Did you know that every cell, tissue and organ in your body has thyroid receptors? This means that if your thyroid isn’t working optimally, chances are you might be feeling pretty “bleurgh” and have multiple health niggles. Most of the time challenges to the thyroid will be underactive or overactive, however, more people nowadays are finding that they are experiencing autoimmune thyroid activity which can lead to a huge array seemingly unrelated of symptoms.
If you are experiencing thyroid-related symptoms, you have just discovered you have raised thyroid antibodies or have been diagnosed with an autoimmune disease called Hashimoto’s Thyroiditis (commonly known as Hashi’s) then read on to discover how nutrition, lifestyle and supplements can help build you back up from the inside out.
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What is Hashimoto’s Thyroiditis?
Hashimoto’s thyroiditis (HT), also known as Hashimoto’s disease is an autoimmune condition. Autoimmunity is a disorder where the immune system starts attacking its own tissues and when you have Hashimoto’s, your immune system is attacking the thyroid gland.
The thyroid gland is butterfly-shaped and located in the front of your neck, and it makes hormones that control metabolism. This includes how quickly your body utilises the energy from the food that you eat as well as your heart rate. Some people describe the feeling as if your internal “spark plugs” aren’t quite firing up your system properly each day and you often feel like you are running on empty.
The typical symptoms associated with Hashimoto’s include fatigue, brain fog, forgetfulness, easy weight gain, sluggish digestion with reflux and/or constipation, feeling cold all the time, low blood pressure, poor blood sugar regulation (drops in energy before or after meals), dry and thinning hair, dry skin, heavy or irregular periods, allergy symptoms, joint and muscle pain, sleep issues as well as anxiety and panic attacks.
Symptoms, especially fatigue, tend to be worse upon waking, and a person with Hashi’s will probably struggle to get up in the morning, feeling quite tired, weak, and wobbly. Many people say they take a few hours to properly wake up and tend to feel much more “normal” and better towards the end of the day.
There are also some co-morbidities associated with Hashimoto’s such as autoimmune reactions to foods such as gluten and dairy, histamine intolerance, mast cell activation, elevated cholesterol and low stomach acid, as well as vitamin and mineral deficiencies such as anaemia (low iron) and low ferritin (iron stores) as well as low selenium and zinc.
Not as many people with Hashimoto’s gain excess weight, compared to those with more classic low thyroid function and many people experience marked Hashi’s symptoms and can have very raised antibodies despite being slim.
People with Hashi’s also often look well in themselves even if they feel debilitated by it. So this tends to be a “hidden” metabolic issue and can easily be overlooked or put down to chronic fatigue, mental health issues or simply low-grade symptoms you need to learn to live with. It can often be masked relatively easily and many people gear their daily activities around their energy dips to compensate.
What causes Hashimoto’s?
The exact cause of this condition is not known, but certain factors such as genetics play a role. People who get Hashimoto’s often have other family members with thyroid disease and can carry the HLA DQ2 or DQ8 genetic SNPs which is also shared with people who develop other autoimmune diseases such as coeliac disease and type 1 diabetes.
Imbalanced gut health is also a primary precursor and many scientific research papers and clinical observations find that intestinal hype-permeability (leaky gut) and an imbalanced gut microbiome can play a significant role prior to the onset of autoimmune conditions including Hashi’s and whilst it is active. Working on gut health is one of the most important things you need to do if you have raised thyroid antibodies.
Hormones are important too, and since seven times more women than men suffer from Hashimoto’s, this suggests that sex hormones influence this condition.
Viruses may also play a role in the onset of Hashimoto’s and in one study over 80% of the people studied had evidence of a prior Epstein Barr viral infection (glandular fever) and that there may be a possible reactivation of this retrovirus which may be part of the onset of an autoimmune thyroid condition. This could potentially be why fatigue is such a common symptom.
More recently papers have been published finding that some people have developed autoimmune thyroid conditions post-Covid, as well as other autoimmune diseases such as type 1 diabetes.
