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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My 5 year old daughter has just been diagnosed by her pediatrician that her auto immune system has killed off her thyroid. She is now taking medication daily and I am looking to gain a better understanding of what is going on. I have asked the doctors hundreds of questions and the only responses that I seem to get are that now she is taking the meds, she will be fine.
I was quite satisfied with these answers but after looking online, I am now quite scared (infertility, anxiety, depression etc).
What should I be doing to help her other than the medication her specialists have prescribed? She is a very intelligent girl but since her diagnosis, I have noticed a very distinct change in behavior. Being so young, I definitely do not want to see her spiral out of control before she even reaches puberty!
Is it a good or a bad thing that we have diagnosed her so young? The reports I have been reading have really got me scared for her, but I am not really sure what I should be doing from here?
Any advice would be helpful. Thanks..
I just switched from Armour to Naturthroid when I found out that Armour has gluten in it. The pharmacist said they cannnot keep track of these companies since they change the formula at random. Is this true and if so, how can we be safe?
Hi all. I am a newcomer to this site and will give you a bit of my history. Diagnosed with UCTD 5 years ago. Hypothyroid 6months ago and just diagnosed with Hashimotos. Have the usual symptoms …. tired, alopecia, raynauds, high cholesterol, blood pressure, weight gain etc. Have just commenced on Armour (having taken Eltroxin for 6months with no improvement in energy levels). My question is… Does Hashimotos come before Hypothyroidism???
When does Chris Kresser ever answer any of these questions. I wrote over a year ago..no answer…any place we can go to find some help from Chris Kresser? Thank yo!
Hi!
Blood type A says do not eat meat especially red meat then vegetarian diet is also not good for hypothyroid disorders. I eat fish but eating fish almost for everyday makes me wonder about mercury issue. I actually don’t know what to eat exactly:(. but I love coconut oil.
I would love to know if there is any way to reduce a goiter. Any thoughts before I give in to surgery?
Good luck bc it’s a long road….Definitely find you an ENT or GP that believes you. I got my ENT to believe that I was having almost all the symptoms(which I was) and it ran in my family distantly which I didn’t even know st the time. I told him my lab work over 10 years had always looked normal, and asked if there is a chance that it could be wrong?! He said an ultrasound of my thyroid would show him definitive answers and if that came up positive then a antibodies test for Hashimoto’s disease would be the next step. I had the symptoms for 10 years and endured horrible symptoms and it made me miserable. I felt bi-polar (extremely moody), lost tons of hair, had dry skin, my thought would swell up & hurt occasionally, etc… I had nodgules on my thyroid, am extremely big thyroid, etc… from the disease. I now see an Endocrynologist and have been finally been properly diagnosed after 10 years of hell. The doctors started thinking I was crazy, but I stuck to my guns and went with my gut. Eventually it paid off lol. I went so long in diagnosed though after a year of treatment I still have many problems and permanent/irreversible damage… Is what I believe. It affected my back and lead to many other problems like Fibromyalgia that I have severe pain all over my body all the time. And have had rods and screws put in my back also bc of these doctors not believing me.
Im 24 yrs old and was diagnosed with hypothyroidism one year ago but never took the medicine for the thyroid. Until one month ago I started taking armor thyroid 30mg.
But came a cross a big problem Im having sexual problems and can seem to get an erection or think about sex i dont know what to do or what test should I get done to help this problem im having?? Any help is highly appreciate thanks in advance.
I have been diagnosed with Hashimotos disease & am currently seeing a endocrinologist. She has done ever test imaginable & have been on meds. Levels for thyroid are in range but I am still extremely fatigued, bowl problems, & all the other symptoms that are associated with this autoimmune disease. My life has dramatically been affected by this disease. I had to quit my job as an aerobics teacher for 15 yrs. now I don’t even have the energy to exercise. Weight gain is off the charts. Depression is another big issue & life just sucks! I have been doing more research on this disease & have seen a lot of information on changing eating habits. Yesterday I started eating an autoimmune diet, but still trying to educate myself. I ran across your site & am asking for any advise you can give me. Thank you.
Hi,
I was diagnosed with Hashimotos in 2009 and
I was getting the same symptoms as you and started a gluten-free diet and since then most of these problems have disappeared and I have much more energy. It doesn’t work for everyone but you could try it alongside your present diet to see, though maybe your autoimmune diet already restricts gluten?
