A streamlined stack of supplements designed to meet your most critical needs - Adapt Naturals is now live. Learn more

The Most Important Thing You May Not Know about Hypothyroidism

by

Last updated on

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

iStock.com/ChesiireCat

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.

Want to learn more about hypothyroidism?

Download This Free eBook

Find out how a thyroid imbalance could be causing your biggest health problems.

"*" indicates required fields

I hate spam, too. Your email is safe with me. By signing up, you agree to our privacy policy.

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?

Like what you’re reading? Get my free newsletter, recipes, eBooks, product recommendations, and more!

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.

ADAPT Naturals logo

Better supplementation. Fewer supplements.

Close the nutrient gap to feel and perform your best. 

A daily stack of supplements designed to meet your most critical needs.

Chris Kresser in kitchen
Affiliate Disclosure
This website contains affiliate links, which means Chris may receive a percentage of any product or service you purchase using the links in the articles or advertisements. You will pay the same price for all products and services, and your purchase helps support Chris‘s ongoing research and work. Thanks for your support!

655 Comments

Join the conversation

  1. Thrnks for all this info. I have just been diagnosed with the hashimoto today after two pregnancies having post partum thyroiditis after delivery & now two years of being on levothyroxin. Im at my breaking point with this. Im stuck with no good doctors or treatments… For the last week ive been waking after just falling asleep shaking, anxiety, blurry vision, naseauted, so scared & unable to sleep. Insomnia for days. Im not sure what to do next. Any advice?nks fo

    • Amy D. I too have had the insomnia as you describe it and after 2 years of misdiagnosis and sleeping pills/anti depressants, I found out myself that it is caused through blood sugar issues. Mine is adrenaline compensating for low blood sugar. Some organic orange juice with salt helps. Sugar for blood and salt to decrease adrenaline. All the best.

  2. My neurologist at UT Southwestern-Dallas/
    MS Clinic will not entertain the idea of using LDN. Instead, they only encouraged and explained the three new oral drugs. Sigh….. all while going through the worst exacerbation ever in my 24 year history with MS.

    By the way, I am seeking a new appointment with another neurologist who is open to other therapies–such as LDN. I am also hypothyroid and using Armour and a small amount of liothyronine. I suspect that my recent MS flare is due to thyroid (mis)treatment when other doctors (including UTSW) insisted that I get off all thyroid meds, so I did that for about 6 months. New labs after that showed me hypo again so back on the thyroid meds. My symptoms have improved however I suspect this current horrible MS flare is partially due to improperly treated hypothyroidism, and stress of course. (I survived 3 layoffs in 6 months time!)

  3. I was put on medication with a TSH of 5.8 10 years ago
    Now I take Armour
    My antibodies are high just have been told I have hashimoto’s
    3 small nodules on thyroid lobes. No symptoms.
    FNA inconclusive .
    now what?

  4. If your going to continue to post old postings I wish you would update them!!! I’ve come to the point that since they are not dated at the top I zip down to the comments to see when people have first commented. This is now 4 years old…

  5. I’m looking for a good endocrinologist for my hypothyroid in the Bradenton/Sarasota area. Anyone live here that can make a recommendation?

  6. Is it possible for diagnosed hashimoto’s to continue many years later and develop fast growing lesion near trigeminal nerve area? As of yet negative testing, did not resond to IV steroids, infact grew. R Facial numbness and R sided arm and leg weakness, balance issues. Trying to decide if bx is right thing to do?

  7. After seven years of having very abnormally low temps and symptoms of Hypothyroidism and doctors would just say you have no thyroid problem because your TSH is normal. The symptoms which only happened for a few days, maybe only every couple of months were happening everyday and I was so sick and exhausted I had to do something.

    With referrals I saw two Endocrinologists, the first only did TSH & T4, like had just been done. The second said I would be happy to do a thyroid panel, and did. TSH was normal, free T4 high end of range and free T3 at bottom of range. But he said you do not have hypothyroidism!

