This is the second post in a series on women and Hashimoto’s thyroid disease. Start with the first post. A root cause approach to healing Hashimoto’s is very similar to all other autoimmune diseases. You may want to check out First 3 Things to Do to Squash Autoimmunity, and So You Got an Autoimmune Diagnosis: What Next? and 5 Steps to Drive Autoimmune Disease into Remission.
In functional and integrative medicine we treat the person rather than the disease. We look for antecedents, or events preceding disease symptoms. We also search for triggers or “root causes” that create the perfect storm for Hashimoto’s genes to flip on. We reduce and remove the triggers so that your immune system can heal. This is the first step to stopping the autoimmune process.
There’s a myriad of environmental triggers for Hashimoto’s disease. Often there are multiple triggers. Ask yourself: What was happening in your life the year before you experienced your first symptoms? Did you undergo an extremely stressful event or time? Stressful times or major life changes are often antecedents prior to symptoms. Other triggers include:
Bacterial and viral infections
Infections are known triggers of autoimmune reactions. These specific bacteria and viruses correlate with Hashimoto’s thyroiditis:
- Bacteria: Yersinia enterocolitica and H Pylori.
- Viruses: Epstein Barr 19 (EBV19) and the viruses Hepatitis B and C, Human T-lymphotropic Virus (HTLV), HIV, Rubella, Herpes Simplex, and Parvovirus.
Additional bacteria and viruses may trigger Hashimoto’s disease.
Chemical and metal toxicity
For a myriad of reasons, the thyroid gland is particularly susceptible to environmental toxins, more so than other endocrine glands.
Of the thousands of chemcials in our environment, specific ones associated with Hashimoto’s include polychlorinated biphenyls, dioxins, phthalates, polybrominated diphenyl ethers (PBDEs), and other halogenated organochlorines. There are likely many more chemicals that could play a part in thyroid disruption.
Nutrient deficiency or overload
These authors show that high iodine intake, as well as deficiencies of selenium, iron, and vitamin D, increase risks for Hashimoto’s disease.
Iodine is essential for thyroid hormone production, however too much iodine may cause Hashimoto’s autoimmunity. You absolutely need selenium to convert T4 to active, usable T3. High iodine intake is particularly risky when selenium is deficient. Once upon a time, iodine deficiency was the most common cause of hypothyroidism in the United States. In the early 20th century, we began to add iodine to salt. Iodine deficient hypothyroidism and related goiters decreased, and Hashimoto’s thyroid disease emerged as the predominant form of hypothyroidism. It’s possible that over supplementation with iodine increased autoimmune thyroid disease.
There is a sect of alternative medicine practitioners who use high-dose iodine supplementation, in the range of 10-15 mg. However, this approach is not supported in scientific and medical literature. I’ve personally treated patients whose Hashimoto’s disease was clearly induced by high intake of iodine prescribed by such practitioners.
Iron, ferritin (stored iron), and vitamin D are frequently low in women with Hashimoto’s.
With most autoimmune diseases, it’s essential to assess gut triggers. In a nutshell, this includes microbial imbalances, food intolerances, and intestinal permeability (leaky gut). All of these conditions can be huge triggers for your immune system to go haywire. In other words, your immune system becomes dysregulated and attacks your own body tissues. This idea is not new, however, at one point it was a fringe concept. At this point, there are hundreds of research papers that validate the connection between gut infections, food intolerances, intestinal permeability, and autoimmunity.
Hypothyroidism and Hashimoto’s disease commonly correlate with small intestine bacterial overgrowth. In this condition, bacteria produce toxic lipopolysaccharides (LPS) byproducts. These endotoxins (toxins produced in your body) get through your intestinal lining and wreak havoc with your immune system.
Hashimoto’s and celiac disease often go together. These researchers conclude:
There is ample evidence of a strong association between celiac disease and several immune mediated diseases, including autoimmune thyroid disorders.
In fact, there’s so much evidence that gluten intolerance correlates with thyroid autoimmune disease, that physicians at prestigious teaching universities such as Stanford and UCSF now recommend that people with thyroid autoimmune disease avoid gluten. Non-celiac gluten sensitivity is a real thing, and testing may reveal that you don’t have celiac disease, but you do have gluten intolerance. As a side note, I’ve worked with patients who were able to bring thyroid antibodies into normal range by completely avoiding gluten.
Once you reduce and remove your triggers, it’s time to activate Treg cells to reduce autoimmune inflammation (upcoming post). Want help navigating Hashimoto’s? Please reach out!