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.
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.
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.
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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OK Now I am confused. If I had a total Thyroidectomy and they found Hashi’s, Can I still have Hashi’s and can it be reaking havoc in my body?
They did. Your TPO antibodies were positive. That’s autoimmune disease.
The other markers are not specific to Hashimoto’s and may or may not be elevated in people with that condition. For example, I have Crohn’s disease which is an autoimmune disease, but I never test positive for any of the serum autoimmune markers.
So, shouldn’t my tests for autoimmune disease come back positive?
Candy: Hashimoto’s is an autoimmune disease, by definition. If you have Hashimoto’s, you have an autoimmune disease. It’s that simple.
The TPO antibodies that were measured by your doctor indicate that your body is producing antibodies to an enzyme in your thyroid gland. This is autoimmunity, i.e. the body is attacking itself.
I am curious about your article stating that all Hashimoto’s is due to autoimmune disease. I was diagnosed about a year ago after much encouragement from my trainer who saw me doing all the workouts but getting zero results. She too has thyroid issues and she encouraged me to get my results from my general doctor as well as my gyno…both of whom told me “your test results came back normal”.
On a hunch and and based on my TSH running around a 4 and my symptoms, I made an appointment with an endocrinologist. She did the tsh test as well as tpo…and the tpo antibodies came high… i think 132 out of 0-30 scale. On synthroid I went and a year later… I am starting to feel like a pin cushion experiment, constant retesting of my blood to find the right dose! I went from 25 to 50 to 75 to a combination of 75/50 mg and now I have been switched to armour (1gr). Of course since the switch, some of the terrible symptoms I was having before being on synthroid have returned including my arms falling asleep at night, very itchy skin, edema and headaches.
A few months ago I suspected the autoimmune relationship, so off to my NEW doctor I went and got the anti-dna, complement C3 and ana blood tests, which all came back normal. So frustrating! My new doctor even checked my pth levels and ordered a scan for my thyroid…which was also “normal”.
So my question is… If there’s an obvious autoimmune relationship, why isn’t it showing up in my results?
Renee,
Thanks for sharing your story. I’m so glad this information has helped you to recover your health. That’s my purpose in doing this, so it’s wonderful to hear from folks like you.
In our province of Canterbury in New Zealand at a latitude of 43 degrees south, all of the population are deficient in Vitamin D at some time of the year and 50% of the population are deficient all of the time, including me. I’m on the same weekly dose as you but expect that I will need a maintenance dose of a similar level i.e. 50,000 i.u. a week or 7,000 i.u. a day. I’ve discussed with my menopause specialist when we should get my Vitamin D level retested and she and I have agreed that after 6 months on this dose, it will be a realistic time to find out what it has done to my abysmally low Vitamin D level which was around 13ng/ml or whatever unit is used in the USA. It started out at 30mmol/L in our units and I would like it to end up at around 80mmol/L as a minimum and 120mmol/L as an optimum.
Anyway, my main point is that beyond a certain latitude, Vitamin D deficiency is endemic in a population. Our cousins, the chimps get around their problem by nibbling on skin cells when they’re grooming their buddies/rellies in the troop!
I have to tell you that finding The Healthy Skeptic put me on the right path in finding the cause of my Hashimoto’s! By what you post here, I am sure that you are familiar w/ Dr Datis Kharrazian? You and he have put me on a road to recovery! Once I was diagnosed w/ Hashimoto’s I began my research finding you, then, Dr Kharrazians book. My doctor had no intention of testing me any further once he diagnosed me w/ the immune disease. He simply put me on Synthroid and sent me on my way. As I researched, I discovered that my symptoms [and I had just about every one] subsided during the summer. Mainly my hair loss! In reading Dr Kharrazians book I had the doctor test my vitamin D levels. Well, as I suspected, I AM deficient in the vitamin and now on 50,000 units 1 day a wk for 8 wks, then 1000 units a day after that. Now, the next step is to find out WHAT is causing my deficiency.
