(The answer is yes.) How to stop Hashimoto’s Thyroiditis before it becomes Primary Hypothyroidism.
Today I’m answering a listener question, and this person wants to know how to stop Hashimoto’s thyroiditis before it becomes primary hypothyroidism.
So they must have had their thyroid panel done. They probably had a TSH that was within the reference range, maybe a T4 within the reference range, or a free T4 within the reference range. But somebody ran thyroid antibodies and they were elevated. So the person may have been told that they have Hashimoto’s thyroiditis, which means the immune system is damaging the gland and there are positive antibodies. And the person was probably told, “Hey, there’s not really much we can do at this point because your TSH and T4 are still normal.”
But this person wants to know what they can do to help reduce the inflammatory process that’s going on, so that they don’t ever develop primary Hashimoto’s. Is that possible? Absolutely.
So typical things that you’ll hear people say is if you have positive antibodies you need to take high dose vitamin D ’cause that can suppress antibody production… There’s a whole bunch of supplements that people typically recommend to lower thyroid antibodies.
Now, I want to do a little side note here – just because you don’t have thyroid antibodies, how is that different from Hashimoto’s thyroiditis where we see antibodies? Not much difference. It’s still immune-driven damage and destruction to the gland. I don’t really care whether they call it Hashimoto’s or not. It’s always immune-driven damage.
The antibodies really create little or no damage to the thyroid gland itself. Most of the damage is caused by the infiltrating lymphocytes coming into the gland, and that happens whether there are antibodies or not, as long as there’s thyroiditis going on. So I think the whole discussion, whether it’s Hashimoto’s thyroiditis or just regular thyroiditis, doesn’t make a whole bit of difference.
I think we get caught up in some of the minutiae of what’s going on. If you have thyroiditis, you have inflammatory damage going on, immune-driven damage to the thyroid gland.
And we need to ask the question, why is the immune system creating damage to the gland? That becomes the most important question. Whether you have antibodies or don’t have antibodies, this treatment strategy should still be the same.
So… back to supplements: do these things work? They might work to lower antibodies if you have ’em, but they may not change the thyroiditis that’s going on.
Okay, so what do you need to do? You need to identify the possible factors that are triggering thyroiditis to occur in the first place. You’ll see lots of theories…
One, in allopathic medicine, they’ll say: “Listen, there’s no consistent cause across the board for why everybody has thyroiditis or Hashimoto’s thyroiditis, so we’re not even gonna worry about the immune response to it. We’re just gonna let the immune system continue to damage the gland, and once the gland has been damaged enough that it can’t make enough thyroid hormone, then we’ll replace it.”
The medical community will tell you that the cause of your thyroiditis is idiopathic, meaning they don’t know why. And I think that’s fair because they don’t know why, and they’re not in the business of looking for why. And there typically isn’t one cause – you could line up 10 people, 20 people, a hundred people with thyroiditis or Hashimoto’s thyroiditis and what’s triggering their immune upregulation could be different for everybody.
Then you have the people, especially in the functional medicine world, who will say that your immune system is just out of control and is attacking your tissues.
Do I think that your immune system just woke up one day and lost control and just started attacking your thyroid tissue like it doesn’t know what’s going on? I don’t, I think that’s probably the least likely scenario.
The third thing you’ll often hear is there’s “one cause.” It’s EBV. It’s because of parasites. It’s because of mold. It’s because of one thing that’s driving the process. And if you just treat and manage this one thing, your condition will improve. For some people, that may be the case and there’s only one thing that’s triggering the thyroid dysfunction to occur. But for most people, I don’t believe this is the case.
And then the fourth theory, which is the one I think happens in most people, is that cells in your body operate in one of two states…
One: they’re in low-stress, what we call “homeostatic manufacturing” mode. They’re trying to bring a lot of thyroid hormone into the system, a lot of glucose into the system, and fat into the system to generate energy so that the cellular machinery can make stuff – protein, enzymes, hormones, and energy.
Or two: your cells are working from a stress response, a danger response. And in that situation, they shift from manufacturing to cell defense.
And it is my belief – and this is what I wrote my book about with Dr. Kelly, The Thyroid Debacle – is that it’s excessive cell stress over time that triggers the cell danger response. And then, adaptively, the cells downregulate their metabolism. Less T4 is converted to T3 so there’s less T3 in the cell. We slow down the manufacturing process and we ramp up defense.
And when that occurs for an extended period of time, and these inflammatory and danger signaling molecules are in circulation, not only can they activate the immune inflammatory systems, but they can also activate the self-destruction of the thyroid gland. These danger particles, these pathogen-associated molecular pro peptides, can bind to receptors on the thyroid gland and actually initiate destruction.
So is the cause of thyroiditis a bacteria, a virus, a toxin, an emotional threat, a trauma, or food? The answer is yes. And it’s probably multiple things, which is why if you’ve tried the one thing and it didn’t work, it’s probably ’cause it’s more than one thing. It’s the entire stress load of multiple things.
But how do you go about addressing it? Well, one of the first things is to write out your health history, and your health timeline from the day you were born to the current day.
List out all the things that may have created stress and strain on your physiology: traumas, antibiotic use, illness, surgeries, procedures, family issues, divorces, and all the things that could have accumulated.
And then consider what was happening in the six months to a year before that actual diagnosis. “When did I actually start having hypothyroid signs and symptoms? What was happening in the six months or more leading up to my diagnosis?” That might help you understand what was contributing to the load that shifted your body into saying, “I can no longer manage the stress and I need to protect myself.”
The next step is to evaluate what Dr. Kelly and I talk about in our book: the Fitness Factors. These are all the key aspects of your health and your physiology that either make you healthier or they result in decreased health.
You can look at your dietary fitness, sleep fitness, respiration, your emotional fitness, your habitual fitness, your physical fitness, your environmental fitness… These are all things you can assess on your own. There are lots of resources on the web, or you can use Part 3 of the Thyroid Debacle Book to get an introductory look all these things.
And then you then look at your metabolic fitness, your microbial fitness, and your genetic fitness. And those are in blue because those are the things you’re probably going to need some assistance with from a trained functional medicine practitioner.
But, if you don’t wanna reach out to a functional medicine practitioner, you can pick up the Thyroid Debacle book and start going through Part 3 and working on things on your own. You want to start raising your level of fitness in each one of these categories. If you don’t do any physical exercise, start adding regular fitness to your daily routine. Just start working on improving each one of these categories. In my office, I give my clients a fitness factor questionnaire so I can look at all of these and get an idea of which systems I need to work on first.
But if you’ve worked on these things and you’re still struggling with signs and symptoms or positive labs, find a functional medicine practitioner to work with. And yes, shameless plug, pick up a copy of The Thyroid Debacle book, read part three, and start working on those strategies.