The Functional Medicine Guide to Hashimoto’s Disease

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Also called Hashimoto’s thyroiditis, Hashimoto’s disease may be caused by diet, allergies, or certain health conditions. Hashimoto’s is more common in middle-aged women than men. 

Symptoms include fatigue, depression, weight gain, and so much more. This condition leads to most cases of hypothyroidism (underactive thyroid).

Hashimoto’s disease is an autoimmune disease that many conventional medical professionals say is incurable. True, there is no pill you can take that always works to reverse Hashimoto’s, but there are several methods that can identify and reverse the root cause of this condition.

At PrimeHealth in Denver, we’ve successfully reversed hundreds of patients’ Hashimoto’s hypothyroidism by pinpointing and treating the underlying cause. Sometimes, it’s as simple as diet. Other times, the cause involved workplace hazards or toxin exposures, which must be addressed differently.

Keep reading to learn more about Hashimoto’s symptoms, causes, and treatments.

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What is Hashimoto’s Disease?

Hashimoto disease is an autoimmune disorder that may cause 30% to 90% of hypothyroidism cases, making it the most common cause of thyroid disease in the US, according to the American Thyroid Association.

Hypothyroidism may impact 5% of Americans, with another 5% estimated to be undiagnosed but still experiencing symptoms.

Hashimoto’s disease and hypothyroidism affect the thyroid gland. This thyroid gland produces hormones that regulate and maintain your body’s ability to make energy (metabolism).

When the thyroid is dysfunctional, your body experiences many adverse symptoms which decrease your quality of life, like chronic fatigue, depression, weight gain, hair loss, and irregular menstruation.

Normally, the immune system protects your body from infection and disease. Autoimmune disease occurs when your immune system doesn’t recognize another system as part of your body and attacks it with immune cells.

Hashimoto’s disease is one of many autoimmune diseases, including type 1 diabetes, rheumatoid arthritis, lupus, and Graves’ disease (a leading cause of hyperthyroidism).

Treating Hashimoto’s disease involves finding and addressing the root cause of immune dysfunction, instead of masking the symptoms with medications.

Hashimoto’s disease is also known as:

  • Hashimoto’s thyroiditis
  • Autoimmune thyroiditis
  • Chronic lymphocytic thyroiditis

Symptoms of Hashimoto’s Disease

What are the symptoms of Hashimoto’s disease? The most common symptoms of Hashimoto’s disease are very similar to symptoms to hypothyroidism and include fatigue, constipation, dry skin, and weight gain. 

The extensive list of Hashimoto’s symptoms includes:

  • Fatigue
  • Increased sleepiness
  • Unexplained weight gain
  • Constipation
  • Increased sensitivity to cold
  • Difficulty getting warm
  • Joint pain or stiffness
  • Muscle pain or weakness
  • Puffy eyes and face
  • Dry skin
  • Brittle hair and nails
  • Hair loss
  • Slow heart rate
  • Irregular menstruation, including heavy flow
  • Difficulty getting pregnant
  • Difficulty concentrating
  • Memory problems
  • Enlargement of your tongue
  • Enlarged thyroid (goiter)
  • Depression
  • Sexual dysfunction in both men and women

Untreated Hashimoto’s disease can result in these severe complications:

  • Myxedema coma, which, in rare cases, diminishes your mental state, dangerously lowers your body temperature, and requires immediate emergency care
  • Heart problems, such as enlarged heart, high cholesterol, heart failure, or other heart diseases
  • Mental health issues, including worsening depression
  • Goiter, where your thyroid swells and appears as a large visible bump on your neck
  • Sexual dysfunction, including reduced libido, irregular and excessive menstrual bleeding (in women), and erectile dysfunction (in men)
  • Reproductive dysfunction, including inability to ovulate and increased risk of miscarriage or premature birth
  • Birth abnormalities, meaning that babies born to women with untreated hypothyroidism have a higher risk of autism and other developmental disorders

Root Causes of Hashimoto’s Disease & Hypothyroidism

There is not one single culprit which causes the immune system to attack thyroid cells. Instead, multiple root causes may result in immune dysfunction and Hashimoto’s thyroiditis.

Below are the most common causes of hypothyroidism and Hashimoto’s disease:

