional medicine doesn’t have effective treatments for autoimmunity. They use steroids and other medications to suppress the immune system in certain conditions with more potentially damaging effects, such as multiple sclerosis, rheumatoid arthritis and Crohn’s disease.

But in the case of Hashimoto’s, the consequences—i.e. side effects and complications—of using immunosuppressive drugs are believed to outweigh the potential benefits. (Thanks to conventional medicine for a relative moment of sanity here.)

So the standard of care for a Hashimoto’s patient is to simply wait until the immune system has destroyed enough thyroid tissue to classify them as hypothyroid, and then give them thyroid hormone replacement. If they start to exhibit other symptoms commonly associated with their condition, like depression or insulin resistance, they’ll get additional drugs for those problems.

The obvious shortcoming of this approach is that it doesn’t address the underlying cause of the problem, which is the immune system attacking the thyroid gland. And if the underlying cause isn’t addressed, the treatment isn’t going to work very well—or for very long.

If you’re in a leaky rowboat, bailing water will only get you so far. If you want to stop the boat from sinking, you’ve got to plug the leaks.

Extending this metaphor to Hashimoto’s disease, thyroid hormones are like bailing water. They may be a necessary part of the treatment. But unless the immune dysregulation is addressed (plugging the leaks), whoever is in that boat will be fighting a losing battle to keep it from sinking.

What the vast majority of hypothyroidism patients need to understand is that they don’t have a problem with their thyroid, they have a problem with their immune system attacking the thyroid. This is crucial to understand, because when the immune system is out of control, it’s not only the thyroid that will be affected.

Hashimoto’s often manifests as a “polyendocrine autoimmune pattern.” This means that in addition to having antibodies to thyroid tissue, it’s not uncommon for Hashimoto’s patients to have antibodies to other tissues or enzymes as well. The most common are transglutaminase (Celiac disease), the cerebellum (neurological disorders), intrinsic factor (pernicious anemia), glutamic acid decarboxylase (anxiety/panic attacks and late onset type 1 diabetes).

For more on how to balance the immune system and treat Hashimoto’s, check out this article.

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Join the conversation

  1. Hello,

    I had TSH 0.102 low and TSH receptor antibody 3.89 High.
    Anti thyrogobulin was 39.84
    anti microsomal was 13.10

    I am living in vietnam and one doctor said it was hyperhtyroidism graves and another said could be hashimotos.
    I had an ultrasound, nothing abnormal seen.
    i was given was thyrozon 10 mg
    and the other was dorocardyl 40 mg.

    There is so much information online, and it seems a lot of contradictory information by experts and I dont know if doctors know the underlying causes of these problems and are just treating symptoms without knowing the causes.

    I would like to know whats the best thing to do to know exactly if i have graves, hashimotos?

    And i heard they not curable, but merely can get them under control. I have felt very tired over 10 months.

    Thank you.

    • Hi James, try to go the natural route. See a naturopathic/functional medical practitioner if you can, they are much more experienced in this field and will recommend/provide natural products. Also google Medical Medium and Dr Jess.
      Best wishes

  2. Hi everyone. I have suffered for years. I was diagnosed 2 years ago with hashimotos autoimmune disease. I could have been diagnosed 5 years ago if my previous Dr. Had read the test results properly. Instead she kept try to tell me I was depressed and in denial. Thank goodness I eventually got my file and found a new Dr.. The biggest problem with this disease is the Dr.s.. At least my new Dr. Admits he does’nt know how to help me and he’s trying to get me to someone who can, so far that has been a bit of a nightmare to. They tell you what you’ve got, give you a pill that barely works and send you on your way. These are my symtoms. No menstration since 30 (I’m 47 now) sweats, chills, fever like body aches but no fever, Arthritis, lots of mucus in my throat, very low blood pressure, feels like I’m going to pass out often. B 12 deficiency, heart palpitations. Horrible pain and major bloating when I eat. Extremely dry skin, some skin pigmentation loss. Very dry hair. Joint and body pain, and now I have a cataract in my right eye. This isn’t all of it but the majority. I also work a full time job. My Dr. Says that I am a highly functional very very sick person. Yay me, seriously. Sorry I’m trying to keep this short. 20 years of suffering has not been fun. Here’s the thing, I realized two weeks ago after a bad specialists appointment, that I wasn’t going to get the help I needed to maybe have a bit of a normal life. Doctors do not have it all going on the way we all think. Infact this disease is way to time consuming for them so what do we do! Take your own life back. I finally realize that I actually can have some impact here. I have been reaserching like crazy to figure this out. So far I have started to journal everything I do, feel, and eat. I definitely have a big digestion problem I lost 40 lbs because I can’t eat do to pain and swelling. So I’m working on healing my gut. It’s definitely helping, my pain is much more tolerable. Still tired all the time but more energy. I watch what I eat. I’m taking a prebiotic and a probiotic as well as a vitamin D. I have a few other thing I’m going to try but I’m introducing things one at a time to see what the reaction is. I’ve read a lot of things about heal your gut heal most of your symptoms. So far so good. Food elimination diet. I highly recommend this for anyone with autoimmune and Hashimotos. Get rid of all gluten, watch foods high in lectin. I’ts not easy ( lots of salads and lean chicken breasts) but it’s necessary if I want to try and live a bit of a normal life. I’m finally listening to what my body is saying. I hope this might help some of you out there. Thanks for reading. I’ll keep you posted.

