Hashimoto's Thyroiditis FAQs

Hashimoto’s thyroiditis is the most common form of thyroiditis—a condition characterized by inflammation of the thyroid gland. It is also the most common thyroid disorder in America. (1) Hashimoto’s is an autoimmune condition that affects the thyroid. That means it is caused by a malfunction in your immune system. Instead of protecting your thyroid tissue, your immune cells attack it. For more information, visit our Hashimoto’s Thyroiditis: Thyroid Treatment Success Secret #2 blog post.

Because Hashimoto’s disease is an autoimmune disorder, the cause involves production of abnormal antibodies. A blood test may confirm the presence of antibodies against thyroid peroxidase (TPO antibodies), an enzyme normally found in the thyroid gland that plays an important role in the production of thyroid hormones. But the TPO antibody test isn’t positive in everyone with Hashimoto’s thyroiditis. Many people have TPO antibodies present, but don’t have a goiter, hypothyroidism, or other problems. (2) For more information, visit our TPO and TGB Antibody Testing blog post.

The conventional answer to this question is that no one knows. But in Functional Medicine, we understand that a multitude of factors can lead to an autoimmune problem. Some things that can cause the immune system to become dysfunctional include, dysbiosis of the intestinal tract and leaky gut, molds, fungus, yeast and pathogenic bacterial overwhelm, food allergies and food sensitivities, blood sugar dysregulation, poor functioning detoxification systems, and genetic predisposition, just to name a few. Any one or a combination of these factors can stress the immune system to the point that an autoimmune condition develops. For more information, visit our What Causes Hashimoto’s Thyroiditis? blog post.

The conventional answer again is no. With a Functional Medicine approach, it is not uncommon for the symptoms of Hashimoto’s to go into remission. I would call this reversing the condition. And antibodies may even return to baseline. The treatment with Functional Medicine is lifestyle changes and if the patient goes back to the old lifestyle, the condition will return. For that reason, we consider this remission and not a cure. For more information, visit our Graves’ and Hashimoto’s: Can the Autoimmune Response be Eliminated? blog post.

In conventional treatment the answer is yes. In a Functional Model it is possible to restore function and no longer need medication. Many factors determine if someone is able to get off medication. For some, the thyroid will not regain normal function due to the years of damage before finding a Functional Doctor. But by restoring function to the supporting process around thyroid function, many people find they need less medication and the medication they do take is more effective. For more information, visit our Hashimoto’s Hypothyroidism: Why Do I Have to Continually Increase My Hormone Dose? blog post.

The thyroid controls many metabolic functions. When the thyroid is slow or hypothyroid, then the muscles of the digestive tract slow down and the stool moves through the digestive tract too slowly, resulting in constipation. For more information, visit our Gut Function: Thyroid Treatment Success Secret #19 blog post.

The connection between T4 and TSH levels and sexual dysfunction is well established. Other hormones are triggered by the low TSH and this might be the cause of sexual function problems: (3) 1. Underactive thyroid can cause hyperprolactinemia, a condition of elevated hormone prolactin — in this case, symptoms are reduced sex drive, breast pain, painful intercourse, and vaginal dryness (4). 2. Changing levels of SHBG (sex hormone binding globulin), which interfere with the estrogen-testosterone-progesterone balance (5). 3. Changes in blood vessel and nerve sensitivity caused by low levels of thyroid hormones (6). For more information, visit our Prolactin and TSH blog post.

There are several mechanisms by which an underactive thyroid can make periods heavier: (7) Without sufficient thyroid hormone, your ovaries may not be able to make enough of the flow-decreasing hormone progesterone (8). Without sufficient thyroid hormone, you may not make enough of the coagulation factors you need to prevent heavy bleeding (9, 10). Without sufficient thyroid hormone, you make less of the estrogen-binding protein SHBG and so are exposed to more estrogen (11, 5). For more information, visit our What are the Symptoms of Hypothyroid in Women? blog post.

Thinning hair is associated with low thyroid function, particularly T3. If you are on thyroid medication, you might be getting T4 but not converting it to T3. With Functional Medicine we work to understand the mechanism that is preventing the T4 to convert to T3. Also, since Functional Medicine is looking at the whole body, we might identify some other contributing factors for thinning hair like nutrient deficiency and imbalances. For more information, visit our What are the Symptoms of Hypothyroid in Women? blog post.

Hypothyroidism increases water retention. Water retention occurs when excess fluids accumulate in the body. It takes place in the circulatory system or within tissues and cavities. Various factors can contribute to water retention, and hypothyroidism is one of them. Hypothyroidism leads to weight gain and changes in body composition. But not the whole weight gain is due to the buildup of fat. Weight gain in hypothyroidism is a complex process, and most of the extra pounds that people put on are due to excessive buildup of water and salt[vi] i.e., fluid retention. Therefore, due to the fact that hypothyroidism causes water retention, patients will notice swelling in their face. Besides facial swelling, people with hypothyroidism may also notice swelling in their hands, wrists, legs, ankles, and feet. Why hypothyroidism causes water retention, you’re probably wondering. It all comes down to the role of thyroid hormones in metabolism. Thyroid hormones regulate metabolic rate. In hypothyroidism, the gland produces lower levels of thyroid hormones, and as a result, the metabolic rate slows down. This causes a chain of reactions that also makes the body hang on to water and salt. The amount of water the body retains depends on the severity of the condition. For example, the more severe hypothyroidism, the more water you retain, the more weight you gain, and facial swelling becomes more noticeable (12).

Hashimoto’s thyroiditis is associated with a degrease in cognitive function. This is referred to as brain fog. Forgetfulness, inability to concentrate as well as anxiety, depression and lack of motivation. Some studies point to the autoimmunity as being the main factor and some point to the cascade of hormonal changes associates with hypothyroidism. In Functional Medicine, we know that multiple factors need to be addressed to not only improve the immune system but also many other systems can be affecting the brain function. Taking a comprehensive approach results in greater outcomes for patients with thyroid related brain fog and memory loss. For more information, visit our What are the Symptoms of Hypothyroid in Women? blog post.

Since your thyroid is the master control of your metabolism, weight gain is often a major concern for patients with Hashimoto’s. A slow metabolism, fluid retention, and all the hormonal changes associates with thyroid problems make it difficult to keep the weight off. Some people find that even after starting thyroid medication and getting their thyroid stimulating hormone (TSH) back into the normal ranges does not improve their ability to manage their weight. By looking at all the factors that lead to the development of Hashimoto’s in the first place using a Functional Medicine model, we are able to not only restore function to the thyroid but address other imbalance that are contributing to the weight gain.