Everything You Need to Know About Hypothyroidism and Hashimoto's Thyroid Disease
Lack of energy and tiredness is one of the early signs of hypothyroidism.
Thyroid disease is a common health concern affecting millions worldwide, with hypothyroidism being one of the most prevalent forms. It is often associated with autoimmune diseases, notably Hashimoto's thyroiditis. Understanding these conditions is vital for anyone experiencing symptoms or seeking better health outcomes. In this article, I’m going to explore the intricacies of hypothyroidism, its signs, causes, and how it relates to Hashimoto's disease. I’m also going to address the important question: can hypothyroidism be cured?
What is Hypothyroidism?
Hypothyroidism occurs when the thyroid gland fails to produce adequate amounts of thyroid hormones. These are hormones crucial for regulating metabolism, energy production, and overall bodily functions. The thyroid, a butterfly-shaped gland located at the base of the neck, plays a key role in maintaining metabolic homeostasis. When functioning optimally, it releases hormones such as thyroxine (T4) and triiodothyronine (T3) into the bloodstream. These hormones influence nearly every cell in the body, affecting processes from heart rate to temperature regulation. This is why hypothyroidism affects every aspect of your life and health - because you need energy for everything you do!
It can arise from various factors, including iodine deficiency, certain medications, and autoimmune diseases. While hypothyroidism can affect individuals of all ages, it is more common in women and older adults. In fact, your age is actually the greatest risk factor for developing hypothyroidism.
What Are the Signs of Hypothyroidism?
Recognising the signs of hypothyroidism is crucial for early diagnosis and treatment. Symptoms may vary in severity and can develop gradually. Some common signs include:
Fatigue and Weakness: A pervasive sense of tiredness, even after adequate sleep, is often reported.
Weight Gain: Unexplained weight gain may occur despite no significant changes in diet or exercise habits.
Cold Intolerance: Individuals may feel unusually cold and have difficulty warming up.
Dry Skin and Hair: Skin may become dry, rough, and flaky, while hair may become brittle and fall out.
Depression and Mood Changes: Mood swings, depression, and cognitive impairment, including memory issues, can also arise (Biondi & Palmieri, 2011; Pizzorno et al., 2016).
Constipation: Slowed metabolism can lead to digestive issues, such as constipation.
Menstrual Irregularities: Women may experience heavier or irregular menstrual cycles.
If you experience several of these symptoms, it's well worth asking your doctor or other primary care provider to run a full thyroid panel (discussed in more detail below).
What is the Cause of Hypothyroidism?
The causes of hypothyroidism can be diverse, with autoimmune conditions being the most common. Other contributing factors include:
Autoimmune Disorders: Hashimoto's thyroiditis is the primary autoimmune condition leading to hypothyroidism. In this condition, the body's immune system mistakenly attacks the thyroid gland, damaging it and impairing hormone production.
Iodine Deficiency: Iodine is vital for thyroid hormone synthesis. A deficiency can lead to decreased hormone production, resulting in hypothyroidism. Other common micronutrient deficiencies in people with hypothyroidism are selenium, zinc, vitamin D, and B vitamins.
Medications: Certain medications, such as lithium and amiodarone, can interfere with thyroid hormone production and metabolism (Miller & O'Reilly, 2020).
Radiation Therapy: Treatments for head and neck cancers may damage the thyroid gland, resulting in hypothyroidism.
Thyroid Surgery: Surgical removal of the thyroid gland or parts of it can lead to reduced hormone levels.
Identifying the underlying cause is crucial for determining the appropriate treatment strategy.
Hashimoto's Autoimmune Disease Explained
Hashimoto's thyroiditis, named after Dr. Hakaru Hashimoto, who first described the disease in 1912, is an autoimmune disorder that specifically targets the thyroid gland. The immune system produces antibodies that attack thyroid cells, leading to inflammation and gradual destruction of the gland. As a result, the thyroid becomes less effective at producing hormones, leading to hypothyroidism.
Symptoms of Hashimoto's
Individuals with Hashimoto's may experience symptoms of hypothyroidism, along with some additional signs, such as:
Goitre: An enlarged thyroid gland, or goitre, may occur due to the inflammation and compensatory enlargement of the thyroid.
Autoimmune Manifestations: People with Hashimoto's are at an increased risk for other autoimmune diseases, such as rheumatoid arthritis, lupus, or type 1 diabetes.
