Hashimoto's Thyroiditis - Myths, Facts, Symptoms, Diagnosis, Treatment

This article on Hashimoto’s thyroiditis covers:

Misconceptions about Hashimoto’s thyroiditis?
What is Hashimoto’s thyroiditis?
Difference Between Hashimoto’s Thyroiditis and Hypothyroidism
Hashimoto’s thyroiditis and Coronavirus (COVID-19)
What causes Hashimoto’s thyroiditis?
Symptoms of Hashimoto’s thyroiditis
Diagnosis of Hashimoto’s thyroiditis
New Treatment of Hashimoto’s thyroiditis

Misconceptions about Hashimoto’s thyroiditis

1. Hashimoto’s thyroiditis means you have hypothyroidism (underactive thyroid.) Not true!

Hashimoto’s thyroiditis is only one of many causes of hypothyroidism.

2. Hashimoto’s thyroiditis is the most common cause of hypothyroidism in the U.S. Not true!

Stress, iodine deficiency and obesity are some other causes of hypothyroidism. And these conditions are more prevalent than Hashimoto’s thyroiditis.

3. TSH – a blood test – is the test to diagnose your Hashimoto’s thyroiditis. Not true!

TSH is a blood test to diagnose hypothyroidism, which can be due to a variety of causes, Hashimoto’s thyroiditis being one of them.

4. Levothyroxine as well as dessicated Thyroid such as Armour Thyroid, Nature-Throid or NP Thyroid treats Hashimoto’s thyroiditis. Not true!

All these medications are replacement for low thyroid hormone when you have hypothyroidism. These medications do not treat Hashimoto’s thyroiditis. An analogy would be like this: A sniper – Hashimoto’s thyroiditis – gets inside a factory – your thyroid gland – and starts to kill the factory workers – your thyroid cells. Consequently, the factory gets low in its product – your own thyroid hormone. Replacing the lost product with borrowed product – Levothyroxine or dessicated Thyroid – may keep the factory running but it does not get rid of the sniper – Hashimoto’s thyroiditis.

5. There is no cure for Hashimoto’s thyroiditis. Not true!

Although there is no cure for Hashimoto’s thyroiditis in the traditional medicine, modern holistic treatment may be able to cure your Hashimoto’s disease.

What is Hashimoto’s thyroiditis?

Hashimoto’s thyroiditis is also called Hashimoto’s disease. Named after a Japanese physician, Hakaru Hashimoto, Hashimoto’s thyroiditis is an inflammation of the thyroid gland. In this disease, your thyroid gland gets infiltrated with immune cells – lymphocytes. That’s why it’s also called chronic lymphocytic thyroiditis.

Hashimoto’s thyroiditis can affect any individual at any age, but typically women at the age of of 20-40 are affected by Hashimoto’s disease.

Hashimoto’s thyroiditis is an autoimmune disease.

Basically, your immune cells start to attack and kill your own thyroid gland. Ultimately, your thyroid gland cannot produce enough thyroid hormone and you develop a state of low thyroid hormone, also known as hypothyroidism. However, you can stop Hashimoto’s thyroiditis, save your thyroid gland from becoming underactive and live a normal life, as you will learn in this article.

Difference Between Hashimoto’s Thyroiditis and Hypothyroidism

Now you understand Hashimoto’s thyroiditis is a chronic inflammation of the thyroid gland due to malfunction of your immune system. Whereas hypothyroidism is a state of low thyroid hormone which develops gradually if Hashimoto’s thyroiditis is left untreated. In other words, Hashimoto’s thyroiditis is the cause and hypothyroidism is the effect.

What causes Hashimoto’s thyroiditis?

First, you need to understand what triggers Hashimoto’s thyroiditis before you can get rid of it.

The following seven factors are known to increase your risk of developing Hashimoto’s thyroiditis – and other autoimmune diseases.

