Hashimoto’s Thyroiditis

First, a few definitions.

Hashimoto’s is an autoimmune condition in which your body attacks your thyroid. Sometimes early stages of Hashimoto’s lead to hyperthyroidism, because the thyroid cells containing thyroid hormone rupture and release more hormone into your bloodstream at once than normal — but because ultimately thyroid cells get destroyed, ultimately Hashimoto’s leads to hypothyroidism. It’s one of the most common causes of hypothyroidism out there, and can look just like garden variety hypothyroidism, except that sometimes it can be a bit harder to stabilize.

There are two parts to your immune system, called “non-specific” (this responds right away to toxic exposure, bee stings, trauma, etc) and “specific” (which takes some time, but is more targeted against specific invaders).  Think of non-specific immunity like a sledge hammer, while specific immunity is more like a scalpel.  The sledge hammer is quick and dirty, and (as you might imagine) will cause a lot of inflammation even in surrounding healthy tissues.  The scalpel, on the other hand, won’t cause as much collateral damage, but it will have to be very carefully directed in order to do any good.

Because your specific immune system (the scalpel) needs careful direction, two kinds of cells are necessary: the T and B cells.

If I can mix my metaphors, think of the T cells as the managers and the B cells as the worker bees (no pun intended) – that is, the B cells actually produce antibodies against specific invaders, while the T cells tell the B cells what to do.

Now there are three types of substances (called antigens) that have the potential to provoke your specific immune system to make antibodies against them.  There are soluble antigens (these come from your diet and your environment), insoluble antigens (these come from microbes and pathogens), and self antigens (these come from your own cells).

Reactions against soluble antigens are called allergies.

Reactions against self antigens are called autoimmune diseases.

Reactions against insoluble antigens is normal immune function.

Those T and B cells that produce the wrong kinds of antibodies are supposed to be destroyed before they ever enter the bloodstream, but since some get out anyway, there’s a built in checks-and-balances system: the Regulatory T cells.

Fortunately, Regulatory T cells are produced in proportion to the number of rogue immune cells (mixing metaphors one more time: if you have more criminals, you need more cops).  But your gut can also produce Regulatory T cells under the right set of conditions.  In fact, 80% of your immune system is in your gut. This makes sense, doesn’t it?  After all, your gut is your body’s first line of defense, since that’s where your organs first come in contact with the outside world.

So with Hashimoto’s patients, as with autoimmune patients of almost any diagnosis, I usually start with the gut (and if I don’t start with it, I always address it at some point).  The goal is to a) produce more Regulatory T cells (more cops) to stop the antibodies against self or soluble antigens (criminals), and b) to increase the production of antibodies against insoluble antigens – the true foreign invaders.

Because of the close relationship between allergies and autoimmunity, one of the things I look for are food allergies, as well as its cousins candida overgrowth, and leaky gut syndrome. Increasing the integrity of the gut lining helps to diminish production of auto-antibodies.

As with any form of hypothyroidism, it’s important to at least assess for adrenal fatigue because there is a huge connection between the thyroid and the adrenals. Think of it this way: when your adrenals are overburdened already, in order to keep up, they tell your thyroid to slow down. Because of this, if you treat the thyroid without addressing the adrenals, you might actually make adrenal fatigue worse (and also, it’s sort of like swimming upstream, or running through molasses: you won’t heal as effectively as if the adrenals and thyroid were working in concert with one another.)

Hashimoto’s requires treatment of (at minimum) the thyroid, the gut, and the adrenals. It’s all interconnected!