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Complications of Untreated or Mismanaged Hashimoto’s Thyroid disease

Hashimoto’s disease, also known as Hashimoto’s thyroiditis, is an autoimmune disorder that overtime destroys the thyroid gland. (*) Left untreated, Hashimotos can give rise to numerous complications (*) that significantly impact a person’s emotional and physical health. In today’s article, I review some of the most complications of untreated or mismanaged Hashimoto’s disease.

The Risks of Ignoring Hashimoto's Disease

Understanding Hashimotos

To fully understand the complications of Hashimotos disease either from untreated or poor management, you need to have a basic understanding of the condition itself. Hashimoto’s disease occurs when the immune system attacks the thyroid gland. This leads to chronic inflammation, destruction of the gland and ultimately an under-active thyroid, known as hypothyroidism.(*) Common symptoms of Hashimotos include fatigue, weight gain, hair loss, heart palpitations, Migraines and depression.

 The Risks of Untreated or Poorly Managed Hashimoto’s disease

Untreated or poorly managed Hashimoto’s disease poses several risks that can expedite the progression of the condition and potentially lead to other health problems. Hashimoto’s disease is a progressive condition, and without treatment, the symptoms will worsen over time. Many patients with long standing Hashimotos, experience increased fatigue, weight gain, hair loss, and depression. These symptoms can impact your daily life, making it difficult to perform tasks and enjoy activities.

One of the primary risks is the persistent underproduction of thyroid hormones, which can result in long-term damage to multiple body systems. Additionally, untreated Hashimoto’s can increase the risk of developing cardiovascular diseases, infertility, mental health disorders, and even cancer.

Common Complications of Hashimotos

Hashimoto’s disease, when untreated or poorly managed, can have various long-term effects on the heart. Some of the potential complications include an increased risk of developing cardiovascular diseases such as atherosclerosis, coronary artery disease, and heart failure. The mismanaged inflammation and hormonal imbalances caused by Hashimoto’s can lead to the buildup of plaque in the arteries, increasing the risk of heart-related complications. Hashimoto’s disease can cause abnormal lipid profiles, including elevated levels of LDL cholesterol (the “bad” cholesterol) and triglycerides. These lipid abnormalities can contribute to the development of atherosclerosis and increase the risk of heart disease.

The under-active thyroid slows down the body’s metabolic rate, leading to the accumulation of triglycerides and low-density lipoprotein (LDL), also known as “bad” cholesterol. These factors contribute to the development of atherosclerosis and can ultimately result in heart attacks or strokes.

Cardiovascular Complications and Hashimotos thyroid disease

Poorly managed Hashimoto’s disease can cause disruptions in the normal electrical conduction system of the heart, leading to abnormal heart rhythms such as atrial fibrillation. This condition can increase the risk of stroke and may require additional treatment and monitoring. Another problem seen with patients who have Hashimotos is Pericardial Effusion.

Most autoimmune diseases are triggered by chronic inflammation. Hashimotos is no different.  Hashimoto’s disease can cause inflammation of the pericardium, the thin sac that surrounds the heart. This inflammation can lead to the accumulation of excess fluid called pericardial effusion, which can put pressure on the heart and impair its function. Lastly, when it comes to cardiovascular complications we need to discuss Homocysteine levels.

Elevated levels of homocysteine are seen more frequently in individuals with hypothyroidism, including those with Hashimoto’s disease. Homocysteine is an amino acid that is normally metabolized in the body. However, when the metabolism of homocysteine is disrupted, it can lead to increased levels in the blood.

Thyroid hormones play a role in maintaining the proper functioning of enzymes involved in the methylation process. Methylation is a chemical reaction that helps regulate the metabolism and breakdown of homocysteine. When thyroid hormone levels are low, the methylation process may be impaired, leading to elevated homocysteine levels. Elevated levels of homocysteine have been associated with an increased risk of cardiovascular disease, including atherosclerosis, blood clots, and stroke.

One thing to note as we review these different complications is that not everyone with Hashimoto’s disease will experience these specific cardiovascular problems. However, regular monitoring, early detection, and appropriate testing is crucial to minimize the risk of long-term effects on the heart. If you have Hashimoto’s disease, it is recommended to work closely with a healthcare professional to optimize thyroid hormone levels, manage cardiovascular risk factors, and promote heart-healthy habits.

