Thyroiditis/Hashimotos Disease

Ok, so as if “gluten” wasn’t a bad enough word that invaded my daily vocabulary, I learned a new one along my health journey; Hashimoto’s Disease.  So, what the heck is Hashimoto’s and what does it have to do with gluten, you ask?

Hashimoto’s disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, is a form of chronic inflammation of the thyroid gland. The inflammation results in damage to the thyroid gland and reduced thyroid function or “hypothyroidism,” meaning the gland doesn’t make enough thyroid hormone for the needs of the body. Hashimoto’s disease is the most common cause of hypothyroidism in the United States.

According to research reported on in the medical journal Digestive Diseases and Sciences, a significant number of patients with autoimmune thyroid disease also have celiac disease.  There are a ton of well written medical pages which you can labor through to learn more about the Hashimoto’s/celiac connection, but the main take-away is that with one auto-immune disorder, tends to come another. In other words, once you have an Immune-compromising condition, you tend to me more vulnerable to other immune disorders.

When it comes to testing for hypothyroid and Hashimoto’s, there are many conflicting opinions of how to test (and treat) the disorder. Note that in 2003, the American Academy of Endocrinologists recommended that all labs (and docs) change their ‘normal’ TSH range from a previous 0.5-5.0 to a more realistic 0.3-3.0. So results above 3 are considered hypothyroid by docs who have revised their ‘normal’ ranges. This is important to note when dealing with traditional insurance plans and medical docs who may be referencing older requirements. As well, if you believe you are suffering from either hypothyroid or Hashimoto’s disease, its best to seek out an Endocrinologist to provide adequate testing and monitoring of your condition.

Common symptoms of Hypothyroidism and/or Hashimoto’s Disease:

• Constipation
• Difficulty concentrating or thinking
• Dry skin
• Enlarged neck or presence of goiter
• Fatigue
• Hair loss
• Heavy and irregular periods
• Intolerance to cold
• Mild weight gain
• Small or shrunken thyroid gland (late in the disease)

Other symptoms that can occur with this disease:

• Joint stiffness
• Weight gain (unintentional)
• Swelling of the face

So, like many of you, I had symptoms which went un-diagnosed, and untreated for so many years, that by the time we figured it all out, I was a bit of a mess. My symptoms included headaches, fatigue, muscle aches, constipation/diarrhea, skin rashes, thinning hair/hair loss (it would come out in clumps when I brushed it) and menstrual irregularities to name a few.I went form one specialist to the next, and almost all told me I was depressed, suffered from anxiety, or just needed to sleep better. By the time I was 25, I was on several different SSRIs and was told to avoid dairy and caffeine for my “Irritable Bowel Syndrome” which I now know is what they call a person who suffers from bowel issues before Celiac and Gluten sensitivities became more commonplace to test for.So, back to Hashi’s; the most important point to take away from this page is that if you go gluten-free, and still suffer symptoms such as I’ve mentioned above, its best to have your doctor test you for the following tests to make sure you aren’t dealing with Auto-immune hypothyroidism as well.Laboratory tests to determine thyroid function include:

• Free T4 test (low)
• Serum TSH (high)
• T3 (low or normal)
• Thyroid autoantibodies:
  • Antithyroid peroxidase antibody
  • Antithyroglobulin antibody

Treatments: 

You may be prescribed with a thyroid hormone replacement therapy (levothyroxine is a common one) if your body is not producing enough of the hormone. Or, you may receive it if you have signs of mild thyroid failure (such as elevated TSH), also known as subclinical hypothyroidism.

Treatment for Hashimoto’s disease may include observation and use of medications. If there’s no evidence of hormone deficiency and your thyroid is functioning normally, your doctor may suggest a wait-and-see approach. If you do need medication, chances are you’ll need it for the rest of your life.

Synthetic hormones

If Hashimoto’s disease causes thyroid hormone deficiency, you may need replacement therapy with thyroid hormone. This usually involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Levoxyl, Synthroid). Synthetic levothyroxine is identical to thyroxine, the natural version of this hormone made by your thyroid gland. The oral medication restores adequate hormone levels and reverses all the symptoms of hypothyroidism.

Soon after starting treatment, you’ll notice that you’re feeling less fatigued. The medication also gradually lowers cholesterol levels elevated by the disease and may reverse any weight gain. Treatment with levothyroxine is usually lifelong, but because the dosage you need may change, your doctor is likely to check your TSH level every six to 12 months.

If you’re showing signs of hypothyroidism while on a thyroid treatment protocol, I encourage any of you (even those already being treated for hypothyroidism) to ask to have your TSH and thyroid antibody levels tested right away.

Useful sites: 

Here are some sites that I reference often in my quest to better understand what I’m dealing with:

A service of the U.S. National Library of Medicine
National Institutes of Health

 http://www.nlm.nih.gov/medlineplus/ency/article/000371.htm

The Mayo Clinic: http://www.mayoclinic.com/health/hashimotos-disease/DS00567

The Thyroid Book by Doctor Datis Kharrazian – he is a Guru when it comes to the proper treatment of Hashimoto’s patients: http://www.thyroidbook.com/

Here’s a helpful brochure you can print out: 

http://www.adclinic.com/images/brochures/Hashimotos.pdf

To good health!