Hashimoto Thyroiditis


Hashimoto Thyroiditis

Thyroiditis or Hashimoto's disease is an autoimmune disease where the immune system does not recognize thyroid gland cells as self, attacks them and gradually destroys them, leading to hypothyroidism.

Hashimoto's thyroiditis is usually diagnosed when patients manifest symptoms of hypothyroidism.


The manifestation of the disease usually occurs with a broad range of metabolic disorders, which are the actual causes of the disease and will be discussed below.

It was first described by the Japanese physician Hakarou Hashimoto in 1912 and was recognized as an autoimmune disease in 1957. It is one of the most common thyroid gland diseases, and in nine out of ten cases affects women.

Symptoms
Due to the gradual destruction of the thyroid gland by the immune system, symptoms of hypothyroidism appear within months or years and include:

  • fatigue and low energy
     
  • weight gain
     
  • constipation
     
  • dry skin
     
  • melancholy and mood swings
     
  • hair loss
     
  • cold intolerance
     
  • reduced sweating
     
  • drowsiness during the day
     
  • memory loss
     
  • joint pain and muscle cramps
     
Hashimoto's thyroiditis is usually diagnosed when patients already experience symptoms of hypothyroidism. These patients may also have abnormal growths of thyroid tissue (thyroid nodules), high levels of TSH, elevated levels of thyroid antibodies, and changes in thyroid gland structure shown by ultrasound scanning.

The usual therapeutic approach for patients without symptoms includes regular monitoring. When the thyroid gland becomes underactive, thyroid hormone (levothyroxine) replacement is administered. Medication is adjusted 2-3 times a year based on TSH levels and by evaluating the patient's symptoms.


Administration of thyroid hormones improves most of the above symptoms when the thyroid gland is underactive. However, it does not address the causative factors that lead to the onset of the disease, and it cannot reproduce the hormone fluctuations into different conditions, as they occur when the thyroid gland functions optimally. 
 
The inability to reproduce the healthy thyroid function through hormone replacement alone is the main reason why many people, although they are on medication, they still have symptoms of hormone imbalance, even though their hormone tests are within a normal range.

Thyroid, The Metabolism Modulator
The thyroid gland is responsible for modulating metabolism, which continually adapts to everyday changes related to external temperature, energy requirements, digestion, and mood changes, among others.
 
In cases like when we are climbing the stairs, or doing physical exercise, the thyroid increases its function and upregulates metabolism. The same happens when it gets cold or when we are under stress, or we must face some difficulty in life,  also when we are happy or excited. 
 
However, when we rest, we are relaxed, sad, or hot; then, the thyroid reduces its function and downregulates metabolism.
 
Lower thyroid hormone levels are likewise the reason why hypothyroidism manifests itself with fatigue, cold intolerance, melancholy, weight gain, and so on. 
 
On the contrary, hyperthyroidism manifests itself with symptoms related to an upregulated metabolism, such as hypertension, weight loss, tachycardia, and heat intolerance.
 
Thus, we can see how the intake of thyroid hormones helps to improve the symptoms of hypothyroidism, and why the adjustments to thyroid medication 2-3 times a year cannot reproduce the continuous and tight regulation of a healthy thyroid, that continuously adjusts metabolism and function within a few seconds. 
 
We have seen through our experience that even when the thyroid gland is under-performing by up to 80%, this percentage can be substituted by hormonal treatment. The remaining 20% of the gland's function is sufficient for most routine metabolism adjustments to the demands of everyday life, permitting a good quality of life.

Hence, it is imperative to do whatever possible to maintain any residual gland function. Even a minimum residual thyroid function allows the body to adapt metabolically to the changes required in everyday living. 


Four Primary Causes of Hashimoto Thyroiditis 
What causes the immune system to not recognize the thyroid gland as self, and starts attacking it?

Through our clinical experience with thousands of cases and the application of Metabolomics on patients with Hashimoto's disease, we have observed that four primary causative factors are contributing to the onset of this disease. 

  1. Low metabolism (due to oxidation and deficiencies in vitamins and other elements)
  2. Insulin resistance
  3. Vitamin D3 deficiency
  4. Psychogenic stress
Long-term exposure to the above four factors lead to alteration of the composition and morphology of thyroid cells and gradually to their non-recognition by the immune system. The thyroid cell morphology changes to such an extent that at some point, the immune system "sees" them as non-shelf cells and attacks them by producing antibodies against them.

It is noteworthy that hypothyroidism further aggravates the above factors by blocking metabolism, increasing both insulin resistance and resistance to vitamin D, also negatively affecting the mood and cognition functions.


What can be Done 
Hashimoto thyroiditis is a disease triggered by genetic factors and factors related to lifestyle habits and the environment. Therefore, the goal of an appropriate therapeutic approach must focus on restoring the deviation from physiological conditions.

The identification of causative factors in Hashimoto's disease, through metabolomic analysis, allows us to do precise and personalized interventions in lifestyle and dietary habits to bring the cells and the body as close as possible to its optimum functioning.




