What Is Hashimoto's Thyroiditis?

Hashimoto's thyroiditis, also called autoimmune thyroiditis or chronic lymphocytic thyroiditis, occurs when the immune system attacks the thyroid cells, destroying them. As a result, the thyroid gland cannot make enough hormones to meet the body's needs.

Depending on its severity, Hashimoto's thyroiditis can cause hypothyroidism, also called underactive thyroid, which usually requires medication to maintain normal thyroid hormone levels.

Indeed, Hashimoto's thyroiditis is the most common cause of hypothyroidism.

What Is The Thyroid?

The thyroid gland is a small, butterfly-shaped gland located in the front of your neck. As part of the endocrine system, it makes hormones and releases them into your body to regulate multiple bodily functions.

For example, the thyroid gland regulates metabolism, body weight, body temperature, heart rate, muscle function, blood pressure, digestion, etc.

Proper thyroid function depends upon it making and releasing precise amounts of thyroid hormones. Overproduction of thyroid hormones can cause hyperthyroidism (overactive thyroid). Conversely, the underproduction of these hormones can cause hypothyroidism (underactive thyroid).

How Common Is Hashimoto's Disease?

The number of people with Hashimoto's disease is unknown.

However, Hashimoto's thyroiditis is the most common cause of hypothyroidism, a condition affecting approximately 1 in 5 Americans. (1)

What Are The Symptoms Of Hashimoto's Thyroiditis?

Hashimoto's symptoms vary widely and may include:

Hypothyroidism Symptoms

• Weight gain
• Cold intolerance
• Thinning hair/hair loss
• Fatigue
• Muscle weakness
• Goiter (enlarged thyroid gland) Goiter is a sign of a dysfunctional thyroid gland and thus can be a symptom of both hypothyroidism and hyperthyroidism.
• Depression
• Brain fog
• Memory problems
• Fertility issues in women
• Irregular menstrual periods
• Constipation
• Heartburn
• Digestive issues
• Sexual dysfunction in both men and women
• Skin changes

Hyperthyroidism

In rare cases, Hashimoto's can cause the thyroid to make more thyroid hormone at first. The overproduction of hormones can trigger hyperthyroid symptoms, including:

• Goiter (enlarged thyroid gland)
• Rapid heartbeat
• Heat intolerance
• Unintended weight loss
• Sweating
• Tremors
• Anxiety
• Mood swings
• Tension
• Sleep disturbances
• Nausea
• Irritability
• Increased blood pressure
• Thinning hair or dry, brittle hair

Causes of Hashimoto's Disease

Below are are the most common causes of Hashimoto's disease.

Autoimmune Disease

Having another autoimmune disease is a common risk factor for Hashimoto's thyroiditis. (2)

Several autoimmune disorders are associated with Hashimoto's, including:

• Celiac disease
• Alopecia
• Type 1 diabetes
• Rheumatoid arthritis
• Autoimmune hepatitis that affects the liver
• Lupus

Genetics

Your risk for Hashimoto's increases if you have relatives with this disease, and the closer the relationship, the higher the risk.

For example, you have a 9 times greater chance of developing Hashimoto's if a first- degrees relative -- parent, sibling, child -- has this disease. (3)

A few genes are associated with Hashimoto's thyroiditis, especially HLA-DR3 and HLA-DR5, increasing your risk of developing this disease. However, having these genes does not mean that you will develop Hashimoto's disease. (4)

Gender

Women are 4 to 10 times more likely than men to develop Hashimoto's thyroiditis. (5) The exact reason for their increased risk is unclear, but experts believe it involves sex hormones.

Age

Hashimoto's disease can strike at any age, but it's more likely to develop in midlife. Women tend to develop Hashimoto's between 30 and 50 years of age. (6)

Infections

Hashimoto's thyroiditis is associated with several bacterial and viral infections, including: (7)

• Epstein-Barr Virus (EBV)
• Yersinia enterocolitica
• Helicobacter pylori (a gut bacteria)
• Hepatitis C Virus

Why are infections associated with Hashimoto's thyroiditis? Infections can create a "stealth microbe" that looks like your thyroid tissues, so the immune system attacks it. 

And as long as the infection persists, your immune system will continue attacking your thyroid gland.

Excessive Iodine Intake

The thyroid uses iodine to make thyroid hormones. So, iodine is essential for  thyroid function. However, too much dietary iodine can lead to the overproduction of thyroid hormones leading to hyperthyroidism (overactive thyroid.)

But studies also suggest that an excessive iodine intake increases the risk for autoimmune thyroid disease. (8)

And if you have Hashimoto's disease, you must work with your doctor to restrict iodine consumption, as this has been shown to improve thyroid hormone production and secretion and help relieve symptoms.

Radiation Exposure

Radiation exposure can damage the thyroid, leading to Hashimoto's thyroiditis. This is common in those exposed to radiation from cancer treatments (especially when the radiation is applied to the neck area) or from nuclear accidents (9).

How Is Hashimoto's Diagnosed?