    They only know how to test for primary hypothyroidism and will not go any further. WHY? I see my tests showing my T4 is not converting to T3 properly.

    I had cancer 12 years ago and went through a year of weekly chemo and Have many on my Mom’s side with Hypothyroism. I could have pituitary or hypothalamus damage. How would I find out if a doctor will not go further?

    Plus, I told my new primary care doctor about trying to get diagnosed and of course do not expect her to take that on, but in talking about tests, she said T3 converts to T4, but I am not going to argue about it with you, go back to your Endocrinologist! Elaina Parton

  8. Hi Chris, thank you so much for this post. I was diagnosed with Grave’s Disease a few years back and ended up undergoing Radioactive Iodine treatment because at the time I had no idea that there might be better alternatives. I would love to see an article from you regarding people like me who have Hypothyroidism as a result of RAI, and not because of Hashimoto’s. I would imagine there are many parallels to Hashimoto’s in the sense that Grave’s is also autoimmune, and that as such is not actually “cured” with RAI. But I would love to hear any specific insights or advice you have regarding this particular scenario.
    Thanks!

  9. thanks chris – interesting – I have under active thyroid plus pernicious anaemia – and the both of them together try to ruin my health most days and succeed most of the time – am on b12 injections every three months (not enough) and levothyroxine (75mg/day) probably not enough – am knackered all the time – but docs here in Scotland wont budge an inch

  10. Thanks for all your information! I am interested in how Hashimoto’s (and hypothyroidism in general) relates to menopause and the changing hormone levels. I have Hashimoto’s, I’m 48 and finding that my mood swings and energy levels seems to be connected to the hormones and the Hashimoto’s. I’m trying to switch to NDT from Synthroid to see if that will help.

  11. I went to a alternative doctor and she told me to stop eating gluten for Hashimotos. I had searched the internet for answers and was surprised that this information wasn’t more available. Gluten causes your intestines to become come permeable, aka leaky gut. Gluten and thyroid tissue are very similar so when your immune system attacks the gluten that leaks out of your intestines and into your body it also attacks your thyroid. My antibodies were very high and after sticking to a strict gluten free diet they were almost normal and all my symptoms went away! One of the keys is healing your gut which means you need to take probiotics and stay away from foods with pesticides which kill the healthy bacteria in your gut. I have cheated on my gluten free diet and felt the effects. I also think avoiding sugar and keeping my life as low stress as possible makes a huge difference in how I feel.

  12. Thanks for this post. Looking forward to part 2…
    I have a question about iodine for hypothyroidism with an autoimmune component (not full Hashimotos) Recommended or not? Thanks!

  13. I was diagnosed with hypothyroidism 8 years ago and I take levothyroxine sodium 1 tablet .125mg per day but my question is I still feel like Im going crazy I cry all the time always depressed and cant hold a steady job because I feel ppl are out to get me so paranoid. what can I do I need to work. HELP HELP

  14. I was diagnosed with Hashimoto’s 10 years ago when they removed half of my thyroid. I have a new doctor who tested my antibodies just to make sure I really have Hashimoto’s and she said it was negative. Is it possible for the antibodies to go away or is one wrong. Also my TSH numbers went from 1. something to .0001. But free t4 and free t3 are both 1.27. HELP She lowered my medication from 125mg to 75. I’ve been here before and not looking forward to gaining 30 pounds in a couple of months again and sleeping 12 hours a day. Again HELP

  15. Hi Everyone,

    7 years ago, when I was 16, I was diagnosed as hypothyroid (VERY high TSH) and was told that it was probably Hashimoto’s (my thyroid glands are a bit swollen).