Thank you so much for your website and blog! And a quick note to your readers: TAKE CHARGE OF YOU OWN HEALTH! Listen to your gut! You know your body!! If you suspect something is wrong MAKE your doctor do the tests! Don’t settle for what your doctor “thinks” the problem is! And if your insurance won’t pay for it the testing, YOU PAY FOR IT! Your family and loved ones love you and need you healthy!!
TO HEALTH!!
Again, THANK YOU!!
The entire series can be found in the Special Reports section.
Here’s the link.
I just found this article while researching Hashimoto’s. Have you continued on this subject? I am in desperate need of more answers. Thank you.
Patricia,
The problem isn’t necessarily the tests you’re getting. It’s how they are interpreted. Watch this video to learn more about what I mean.
Also, remember that Hashimoto’s is an autoimmune disease affecting the thyroid. To treat it properly, the immune system must be addresses since it – not the thyroid gland – is the underlying cause of the problem. Unfortunately, the conventional model doesn’t recognize this even though it’s abundantly clear in the scientific literature that this is what’s happening.
You’re best bet is to find a functional medicine practitioner that understands these issues.
Could someone please help me by answering one question. I was diagnosed with Hashimotos over 7 years ago and have been taking synthroid since then. The usual thyroid blood test (T3 ) has been performed intermittently since that time (during physicals, or when I had symptoms that I thought might be related to Hashimotos) and it always comes back “normal” according to my PCP. I suffer from depression – am being treated with medication – but have been through an especially difficult 2 years. I have many symptoms right now that are present in both depression and hypothyroid disorders and it’s become necessary for me to figure out what exactly is wrong because I seem to be getting worse rather than better. It’s ression or thyroid related, since so many are identical. My hair is falling out and I’m gaining weight despite not eating. My question is this: is their another blood test that will give an accurate picture of what is going on with the Hashimotos and if it is the cause of my worsening condition? I keep reading that the standard blood tests (T3, T4) do not give the complete picture and that if symptoms are present more examination is needed. My doctor doesn’t seem to give this view any credence and I always feel like a hypochondriac when I bring it up. Should I forget the PCP and see an endocronologist? Is that the only way to get to answers that I need? Any advice that makes sense would be greatly appreciated.
an endocrinologist may not be any more enlightened than the jerk you’re currently seeing…. i wish you good luck in finding a better doctor — they’re few, but they’re out there.
I agree with the fact that some endocrinologists are still in the learning process
The immune attack in Hashimoto’s is focused on the thyroid gland, but many Hashi’s patients also have antibodies to other tissues. And of course the effects of Hashimoto’s are systemic – the entire body is affected.
ok so the RECEptors and thyroid hormone are what is throughout the body but not thryoid cells. Am I correct? In that case hashi’s would stay within the thryoid gland. Correct?
Yes. Thyroid cells are in the thyroid gland. Thyroid hormone is present throughout the body. Most cells have receptors for thyroid hormone. That’s how thyroid hormone regulates metabolism.
but thryoid cells are what allows all cell metaboloism. which means to me that thryoid cells are located throught the body in order for cell metabolism to take place. Am I wrong about thryoid cells and cell metabolism?
Thyroid “cells” aren’t located throughout the body. All cells do have receptor sites for thyroid hormone, though. That’s not the same thing.
However, a thyroidectomy is a bit like scraping chewing gum off the bottom of a shoe. They rarely remove the entire thyroid gland. It’s very close to other important structures in the throat so they have to be very careful.
This means that, yes, if you have Hashimoto’s, it’s entirely possible that your immune system will continue to attack what’s left of your thyroid gland. That’s why it’s so important to address the autoimmune component.
