Hashimoto’s disease is an autoimmune disease impacting the thyroid.  It is the most common cause of low thyroid.  There are primarily two different levels of Hashimoto’s depending upon your lab results: Euthyroid and Thyroiditis.  A comprehensive thyroid panel should be obtained including free values and antibody markers. (TPO and TgAB)

Traditionally only TSH and T4 are evaluated.  TSH is responsible for telling your thyroid to produce thyroid hormone and is elevated when the thyroid is not producing enough.  T4 is the main hormone created by the thyroid.  There are many other labs values that can and should be obtained to create an accurate picture of thyroid health.  The labs allow for more than an evaluation of hormone production but shows conversion efficacy to the active form, T3.

Euthyroid Hashimoto’s

Many individuals will have Euthyroid Hashimoto’s, which means you test positive for antibodies but it has not resulted in enough damage to the thyroid to impact thyroid levels. This means an autoimmune process is occurring as the thyroid is still being damaged.

Traditionally this is very frustrating for patients as they feel hypothyroid but are repeatedly told there is nothing wrong with them.

While thyroid levels have not been impacted, it is important to know that it is common to have symptoms of hypothyroidism.

Common Symptoms:

  • Fatigue
  • Thinning Hair
  • Weight Gain
  • Brain Fog
  • Headache
  • Brittle Nails
  • Constipation

It is important to start treatment to preserve thyroid function and decrease antibody levels.  At this point in time diet, lifestyle, and supplements are key to maintaining function of the thyroid and controlling the immune response by decreasing inflammation.

Hashimoto’s Thyroiditis (Hashimoto’s Disease)

Once your lab levels show impaired release of thyroid hormones in addition to antibody levels you have progressed to Hashimoto’s Thyroiditis.  Depending on your lab values thyroid replacement may be part of the approach.  Most of the approaches using only thyroid replacement will fail as it does not address the whole picture.

Hashimoto’s Treatment

Traditional treatment would focus on replacing thyroid hormones, but with Hashimoto’s many still feel as if they are hypothyroid even though their lab hormone levels have returned to level.  This is because the autoimmunity component is not being addressed.

Treatment of Hashimoto’s Thyroiditis is much like Euthyroid.  Diet, lifestyle, and supplements are an essential component in the treatment plan, but in addition to this many patients need hormone replacement.  A holistic approach needs to be taken for the best results possible. As noted in the diagram above is that T4 is converted to the usable form of T3 by both the liver and gut. This means that if there are underlying issues with either the gut or the liver then your thyroid cannot function at the full level.

Part of the holistic approach is to identify what is driving the autoimmunity. Based upon your history we will determine the need to evaluate for chronic infections, adrenal problems, other autoimmunity, and additional specialty testing to provide you with the answers you need.