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Hashimoto’s Autoimmune Thyroid-Patients with Normal TSH Values-

Do you have normal a normal TSH or thyroid hormone levels? but suspect Hashimotos disease?  Hashimoto’s disease, also known as Hashimoto’s thyroiditis, is an autoimmune disease that affects the functioning of your thyroid. In this article, we’ll answer that question and explain in greater detail what Hashimoto’s disease is and how to know whether you have it .

Because Hashimotos shares many symptoms with other thyroid conditions, Hashimoto’s disease can be difficult to detect early especially if your doctor or endocrinologist does not evaluate your Thyroid antibodies.

Is Hashimoto’s really a big deal?  A lot of doctors say, have the attitude that Hashimoto’s is no big deal.  You simply take your thyroid medication and you live with it. “There’s nothing you can do about it.” does any of this sound familiar? What your doctors and endocrinologist have failed to tell you is that taking thyroid replacement will not stop the autoimmune destruction caused by Hashimotos disease, and they also have not told you that its most likely your immune system will attack other tissues of your body like your joints, your pancreas, your intestines or some other gland, muscles, organ in your body. What they also don’t tell you is that 90% of people diagnosed with hypothyroidism have Hashimotos when they get properly tested.

If you’re suffering with Hashimoto’s, you know how bad the symptoms can get. There are your classic low thyroid symptoms like;

  • Constipation
  • Dry skin
  • Vaginal dryness
  • Muscle weakness
  • Feeling cold all over all the time
  • Frequent sweating
  • Hair loss
  • Depression

But then there are symptoms like heart palpitations, panic attacks, the sudden weigh loss, the nervousness, anxiety and irritability, and the sweating attacks to name a few.

Hashimotos Bloodwork

Take a look at the  blood work I recently ran on a patient. There are a couple of things worth pointing out. First you notice that Thyroid peroxidase markers are 718. Normally, you shouldn’t have thyroid antibodies present. Next take a look at the TSH level of 2.7. This is well within range, Now take a look at the Free T4 levels at .85 Again while these are low they still fall within range. This patient has a history of inward trembling, insomnia, hair loss and extreme fatigue and for years her doctor refused to look at anything other than her very normal TSH.

As you can see form this study published in Expert Review of Endocrinology and Metabolism- A patient suffering with a Thyroid disorder Should Have their Antibodies tested. Patients can have normal thyroid stimulating hormones (TSH) but have Hashimoto’s.


Thyroid peroxidase

Imagine how long this patient was suffering prior to coming to our office and getting the proper diagnosis that she has Hashimotos Thyroiditis. Again, you can clearly see that her TSH is normal, Her Free T4 levels are Normal. Another interesting factoid is that you will notice her Total cholesterol is elevated as well as her calculated LDL cholesterol is elevated. Cholesterol production is in part regulated by your thyroid gland. This is a case in point why it’s critical to have a complete thyroid panel performed.  The persons whose world is crashing down.

For more information on the link between cholesterol and Thyroid disease you can read this article here


  • What if your doctor never ran these tests?
  • What if all your doctor has been doing for the last five or 1o years is changing your thyroid medication during your annual visit. 
  • What if your doctor just prescribed new medications for new symptoms? statins for your high cholesterol, beta blockers for your heart palpitations, antacids for your acid reflux, Ambien for your insomnia and antidepressants for your depression? Do you see how quickly this gets crazy?

Most Common Cause of Thyroid Disease

Hashimoto’s is the most common cause of low thyroid. (NOT iodine deficiency or tyrosine deficiency). New research proves that when women have TPO antibodies– decreased quality of life even if their TSH and their hormone levels are normal.


Hashimoto's Autoimmune Thyroid-Patients with Normal TSH Values- 4

Hashimoto's Autoimmune Thyroid-Patients with Normal TSH Values- 3

You Don’t Need To Feel Helpless When You Have Hashimotos?

There’s thousands of women who are suffering with Hashimoto’s…who feel helpless….because no one will help them or know what to do with them. If you’re reading this and you have positive TPO antibodies or positive TGB antibodies, here’s some piece of mind…

…Understand that the research shows that you can have “normal” TSH levels and still suffer with all of these symptoms. This study I mentioned gave approximately 600 women questionnaires, and the researchers found out that…

  • constipation
  • dry skin
  • hair loss
  • vaginal dryness
  • weakness
  • feeling cold all the time
  • requiring excessive amounts of sleep to function….

all occurred while TSH levels were normal. What I cant help but wonder is had these woman had a complete thyroid panel performed, how many of these woman would have actually been properly diagnosed?

Women with Positive TPO Antibodies Are Having a Horrible Time With Symptoms Even Though They Are Not Classically “hypothyroid.” Yet

They also analyzed the kinds symptoms in two groups of these women–those with TPO antibodies  less than 121 or TPO antibodies greater than 121.  What they found out is these women are suffering in all domains: social roles, their zest for life, their physical ability, their pain.

If you’ve ever been made to feel that you’re crazy, or “just depressed” because you’ve got these TPO/TGB antibodies–but you’re not low thyroid… so the symptoms you’re having can’t be due to Hashimoto’s…

Well, now you can go back to that doctor and say…“Why don’t you read this study? Why don’t you read something that’s up to date? There is a reason I feel bad.”

