Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones (T3 and T4) to satisfy the many needs of the body. Low Thyroid function leads to a variety of symptoms and health issues. In today’s article, I’m going to share with you the number one cause of hypothyroidism, why thyroid replacement is not helping you feel better and how functional medicine can help you if you have Hashimotos.

If your doctor diagnosed you with hypothyroidism because your thyroid is not making enough hormones, and those hormone levels are replaced, shouldn’t you feel better? 

If you have been diagnosed or recently diagnosed with Hypothyroidism then you are already familiar with many of the low thyroid symptoms that most people experience. But you might be wondering why you still feel lousy despite taking hormone replacement.

Classic Symptoms of Hypothyroidism

• Fatigue: A common symptom due to reduced metabolism and energy production.
• Weight Gain: Slowed metabolism can lead to weight gain and belly fat.
• Cold Intolerance: Reduced ability to generate body heat may cause sensitivity to cold weather.
• Dry Skin and Hair: Decreased metabolic activity can lead to skin and hair issues.
• Muscle Weakness and Aches: Musculoskeletal discomfort is due to slower metabolic processes.
• Depression: Mental processes can be affected, leading to mood changes.
• Constipation: Slow digestion and bacterial overgrowth (SIBO) is another common issue.
• Bradycardia: Slowed heart rate can occur.
• Goiter: Enlargement of the thyroid gland in some cases due to compensatory mechanisms.

The Number One Cause of Hypothyroidism Is Not What You Think

The number one cause of hypothyroidism in the United States is not an Iodine deficiency, it’s not radiation treatment, its not even thyroid surgery!, it is an autoimmune disease called Hashimoto’s thyroiditis that often goes undiagnosed because it’s not routinely evaluated (*).

This is an autoimmune disorder in which the body’s immune system mistakenly attacks the thyroid gland, gradually destroying thyroid tissue (*). Hashimoto’s thyroiditis is the most common form of hypothyroidism, significantly impacting thyroid function and resulting in the typical symptoms of an underactive thyroid, such as fatigue, weight gain, and depression.

Early diagnosis and proper blood testing are essential to the management of hypothyroidism caused by Hashimotos.

More Than a Thyroid Problem and Why Medicine Has It All Wrong!

Traditional medicine typically addresses this Hashimotos with hormone replacement therapy, but an increasing number of patients are finding little to no relief with their thyroid symptoms (*).

Many thyroid patients are seeking complementary approaches like functional medicine to better manage their symptoms and improve overall health. Functional medicine offers a holistic perspective by emphasizing the root causes of illness and promoting optimal health through personalized care.

Given the complexities of autoimmunity, it seems silly to me why many doctors are not doing more for their patients? If the underlying cause (for the vast majority of people) is an autoimmune disease, why are doctors not asking whats causing or triggering the immune system imbalance.  Taking Thyroid replacement, while it may increase thyroid hormone levels, fails to address the underlying cause of Hashimotos Hypothyroidism.

A comprehensive approach to managing thyroid autoimmune disease that addressed “Why” is more effective than just replacing hormone levels. While I understand that many patients just want to take a pill and feel better, this only hurts the patient in the long run. You can only ignore the problem for so long before you eventually need to address the cause. Read this article that explains what happens when you ignore hashimotos long enough. 

Getting to the root cause involves lifestyle interventions, dietary adjustments, stress reduction, and addressing potential environmental triggers. Sometimes it does require conventional hormone therapy but hormone therapy is not a replacement for the real problem.

Adopting a Holistic Thyroid treatment plan can better manage both the symptoms and underlying pathology of autoimmune thyroid conditions, aiming for optimal long-term health outcomes.

Hashimoto’s Thyroiditis What Triggered It?

The exact cause of Hashimoto’s is not entirely understood, but several factors (triggers) are believed to contribute to its development, including:

1. Genetic Predisposition: A family history of thyroid disorders or other autoimmune diseases can increase the risk of developing Hashimoto’s.

2. Environmental Triggers: Factors such as stress, intestinal (gut) dysbiosis, chronic infection, and high iodine intake have been suggested as potential triggers that could activate the immune system against the thyroid and other tissues of your body.

3. Hormonal Changes: The condition is more common in women, particularly during periods of hormonal change such as pregnancy, menopause, or puberty, suggesting a link between hormone levels and autoimmune activity. (*),(*),(*)

Your Thyroid and Hashimotos

There are two parts to your immune system, TH1 and TH2 and they should be in balance, kind of like a teeter-totter effect thanks to Th3.  One should not be higher than the other.

If your immune system goes out of balance, one system (TH1 or TH2) will become dominant and this will cause your immune system to attack your body.  There are specific blood tests that need to be run to determine if you are autoimmune and if one part of your immune system is dominant.

Now, the problem with autoimmune conditions is that just doesn’t attack one area of your body…your thyroid.  It can and eventually will attack other areas of your body.

It can attack your pancreas, causing diabetes or it can attack your gut, and your gut causing IBS or it can attack your joints, rheumatoid arthritis, it can attack your RBC causing Hemolytic anemia, It can attack your gut leading to B12 and pernicious Anemia. Left unbalanced, it potentially can attack any tissue in the body.