Reproductive Complications of Hashimotos

Women with Untreated or mismanaged Hashimoto’s disease, are prone to various reproductive difficulties. Hypothyroidism can disrupt the menstrual cycle, leading to irregular  heavy periods, anovulation (cycle without ovulating) and difficulty conceiving. Additionally, pregnant women with this condition have a higher likelihood of complications such as preeclampsia, premature birth and miscarriage, particularly in the early stages of pregnancy. Proper treatment and regular monitoring are essential for managing these risks and increasing the chances of a successful pregnancy.

Hormone Complications Seen In Hashimotos

Women with Hashimoto’s disease commonly experience hormone imbalances, which show up in several ways. The most common hormone imbalances seen in women with Hashimoto’s include imbalances in estrogen, progesterone, testosterone, Cortisol, Prolactin, and Insulin.

Estrogen and Progesterone:

Hashimoto’s disease can also affect estrogen and progesterone levels, which are crucial for reproductive health and menstrual cycle regulation. Imbalances in these hormones can lead to irregular or heavy periods, cycle irregularities, and fertility issues. Often, we refer to this imbalance as estrogen dominance.

Common Hormone Complications Seen In Hashimotos 

Adrenal Gland Problems

Hashimoto’s disease is an autoimmune disorder, and like most chronic autoimmune disorders, Hashimotos disrupts the normal regulation of cortisol, the primary stress hormone. Women with poorly managed Hashimotos often struggle with problems with Cortisol. Both low and high cortisol levels can impact energy levels, sleep patterns, and the overall response to stress. We see Adrenal Fatigue in most woman we work with who have Hashimoto’s and Graves disease.

Insulin and Blood Sugar Regulation:

Insulin resistance and imbalances in blood sugar levels are often observed in individuals with untreated or poorly managed Hashimoto’s. These imbalances can contribute to weight gain, difficulty losing weight, and an increased risk of developing conditions like diabetes.

Sex Hormone-Binding Globulin (SHBG):

SHBG is a protein that binds to sex hormones, such as estrogen and testosterone, circulating in the blood. Hashimoto’s disease can alter SHBG levels, which in turn affects the availability and activity of sex hormones in the body. Woman with low sex drive, low stamina, irritability often have problems with SHBG and their androgen levels DHEA, testosterone, Free Testosterone.

Mental Health Disorders and Complications of Hashimotos

Untreated or mismanaged Hashimoto’s disease can have a significant impact on mental health. The imbalance of thyroid hormones can lead to various mental health problems. The most common mental health problems caused by untreated Hashimoto’s disease include: depression, anxiety, Cognitive impairment, moods swings.

Hypothyroidism, a result of untreated Hashimoto’s disease, can cause a persistent feeling of sadness, loss of interest in activities, and a lack of energy. These symptoms often overlap with those of clinical depression. The low levels of thyroid hormones affect the production of neurotransmitters like serotonin, contributing to the development of depression.

Anxiety disorders, including generalized anxiety disorder (GAD) and panic disorder, are commonly associated with untreated Hashimoto’s disease. The disrupted thyroid hormone levels can result in feelings of restlessness, irritability, and an increased sense of worry. Anxiety symptoms may be further compounded by physical symptoms such as heart palpitations and tremors.

complications of Hashimotos Depression, anxiety Brain Fog

Hashimoto’s disease can affect cognitive function, resulting in difficulties with memory, concentration, and overall cognitive performance. This condition, commonly known as “brain fog,” can have a significant impact on daily functioning and may contribute to feelings of frustration, hopelessness and decreased productivity.

Fluctuating levels of thyroid hormones as seen in patients who have Hashimotos often lead to mood swings, which involve sudden and intense changes in motions. Individuals with improperly manages Hashimoto’s disease also often experience periods of irritability, anger, and heightened sensitivity to stress. These mood swings can strain relationships and lead to a diminished quality of life.

Increased Cancer Risk

While the risk of developing cancer from Hashimoto’s disease is relatively rare, studies have shown an increased likelihood of certain types of thyroid cancer in individuals with untreated poorly managed Hashimoto’s. Regular monitoring and proper management of the condition are crucial to detect any abnormal changes in the thyroid gland and mitigate the risk of developing cancer.

