If you are reading this blog than you probably suspect you have, or were diagnosed with, Hashimoto's Thyroiditis. You are likely looking for answers because you can't figure out why you feel so bad. Hopefully, this blog offers you some answers that give you hope that treatment is accessible, and that your symptoms can be managed, thyroid blood work numbers can be improved (even the autoimmune markers!) and you can get your life back!
Patients often seek treatment for one of two reasons. Firstly, they are currently being treated with a thyroid medication but still feel terrible with worsening symptoms of anxiety, sleep problems, brain fog, constipation, acid re-flux, sweating, weight gain, fatigue, racing heart, the list goes on and on. The patient can't figure out why they have worsening thyroid symptoms but their primary care tells them their labs are normal and their thyroid looks fine. Most of these patients have had their thyroid medication dose adjusted multiple times but still don't feel well, or only have a slight reprieve in symptoms. These patients have only had their low functioning thyroid identified, yet no identification of a potentially lingering autoimmune disease called Hashimoto's Thyroiditis.
The second scenario we often encounter occurs once a patient has already been diagnosed with thyroid autoimmunity and low functioning thyroid (aka Hashimoto's). Both their immune system and the functioning of their thyroid gland continues to decrease as the autoimmune disease progresses. These patients have been prescribed thyroid medication for low functioning thyroid and are told that they are being treated effectively. Not a single mention of the immune system is typical for patient education in these cases. As their symptoms progress patients will experience racing heart, anxiety and sleepless nights. That is because they are only being treated for the symptoms of the Hashimoto's, but most likely very little attention is being paid to what could be causing the immune system dysregulation in the first place.
So, no matter which category you are in, if you just have low functioning thyroid or if you have autoimmunity along with your thyroid issue (aka Hashimoto's) the treatment is exactly the same! Does this seem odd? Both of these conditions will continue to progress without a little education on what could be causing the thyroid, and immune issues to begin with. The lack of answers and treatment options become incredibly frustrating for most patients. A lot of these patients eventually seek us out hoping to find answers to the why, yet they are beaten down, sick and frustrated all the same.
Some staggering statistics:
Did you know that Hashimoto's can be found in 13.4 to 38 percent of the population. Synthetic thyroid hormones have begun to top the pharmaceutical top-seller list for the last 3 years. With statistics this high, it makes great sense that something more is going on inside our bodies, in our environment, or in our lifestyle to cause these statistics!
Since this problem is so common, you would think modern medicine would be better at diagnosing it. Yet, the unfortunate story is that many people, especially women, live with either underdiagnosed overactive or underactive thyroid function. Often, these same people have been diagnosed but subsequently improperly treated. For example, in a December 2010 survey out of the United Kingdom, 1,037 people being treated for hypothyroid consented to having their hormone levels rechecked - about 37.2% of them were taking incorrect hormone dosages; 19.8% too much hormone and 17.4% too little. Why is this important? The mismanagement of this condition, or the improper diagnosis, is going to end up making the patient feel worse, not better. If they are prescribed too much thyroid medication they can end up with inability to sleep, anxiety, panic attacks, sweating, hearing voices, heart palpitations, and an increase in resting pulse rate. If they are taking too little they generally end up continuing to feel all of the original symptoms they felt before, like being sluggish, gaining weight, constipation, temperature dysregulation, acid reflux, etc. What if we told you that the bottom line is that it isn't just a low functioning thyroid causing the problems but an autoimmune condition?
The number one question I get asked when we find TPO antibodies on lab work is, what is Hashimoto's? Hashimoto's unfortunately, is a condition wherein the immune system begins attacking the thyroid gland, as if it were an outside pathogen needing to be addressed, instead of just another body system. These constant immune attacks eventually render the thyroid gland unable to perform its functions and ultimately leaves it unable to produce the hormones the body needs.
So the first question to be posed should be:
Where exactly is the patient on the spectrum? Do you they have hypothyroid, Hashimoto's, or both?
The conventional medical treatment for hypothyroid, or simultaneous hypothyroid and Hashimoto's, is generally synthetic hormones. We've heard of all sorts of interesting treatments for Hashimoto's over the years within mainstream medicine. One of the most jaw-dropping treatments for the management of Hashimoto's was, "drink a lot of water." In our years of treating thyroid conditions, we've never had a patient tell us they drank enough water to suddenly cure their chronic autoimmune condition! It is incredibly frustrating to see just how sick patients are, along with the lack of answers they've received, (even with a diagnosis), and despite hormone treatment, they still feel terrible.
We say all of this because it is important to find anything that could be causing the immune system dysregulation. During an initial appointment it is so important to ask about past viral infections, previous living situations, past travel, past chemical exposure, etc. In our experience the patient has encountered something that could have dysregulated their immune system. When we run lab tests dormant viral infections will more often than not come back positive. On their CBC (complete blood count) we will see changes to white blood cells, lymphocytes, neutrophils and increased inflammation. Some of this blood work is off pathologically which means they are outside of the standard laboratory reference range and it was flagged, or it is only outside of the functional laboratory range, which is generally not flagged. When additional labs are run, you will surely find a chronic infection that as been laying latent in the immune system. I find this always to be the case with Hashimoto's patients.