Immune System and Hashimoto’s: The Role of Th1, Th2, and Th3

Understanding the immune response in Hashimoto’s thyroiditis is critical. The immune system is made up of various components, among which T helper (Th) cells play a pivotal role. These cells are classified mainly into Th1, Th2, and Th3, each responsible for a different type of immune response.

1. Th1 Immunity: Th1 cells are typically involved in responding to intracellular pathogens, such as viruses, and activating macrophages. In Hashimoto’s, an imbalance may occur where Th1 cells are overly active, leading to inflammation and tissue damage in the thyroid. This Th1 dominance can perpetuate the cycle of autoimmunity and inflammation.

2. Th2 Immunity: Th2 cells are responsible for responding to extracellular pathogens, such as parasites, and are involved in humoral immunity. In autoimmune diseases like Hashimoto’s, an imbalance can occur between Th1 and Th2, with Th1 responses often being more prevalent.

3. Th3 Immunity (Regulatory T Cells): Th3 cells or regulatory T cells (Tregs) play a crucial role in immune tolerance by suppressing immune responses and preventing autoimmunity. If the function or number of Th3 cells is compromised, as sometimes seen in Hashimoto’s, this can lead to unchecked Th1/Th2 activity and the progression of autoimmune thyroid damage.

In Hashimoto’s thyroiditis, the immune response is primarily considered to be “Th1-dominant,” meaning that the body’s immune system leans towards a Th1 type of response, characterized by T cells which attack the thyroid tissue, leading to the destruction of thyroid cells and the development of hypothyroidism; in contrast, a Th2 response would be more humoral, involving antibody production, which is not the primary mechanism in Hashimoto’s

Treating Hashimotos With Functional Medicine

Functional medicine seeks to address the body as an integrated system rather than isolating symptoms. Practitioners focus on the unique factors contributing to each individual’s condition. For Hashimoto’s, this might involve:

1. Personalized Assessment: Functional medicine practitioners conduct comprehensive evaluations to understand each patient’s lifestyle, environment, and genetic predispositions. This includes a detailed history, laboratory analyses, and consideration of environmental and psychological factors that may contribute to autoimmune activity.

2. Root Cause Identification: The goal is to uncover underlying causes of autoimmune dysfunction, which may range from gut health imbalances, chronic inflammation, food sensitivities, and nutrient deficiencies, to environmental stressors such as toxins.

3. Integrated Treatment Plans: Once potential triggers are identified, a tailor-made treatment plan is developed to restore health balance. This often Focuses in on

• Diet and Nutrition: An anti-inflammatory diet can support immune function and reduce autoimmune reactions. Commonly recommended strategies include incorporating foods rich in antioxidants and omega-3 fatty acids and avoiding gluten, dairy, and processed foods that might trigger inflammation. Patients benefit from specific dietary plans, such as the Autoimmune Protocol (AIP), removing food sensitivities and an anti-inflammatory diet.
• Nutrient Supplementation: Certain nutrients like selenium, zinc, and vitamin D are critical in supporting thyroid function and modulating immune responses. Supplementing these, under professional guidance, can aid healing.
• Gut Health: Since a significant portion of the immune system resides in the gut, improving gut flora and integrity may lower autoimmune activity, involving probiotics, prebiotics, and, in some cases, elimination of gut irritants.
• Stress Management and Lifestyle: Stress has negative effects on the immune system. Correcting any stress hormones that may be elevated or depressed becomes important in managing hypothyroidism caused by Hashimotos.
• Detoxification and Environmental Factors: Detoxifying the body from heavy metals and other toxins can further support immune health, along with addressing potential environmental triggers like mold or household chemicals.

4. Monitoring and Adjusting: Ongoing assessment and adaptation of treatment plans are vital components in functional medicine. As patients respond to interventions, plans are adjusted to ensure continued progress towards optimal health.

Benefits of Functional Medicine for Hashimoto’s Patients

While hormone replacement therapy with synthetic thyroid hormones (like levothyroxine) may help manage the hormone levels in individuals with Hashimoto’s thyroiditis, managing Hashimoto’s often requires additional strategies beyond just taking hormone pills. Adapting a functional medicine approach offers several potential benefits, including:

1. Holistic Care: By treating the whole person, not just symptoms, individuals often experience improvements in overall well-being alongside thyroid health.
2. Empowerment: Patients gain a better understanding of their condition and become active participants in their health management.
3. Reduced Reliance on Medication: While not a substitute for necessary medication, functional medicine can often reduce the need for medication and enhance quality of life.

1. Adrenal Fatigue and Thyroid: How Are They Connected?
2. Menopause and Hypothyroidism-Managing Hypothyroidism During Menopause
3. Thyroid Medication Not Working? 10 Reasons Why Your Thyroid Medication Stopped Working
4. Brain Fog And Hashimotos- Why People With Hashimotos Struggle
5. 10 Of The Most Common Gut and Intestinal Problems Seen In Patients with Thyroid and Hashimoto’s Autoimmune Disease
6. How Can I Increase My T3 Levels Naturally?

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