    • Gina, have a read through the comments on here they can be helpful, if you want to get better it’s best to gain as much knowledge as possible. See a functional/nutritional practitioner if you can, also look into the medical medium and Dr Stephen Cabral. Best

    • Colostrum will heal your gut immune tree 6 powder. I know God sent this as a tool for my child with many gut issues from Autism and it works! God Bless

  3. Am 60 yr old lady. Had thyroidectomy 10 yrs ago cos of v large goitre. Previously on 200mg thyroxine for 20 yrs and still on same dosage. Havent felt “right ” for many yrs. Deeloped weight probs so now got bad arthritis but also now seem to catch one cold after another. Obviously comprimised immune system. Can anyone suggest something to help?

    • I’m a male 34 and feel the same way for the past 7 years. Watch the program Fat,Sick, and Nearly dead. I’m on my 5th day and I’m going the whole 60. I’ve already lost 18lbs and I’m more social. My depression is almost nonexistent and my energy is crazy high! I had tried everything but nutrition and this is nooo joke. Please check it out. Let me know if you have any questions. I do the mean green juice. Anything that’s green I juice. Good luck Tracie

  4. I’m actually quite young to have this disease/condition (i’m 16 years old) and all I want is for my teachers and administration to understand that when i’m sick, i’m actually sick, i’m not pretending because I don’t want to be there. I tend to become sick more than other kids, I have told them multiple times that i’ve got Hypothyroidism and that it affects my immune system, and they don’t seem to believe me.
    What should I do?

    • Hi Sydnee, firstly read through the comments on here you may find them to be helpful. Secondly it may help you to cut out or at least reduce dairy and gluten for 2 weeks and see how you feel (both of these foods are inflammatory). Lastly, if you are able to get a juicer and have a glass of straight celery juice every morning on an empty stomach; celery juice is one of the most powerful and healing juices you can drink and can transform your health in as little as a week. Best wishes

    • Vitamin D deficiency is common with hypothyroidism. Vit D will effect your immune system, as well as your thyroid function. I recommend finding a naturopath and ask to switch to Armour Thyroid, or another form on Natural Desciated Thyroid

      • Yes. The natural thyroid replacements work much better for many people. Vitamin B,C,D Calcium, Magnesium and Selenium are important. I also take a baby aspirin, Turmeric and low dose Naltrexone to lower the inflammation levels.

    • We’re also same Sydnee..

      I’m not that prepared and having enough knowledge about this diseases until i’m already experiencing these symptoms this time so I’ve made my efforts to do researches.Thank you for this article by the way.I’m only 17 years old..and I can’t remove my fears for this..I have my dreams needed to fulfill to..but then joint pains and other symptoms hinder me..I’m having my medication for almost one year..it’s really not easy to deal with.

      But don’t feel alone Sydnee..you’re and we’re not alone for this fight..We have Him..to look for strengths in times when this disease really causing pains for us. He’ll never fail us.

      To your condition Sydney, it’s better to have time for them to explain your condition..or just your medical certificate speaks for you to really have an excuse..and to let them believe..I’ve aslo through with that situation..my neck seems larger than the normal size and even my teachers noticed it. My confidence to talk in front slowly ate (or eaten?, sorry for some wrong grammars if there’s any.) up by it..and as of these days, i’m also feeling the same way..I have to give an excuse letters for my check ups and blood tests..My teachers keep asking, are you ok?how could I tell them seriously,it’s not at all. They feel that pityness for me..and that’s not really nice to know when they’ll do your favor just because they considering your condition..How I view myself is really in low state..