Can you please help me understand why, after removing half my thyroid 14 years ago and being diagnosed with Hashimoto, that I now also have Graves disease. I was told back then, I would be on thyroid hormone for the rest of my life, and now, my dose is so small, that the next step is to just go off of it. I’m very confused as to how I can have antibodies for both diseases. My levels have been pretty steady up until this last year, and they started lowering the dose. I’m getting worried that its not heading in a good direction,
I was diagnosed with Hashi hypothyroid in 2009 and also Graves disease because I have what they called ‘hot nodules’, areas that are hyperthyroid, mostly I am hypo but sometimes the hyper has the upper hand so I get hot flushes and other hyper symptoms.Normally I take thyroxin but if I get the hyper symptoms I reduce the dose or stop it altogether for a few days till I feel better. The specialist explained that the two coditions are fighting each other so we don’t know which will win out in the end, every so often I have tests to check how things are going, really I’m hopeful that maybe the two will settle down and my thyroid will return to normal eventually but maybe I will just have to put up with this forever.
Hi,
My son is 11 years old but look like 8 years old as he diagnosed hypothyroid (primary level) 2 years back. He is taking thyroxin 100mcg at this stage. Most of the time he doesn’t feel well. i am worried about his poor growth.. Please suggest me what another tests i have to go for him to improve his health and growth..also recommend me diets as well.. Should i send him to the gym or let him participate in regular physical activities (football, tennis, ice-hockey, swimming etc).
Surprise from Celiac Disease
Study of a potentially fatal food-triggered disease has uncovered a process that may contribute to many autoimmune disorders.
Scientific American
August 2009
By Allesio Fasano professor of pediatrics, medicine and physiology and director of the Mucosal Biology Research Center and Center for Celiac Research at the University of Maryland School of Medicine
“For years CD (celiac disease) was considered a rare disease outside of Europe. In North America, for example, classic symptoms were recognized in fewer than one in 10,000 people. In 2003, we published the results of our study – the largest hunt for people with CD ever conducted in a North America, involving more than 13,000 people. Astoundingly, we found that one in 133 apparently healthy subjects was affected, meaning the disease was nearly 100 times more common than had been thought. Work by others researchers has confirmed similar levels in many countries, with no continent spared.
How did 99 percent of cases escape detection for so long? The classical outward signs – persistent indigestion and chronic diarrhea – appear only when large and crucial sections of the intestine are damaged. If a small segment of the intestine is dysfunctional or if inflammation is fairly mild, symptoms may be less dramatic or atypical.
It is also now clear that CD often manifests in a previously unappreciated spectrum of symptoms driven by local disruptions of nutrient absorption from the intestine. Disruption of iron absorption, for example, can cause anemia, and poor folate uptake can lead to a variety of neurological problems. By robbing the body of particular nutrients, CD can thus produce such symptoms as osteoporosis, joint pain, chronic fatigue, SHORT STATURE, epilepsy, dementia, schizophrenia and seizure.
Because CD often presents in an atypical fashion, many cases still go undianosed. This new ability to recognize the disease in all its forms at an early stage allows gluten to be removed from the diet before more serious complications develop.”
Ben..
I was just recently diagnosed with gluten sensitivity (blood test) and autoimmune thyroid disease (Hashimotos). So far other book resources I’ve found informative are Dangerous Grains (authors?) and Grain Brain by Dr. David Perlmutter (neurologist).
I’m currently working with a functional medicine practitioner to help identify other autoimmune triggers. Gluten sensitivity or celiac disease most often coexists with other food sensitivities. This involves an elimination diet and then adding foods back in one at a time. No easy task. Plus all the blood, saliva (hormone) and stool sample testing in beginning then in 3 months all over again to monitor progression.
I feel positive for your son as he has a great advocate in you. Plus he has many years before he gets to my age 47 to get to the root cause of his issues. I played sports in middle school, but unfortunately not in high school cause I slept through most of it. Surprise surprise. My cousin (47 male) had same issue as your son and took growth hormone. Doubt he was ever tested for gluten sensitivity/celiac. To this day he suffers from IBS as does his other 3 siblings. I believe it’s all connected (families). He did participate in sports and does to this day and is very athletic.
Good luck in your journey. I believe your son has a bright future.