Genetic predisposition. Often there is a family history of Hashimoto’s thyroiditis or another autoimmune disorder such as Type 1 diabetes, lupus, rheumatoid arthritis, asthma, eczema, M.S, vitiligo, Crohn’s disease, etc.
Gender: Hashimoto’s thyroiditis, like other autoimmune disorders, is much more common among females than males, a ratio of 6:1, to be precise.
Stress: A history of physical as well as emotional stress is often present in patients with Hashimoto’s thyroiditis. Physical stressors include a viral or bacterial illness. Emotional stressors include traumatic events such as divorce, death, terrorism.
Personality: People who worry a lot are more prone to develop Hashimoto’s thyroiditis as well as other autoimmune diseases. Many suffer from chronic anxiety, phobias, panic attacks. A diagnosis of Hashimoto’s thyroiditis or another autoimmune disease makes them even more anxious, and a vicious cycle sets in.
Vitamin D deficiency is strongly correlated with a high risk of developing Hashimoto’s thyroiditis as well as other autoimmune disorders ¹. This is how: Vitamin D modulates the optimal functioning of the immune system. A deficiency of Vitamin D can lead to hyperfunctioning of the immune system, which can result in Hashimoto’s disease.
Western diet, which is packed with processed foods, junk food, preservatives, commercial farming, GMO foods, etc. Sadly, this unhealthy diet is now regularly consumed all over the world. This may be one reason why the incidence of Hashimoto’s thyroiditis, and other autoimmune diseases is rapidly increasing in the world.
Infections, especially Epstein-Barr virus infection can trigger Hashimoto’s disease and other autoimmune diseases. ²
Vaccines in certain susceptible individuals – especially those with allergies and family of autoimmune diseases – may rarely trigger the development of autoimmune diseases. ³

In Summary:

In a genetically predisposed person, especially a female who is on a typical Western diet, worries a lot and is also low in vitamin D, a viral infection or a vaccination can trigger Hashimoto’s disease.

Hashimoto’s thyroiditis and Coronavirus (COVID-19)

Patients with Hashimoto’s thyroiditis appear to be at an increased risk of severe illness from coronavirus. In a recent study, researchers analyzed the data of 2169 patients with COVID-19 . They concluded there was a significant correlation between thyroid disease and severe COVID-19 disease. ⁴

What is the mechanism for an increased risk of severe illness from coronavirus if you have Hashimoto’s thyroiditis?

Thyroid hormone is an important regulator of our immunity. Thus, too little – or too much – thyroid hormone can have a negative effect on your immunity to fight off coronavirus – or any other infection. In addition, there is an increase in the proinflammatory cytokines – messenger molecules between immune cells – in Hashimoto’s thyroiditis. ⁵

An increase in the proinflammatory cytokines causes Cytokine Storm – a major reason why coronavirus patients end up in the ICU – Intensive Care Unit – and are at risk of dying from coronavirus. 6

Symptoms of Hashimoto’s thyroiditis

Hashimoto’s thyroiditis by itself does not cause any specific symptoms except for an enlargement of the thyroid gland in some – but not all – individuals. An enlarged thyroid gland is also called a goiter. However, Hashimoto’s thyroiditis is only one of many causes of goiter.

Your thyroid gland can produce enough thyroid hormones in the early stages of Hashimoto’s thyroiditis. Therefore, you do not experience any symptoms of underactive thyroid.

If Hashimoto’s thyroiditis is not diagnosed and treated appropriately as is often the case, the autoimmune process continues to worsen and kill your thyroid cells.

Eventually, Hashimoto’s thyroiditis has killed enough of the thyroid gland. Then, your thyroid gland is unable to produce adequate amounts of thyroid hormone. At this stage, you start to develop symptoms of underactive thyroid – hypothyroidism.

Symptoms of Hypothyroidism:

1.Hypothyroidism often causes weight gain or difficulty losing weight due to a decrease in your metabolism. Lack of exercise due to muscle and joint pains further adds to your weight. In addition, there is often an element of emotional eating due to an associated depressed mood.