Other influencing factors may include the western diet (high convenience, high sugar, low fat, low protein), chronic stress, nutrient deficient soils (especially lack of selenium), not enough or too much iodine, and a build-up of heavy metals such as excess mercury and aluminium.
Thyroid Stimulating Hormone Testing
If you are struggling with thyroid symptoms, you may initially be diagnosed through a blood test with hypothyroidism (or underactive thyroid). This is if your Thyroid Stimulating Hormone (TSH) is raised above 4.2 mU/L in the UK and indicates your thyroid gland isn’t making enough hormones to support your body. If this continues to be the case you would then usually be prescribed a medication called Levothyroxine.
It must be noted that in the UK a “normal” TSH lies within the reference ranges of 0.27 – 4.2 mU/L, however, these parameters are much broader than in many other countries in the world, and it is thought that the optimal is in fact 0.45 – 2.5 mU/L. In some countries so much so, it’s advised that a woman does not try to get pregnant unless TSH is below 2.5 mU/L as any higher can pose risk for infertility, miscarriage or premature birth. It is also thought that psychiatric medication works better if the thyroid is working optimally.
So, if your doctor says you don’t have an underactive thyroid, or your thyroid medication is not helping as much as you hoped, and you are still experiencing clear-cut thyroid symptoms then it is worth checking your thyroid antibodies.
Thyroid Antibody Testing
The two key thyroid antibodies are Thyroglobulin antibodies and Thyroid Peroxidase antibodies These both need to be checked if you have thyroid symptoms with or without a normal or optimal TSH. In the UK, GPs do not routinely test for these thyroid antibodies, this is usually only carried out if you see an endocrinologist, a private GP or a functionally trained naturopath/nutritional therapist well-versed in autoimmune thyroid conditions. Private testing for thyroid antibodies can be relatively inexpensive and this information is a crucial piece in the thyroid puzzle.
As always, it is important to report raised thyroid antibody markers to your GP or endocrinologist to rule out any underlying structural changes to the thyroid, for example thyroid nodules or cancer which are checked via ultrasound. If your antibodies are raised, this usually indicates that autoimmune activity called Hashimoto’s Thyroiditis is present, however, your GP will also screen for another autoimmune disease called Graves.
Very often people associate higher antibody readings with more symptoms and declining health, however, it is important to remember that although it is beneficial to bring the antibody number down, it is equally important to really tune in to your body and notice how you feel, focus on supporting your overall health and this includes some much-needed self-care.
Since there are very limited medical treatments for this type of thyroid condition, especially when thyroid medication is not appropriate or working well enough, many people turn to nutrition and lifestyle to try and get some relief.
Once your body has become autoimmune it is hard to reverse this entirely but many people can manage it to such a degree that they only experience minimal symptoms. Please also be mindful that people with an autoimmune skew to their immune system, may experience more than one autoimmune disease, and my tips below may also help with overall autoimmunity and make a start on improving how you feel, whilst also going some way to future-proofing your health.
Eight Ways Nutrition Can Help Your Thyroid
If you have raised thyroid antibodies and are looking for ways to help improve how you feel, here are eight things you can try to see if this brings some relief to your symptoms:
- Balance your blood sugars. An out-of-sync thyroid can decrease glucose absorption, leading to an accumulation of blood sugar. This in turn may cause more insulin to be produced to use up any excess glucose, eventually leading to insulin resistance. Symptoms can include feeling “hangry” before meals and significant drops in energy and blood glucose within two hours of eating leading to an energy crash. This is where increasing protein, healthy fats and vegetables at every meal can make a massive difference and stabilise blood sugars and energy levels.
- Trial removing gluten from your diet. Studies indicate that raised thyroid antibodies may be linked to non-coeliac gluten sensitivity. Many people report feeling less sluggish and more energised quite quickly after switching to a gluten- free diet or reducing wheat, rye, barley and standard oats significantly. Their tummy can also feel more comfortable and less bloated, and it may be easier to pass a bowel movement.