I had hashimotos thyroditis AND papillary thyroid cancer. I ahs a total thyroidectomy. My question is this: Since hashimotos attacks the thyroid cells and gland, is it not possible that even after a thyroidectomy, that the hashimotos could continue to attack thyroid cells in the wholw body since thyroid cells are found in the entire body? I worry about this because it makes logical sense that hashiotos would attacj thryroid cells where ever they are which is the entire body. Has anyone done a study of this? Is this even medically conceivable? Can you answer my question so that I can understand this better and not have anxiety over what else is happening in my body? Thank you for any help or guidance that you can probvide.
I’ve found your series on the thyroid very interesting. My question is that I was diagnosed with hypothyroidism 7 yrs. ago, but have never tested positive for the antibodies that would indicate it is caused by hashimoto’s. I’ve researched, but I can’t find a cause for the hypothyroidism. BTW, I was on Synthroid for a few years, then took myself off of it – never felt any different on or off. I just had bloodwork done – TSH was high at 8.9, Free T4 on the low end of normal at .98 (range of .82-1.77). New doctor recommends restarting synthroid, although they aren’t pushing it. But they did recommend an ultrasound of my thyroid, although she (nor any other past doc.) feels anything unusual upon exam. Do you have any insight for me as to what could be causing the hypothyroidism? I hate to treat without a real understanding of the cause. My symptoms are not severe – some fatigue,but not unusual, don’t like the cold.
Thank you!
I had a total thyroidectomy and was diagnosed with Hashimotos in june 2010. Since the thyroid was totally removed how does this affect the hashimotos? My doctors seem very content ordering Synthroid and testing TSH and T4. Doctor says will take about a year to get on right dose of Synthroid and thinks all symptoms will subside. Should I be on a gluten free diet? I am very bloated and cannot lose weight also have bad joint pain and pain in bottoms of feet. My blood sugar is also high but doctor feels it will go down once meds regulate. I am extremely tired all the time and have temperature fluctations with profuse sweating.
Removing the thyroid gland is somewhat akin to removing chewing gum from a shoe. It’s nearly impossible to remove the whole gland, because it is so close to the trachea / voice box and other important anatomical structures. What this means is that, if you have Hashimoto’s, autoimmune attacks on the thyroid can persist even after thyroidectomy. Therefore all of the information in these articles still applies to you.
Hello:
Thank you very much for your research and insight. I have been told I had a large thyroid since I was a teenager, I’m 35 now. After many, many, many years of frustration and doctors who just kept blaming things on depression–the number go-to diagnosis when doctors can’t figure things out– I was diagnosed with thyroid cancer at age 30. When my thyroid, lymph nodes, and 10 large tumors the size of golf balls were removed, I had to have radiation treatment to kill off my thyroid. It has taken me years to find the right Endocrinologist, just last February 2013, that told me I had Hashimoto’s disease. Let me tell you I fit all of the symptoms of Hashimoto’s disease, down to my feet, hands, joints and unbelievable long menstrual cycles, which began in 2009.
I was so happy that I had a name for my symptoms, and when my doctor finally gave me a higher Synthroid, something I had been fighting for, for a long time, I thought okay my symptoms will be gone now, right? No, not exactly. Although I do slightly better with the increased Synthroid I am still having problems. Again, I was told it’s depression. Let me just say, I’ve felt depression before, especially on my long menstrual cycles. It’s like everything is bland, or unexciting. There’s always something wrong and dissatisfying–SNL’s Debbie Downer for sure. However, my symptoms and mood were more related to frustration with my health. Anyway, I thought they would go away with the increase in of Synthroid but they haven’t.
After reading your blog I’m wondering if I still have Hashimoto’s disease even though my thyroid is gone and it was zapped with radiation because I am still feeling most of the symptoms.
As someone who was diag. about 2 years ago with hpothyroidism, I take synthroid daily. Would I do better on the Armour? I am a nurse, but never see it ordered, always the synthroid.
There are several factors that determine which thyroid hormone is best for each person. I’ll be writing about them in a future article.