A friend recently messaged me saying a few of her friends “are being knocked around by Hashimoto’s,” and asked if I had some advice.
As I entered my 40s I was confronted with the dreaded bulge. I exercised more and ate less but couldn’t budge it. I also suffered from tiredness, constipation, hair loss, severe menstrual cramps and dry skin.
A little research revealed these symptoms could be associated with a sluggish thyroid gland. Obligingly, my GP ran blood tests and confirmed my anti-thyroid antibodies were too prolific to count. My body was attacking itself.
Japanese physician and academic, Hakaru Hashimoto, discovered these antibodies in the early 1900s. The target organ—in my case the butterfly-shaped gland at the base of my neck—differentiates Hashimoto’s thyroiditis from other increasingly pervasive auto-immune diseases like type 1 diabetes, rheumatoid arthritis, celiac and inflammatory bowel disease.
I was one of the lucky ones to discover this oft-overlooked condition early. Hashimoto’s thyroiditis affects around 12 percent of Australians. Nearly ten times more endemic in women than men, it is most common between 40 and 60 years of age.
As a forty-something female with a familial history of thyroid conditions, I was in the high-risk category. Genetics can increase susceptibility. But its increasing prevalence suggests lifestyle factors weigh in.
My GP prescribed synthetic Thyroxine to replace T4, a hormone normally produced by the thyroid gland. The thyroid also produces small amounts of T3, the active hormone, but most T3 is converted from T4 by the liver and bodily tissues as required. All body cells need these hormones to regulate metabolism.
Other tests revealed alarmingly low vitamin D levels (20ng/ml), linked to under-active thyroid and autoimmunity. I added vitamin D supplements. But despite these pills and my new daily jogging routine, my energy levels stayed down while my weight stayed up.
Another doctor prescribed compounded thyroid extract, containing T4 and T3. My energy levels improved, and weight stabilised. But shedding excess kilos remained an uphill battle. Alas, you can’t just take more thyroid hormones. The human body has fine-tuned homeostatic feedback loops, so the more hormone the thyroid detects, the less it produces.
Being a nutrition researcher, I scoured the literature. I learned that the thyroid needs selenium (rich in foods like Brazil nuts, oysters and tuna) and iodine (in seaweed and fish) to produce hormones. Levels must be tested and monitored to avoid overdosing.
Other research points to intestinal permeability, or “leaky gut”, as a likely culprit for autoimmune disease. Our gut lining is the interface between our body and the outside world. Its exquisitely complex jobs include letting nutrients in while blocking toxins, pathogens or undigested food. If these substances enter the blood through a compromised intestinal barrier, the immune system mounts an attack.
Increasing evidence suggests the 100 trillion bacteria and other microbes that subsist in our gut facilitate this immune response and protect the intestinal barrier’s integrity. I had taken regular series of antibiotics while growing up to fight recurring tonsillitis and other ailments. Antibiotics dramatically decrease bacterial diversity, research shows. I decided to take probiotics.
In support, a study published last month reported that patients with Hashimoto’s thyroiditis had an altered microbiome profile compared to healthy controls. These differences were correlated with clinical symptoms, suggesting gut bacteria could be involved in the disease’s pathogenesis.
Soy products emerged as a possible contributor to autoimmune thyroid disease. Soy products had been a staple in my diet, so these were out.
Stressors, both physical and psychological, impact immune function and may also trigger autoimmune disease. A review of this association concluded that “treatment of autoimmune disease should thus include stress management and behavioural intervention to prevent stress-related immune imbalance.”
This made sense and became another target in my work and personal life. I also added magnesium, associated with stress, to my daily regime.
But autoimmune disease research is scant. I drew on some general principles. My diet was already high in nutritionally rich plant foods and I progressively ate less processed food, even relinquishing my favourite potato chips and ice cream. Some research suggests protein can curb appetite. I started taking whey protein powder and noticed food cravings subside. Bolstered by this I eliminated sugar and cut out bread, pasta and pastries.
Sugar alters the gut microbiome and can cause inflammation. Some evidence links gluten with intestinal permeability. This research says gluten triggers the release of zonulin, a protein that helps maintain tight gut barrier junctions. However, more research is needed to establish gluten’s role in autoimmune conditions other than celiac disease. Read more