Hashimoto's thyroiditis: balancing hormones through root cause resolution

Hashimoto’s thyroiditis signs and symptoms

Hashimoto’s is notoriously difficult to diagnose because of the inconsistent symptoms experienced by people with the condition. Often silent in nature initially, Hashimoto’s thyroiditis may not present with any symptoms until the condition is advanced, and underactive thyroid or hypothyroid symptoms set in.

Due to the volatile nature of the condition as an autoimmune disorder, people with Hashimoto’s may also experience symptoms of an overactive thyroid, or hyperthyroidism.

This is confusing and frustrating for people living with Hashimoto’s, and can often lead to misdiagnosis and delayed or incorrect treatment.

One of the first signs people with Hashimoto’s thyroiditis might notice is swelling at the front of the neck. This is a result of the enlarged thyroid, or goitre. Left untreated, Hashimoto’s can cause the thyroid gland to gradually shrink over time as the cells are destroyed.

Common symptoms people with Hashimoto’s may experience include:

• Weight gain
• Puffy face
• Leaky gut syndrome (increased intestinal permeability)
• Joint and muscle pain
• Sensitivity to cold
• Fatigue
• Dry skin
• Enlarged thyroid
• Hoarse voice

Unfortunately, it doesn’t end there.

The thyroid gland is responsible for metabolism and is involved in many other functions and systems in the body, so when thyroid function is disrupted by Hashimoto’s, a wide range of other complications can develop, including:

• High cholesterol
• Heart disease
• Infertility
• Chronic constipation
• Hair loss
• Depression
• Slow heart rate
• High blood pressure
• Memory problems

Hashimoto’s can also lead to some rare but very serious complications if left untreated, including:

Myxedema: A life-threatening condition that leads to drowsiness followed by profound lethargy and unconsciousness. A myxedema coma can be triggered by exposure to cold, sedatives, infection, or other stress. Myxedema is a medical emergency.

Birth defects: People with untreated hypothyroidism due to Hashimoto’s may have a higher risk of having a child with birth defects, including intellectual and developmental delays, cleft palate, and heart, brain, and kidney issues. Checking thyroid levels prior to conception and monitoring thyroid levels during pregnancy may help to ensure the appropriate intervention is taken to avoid these complications.

What causes hashimoto’s thyroiditis?

Affecting about 1 in 100 Australians, and ten times more common in women than in men, hashimoto’s is the most common form of thyroiditis.

It is more common in people with a family history of thyroid disease, and those with other autoimmune diseases including type 1 diabetes, Addison’s disease and coeliac disease.

Those with an existing autoimmune condition are also at greater risk of developing another autoimmune condition like Hashimoto’s thyroiditis. Around 25% of people with an existing autoimmune condition go on to develop three or more autoimmune conditions over their lifetime, thought to be caused by genetic and environmental factors.

With autoimmune disorders like Hashimoto’s, genetic, dietary, environmental and hormonal factors, stress, as well as underlying viruses, bacteria or fungal infections are all possible causes.

Researchers have also found strong associations between Hashimoto’s and impaired gut health conditions such as food sensitivities, microbiome dysbiosis and increased intestinal permeability.

As mentioned earlier, people with other autoimmune conditions are more susceptible to developing Hashimoto’s, including:

• Addison’s disease
• Autoimmune hepatitis
• Coeliac disease
• Lupus
• Pernicious anaemia
• Rheumatoid arthritis
• Sjögrens syndrome
• Type 1 diabetes
• Vitiligo

Risk factors that increase the likelihood of developing Hashimoto’s disease include being a female of middle age (40-60 years old), and having family members with Hashimoto’s or another autoimmune disease.

Natural vs conventional hashimoto’s treatments

The conventional treatment approach for Hashimoto’s usually doesn’t treat the underlying autoimmune condition. Instead, people with Hashimoto’s usually receive the standard treatment for hypothyroidism that develops as a secondary symptom.

Thyroid hormone and antibody testing is used to diagnose Hashimoto’s, and conventional hypothyroidism treatment involves taking synthetic Levothyroxine.

Unfortunately, conventional testing isn’t always as sensitive as needed to identify early-stage Hashimoto’s, and misinterpretation of results can result in misdiagnosis.

Regular monitoring of thyroid hormone levels should continue throughout treatment, so the dosage can be adjusted according to thyroid hormone levels.

As this approach doesn’t address the underlying autoimmune disorder, synthetic thyroid hormone may be required long term, or even for life.

The Melbourne Functional Medicine approach to hashimoto’s thyroiditis

Personalised assessment and treatment of what’s causing your Hashimoto’s

Unlike the conventional approach which only addresses the thyroid, the functional medicine approach to Hashimoto’s thyroiditis involves finding and addressing the root cause and contributing factors of the underlying autoimmune disorder.

Following advanced thyroid panel testing, our practitioners prioritise supporting the immune system and restoring normal immune function, while also supporting optimal functioning of the thyroid.

This is a proactive, whole-of-person approach that focuses on restoring homeostasis to the body, which may enable the thyroid to resume normal function.

While some people may have a greater genetic predisposition to Hashimoto’s that can’t be changed, there is usually a triggering event or environmental circumstance that leads to the development of the condition. Our practitioners can work with you to identify any potential bacterial overgrowth, lingering virus, fungal infection, toxin overload, food sensitivity, heavy metal or mould exposure that could potentially be the trigger of your autoimmune disorder.

Gut health and a strong and diverse microbiome are also directly related to immune function and thyroid health. We know intestinal barrier function plays a key role in the prevention of autoimmune conditions. This is because compromised intestinal barrier function, or ‘leaky gut’, creates dysregulation of the immune response.

To support these aspects of your health, our practitioners may recommend some of the following steps as part of personalised treatment plan.

Eliminate inflammatory foods and beverages 

A protein called zonulin can increase intestinal permeability and promote autoimmune disorder, and is released when the small intestine is exposed to gluten. As a result, our practitioners will generally recommend removing gluten containing foods from the diet, along with other potentially inflammatory foods. This will look different for everyone, though may include alcohol, soft drinks, dairy, sugar, artificial ingredients, processed foods and refined carbohydrates.

Increase healthy fats and nutrient-rich wholefoods

Foods rich in thyroid-supporting nutrients like selenium, zinc, iron, B vitamins, and vitamin A, as well as wholefood sources of healthy fats like olive oil, avocados, olives, nuts, seeds, wild-catch fish and sardines.

Nurture gut health

Removing inflammation is the first and most important step in improving gut health. We can then go about restoring healthy gut function and a diverse microbiome with probiotics and supplements, as well as cultured foods like kombucha, kimchi and broths, and prebiotic-rich foods like leeks, onions and plantains.

Remove toxins

Everyday activities expose our bodies to toxins including heavy metals, radiation, microparticles and other potential hazards. We can reduce the toxin load by removing environmental toxins from our home and using only natural and organic haircare, skincare and cleaning products, using air and water filters, and avoiding hazardous chemicals including perfumes which can interfere with hormone levels.

Reduce stress

A reduction in stress levels is essential for the health of people with autoimmune disorders. This is because chronic stress elevates cortisol levels and disrupts other hormone levels in the body, including the thyroid. Our practitioners and health coaches can help you develop a stress reduction plan which might include improving sleep, practicing restorative yoga, meditation, more outdoor time, exercise, and mindfulness.

These are just some of the ways our healthcare team can support people with Hashimoto’s and underactive thyroid at Melbourne Functional Medicine. The approach for you may be different depending on your individual findings. Self-diagnosis and treatment of Hashimoto’s are not recommended due to the serious nature of the condition.

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