Importance of Proper Treatment

Proper treatment of Hashimoto’s disease is essential in minimizing the risks and complications associated with the condition. Diagnosis typically involves regular monitoring of thyroid function and hormone levels, along with lifestyle modifications. In some cases if substantial damage has been done to the thyroid gland or the thyroid has been removed because of nodules, medication.

Functional Medicine and Hashimotos- How To Properly Manage Your Hashimotos.

Functional medicine offers a very different approach to Hashimotos. While traditional medicine focuses solely on thyroid hormones levels, Functional medicine doctors emphasize the triggers behind the autoimmune disease. Why is the immune system attacking the thyroid gland and what can we do to stop, slow down or even reverse the damage.

Functional medicines focus is on Identifying and addressing the underlying root causes of disease, rather than just treating symptoms. Functional medicine takes into account the interconnectedness of various systems in the body and acknowledges that imbalances in one area can affect other areas as well. The proper treatment of Hashimotots involves more than taking thyroid replacement. In fact, if all your doctor does is provide thyroid replacement and while ignore the root cause or triggers behind your immune system dysfunction, you are not receiving proper treatment for your Hashimotos. This is case of poorly treated and mismanaged care.

Hashimotos Treatment- More than Just Thyroid Replacement. 

Many people with autoimmune Hashimoto’s disease have this misunderstanding that by taking thyroid replacement they are somehow receiving treatment for their Hashimotos. This is not the case. Remember Hashimotos is an autoimmune disease, it just happens to be destroying your thyroid gland.

Many traditional doctors and endocrinologists are not concerned about the damage the immune system is doing to the thyroid. They only focus on replacing low hormone levels.  The entire patient experience is Reactive rather than proactive.

Every question in Functional Medicine starts with “WHY.”

Why is your immune system attacking your thyroid?- sounds like a logical place to start when you have Hashimotos Right? in traditional medicine, everyone is treated the same. when you visit your doctor, he tests your hormone levels, if they are low, they increase the thyroid hormone dosage and if the thyroid hormone levels are too high, they lower the thyroid hormone dosage. When your levels are all over the place, they simply change you from one thyroid medication to another thyroid medications. This is the management for people with Hashimotos. In functional medicine, we recognize everyone’s root cause will be different.  We all have different genetics, we all have different health histories and lifestyles, we have different lifestyle stressors.

Science no longer supports the idea that once the immune system is activated that it just becomes this self sustaining attack with no ability of slowing down, reversing it and stabilizing it. We now know that autoimmune diseases can be reversed, and that individual triggers behind the autoimmune disease need to be identified in order to accomplish this.

What this means is that if you can break the cycle by first identifying the autoimmune triggers (*) and then treat those triggers, you can put the immune system in a more harmonious stabilized state. This in turn shuts down the attack on your thyroid.

What are these Autoimmune Triggers? These may be issues pertaining to the gut or gut microbiome(*). Leaky gut, bacterial or fungal intestinal dysbiosis,(*) food sensitivities, high viral load caused by Epstein BARR virus, Cytomegalovirus virus, herpes virus or other pathogens, (*) Other triggers may be environmental. These may include chemical sensitivities to plastics (*) or mold toxins.(*) Other triggers may include High/Low levels of cortisol, a hormone released in response to stress. Other Triggers may include hormone imbalance, nutritional imbalances (*).

When Did You First Notice You Weren’t Feeling Well

Do you recall when you first started feeling sick? Was it after a vaccine? Was it after a dental procedure?, was it a tick bite? or after you found mold in your air conditioning unit?. Was it after you started taking the birth control pill?, again these are all questions a good functional medicine doctor will start asking. In my office, my new patient application is set up in such a way that we go through all these questions and the different systems of the body. The purpose is so that we can identify what systems of the body are compromised. This is a stark difference when you compare this to traditional medicine and endocrinology.

Are your doctors treating the symptoms or are they stepping out of the box and asking the questions that matter?. No thyroid medication is ever going to stop this autoimmune attack, the focus needs to be on creating a healthy body, not raising and lowering hormone levels. Once you step out of that box, you will clearly see that there is hope and that you can feel good again.

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