Through thousands of cases of Hashimoto's Disease, we've seen, that correcting deficiencies in vitamins and other elements, repairing metabolism and regulating weight at healthy levels can radically change the course of Hashimoto's disease for the better.

85% of our patients experience a significant improvement in their quality of life. In particular, bodyweight reduction, fluid retention resolution, increased energy levels, and improved mood are some of the main symptoms associated with Hashimoto's disease that improve.

It is vital to intervene as early as possible to remedy the above and check the progression of the disease.

Take the first step today.


 



Additional References

  1. Hashimoto Thyroiditis. https://emedicine.medscape.com/article/120937-overview
  2. Hashimoto Thyroiditis. StatPearls.Dana L. Mincer; Ishwarlal Jialal. Feb. 23 2020. https://www.ncbi.nlm.nih.gov/books/NBK459262/   
  3. Diagnostic Criteria in Autoimmune Diseases. Shoenfeld, Yehuda; Cervera, Ricard; Gershwin, M. Eric (2010). Springer Science & Business Media. p. 216.
  4. Correlation Between Hashimoto's Thyroiditis-Related Thyroid Hormone Levels and 25-Hydroxyvitamin D Guanqun Chao, Yue Zhu, Lizheng Fang. Front Endocrinol (Lausanne). 2020 Feb.  https://pubmed.ncbi.nlm.nih.gov/32117049/
  5. Multiple Nutritional Factors and the Risk of Hashimoto's Thyroiditis Shiqian Hu, Margaret P Rayman. Thyroid . 2017 May. https://pubmed.ncbi.nlm.nih.gov/28290237/
  6. Improving the Vitamin D Status of Vitamin D Deficient Adults Is Associated With Improved Mitochondrial Oxidative Function in Skeletal Muscle Akash Sinha et. al. J Clin Endocrinol Metab . 2013. https://pubmed.ncbi.nlm.nih.gov/23393184/ 
  7. Changes in Glucose-Lipid Metabolism, Insulin Resistance, and Inflammatory Factors in Patients With Autoimmune Thyroid Disease Yi Lei et. al. J Clin Lab Anal . 2019https://pubmed.ncbi.nlm.nih.gov/31350776/ 
  8. Stress and Thyroid Autoimmunity Tetsuya Mizokami. Thyroid . 2004 Dec https://pubmed.ncbi.nlm.nih.gov/15650357/ 
  9. Hashimoto’s thyroiditis and papillary thyroid cancer: are they immunologically linked? Margret EhlersEmail the author Margret Ehlers, Matthias Schott. Trends in Endocrinology and Metabolism xx (2014) 1–9 1. https://www.cell.com/trends/endocrinology-metabolism/fulltext/S1043-2760(14)00160-X 
  10. A Potential Link between Environmental Triggers and Autoimmunity Aristo Vojdani. Autoimmune Dis. 2014; 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945069/  
  11. Thyroid Hormone Effects on Mitochondrial Energetics Mary-Ellen Harper 1, Erin L Seifert.  https://pubmed.ncbi.nlm.nih.gov/18279015/ 
  12. Cognitive and Affective Dysfunctions in Autoimmune Thyroiditis Thomas Leyhe, Karsten Müssig. Brain Behav Immun . 2014 https://pubmed.ncbi.nlm.nih.gov/24685840/
  13. Autoimmune Thyroid Disorders M. A. Iddah and B. N. Macharia. ISRN Endocrinol. 2013; 2013: 509764.
  14. Role of “Western Diet” in Inflammatory Autoimmune Diseases Arndt Manzel,1 Dominik N. Muller,2 David A. Hafler,3,4 Susan E. Erdman,5 Ralf A. Linker,1 and Markus Kleinewietfeld3,4,6Curr Allergy Asthma Rep. 2014 Jan; 14(1): 404. 
  15. Application of Metabolomics: Focus on the Quantification of Organic Acids in Healthy Adults Dimitris Tsoukalas. Int J Mol Med . 2017. https://pubmed.ncbi.nlm.nih.gov/28498405/
  16. Targeted Metabolomic Analysis of Serum Fatty Acids for the Prediction of Autoimmune Diseases Dimitris Tsoukalas, Vassileios Fragoulakis, Evangelia Sarandi et. al. Frontiers in Molecular Biosciences, Metabolomics (6), November 2019. https://www.frontiersin.org/articles/10.3389/fmolb.2019.00120/full
  17. SERUM METABOLOMIC PATTERNS IN PATIENTS WITH AUTOIMMUNE THYROID DISEASE Jia Liu et. al. Endocr Pract . 2020 Jan. https://pubmed.ncbi.nlm.nih.gov/31557082/
  18. Enhanced oxidative stress in Hashimoto's thyroiditis: inter-relationships to biomarkers of thyroid function.Rostami R1, Aghasi MR, Mohammadi A, Nourooz-Zadeh J. Clin Biochem. 2013 Mar
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