- Supplement with selenium. This mineral, which is not very abundant in our food chain anymore, has been shown to reduce antibody levels and influence mood and wellbeing. Find selenium mainly in Brazil nuts as well as eggs and pulses.
- Support stomach acid. Many people with raised thyroid antibodies suffer from acid reflux which can lead to regurgitation of food, heartburn and excess hiccups and belching. Sometimes this is due to low hydrochloric acid levels in the stomach and can be supported by chewing on bitter leaves like rocket, endive and chicory and consuming apple cider vinegar and lemon juice at mealtimes.
- Constipation relief. This is one of the more persistent symptoms that accompany raised thyroid antibodies. Drink a cup of hot water and lemon on waking and breathe deeply for a few minutes to get the digestion kick-started in the morning. Add in plenty of magnesium, flax seeds and prunes if things remain sluggish. Kiwi fruits with the skin on can also provide enough fibre to get the bowel moving.
- Increase Iron. Often low ferritin (iron stores) accompanies raised thyroid antibodies as active Hashimoto’s can impair iron absorption in the gut. Ideally, ferritin levels should be over 70 in blood tests for optimal energy levels, and it also helps to keep T4 within range, which is another thyroid marker. Ask for iron and ferritin to be tested alongside thyroid antibodies.
- Supplement with Vitamin D. As well as a thyroid receptor in every cell, we also have a Vitamin D receptor, and a high prevalence of vitamin D deficiency has been found among people with Hashimoto’s thyroiditis. It is thought that optimising vitamin D blood levels to around 100/110 will help overall autoimmunity and may slow down the development of hypothyroidism (raised TSH).
- Include Vitamin B1 (thiamine) supplement. This can be a game changer for people who experience long-term fatigue, feelings of exhaustion and brain fog associated with raised thyroid antibodies. Vitamin B1 is an important vitamin that acts as your spark plugs to help regulate your energy. It can often be depleted in people who drink moderate or high levels of alcohol on a regular basis and another indicator you might need to supplement with Vitamin B1 is marked reactions to insect bites.
If you have been to your GP regarding thyroid-related symptoms but are still feeling rotten, please get in touch. Our NatureDoc practitioners specialising in thyroid health can support you with nutrition and food supplement guidance. We can also organise private tests to delve a bit deeper into your thyroid health and help to build a personalised health plan for you.
- Hashimoto’s thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation
- Multiple Nutritional Factors and the Risk of Hashimoto’s Thyroiditis
- Gut microbe drives autoimmunity
- The thyroid and the gut
- All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases
- Systematic review of COVID-19 and autoimmune thyroiditis
- The role of Epstein-Barr virus infection in the development of autoimmune thyroid diseases
- Zonulin, regulation of tight junctions, and autoimmune diseases
- The hypoglycemic side of hypothyroidism
- Autoimmune Hypoglycaemia
- Celiac Disease and Autoimmune Thyroid Disease
- Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study
- Extra-intestinal manifestations of non-celiac gluten sensitivity: An expanding paradigm
- Selenium Supplementation for Hashimoto’s Thyroiditis: Summary of a Cochrane Systematic Review
- Iron and the immune system
- Iron Deficiency, a Risk Factor of Thyroid Disorders in Reproductive-Age and Pregnant Women: A Systematic Review and Meta-Analysis
- Celiac Disease and the Thyroid: Highlighting the Roles of Vitamin D and Iron
- Vitamin D Treatment in Patients with Hashimoto’s Thyroiditis may Decrease the Development of Hypothyroidism
- Vitamin D Deficiency and Its Association with Thyroid Disease
- Correlation Between Hashimoto’s Thyroiditis–Related Thyroid Hormone Levels and 25-Hydroxyvitamin D
- Thiamine and Hashimoto’s Thyroiditis: A Report of Three Cases