2. Fatigue, which is due to decreased metabolism, as well as other effects of hypothyroidism, such as depressed mood, weight gain, muscle aches and pains, anemia (low blood count) and decrease in cardiac output (pumping action of heart).

3. Hypothyroidism may cause enlargement of the tongue which can lead to sleep apnea. In addition, your voice may become hoarse and husky.

4. Hypothyroidism usually affects your skin which becomes puffy, cool, and dry. There is puffiness around the eyes, coarse facial features, swelling of hands and feet and supra-clavicular fossae (space above your collar bones).

In some patients, the skin may even get a yellowish tint due to accumulation of carotene in the blood, as its conversion to Vitamin A is decreased in hypothyroidism.

Often, there is hair loss/thinning of hair, which affects the head as well as the rest of the body. In particular, there is thinning of hair at the outer side of the eyebrows. Nails are brittle and grow very slowly.

Many patients with hypothyroidism also have low body temperature due to a decrease in basal metabolic rate. They may also develop intolerance to cold temperature.

5. Hypothyroidism often causes muscle cramps, joint pains, and accumulation of fluid in the Joints, known as effusions. Muscles are typically stiff and do not relax easily, which gives rise to muscle aches and pains. Stiff muscles also cause tendon reflexes (done by your physician) to be slowed, especially in the relaxation phase, which is called “hung-up reflexes.”

6. Hypothyroidism may affect the Intestines. Constipation may develop due to decreased intestinal movement. Sometimes, it can lead to gaseous distention of the intestines, called myxedema ileus. In extreme cases, fecal impaction can develop.

7. Psychological – psychiatric symptoms may develop such as depression, lethargy, lack of motivation. Anxiety may develop or get worse.

8. Hypothyroidism can affect your brain and cause forgetfulness, decreased memory and impaired cognitive function. Some patients are mistakenly labeled as having Alzheimer’s dementia.

Dizziness may develop due to malfunction of the inner ear and cerebellum – a part of the brain involved with equilibrium.

Lack of balance may also be due to Vitamin B12 deficiency which is quite common in patients with Hashimoto’s thyroiditis due to an associated deficiency of the intrinsic factor – a substance normally produced by the stomach cells.

9. Hypothyroidism may cause “Carpal tunnel syndrome,” which manifest as tingling and numbness in the hands.

10. Hypothyroidism can affect the heart and blood vessels in several ways:

Cardiac output (pumping of heart) is decreased. There is accumulation of mucinous material inside the muscle of the heart, which becomes weak and less elastic.

A decrease in the elasticity of the heart muscle causes diastolic blood pressure (the lower number in blood pressure reading) to be elevated.

In addition, there is an increase in the peripheral vascular resistance which further increases diastolic blood pressure. It also causes poor circulation, especially in the legs.

Slowing of the heart rate develops frequently, which in severe cases can lead to syncope – sudden loss of consciousness.

Pericardial effusion (fluid accumulation in the sac around the heart.) may develop rarely. All of the above findings are collectively called myxedema heart.

Hypothyroidism raises your cholesterol by raising LDL cholesterol (bad cholesterol) and triglycerides (fats) levels in the blood. In this way, hypothyroidism increases your risk of developing coronary heart disease and heart attack.

11. Hypothyroidism often causes excessive and prolonged menstrual flow, giving rise to iron deficiency with or without anemia. On the other hand, hypothyroidism is sometimes associated with an increase in Prolactin, a hormone produced by the Pituitary gland. High Prolactin level can cause lack of menses and milky discharge from the nipples. Prolactin can be easily measured in a fasting blood test.

Hypothyroidism due to Hashimoto’s thyroiditis can cause frequent miscarriages and decreased fertility in women. In addition, it can lead to a decreased libido in both women and men.