Diagnosis
Diagnosis of Hashimoto's and/or hypothyroidism typically involves blood tests to measure thyroid hormone levels. If you suspect you have hypothyroidism or Hashimoto’s, it’s vital that you get the following tests done:
TSH: This is the form of thyroid hormone produced in the pituitary gland. It stimulates the thyroid to produce T4 and some T3. Also known as thyroid stimulating hormone.
T4: The primary hormone produced by the thyroid gland, playing a crucial role in regulating metabolism, growth, and development, and is converted into the more active form (T3) in the body. Also known as thyroxine.
T3: The active thyroid hormone that regulates metabolism by influencing the rate at which cells use energy, and it is primarily produced through the conversion of thyroxine (T4) in tissues such as the liver. Also known as triiodothyronine.
RT3: An inactive form of the thyroid hormone T3, produced when the body converts thyroxine (T4) into rT3 instead of the active T3. rT3 helps regulate metabolism by acting as a brake on the effects of active thyroid hormones, especially during times of stress or illness. Also known as reverse triiodothyronine.
Don’t be fooled if anybody, including your doctor, tells you all you need to check thyroid function is TSH and/or T4. A 2013 study found that, of 2 267 women found to have elevated thyroid antibodies, all had TSH within the normal or only slightly elevated range. TSH is clearly NOT a good biomarker for thyroid issues. By checking T4, T3, and RT3, you will also be able to understand thyroid hormone production and usage in your body.
The following tests are also needed to assess for Hashimoto’s Thyroiditis:
Anti-thyroid peroxidase (anti-TPO)
Anti-thyroglobulin antibodies (anti-TPG)
If your doctor or primary care provider won’t run these tests for you, you’re not helpless. There are more and more options empowering people to take charge of their own health. If you’re in Australia, my go to lab testing services are Instant Script, iMedical, and i-screen. You can also order hair mineral analyses from various online providers.
If you do get a diagnosis, you’re probably going to be told that treatment involves hormone replacement therapy with levothyroxine, a synthetic form of T4, to restore normal hormone levels and alleviate symptoms. In fact, you’ll probably be told that this is the ONLY way to treat hypothyroidism.
I strongly disagree and am myself in complete remission from Hashimoto’s. I never took a drop of medication for it. You can also get desiccated pig thyroid, which, anecdotally, some people tolerate better and it’s more efficacious. If the issue is not with stimulation of the thyroid gland or production of thyroid hormone, but with conversion from T4 to T4, this can provide a form of T3 that’s close enough to human T3 to be used by our own mitochondria. But once again, remember that recovery may be possible.
While Hashimoto’s and hypothyroidism can be traced back to genetic factors, they’re also epigenetic. This means that the genes involved are malleable, and can be turned on and turned off. You can read a bit more about that here. Depending on how much damage has been done to your thyroid, you may not even need medication.
Can Hypothyroidism be Cured?
The question of whether hypothyroidism can be cured often arises among those diagnosed with the condition. Everywhere you read, you’ll see things like the following statement.
While there is currently no known cure for hypothyroidism, it can be effectively managed. Treatment focuses on normalising thyroid hormone levels through medication and lifestyle modifications.
This is what ChatGPT wrote for me when prompted.
It’s true that there is no medical cure for hypothyroidism. No pill will give you back your energy and zest for life. However, it’s important to understand that hypothyroidism and Hashimoto’s are lifestyle diseases. The things that cause them are the everyday decisions that you make. Undoing them relies on understanding the cause underpinning your condition. Many factors can contribute (these are the five pillars of Ecological Nutrition), but at the end of the day, it all comes down to oxidative stress and mitochondrial dysfunction (which you can read more about here). Reducing oxidative stress and getting your mitochondria working the way they should is the key unlocking health and wellbeing.
I know I’ve made this sound simple. It’s not; healing is a complicated process that depends on understanding the underlying causes of your issues.
You need to understand what’s causing your oxidative stress and sometimes your genetics such as methylation and detoxification genes.
You may also find that a small amount of medication is helpful at the start of your journey. But to say that hypothyroidism or Hashimoto’s Thyroiditis can’t be cured is a gross misstatement.
There are plenty of anecdotal stories on line, plus examples in the academic literature, showing that these conditions can indeed be reversed.
The first step you need to take towards doing this is deciding. It may sound trivial but if you make a commitment to yourself, it will set you on a path toward the kind of health and wellbeing that you dream about.
Conclusion
Hypothyroidism, particularly when associated with Hashimoto's thyroiditis, can significantly impact your quality of life. Understanding the symptoms and causes broaden your treatment options.
But the most important thing you can do is educate yourself and make a commitment to your own wellbeing and health.