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Hashimoto’s disease is an autoimmune condition of the thyroid gland where the body starts producing antibodies against the thyroid tissue.
The attack of the antibodies ultimately leads to thyroid destruction, causing hypothyroidism or underactive thyroid. Hashimoto’s disease most commonly affects women aged 30–50 years.
Causes of Hashimoto’s Disease
Hashimoto’s disease is an autoimmune condition and the exact cause is unknown. However, it is thought that the development of Hashimoto’s disease is an interplay between genetics and environmental factors.
The characteristic histopathological change seen in Hashimoto’s disease is the lymphocytic infiltration and consequent destruction of the thyroid gland.
Antibody-dependent, T-cell-mediated cytotoxicity leads to the apoptotic destruction of thyroid follicles, which ultimately affects the thyroid gland’s capability to secrete thyroid hormones, leading to hypothyroidism.
Symptoms of Hashimoto’s Disease
Hashimoto’s disease often remains undiagnosed in its early stages due to the lack of symptoms. Even in advanced stages, when the symptoms do become noticeable, they are often confused with those of other diseases, leading to a misdiagnosis.
Thus, it is very important to learn about the manifestation of this disease and seek proper medical assistance for the correct diagnosis. The most common symptoms that people with Hashimoto’s disease experience are:
- Weight gain or difficulty in losing weight
- Feeling cold
- Dry and thinning hair
- Mood changes such as depression and anxiety
- Menstrual problems such as irregular periods or heavy periods
- Fertility issues
- Chronic pain, especially in the muscles and joints
- Dry and rough skin
- Swelling, especially around the eyes and face
Medical Treatment for Hashimoto’s Disease
As Hashimoto’s disease ultimately causes hypothyroidism, or low thyroid hormone levels, the conventional treatment is thyroid hormone replacement therapy. The standard drug is levothyroxine. Other thyroid formulations are available on the market but are less commonly used.
The doctor may also recommend certain nutrient supplements such as selenium, zinc, iodine, magnesium, and omega-3 to better manage the condition.
Diagnosing Hashimoto’s Disease
Hashimoto’s disease is diagnosed based on the results of blood tests, which include:
1. Thyroid-stimulating hormone (TSH) level test
The most basic screening blood work to check for Hashimoto’s disease is a TSH test. High levels of TSH signify hypothyroidism and point toward Hashimoto’s disease.
But it is also important to look at the levels of individual thyroid hormones, such as free T3 and free T4, to get an accurate assessment of the functioning of the thyroid gland.
2. Thyroid antibody test
Most of the time, physicians only check TSH levels and do not check the thyroid antibodies, which is the reason they miss the diagnosis of Hashimoto’s disease.
Thus, ask your doctor about checking the levels of your thyroid antibodies, namely, thyroid peroxidase (TPO) antibodies and thyroglobulin antibodies. Hashimoto’s disease causes elevated levels of these antibodies.
The diagnosis of Hashimoto’s disease can be made through simple blood work, which should include the measurement of not only thyroid hormone levels but also thyroid antibody levels.
Management of Hashimoto’s Disease
Hashimoto’s disease is caused by both genetic and environmental factors.
While you can’t do anything about the former, you can very try and control the latter to bring the disease under control. This includes various lifestyle changes, such as:
- Diet: A diet that is mainly plantbased with lots of vegetables, low carbohydrates, and less processed foods can help heal the thyroid.
- Stress reduction: Reducing the amount of stress can help Hashimoto’s disease, too. Stress management techniques such as deep breathing, meditation, and yoga can help with the symptoms associated with Hashimoto’s disease.
- Sleep: Good-quality sleep is essential in healing the thyroid. In today’s times, people compromise their sleep for other activities, which can have detrimental effects on thyroid health. Sleeping for at least 7–8 hours is very essential.
- Exercise: Body movement is very important and regular exercise can certainly positively influence the symptoms associated with Hashimoto’s disease.
Dietary Interventions for Hashimoto’s Disease
Diet plays an important part in improving Hashimoto’s disease. Research studies have been done to look for dietary interventions that can help manage this autoimmune disease.
One such study saw significant improvement in thyroid antibody levels when participants avoided eating red meat, eggs, dairy products, bread (gluten), and legumes and ate a low-carbohydrate diet with lots of leafy greens and other vegetables. (1)(2) There has long been concern about gluten causing issues with autoimmune conditions, especially Hashimoto’s.
Also, the majority of the people with Hashimoto’s disease have trouble losing weight or are already overweight. Thus, a low-carbohydrate diet can help their thyroid to function better while simultaneously aiding weight loss. (3)
Here are the dietary recommendations I give to my patients:
- Avoid processed foods and added sugar.
- Limit processed meat, especially red meat.
- Consume gluten-free and dairy-free foods.
- Eat lots of vegetables daily.
- Try to add fish to your diet as much as possible.
- Eat low-carbohydrate foods.
Can Hashimoto’s Disease Be Cured Permanently?
Hashimoto’s disease is still without a permanent cure, and the only treatment available is thyroid hormone replacement therapy, which is generally a lifelong treatment.
But with functional medicine treatment protocols, there is hope that this disease could be controlled better and, in some cases, even managed without medications.
Does Hashimoto’s Disease Increase the Chances of Developing Cancer?
Hashimoto’s disease is characterized by the presence of thyroid antibodies, mainly thyroid peroxidase and thyroglobulin antibodies.
Recent studies have seen a positive correlation between the presence of these antibodies and having thyroid cancer. (4)(5) So, it does look like Hashimoto’s disease increases the chances of developing thyroid cancer.
It not only increases the risk of thyroid cancer but also other cancers, such as non-Hodgkin’s lymphoma and breast cancer. (6)
Risk Factors for Hashimoto’s Disease
Hashimoto’s disease is associated with the following risks factors:
- Genetics: The risk of getting Hashimoto’s disease is higher in those with family members who are afflicted with the condition.
- Sex: Females are much more likely to get Hashimoto’s disease than males.
- Age: Middle-aged women are more likely to develop Hashimoto’s disease, especially those between 30 and 50 years old.
- Radiation exposure: Exposure to excessive levels of radiation increases the chance of acquiring Hashimoto’s disease at a later age.
- Infections: Some viral infections such as an Epstein Barr virus infection and German measles can trigger Hashimoto’s disease.
- Other autoimmune conditions: Other autoimmune conditions such as lupus and rheumatoid arthritis increase the risk of Hashimoto’s disease.
Complications of an Untreated Hashimoto’s Disease
Hashimoto’s disease gradually evolves into hypothyroidism, which if left untreated or managed poorly can cause serious complications such as:
- Enlarged heart or heart failure
- Mental health problems ranging from depression to reduced cognition
- Myxedema coma
- Decline in sex drive (libido)
Pregnant women with a bad case of Hashimoto’s disease can suffer the following complications:
- Placental rupture
- Preterm delivery
- Low-birth-weight babies
- Postpartum hemorrhage
- Physical/neurological/psychological problems for the child
Hashimoto’s disease is an autoimmune condition, and the prevalence of this disease is increasing rapidly all over the world.
Hashimoto’s disease can be easily diagnosed with simple blood tests. However, it often goes undiagnosed. Conventional medicine has limited modalities to offer when dealing with Hashimoto’s disease.
Lifestyle factors such as improved diet and stress reduction can positively impact health and should be part of the treatment plan for Hashimoto’s disease.
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