Hi Chris, I have a question. Your link in the sentence starting with “Studies show that 90% of people with hypothyroidism are producing antibodies to thyroid tissue” does not actually take me to any studies but to an article stub of which I can’t read the rest due to a paywall. The article does not actually cite any studies either. It doesn’t even say that 90 % of hypothyroid patients have antibodies to thyroid tissue, it says that “An autoimmune cause accounts for approximately 90% of adult hypothyroidism”, which is not the same thing. I for one have Ulcerative Colitis and I do have hypothyroidism, but no antibodies to thyroid tissue have ever been detected. Now, I know that you think this doesn’t prove that I don’t have Hashimoto’s and maybe it doesn’t, but the thing is that my main problem seems to be in the conversion of T4 to T3. The one sort-of capable endocrinologist I ended up finding after scouring the internet (and after lots of arguing with my former doctor) seems to think that the body intentionally cuts down on the conversion of T4 to T3 (leading to increased production of rT3) when there are certain systemic problems present such as inflammation in the gut. He said it was sort of like taking the foot off the gas pedal to prevent the engine from overheating while you’re going uphill. I think there is merit to that idea. I’m now on naturally desiccated thyroid (50µg T4 and 14µg T3) and while my TSH has plummeted and the fT3 has gone up, the fT4 has actually gone down. It seems like my brain is telling the thyroid to do anything to *prevent* the level of hormones in my blood to rise above a certain level. So basically what I’m saying is that while my hypothyroidism might be caused by my autoimmune disease, I don’t actually think it is Hashimoto’s and I don’t think the article says that either. I would still like to see those studies though.
When does Chris answer our questions?
Hi, I started reading your book yesterday, and am wanting to start my 30day reset. The problem is, I can’t figure out if my hypothyroidism (not hashimotos) is an autoimmune form, as stated in the book. I have plain old hypothyroidism.
After being diagnosed with hypothyroidism 17 years ago I was sent to endocrinologist who tested me for hashimoto’s and test said I had it. However was recently tested and doctor says I don’t have it. Is it possible for this to happen? I have been treated with synthroid then changed to armour then back to t4 and t3 combo.
Unless the first diagnosis was misdiagnosed, then i can’t see how this is possible.
Either you have the Genetic Mutation which causes your Immune System / Antibodies to attack your Thyroid and slowly destroy it, or you don’t.
Various lifestyle factors can make this worse, but i would say it is unlikely that the disease would just disappear if you have it. It will likely continue to slowly scar your thyroid again. Thyroid destroying Antibodies should be present in your blood samples.
Hi, I have hypothyroidism, osteoporosis, sponyliolesthesis (decompression and fusion on L5) spinal stenosis, bowel prolapse (bowel resection), bladder prolapse (2 bladder repairs) silent sinus syndrome, depression, memory loss, early menopause (38). Could all of this be related to my immune system? I’m just wondering why all the health problems. I’m 52. I’m. On Synthroid, Fosovance, Wellbutrin. Thanks.
Michele
Dr. Chris,
What are your thoughts on human trial results recently released re
‘Anatabine supplementation decreases thyroglobulin antibodies in patients with chronic lymphocytic autoimmune (Hashimoto’s) thyroiditis: A randomized controlled clinical trial’
Objective: The effects of anatabine in patients with Hashimoto’s thyroiditis.
Results: Anatabine treated patients had a significant reduction in absolute serum TgAb levels from baseline by study end relative to those on placebo (p=0.027); however, there were no significant changes or differences in treatment group means for TPOAb or TgAb. Mean (±SD) TgAb values decreased by 46.2 (±101.1) and 3.9 (±83.9) WHO units for the anatabine and placebo groups, respectively. Significantly more patients had a >20% drop in TgAb in the anatabine than placebo group (p=0.023). Overall the anatabine supplement was safe and well tolerated, although significantly (p<0.05) more patients in the anatabine group reported AEs.
Conclusions: These results demonstrate an immunological effect of anatabine on TgAb levels. Further studies are warranted to dissect longer-term effects and possible actions of anatabine on the course of Hashimoto’s thyroiditis.
http://jcem.endojournals.org/content/early/2013/10/31/jc.2013-2951.abstract?papetoc
Dr. Chris,
The condition of my sister with a toxic thyroid goiter really bothered me so much.
Please educate me her sickness so that I know where to start.
Thank you!
Loving this site. Very informative. Does anyone have info on being thyroid hormone replacement resistant. I had the iodin ablation done 15 years ago been to the highest dose of of meds three diffrent times three different doctors. All three say I’m replacement resistant. Im 36 and feel and act like I’m in my 80s. I do have a vitamin b12 shot once a month and take iron and vitimin c.im left feeling hopeless. That I’ll ever feel good. And afraid of loseing my mind.
If hypothyroid condition caused by an autoimmune reaction , is it possible to test the person for the specific cause of the autoimmune disease, perhaps specific antibodies present, in order to avoid something in future ? Also if it’s been an autoimmune response does it become permanent with a gradual worsening as the response antibody continues to attack affected area, or other areas, or can you minimise or reverse condition by omitting cause, if it was identified. Finally can stress cause an autoimmune response severe enough to trigger hypothyroidism ?? Lots of questions but I would appreciate a medical response, can you tell I’m newly diagnosed and desperate to minimise condition ???