Hashimoto’s autoimmune thyroiditis is a very common condition of low thyroid hormone function. Treatment by a mainstream physician will be very different than by a functional (integrative) medicine physician. You deserve to know about both.

What is Hashimoto’s Thyroiditis?

Dr. Hakaru Hashimoto first described it in 1912. It is thyroid gland inflammation. Another name is chronic lymphocytic thyroiditis. Hashimoto's thyroiditis is an adult disease, reportedly 5-10 times more common in women than in men.

Initially, something stimulates the thyroid gland to over-produce thyroid hormones (a hyperthyroid state). Then over time, this inflammation blocks the thyroid gland from producing enough hormone, resulting in low thyroid function (hypothyroidism).

Here is a little more on how this works. As you may know, blood tests show elevated antibodies that block the function of target thyroid-specific proteins such as thyroperoxidase and thyroglobulin. These antibodies develop because T lymphocytes, a type of white blood cell involved in inflammation, invade the thyroid gland to cause silent, painless inflammation. This inflammation gradually destroys the thyroid tissue so that ultimately there is little to no thyroid hormone being produced. This hypothyroid person then experiences the symptoms of low thyroid function.

The basic symptoms of low thyroid function may include:

• Sensitivity to cold; hands and feet often cold

• Feeling tired in the daytime when sitting or at rest

• Unwanted weight gain; morning puffy face/swollen eyelids; water retention

• Constipation, abdominal bloating, or colitis symptoms

• High blood cholesterol; high blood pressure

• Memory/concentration impairment; often confused, depressed, or early dementia

• Depressed mood or anxiety upon waking

• Dry or slow-growing hair or nails/excessive hair loss; acne, eczema, psoriasis

• Hoarse voice, slowed speech

• Stiff or painful joints; rheumatoid or osteoarthritis; carpal tunnel syndrome

• Endometriosis, infertility, menstrual disorders, or abnormal uterine bleeding

• Frequent colds, sore throats, ear aches, or other infections
   

Contrasting views and treatments

Now let me point out the treatment approach for Hashimoto’s thyroiditis by mainstream medicine. The following are statements from typically published[1] mainstream medicine articles regarding Hashimoto’s. The italicized phrases below are generally not correct. They contrast greatly with the functional medicine treatments that I’ll present in my next article.

1. The underlying cause[s] of the autoimmune process remains unknown.

2. Treatment with synthetic hormone medications is usually effective.

3. Treatment options for Hashimoto's thyroiditis are oral thyroid hormones to maintain normal thyroid hormone levels.

4. The most useful assay for determining thyroid status is measurement of TSH [thyroid stimulating hormone] in the blood.

5. The underlying cause of the autoimmune process remains unknown.

6. People with Hashimoto's thyroiditis do not need to follow a special diet. There is no evidence to suggest that specific foods have any effect on worsening or improving the condition.

7. The treatment of choice for Hashimoto's thyroiditis is typically synthetic T4 or thyroxine (levothyroxine). The medication must be taken indefinitely, and successful treatment alleviates the symptoms and signs of hypothyroidism. There is no scientific evidence that natural treatments are able to reverse hypothyroidism.

8. The dosage of levothyroxine may need to be modified after checking TSH levels once yearly.

9. Specific blood tests determine the level of thyroid function.

According to new data from a prominent group of endocrinologists from Belgium, low thyroid hormone function is estimated to affect nearly 50 percent of adults,[2] and cannot be detected by lab testing alone. In fact, I have found that these blood tests (TSH, T3, T4) do measure thyroid hormones circulating in your blood, but often do not measure how well your thyroid hormones work in your thyroid-sensitive tissues (i.e. their function). Ever heard of insulin resistance? One of the effective treatments for insulin resistance of type 2 diabetes is in fact, insulin injections!

I am excited to share with you the functional/integrative medicine approach to managing and treating Hashimoto’s thyroiditis in my next article.

To feel well,

Michael Cutler, M.D.

[1] https://www.medicinenet.com/hashimotos_thyroiditis/article.htm#what_tests_diagnose_hashimotos_thyroiditis

[2] Barnes, Broda O: Solved: The Riddle of Heart Attacks, Robinson Press, Fort Collins, CO, 1976.