So what causes the immune system to attack your thyroid?
One of the main chronic viruses we see in our Hashimoto's cases is an old Epstein Barr infection. EBV is also known as Mononucleosis. EBV is part of the Herpes family. These types of infections are opportunistic, which means they lay dormant for years until someone experiences a life event that compromises their immune system. Lo and behold, that old virus rises up and creates havoc on the system. A common finding is a patient will be in a car accident, go through menopause, or a divorce, or similar stressful life event for example, and suddenly their health plummets. Another unfortunate issue we see in practice, is sometimes these viruses can be managed with antiviral herbs. What we find more often than not, is the herbs suppress the virus, but they do not eliminate it. Then, when cold and flu season arrives they end up with the same upper respiratory infection they always come down with, or their reoccurring sinus infection comes back. This is most likely their weak area where some pathogens are already harboring.
Essentially, what happens is viruses, bacteria, and yeast overgrowth can create biofilms. Biofilms are a protective barrier around pathogens that keep them protected from antivirals, antibiotics, and antifungals. These pathogens are left active in the body even after a course of antifungal, antibiotic or antiviral medications. This goes for both mainstream medical and alternative treatments. Unless the practitioner is directly targeting the biofilms first, then the pathogen inside them, odds are good that they will continue to have biofilms around the infection (whatever infection that might be). Those biofilms consistently create issues for your immune system. In every last one of our chronic cases, from Hashimoto's to Addison's disease, all of these patients have experienced Mononucleosis (Epstein Barr virus) or another unexplained infection, that was never diagnosed but they recount being "pretty sick" at some point in their history. These patients also generally have parasites, yeast overgrowth, SIBO, Helicobacter pylori (H.pylori) infections, and/or a combination of all 3, which is not uncommon. Most of the patients all also have a chronic viral infection, like EBV.
Are you beginning to understand how all of these issues could weaken the body over time leading to immune system confusion?
To make things worse, we factor in all of the chemicals we are exposed to every 7 days (estimated over 80,000 each week). A large portion of these chemicals have not been studied for effects to the human body or its systems. A lot of the chemicals that have been studied are identified as "endocrine disruptors." An endocrine disruptor is something that can adversely affect your hormones. Some of these chemicals also have a high likelihood of causing cancer. Did you know most tap water has detectable levels of chemicals known to cause cancer? You can check your zip code here. Many of the chemicals that we are exposed to can be found on www.ewg.org. You can look up many of the products you use to clean your home, put on your skin or in processed food. The Environmental Working Group's website is a great source of information to help people make better informed decisions about the chemical exposure they can control in their homes, in their food and personal care items. You can view what types of things could be weakening the immune system (potentially carcinogenic), dysregulating hormones (endocrine disruptors), or causing unnecessary stress on your liver from their site.
Possible dietary contribution to Hashimoto's:
The foods we eat play an important role in modulating the level of inflammation in our bodies and it helps keep our autoimmunity at bay or from worsening.
We will have another blog soon that covers food sensitivities, specifically. That said, in order to determine food sensitivities we will have patients commit to an elimination diet or we will run a Cyrex Labs food sensitivity panel found here. Most patients have been through food allergy testing previously, which is different than food sensitivity testing. A food allergy can be a life threatening histamine reaction and is much further down the spectrum than food sensitivity. If you have a food allergy, you must avoid that food at all costs. A food sensitivity can be very unpleasant and can cause the patient much harm, but they are generally less dramatic than an allergy and are technically different.
Food sensitivities create unnecessary inflammation in your system and cause the body to be inflamed. Because food sensitivities create an immune response, it is possible that repeated exposure to that item can eventually turn into an allergy. To add to the confusion a bit there are also foods that cross react to each other.
Let's say for example you have an allergy to wheat or even a sensitivity. You avoid wheat because you feel bad when you eat it, mood changes, etc. You tend towards gluten-free products or eating additional rice. Suddenly, you start to feel bad on your new diet. Certain foods can cross react to wheat in both food sensitivities and food allergies. Meaning, your body begins to develop a sensitivity to rice or tapioca. The body is now having an immune system reaction to other products or cross reacting to other types of grains. If we can't figure it out on an elimination diet, we use the Cyrex Array 4 to determine what other foods could be causing issues or progressing the autoimmune disease. Knowing what is a food sensitivity helps us craft a diet for optimal eating for the patient to reduce inflammation and decrease the immune system flares in the body. Food we eat that we are sensitive to causes and immune reaction. An immune reaction is going to progress a disease like Hashimoto's or any other autoimmune disease.
We hope this blog gives you some good ideas of what could be at the root cause of creating autoimmune flares and progressing autoimmune diseases like Hashimoto's.
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