      It maybe hard for others to understand our condition but the again, you’re not alone..

      Since now, i’m also searching for a relief for my joint pains and for the other symptoms..Can somebody help me?or any suggestions what to do to help me ease the pain?Your replies are much appreciated for me.Thank you.

      • Ericka – magnesium is very good for joint pain, google “magnesium joint pain” to research which is best

    • Hello, Sydnee! Please check out Hypothyroidism Revolution, It’s has done amazing things for me, and I am hypothyroid.

  5. First of all, my heart goes out to those who – like me – are dealing with a multitude of symptoms. I’d like some advice on what I should do next. I apologize now as I’m going to be wordy! 🙂

    * I’ve been overweight my entire life. At my highest, I was 403.

    * Had a Gastric Bypass in 2001. Lost 171 lbs. Gained 68 lbs of that back by 2015.

    * Between a 2015 revisional to my GBP and taking 37.5 mg of Phentermine, I’ve lost 56 lbs and kept it off.

    * Diagnosed with Hashimoto’s in 2014. I take 50 mcg of Levothyroxine and my TSH/T4 comes back in the “normal” range per my endocrinologist

    * Tested for low Cortisol in 2014 by my endo – told it was fine. I started the test with a level of 1.3 (low “norm” is 3.7!) but did raise up to normal after the two injections.

    * Since 2014 I’ve been battling with low ferritin, and some times anemia. Told by my PCP, GBP doc, and endocrinologist this is because of the GBP. The thing is, I recall in the mid 80’s feeling much like I do now, BEFORE my bypass!

    * Been on iron supplements several times. They would help – but only temporarily.

    * Just saw a hematologist – who again says my current low
    ferritin is because of the GBP. She says the supplements won’t help though and ordered 2 Feraheme Infusions for me. Had the first on 3/15 – with another 3/21. Don’t feel anything yet, but that’s common I know.

    * As of 2/20 my ferritin was 8 (scale of 12-260), my Iron is 66 (scale of 25-170), my TIBC is 402 (scale of 250-450) and my Iron % Saturation is 16% (scale of 20 – 50%)

    * I’ve been tested for RA, and Lupus. Been told I don’t have either.

    * List of current issues I’ve been dealing with for nearly a month now:
    – extreme, extreme fatigue (sleep just fine, no sleep apnea as I’ve been tested)
    – always cold
    – craving sugar like mad
    – very depressed (I was diagnosed with Anxiety/Depression back in 1994 – take 30 mgs of Paxil for this)
    – Itchy skin
    – mild edema in left leg (sometimes in right leg as well as fingers)
    – achy joints
    – sore muscles
    – cramping muscles
    – unexplained weight gain/weight loss (though I’m still trying to stick to my diet – I want to lose another 44 lbs at least!)
    – slightly elevated bun/creat (31.3 with the “norm high” being 25) – told I was “slightly dehydrated” by my endocrinologist.
    – drink at least 60oz of liquid a day (if not more). Also eat a lot of “wet” foods – watermelon, broccoli, brussel sprouts. I can’t imagine why I’m dehydrated!

    One thought from all this: Going to my PCP on the 22nd – hoping she’ll refer me to a nephrologist. I want to revisit the cortisol issue again.

    Another thought: I’m wondering if I don’t possibly have Autoimmune Hemolytic Anemia – but the hematologist completely disagrees. My PCP and endocrinologist have no idea.

    WHEW! Wordy, I know!

    Does anyone have any advice for me? Should I just chalk it up with low iron and be done? Or should I pursue the nephrologist? The hematologist thinks most of my symptoms are from the “slightly low” iron levels. She feels given a few weeks with the 2 infusions, I should be fine.


    Thanks everyone!

    • Capodo – sounds like you have an autoimmune issue. Heal your gut. 3 days of bone broth fast and/or juice celery (celery: 16oz/2 glasses); drink both broth and celery on empty stomach (you should notice a difference in a week, if not two). Also look into Colostrum by Immune Tree. Best wishes.

    • Sounds like hypothyroidism to me. I am hypothyroid as well, and I have been following a program by Tom Brimeyer called Hypothyroidism Revolution, look him up. I have had AMAZING results from it! Good luck!