Several tests may be used to diagnose Hashimoto's, including: 

• Physical examination to check for an enlarged thyroid gland
• Thyroid function tests (TFTs): A blood test to check for levels of TSH (thyroid-stimulating hormone), Free T3 and T4 levels
• Blood tests to check levels of antibodies that contribute to thyroid hormone production
• Ultrasound to see if there's is compression of the esophagus and trachea

Treatments for Hashimoto's Thyroiditis

Because Hashimoto's disease does not always progress to hypothyroidism, no specific treatment is warranted in the early stages. (10)

But since this autoimmune disease increases your risk for hypothyroidism, your doctor will usually monitor your thyroid function closely. (10)

If it progresses to hypothyroidism, the standard medical treatment is thyroid hormone therapy using synthetic thyroid hormone levothyroxine. (11)

Taken orally, this medication reverses hypothyroidism along with its symptoms. Thyroid hormone levels are periodically checked to ensure the correct dosage amount.

Natural Treatments for Hashimoto's Disease

Eat Selenium-Rich Foods

Selenium is a trace element that plays a critical role in the body and is the second most essential element for thyroid gland function after iodine. (12,13)

In addition, several research studies suggest that selenium supplementation can reduce thyroid autoimmune antibodies.

In one study, women with Hashimoto's thyroiditis reduced their thyroid autoimmune antibodies by a whopping 21% by supplementing with 200 mcg of selenium. (14)

To ensure you get enough thyroid-supporting selenium, be sure to include some of these selenium-rich foods in your diet:

• Brazil nuts
• Chicken
• Oats
• Beef
• Tuna
• Oysters
• Salmon
• Sunflower seeds

If you have an underactive thyroid, please check with your doctor to see how much selenium you need each day.

What about Selenium Supplements?

Selenium is available as part of a multivitamin or multimineral formula. You can also purchase selenium as a stand-alone supplement.

Most people get enough selenium through their diets, so a deficiency of this nutrient is rare. But, if you eat too many selenium-rich foods -- such as Brazil nut -- or take it in supplement form, you can exceed the upper limit.

According to the National Institutes of Health, adults should get no more than 400 mcg per day of selenium. If you exceed this limit, you can experience side effects that may include: (15)

• Garlic breath odor
• Metallic taste in the mouth
• Hair loss or brittleness
• Nail loss or brittleness
• Skin lesions
• Nausea
• Diarrhea
• Fatigue
• Skin rashes
• Irritability
• And more

Reduce Sugar Intake

Sugar causes systemic inflammation that can negatively affect thyroid hormone levels, potentially worsening your Hashimoto's symptoms.

Please remember that most of your sugar intake comes from processed foods, so reducing sugar means reducing or eliminating processed foods from your diet.

Eliminate Inflammatory Foods

Since Hashimoto's disease inflames the thyroid gland, eliminating inflammatory foods is essential for managing the symptoms of this disease.

Here is a shortlist of inflammatory foods you'll need to remove from your diet.

• Gluten
• Sugar
• Sodas
• Ready-to-eat meals
• Saturated fats
• Fried foods
• Artificial sweeteners
• Grain-fed meets
• Milk (and milk products)
• Trans fats
• Fully hydrogenated oils
• Processed meats

Get More Sleep

Insomnia is a common occurrence with Hashimoto's disease, which can worsen symptoms like fatigue.

Here are a few natural ways to improve your sleep.

• Set and follow a sleep schedule. If you go to bed at the same time every night and awaken at the same time every morning, you'll train your body to sleep during that specific period.
• Avoid caffeine later in the day. Caffeine is a stimulant that can prevent sleep if ingested too close to bedtime.
• Avoid drinking water or other fluids at least three hours before bedtime to prevent waking up to urinate during the night.
• Make sure to empty your bladder before going to bed.
• Try not to watch TV or use your computer or tablet an hour before bedtime. The light from these screens disrupts your brain's melatonin production.
• Practice mind and body relaxation techniques before bedtime.
• Avoid napping during the day.
• Try not to perform aerobic exercises before bed, as the resulting adrenaline can interfere with sleep.

If you've done all this and still experience sleep issues, please talk to your doctor about appropriate medical interventions.

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References

1- https://pubmed.ncbi.nlm.nih.gov/29083758/
2- https://pubmed.ncbi.nlm.nih.gov/20103030/
3- https://onlinelibrary.wiley.com/doi/10.1111/cen.13323
4- https://pubmed.ncbi.nlm.nih.gov/1676351/
5- https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease
6- https://flo.health/menstrual-cycle/health/symptoms-and-diseases/hashimotos-disease
7- https://hypothyroidmom.com/hashimotos-disease-the-infection-connection/
8- https://www.nejm.org/doi/full/10.1056/NEJMoa054022
9- https://pubmed.ncbi.nlm.nih.gov/20578899/
10- https://my.clevelandclinic.org/health/diseases/17665-hashimotos-disease
11- https://www.mayoclinic.org/diseases-conditions/hypothyroidism/diagnosis-treatment/drc-20350289
12- https://ods.od.nih.gov/factsheets/Selenium-HealthProfessional/
13- https://www.healthbeckon.com/selenium-rich-foods/
14- https://pubmed.ncbi.nlm.nih.gov/2045471/
15- https://ods.od.nih.gov/factsheets/selenium-healthprofessional/