Hashimoto’s thyroiditis and Grave’s disease are autoimmune conditions where the immune system attacks the thyroid gland, which produces hormones that regulate metabolism, energy and mood. In these autoimmune conditions, the immune system creates anti-thyroid autoantibodies (aka thyroid antibodies) that damage the thyroid gland.
Hashimoto’s disease is the most common cause of hypothyroidism (click here if you are hypothyroid and trying to get pregnant). You might have experienced symptoms such as fatigue, brain fog, weight gain, anxiety, digestive issues, hormone imbalances, fertility challenges and/ or miscarriages- and were subsequently diagnosed with hypothyroidism. Did your doctor test for thyroid antibodies? The presence of thyroid antibodies in the blood, along with high TSH or low FT4 is indicative of Hashimoto’s. You may already be on thyroid medication (i.e. levo-thyroxine) but if your thyroid antibodies are still high, their presence may cause continuous damage to the thyroid tissue.
Many people with this condition wonder if those antibodies will ever decrease or normalise. To answer this question, we need to understand what might cause the immune system to start attacking the thyroid in the first place. Although genetics play a role in the susceptibility of getting Hashimoto’s, whether those genes activate disease depends on certain environmental and lifestyle factors. Some points to consider:
- The gut microbiome, the community of bacteria that live in your intestines, play a key role in regulating the immune system. When your gut flora is out of balance, the immune system can lose its balance too and become more inclined to mistaken the thyroid for something that needs to be attacked.
- Some studies have found that individuals with thyroid disorders have significantly lower numbers of Bifidobacteria and Lactobacilli (beneficial bacteria) and significant higher levels of Enterococcus species (considered an opportunistic pathogen) compared to healthy controls. Other studies have found that H. pylori infections are more commonly found in people with Hashimoto’s disease than those without. A 2015 study found that getting rid of Blastocystic hominis infections normalised thyroid hormones and decreased thyroid antibodies. The gut definitely plays a role in autoimmune conditions.To investigate each patient’s unique microbiome, Dr. Yik offers various lab testing, including the GI MAP (GI-Microbial Assay Plus) test, a comprehensive stool analysis that includes an FDA-approved DNA/PCR assay for GI pathogens (bacteria, parasites, viruses, yeast, etc.).
- Food sensitivities or intolerances can cause chronic inflammation and trigger unwanted immune reactions. Research shows that there’s a link between thyroid autoimmunity and gluten. Many, though not all, people with Hashimoto’s disease have a gluten sensitivity. In some cases, thyroid antibodies return to normal when gluten is removed from the diet. In Dr. Yik’s practice, dairy and eggs are also common food sensitivities found in patients with Hashimoto’s or Grave’s disease. If you decide to do the test, remember to get tested for food intolerances, not allergies (click here to read about the difference).
- In practice, Dr. Yik has found a link between Hashimoto’s thyroiditis and Epstein Barr virus (mononucleosis). How do underlying infections lead to autoimmunity? One theory is the molecular mimicry theory, in which the immune system remembers specific proteins on the viruses that it correctly attacked, but then it starts attacking other proteins in the body that look similar to the virus protein. Another theory, the bystander effect, is where the immune system attacks healthy cells along with the virus.
- Could you be deficient in nutrients? You may be eating healthy, but if you have gut dysbiosis or gut inflammation (see above), you may not be absorbing the nutrients from foods you eat. The cells that line the gut have fingerlike projections called villi, which increase the surface area for transporting nutrients into the body. When the gut is inflamed, these villi can become shortened, which results in impaired nutrient absorption. Low vitamin D, selenium, vitamin A and zinc are all associated with the development of Hashimoto’s.
- Chronic stress and heavy metal toxicity have also been linked to thyroid autoimmune disease.
If you have Hashimoto’s or Grave’s disease, it’s important to find a doctor who addresses the underlying causes of your condition, not just prescribe thyroid medication to “balance” hormones.