    • A friend of mine normalized her very low iron when she switched from levothyroxine, a T4 medication to NatureThroid, a T4-T3 combination medication. She was not expecting that to happen and her nurse practitioner was amazed! After years of infusions for low iron, the right thyroid medication made a surprising difference for my friend. I’m not qualified to give medical advice, however, I thought you might like to hear what happened.

    • It sounds like you might have candida yeast overgrowth, especially with the sugar cravings, or parasites or even adrenal fatigue. Conventional doctors won’t help you with that. FInd a GI specialist and ask for a comprehensive stool test and other testing. Good book to check out is Digestive Wellness 4the edition. You can buy it on Amazon.com. hope this helps you. I also have hashimotos but can’t take my armour thyroid Med 1/4 grain because it makes me have side effects of turning bitchy and irritable and it makes me look so wired I could get arrested for looking like I am high on drugs. W t f. My body is also out of progesterone (0.5) and I am trying to get my insurance company to pay for a script of the biodentical version. I don’t know if you all know this but if yout have any hormonal imbalance at all (estrogen, progesterone) adrenal hormone imbalance etc, it will screw with your thyroid gland and make you get hashimtos or worse. It will also cause your thyroid meds not to work right no matter what. Also since hashomtos is an autoimmune disease the problem is not with your thyroid its with your immune system and that is what needs to be addressed first in order to heal your thyroid. I just love falling apart as I get older. I can relate to what some other person was saying aboyt their dictor thinking they are crazy because i told mine that i have IBS C( used to be d before menopause) and the quack told me it was all in my head and she even had the gall and audacity to put in the notes in my medical record that all of my symptoms are probably “psychologically” related. I was so insulted and pissed when i read that i called the clinic and told off the doctor and told her i dont know where you get off but if you EVER contact me again for anytjhing I swear to god i am going to call an attorney
      and file a lawsuit against you, the clinic and 4 other doctors for medical malpractice and negligence. She even refused to give me a script for progrsterone when i showed her the results of my last blood tests and told me i didnt need prigesterone because i am getting old and it didnt matter if i got fat and my breasts go flat etc. i am so sick of stupid conventional doctors who dont teally give a s….. lol

      • I have found this for more than 20 years. Wellness clinics, nutritionists, or alternative medicine doctors are more accepting of these types of symptoms and methods to heal them. I am no asymptomatic but I have made a 75% improvement, mostly through glutamine powder for leaky gut and food sensitivity testing and elimination. I believe probiotics are an absolute must. I really trust a company called optibac in the UK. They have done extensive studies on strains. I use them exclusively. Progesterone has been a huge help for me for any number of symptoms. You can buy progesterone cream over the counter. The skin absorbs most of the medicine unlike digestion killing 80-90% of what is taken orally. You can even get progesterone cream from cow or pig thyroid that has been dessicated. Lastly, take a look at CBD oil. It is derived legally from hemp and it is exploding right now. It is the only thing that helps my pain. I was convinced I had rheumatoid arthritis. I take 25 mg CBD oil under my tongue 3 times a day. There are numerous ways to take it. You should see whats out there and the results that they are getting. Emergency Rooms are going to start using it. I wish you well in this quest. I have not found everything I need yet but I don’t give up and neither should you (I have wanted to give up at least 3 times but dissability income is really low).

        • Hi Rena, may I ask how much glutamine powder you took and how long it took from starting it when you seem to notice a difference? Also which CDB oil have you been using? Unfortunately there are a lot out there which are no good. Thank you

  6. Why are the number of people suffering from thyroid disorder continuing to rise each year as you stated in the beginning of your artical?
    I have had conversations with GP and endocrinologist about wheat, glyren etc. they tell me I’m nuts no connection ?

    • Environment+genetic predisposition+stressful trigger. Leaky gut= gluten and lactose intolerance over time. Thyroid+leaky gut=autoimmune diseases. Body mistaking and attacking healthy cells. Some say it might be cause by bacteria, viruses, or dependence on antibiotics that kill off healthy instestinal flora. I went to school with your brother, Mark!

    • Milk,eggs, soy etc.. The food served in this country is the issue. It causes the DNA damage, attacks the gluten particles on your thyroid, then life as you know it is over!!! I’ve suffered my whole adult life (30 +yrs). No doctor will help you, its simply not in the medical protocol. Medical biz will only give you more chemicals to throw you into a deeper tailspin. There is no answers. I found that measles,mono have a lot to do with your future health.. They’re killing us all slowly…