12. Eyes may be affected by hypothyroidism. Night blindness may develop due to decrease in synthesis of Retinal from vitamin A.

Thyroid Eye Disease – TED – a feature of Graves’ disease can rarely develop in Hashimoto’s thyroiditis. It manifests as bulging eyes, excessive lacrimation, and sometimes double vision.

13. Serious Complications: Prolonged, untreated hypothyroidism can be serious. In addition to severe fatigue, weight gain, depression, memory loss and dizziness, it can lead to a coma, known as myxedema coma, which carries a high mortality if treatment is not initiated promptly. Certain factors can trigger myxedema coma, which include exposure to severe cold, trauma and infections.

In Conclusion:

Hashimoto’s thyroiditis may not cause any symptoms in its early stages. If left untreated, hypothyroidism develops and can affect every organ of the body and give rise to a number of symptoms including weight gain, severe fatigue, muscle and joint pain, depression, dizziness, forgetfulness, weak heart and even coma in severe cases.

What is a Hashimoto’s flare up?

Hashimoto’s flare up is an exacerbation of your Hashimoto’s disease. It is also called Hashimoto’s attack. What triggers a Hashimoto’s flare up? Usually stress, vitamin D deficiency and an infection or vaccination can trigger a Hashimoto’s flare-up.

Symptoms of Hashimoto’s attack are basically worsening of the symptoms of hypothyroidism as well as those of the infection or stress. Usual symptoms include severe fatigue, muscle aches, joint pains, depressed mood and lack of motivation.

Blood Test to Diagnose Hashimoto’s Thyroiditis

Diagnosis of Hashimoto’s Thyroiditis is made by detecting antibodies to the thyroid gland. There are two antibodies that get elevated in Hashimoto’s thyroiditis:

TPO (Thyroid Peroxidase) antibodies

and

TG (Thyroglobulin) antibodies

Some people have elevation of both antibodies, while others may have only one type elevated. Therefore, it is important to have a blood test for both anti-thyroid antibodies.

Physician typically also order a blood test for TSH, Free T4 (thyroxine) and Free T3 (triiodothyronine) to assess the status of your thyroid hormone production. But these tests – TSH, Free T4 (thyroxine) and Free T3 – do not diagnose Hashimoto’s thyroiditis.

New Treatment of Hashimoto’s thyroiditis

You can stop Hashimoto’s thyroiditis from damaging your thyroid gland at any stage of the disease. The best time, of course is in the early stages of Hashimoto’s thyroiditis when your thyroid function is normal. If diagnosed and treated at this early stage, Hashimoto’s thyroiditis can be cured.

Unfortunately, most physicians including endocrinologists will advise you to wait until you become hypothyroid. It’s like watching a train wreck in slow motion. And then when you finally become hypothyroid, they start you on Levothyroxine.

They recommend this type of plan because there is no treatment of Hashimoto’s thyroiditis in regular medicine. As a traditional endocrinologist, I used to give the same advice to my patients with Hashimoto’s thyroiditis.

But things changed! About twenty years ago, I developed a new treatment strategy to treat Hashimoto’s thyroiditis. It is based on scientific knowledge of Hashimoto’s thyroiditis. I employed this new strategy in my patients and followed them closely with frequent testing for thyroid antibodies and thyroid function. The results have been amazing.

We were able to stop Hashimoto’s thyroiditis as evidenced by the normalization of thyroid antibodies in the vast majority of my patients with Hashimoto’s thyroiditis.
Those who were in the early stages of Hashimoto’s thyroiditis were able to keep their thyroid function normal as evidenced by the blood tests – TSH, Free T4 (thyroxine) and Free T3 (triiodothyronine).
Those whose thyroid gland was already damaged by Hashimoto’s thyroiditis – and were already on Thyroid hormone replacement (Levothyroxine, Armour thyroid, Nature-Throid) were able to gradually reduce the dose of their thyroid hormone pills.