    But I just got lab work done today and my Thyroid Peroxidase Antibodies (TPO Ab) were only 4 IU/ML (within the normal range of <9). I don't think my TPO Ab had ever been tested before, it was only done this time per my request. Does this mean I don't have Hashimoto's!? Any answer would be helpful 🙂

    PS. In case it matters, my other results were:
    TSH 0.411 (slightly low?)
    T3 2.9
    T4 1.40

    I have been on synthroid (88 ug) for the last 7 years…hadn't really had a problem with anything till about a year ago, when I started feeling exhausted all the time…

  16. No matter what I write here, I am ignored.
    I like Dr. Eric better as he responds to EVERYONE.

    Good bye.

    • I guess symptoms of Thyroid disorder really does cause pessimism… i would answer your questions.

  17. I have been researching as of lately alot about proper diet for hypothyroid disorder. I have been diagnosed with it for about 8 years now and have been on medication. My biggest problem is the fact that I cannot burn fat not matter how much I workout or eat well. I workout 5 to 6 times a week and love to be active which has been helpful because I don’t see the benefits in my size, it would be easy to just stop but I actually enjoy it. I experience brain fog, extreme fatigue, heart palpitations, you name it I experience it. I have recently done a 30 day vegan diet and it has actually made my symptoms worse so I decided to stop that. I just want to be the healthiest I can be and to feel good for once. I will try ANYTHING to help correct my thyroid symptoms. I am big on being natural so I really hate taking medication, I would love suggestions on a new way of eating to help me look and feel my best. Any suggestions would be great!

    • Hi Kendall,

      The biggest three dietary recommendations I have read are (in order of importance, I think):
      1. Gluten free
      2. Soy free
      3. Dairy free

      I would try one or all of these…good luck!

      PS. I don’t think that going vegan is especially good for thyroid disease…there are essential amino acids/proteins we can only get from animal products. I personally do not usually eat meat, for ethical reasons, or dairy, because it doesn’t agree with me…but I do eat eggs and fish, and I have found those two things to be an important part of my diet.

    • I am feeling better since I dropped grains. I used to eat lots of soy and grains including gluten products some of which made me really tired and bothered my vision.

  18. I have been dealing with Thyroid issues since I did research on my symtoms and let the physician know to check my thyroid. Amazingly it was out of whack so they put me on levothyroxine. Now I’m having heart palpatations! I keep telling them that I want to know what is causing the thyroid issue and they tell me it just sometimes happens. I will NOT accept that because it just does not happen without a cause. I want to get to the bottom of the autoimmune issue so that I can get better. I’m tired of being sick! I have low vitamin D & Potassium and positive ANA along with Shrunken Thyroid elevated cholesterol. Any suggestions???

    • Deb,
      I also had very low vitamin D, so I now take D-3 2000, at night.
      I also atke Triple Magnesium w/ coconut oil. Coconut oil helps so much with constipation from low thyroid.

      During the day, I started taking CO-Q-10, Green tea complex, and resveratrol. The resveratrol gave me much needed energy, but suddenly, when I went to re-order, the price nearly doubled.

      My TSH levels change every time I get tested, and I am back to being exhausted once again. I get up at 8am, and usually by either 11AM or 1PM, I HAVE to take a nap for like 3 hours! This cannot be normal.

      I am not feeling as good as I should be, and I have notes from an online seminar (it was free) I attended for an hour, through another endocrinologist. I need to get my cortisol levels tested, and also my hormone levels. All these come into play, and need to be addressed.

      This is the most annoying disease, and it took 11 years for me to be diagnosed. Every doctor I have, blamed me for the weight gain.

      I hope you find someone to help you, so you feel better.

  19. It took 11 years to find out I had Hashimotos, and it was myself, that figured it out.
    All my doctors kept telling me to stop eating Burger King.
    I do not eat burgers at all. What a bunch of idiots out there.

    I have been on synthroid, different doses, as my TSH levels go up and down like the stock market.

    I am exhausted again, and I sleep most of the day, after sleeping 9 hours every night. I cannot get anything done, and even cooking dinner, is a burden.

    Who wants to go on like this? Not me. There has to be a better way to deal with this chronic disease. I am so fed up, I do not know what else to do, or what they are missing.

    Anyone else, lose weight, then go back to being tired full time?