  • Food sensitivity: Food allergens can lead to Hashimoto’s disease. Allergies and sensitivities may play a role in the development of autoimmune diseases. Gluten is a major food trigger for Hashimoto’s, especially for patients with existing celiac disease or gluten sensitivity.
  • Infections: Tick-borne infections like Lyme disease, viral infections like Epstein-Barr, and gut infections like candida may lead to Hashimoto’s disease and an underactive thyroid.
  • Nutritional deficiencies: Nutrient deficiencies (such as iodine, zinc, vitamin D, or iron deficiency) may trigger hypothyroidism or autoimmunity. Simple dietary changes can treat this potential root cause.
  • Leaky gut: When your intestines are inflamed for long periods, the tight junction proteins in your intestines allow toxins and bacteria to escape from the gut where they belong and into the bloodstream, causing inflammation. Leaky gut is closely associated with autoimmune disorders and hypothyroidism.
  • Toxin or radiation exposure: Harmful toxins or radiation can wreak havoc on your thyroid. Watch out for heavy metal exposure, mold, pesticides, and industrial chemicals. If you suspect you have Hashimoto’s, check your body, home, or workplace for abnormal levels of radiation or toxins.
  • Injury or trauma: Following trauma to your thyroid (such as neck injury, thyroid cancer treatment, or surgery), your thyroid gland may get damaged, leading to hypothyroidism.
  • Genetics: Hashimoto’s disease can run in families. You’re at a higher risk if your parents or grandparents experienced Hashimoto’s thyroiditis. There are many genetic factors that influence whether you develop Hashimoto’s.
  • Hormone imbalance: Imbalanced hormone levels (not just your thyroid hormone levels) can trigger an underactive thyroid. Pregnancy, menopause, puberty, and chronic stress may all cause an imbalance in hormones.

Am I at risk for getting Hashimoto’s disease?

You’re at the highest risk for getting Hashimoto’s disease if you’re a middle-aged woman experiencing other autoimmune disorders and have a family history of Hashimoto’s. Pregnancy and workplace exposure to toxins also increase your risk of autoimmune thyroiditis.

Hashimoto’s disease risk factors include:

  • Being female
  • Age 30 to 50
  • Genetics, family history
  • Other autoimmune diseases
  • Pregnancy-related immunity and hormonal changes
  • Radiation or toxin exposure

How do I get tested for Hashimoto’s disease?

To get tested for Hashimoto’s, ask your doctor about the condition and tell them about your symptoms. Your doctor should then begin the diagnostic process.

To diagnose Hashimoto’s disease, your healthcare provider may take your medical and family medical history, then perform a physical exam, feeling your thyroid gland through your neck to determine if it’s enlarged.

Hashimoto’s disease is diagnosed by a blood test. The diagnosis is made by the elevation of at least 1 of the 2 antibodies associated with the disease. Those antibodies are: (1) Anti-Thyroperoxidase Antibody (anti-TPO Ab) and (2) Anti-Thyroglobulin Antibody (Anti-TG Ab). 

An imaging test may be ordered. An ultrasound of your thyroid gland can show your thyroid’s size and physical wellness, or if any nodules are growing in your neck. If Hashimoto’s disease is present, then the ultrasound will show a “heterogeneous thyroid gland,” indicating inflammation. 

Blood tests may also be ordered to check if you have enough thyroid hormone. Conventional endocrinologists often focus on TSH levels (from your pituitary gland) and perhaps free T4 levels, but that’s not close to enough to get the full picture of your diagnosis.

At PrimeHealth’s integrative clinic, we use extensive blood testing to measure the following:

  • Thyroid-stimulating hormone (TSH)
  • Free T4 (thyroxine)
  • Free T3 (triiodothyronine)
  • Total T4
  • Total T3
  • Reverse T3
  • Thyroid-binding globulin (TBG levels)
  • Anti-thyroglobulin and anti-thyroid peroxidase antibodies (TPO) antibodies (Hashimoto’s thyroid antibodies)

Your diagnosis is more precise when we get the full picture of your thyroid health. Precise testing and diagnosis lead to the most targeted treatment.

Treatments (Medical & Natural)

Most people (but not everyone) with Hashimoto’s disease develop hypothyroidism, which can drastically impact their quality of life.

Hormone replacement therapy is the most common conventional treatment, but dietary and lifestyle changes can go a long way in treating the root cause of your autoimmune thyroiditis.

1. Dietary Changes

The autoimmune Paleo (AIP) diet is a great meal plan to combat Hashimoto’s disease. For 1-6 months, this restrictive diet reveals food allergens and sensitivities. At PrimeHealth, our first-line approach is starting an AIP diet, rather than throwing you on side effect-laden drugs.

What foods should you avoid with Hashimoto’s? Below are listed foods you should avoid with Hashimoto’s disease. The AIP diet excludes:

  • Gluten
  • All nightshade vegetables (tomatoes, eggplants, potatoes, okra, peppers)
  • Industrial seed oils (canola, vegetable oil, etc.)
  • Beans and legumes
  • Dairy products
  • Nuts and seeds
  • Grains
  • Sugar
  • Sugar alcohols
  • Artificial sweeteners
  • Chocolate
  • Coffee
  • Alcohol
  • All processed foods

On this diet, recommended foods include:

  • Vegetables, except for nightshades
  • Proteins (poultry, eggs, beef, pork, seafood, etc.)
  • Non-dairy fermented foods (like apple cider vinegar or kombucha)
  • Herbs (garlic, turmeric)
  • Gelatin
  • Bone broth
  • Arrowroot starch
  • Unsweetened green tea

Outside of the AIP diet, an interesting 2020 study found that individuals with Hashimoto’s thyroiditis ate differently than the control group. Hashimoto’s patients ate:

  • More fat
  • More processed meat
  • Less red meat
  • Less plant oil, such as olive oil
  • Fewer non-alcoholic beverages
  • Fewer whole grains

Food plays a critical role in immune and thyroid health. At PrimeHealth, we pair all our patients with a health coach for dietary recommendations.