Other Symptoms of Hashimoto’s disease

If you suspect you have Hashimoto’s disease, below is a list of the symptoms you should look out for:

Thyroid Nodules and Thyroid Goiter

Thyroid nodules and Goiters are incredible common with Hashimotos disease. A goiter is an enlargement of the thyroid gland. When you hear about someone say, “I have a Goiter”- you might be visualizing someone that looks like they just swallowed a softball and it got stuck in their throat.

Here’s the real deal. Like I just mentioned a goiter is an enlargement of the thyroid gland tissue. It’s most commonly caused by excessive stimulation of the gland as in the case of Hyperthyroidism or in the case of an undiagnosed autoimmune disease known as Hashimoto’s. Either way if you have a Goiter you can almost bank on the fact that you have an autoimmune disease. Both Hyperthyroidism and hypothyroidism are autoimmune diseases that cause Goiters and thyroid nodules. For many people in the early stages of Hashimotos, symptoms of hyperthyroidism is also present.


Hyperthyroidism is when your thyroid gland produces more thyroid hormones than your body needs. As your thyroid comes under attack from your immune system due to Hashimoto’s disease, it can become overactive. The symptoms of an overactive thyroid then become potential symptoms of Hashimoto’s disease. Common indications of hyperthyroidism include:

  • Fatigue

  • Unexpected weight loss

  • Higher than usual appetite

  • Rapid or irregular heartbeat

  • Being unusually bothered by the heat or sweating more than usual

  • Weakness or shaky hands

  • More frequent bowel movements

  • Nervousness or irritability

  • Difficulty sleeping

Whats Going To Happen To Me If I Have Hashimotos?

If you simply rely on Thyroid replacement as the fix to your Hashimotos disease, then over a period of time, your thyroid gland will completely shut down and you will become permanently hypothyroid depending on your doctor to a large degree guessing about the dosage of Synthroid or levothyroxine you should be taking. From one month to the next, you doctor will change your dosages. One month he or she will increase your dosage, the next month he will be decreasing your dosage. This is problem number one. But problem number two is the bigger problem. The Bigger problem is that the longer your immune system stays dysregulated and attacking the thyroid gland, the greater the likelihood you will develop another kind of autoimmune disease like the ones you see listed below. The most common autoimmune diseases associated with Hashimotos include Celiac Disease, Lupus, Multiple Sclerosis, Pernicious anemia, Rheumatoid arthritis, and skin conditions like vitiligo, Psoriasis and eczema (Trusted Source).

Hashimoto's Autoimmune Thyroid-Patients with Normal TSH Values- 2

Functional Medicine and Autoimmune Thyroid disease

Functional medicine has a lot to offer women suffering from chronic disease, including Hashimoto’s. By understanding each woman’s root causes, we can work to restore immune balance from the root of the issue. The result is often improvement of symptoms and a halt or reversal of the disease process. It isn’t always a single solution or quick fix, but often takes a variety of interventions and significant lifestyle change.

Can Hashimoto’s Disease Be Reversed?

The conventional medicine approach to Hashimoto’s is to manage thyroid hormone levels just as in other cases of hypothyroidism. Often, this means thyroid hormone replacement, where thyroid hormone is taken orally. While medication is helpful, and often necessary, this approach fails to address the root cause issues that are driving immune dysfunction and tissue damage.

Many women come to me for another opinion, when they keep increasing their medication dosage, but continue to have symptoms of Hashimoto’s hypothyroidism. Reversal of Hashimoto’s might depend upon how much damage to the thyroid has already occurred, but in some cases reversal or remission is possible. In many cases, thyroid medication remains part of the overall treatment strategy, along with diet and lifestyle change to address root causes, halt disease progression and resolve symptoms.

we want to understand the complete picture of thyroid health. I’m also interested in other hormone imbalances, since all hormonal systems are connected. A thyroid imbalance may lead to an imbalance in sex hormones or an adrenal imbalance may contribute to thyroid imbalance, as examples.

Diet, Nutrition And Hashimoto’s Disease Improvement- Follow These tips. 

You may be wondering what you can do to start taking control of your health. Here are some places to focus on in order to dampen autoimmunity and address the root causes pieces:

  • Get A Complete Thyroid Hormone Panel. While your insurance company will not pay for all of these Thyroid markers, it’s well worth the investment of knowing whether or not you have Hashimotos and what pattern of Thyroid disease you have.
  • Eliminate gluten and identify food sensitivities in the diet. A gluten-free trial is warranted for those with Hashimoto’s and other autoimmune disease. An elimination diet may be used as a jumping off point to discovery our personal Hashimoto’s disease diet.
  • Follow a nutrient-dense whole food diet. It is important to meet protein and micronutrient needs in order to support proper immune function. Functional testing for omega-3 fats, vitamins, minerals and amino acids may be warranted in order to personalize your diet and supplement protocol.
  • Balance the microbiome. Microbiome health is foundational. Functional stool testing is helpful to uncover any pathogenic infections, markers of permeability and imbalances. Targeted gut support is essential.
  • Learn to manage stress. Stress is a huge factor when it comes to autoimmunity and thyroid health. The thyroid and adrenals influence each other; when the body perceives stress, it will dial down thyroid function for protection.
  • Get rid of toxins. This means addressing environmental toxin exposures from all areas of life by choosing organic, using clean personal care and cleaning products, filtering drinking water, filtering indoor air and educating yourself about exposures. Support detoxification to help clear those exposures that you can’t control.

As you can see, a functional medicine approach to Hashimoto’s is a truly comprehensive one. It includes conventional treatments such as hormone replacement, but also utilizes the power of food lifestyle tools as root cause medicine.

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