2. Levothyroxine Hormone Replacement

Thyroid hormone replacement therapy for hypothyroidism and Hashimoto’s disease involves prescribing synthetic levothyroxine (T4). FDA-approved brand names include Levothroid®, Levoxyl®, Synthroid®, Tirosint®, and Unithroid®.

This treatment (which comes with side effects) helps the thyroid but not necessarily your immune system, which is the root problem. 

If you do not address the root cause of your hypothyroidism (thyroid inflammation) and only give thyroid hormone replacement, many of your symptoms will not resolve. In general, you’ll still have a need for higher and higher doses of medications in the future.

Functional practitioners may opt for porcine thyroid hormones (natural thyroid hormones from a pig). These are a combination of levothyroxine (T4) and liothyronine (T3) and are more biocompatible than synthetic, man-made drugs. 

However, when synthetic levothyroxine is necessary, PrimeHealth’s specialists may prescribe them. At PrimeHealth, we also may prescribe a compounded version of levothyroxine (T4) and liothyronine (T3) personalized to your unique needs. Not everyone can find the perfect T4/T3 combination on the market, so this is a great way to find the perfect dose for you. 

Levothyroxine drugs are supposed to restore the normal function of your thyroid. Patients usually need to take it every day for the rest of their lives. Your healthcare provider can adjust your dose at any time to ensure healthy thyroid function.

Levothyroxine pills are available in several different strengths, which your doctor can adjust based on factors such as:

  • Age
  • Weight
  • The severity of thyroid disorder
  • Other health problems
  • Other medicines

Once you start levothyroxine treatment, your doctor may order a thyroid-stimulating hormone (TSH) blood test to monitor your thyroid function. It may take months for thyroid symptoms to subside. Large goiters that don’t go away may necessitate thyroid gland removal.

3. Lifestyle Changes

It sounds too good to be true, but certain lifestyle changes may treat the root cause of your Hashimoto’s disease, thus resolving the issue naturally.

Stress is a major factor in disrupting normal immune and thyroid function. Relieving stress in your everyday life can lead to a stronger hormone level balance and potentially reverse autoimmune hypothyroidism. 

Here are some tips on reducing stress:

  • Meditation is an easy way to alleviate stress and lessen symptoms of hypothyroidism. Praying is a form of meditation that can also improve your spiritual life, which is also important to stress reduction.
  • Getting 7-8 hours of sleep is important in coping with stress, as is the quality of your sleep. To get better sleep, try avoiding blue light exposure an hour before bedtime. Blue light is emitted from most electronic devices, like your television and cell phone.
  • Spending time outside, especially in primarily green locations, lowers stress levels. This can include exercising in your neighborhood, walking the dog, or enjoying a park.
  • Prioritizing fulfilling your own needs over pleasing others. This is a concept that Gabor Mate, MD speaks of frequently in his books about trauma and its link to various chronic conditions like autoimmunity.

4. Supplements

Depending on the underlying cause of your autoimmune thyroid disease, targeted supplements may benefit you. Common dietary supplements for hypothyroidism and Hashimoto’s disease include iodine, vitamin D, and selenium.

For medical-grade, third-party-tested supplements, please visit our online store

Female hormone imbalances may benefit from a combination of certain dietary supplements, such as:

Below are supplements that may help heal a leaky gut, depending on the root cause of your gut inflammation:

5. Peptide Therapy

Peptide therapy is a safe, new, and exciting method of targeting specific health problems in the body. Peptides are simply proteins with shorter molecular chain lengths.

Certain peptides appear to treat autoimmune dysfunction. BPC-157 is a commonly used, safe, and effective peptide for enhancing intestinal barrier repair and can, therefore, be used to potentially help with autoimmune diseases. 

Fortunately, peptide therapy doesn’t have the adverse effects associated with non-specific immune suppression, such as an increased risk of infection.

Get Tested and Treated For Hashimoto’s Disease

If you suspect you are experiencing Hashimoto’s disease symptoms, you should talk to your healthcare provider about getting tested. A medical questionnaire, blood tests, physical examination, and imaging may paint a complete picture of your diagnosis.

Once you get tested, get treated. Whereas many mainstream doctors only prescribe pharmaceuticals to mask symptoms, integrative and functional doctors target the root cause. If you treat the root cause, the symptoms should go away in turn.

Schedule a free phone consultation with PrimeHealth today! We are located in Denver, Colorado, near scenic Walker-Branch Park.


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