If you’re struggling with fatigue or unexpected weight gain, perhaps you’ve suspected that you might have a thyroid problem. In fact, these are just a few of the many symptoms you may experience when you are hypothyroid, meaning that your thyroid is underactive.

But your thyroid may not be the underlying cause of your symptoms. It is estimated that 90% of those conventionally diagnosed with hypothyroidism actually have Hashimoto’s disease, also known as chronic lymphocytic thyroiditis. It is an autoimmune disease which means the body mistakenly attacks its own tissues.

In the case of Hashimoto’s thyroiditis, the immune system infiltrates and damages the thyroid gland, a small butterfly-shaped gland at the front of the neck. Specifically, immune cells produce proteins called antibodies that capture and neutralize substances required for the production of thyroid hormone. The resulting low levels of thyroid hormone lead to the development of a wide array of possible symptoms.

Signs and Symptoms Of Hashimoto’s Disease

Symptoms may initially be mild and hard to notice. But over time, they become increasingly apparent. In general, the disease involves a slow and progressive destruction of the thyroid gland. However, there may be intermittent periods during which symptoms change as the thyroid seems to regain function, even causing temporary hyperactive thyroid.

  • Fatigue and sluggishness
  • Unexplained weight gain
  • Puffy face
  • Insomnia
  • Forgetfulness
  • Anxiety and depression
  • High blood pressure
  • Periods of sweating, weight loss, and irritability
  • Sore Throat
  • Tongue enlargement
  • Trouble swallowing
  • Swelling in front of the neck
  • Acne
  • Rashes
  • Headaches
  • Bloating
  • Constipation
  • Pale, dry skin
  • Brittle nails
  • Hair loss
  • Increased sensitivity to cold
  • Joint pain and stiffness
  • Muscle spasms
  • Stiff and tender muscles
  • High cholesterol
  • Infertility in women
  • Excessive or prolonged menstrual bleeding

What Causes The Immune System To Attack The Thyroid?

While the exact cause is unknown, genetic factors appear to play a role in developing Hashimoto’s disease. A combination of factors such as age, gender, and other autoimmune or endocrine disorders can also contribute. While there isn’t a whole lot you can do to change your genes, there are actions you can take to remove possible triggers of an autoimmune response. This is key to appropriately managing Hashimoto’s thyroiditis.

6 Ways to Manage Hashimoto’s Disease Naturally

Conventional thyroid medication may improve your thyroid hormone levels and help alleviate your symptoms, but it doesn’t address the true problem – the dysfunction of your immune system. If you can determine what factors are responsible for the autoimmune response, then you can naturally manage the disease by removing these triggers.

Here are six areas to address when you’re looking to reduce the autoimmune response with natural solutions:

1. Nutritional Deficiencies

There are many nutrients that are essential for the normal function of the thyroid and immune system. When you are deficient in these nutrients, you may be more prone to develop autoimmune conditions like Hashimoto’s disease.

  • Selenium is required for the conversion of T4 (the inactive form of thyroid hormone) to T3 (the active form). Without enough selenium, the thyroid hormone remains inactive and Hashimoto’s symptoms may develop. Furthermore, studies have shown that Hashimoto’s patients who take selenium have reduced thyroid antibody levels. 200 mcg is a common starting dose. But there is a narrow window between a dose that is effective and a dose that is toxic. So it is wise to seek the guidance of a healthcare provider to find the right dose for you.
  • Zinc: low zinc levels compromise T3 production because zinc also factors into the enzyme conversion of T4 to T3. Without enough zinc, your hypothalamus has difficulty measuring thyroid hormone levels as well. This impairs your ability to appropriately signal thyroid hormone production when levels get low. It is recommended to take no more than 30 mg of zinc per day unless you are working with a healthcare provider who advises a higher dose.
  • Vitamin D deficiency is associated with the presence of antibodies to thyroid. All Hashimoto's patients should have an annual check of their 25-hydroxy vitamin D levels. Studies show that the level should be 60-80 ng/ml for optimal thyroid and immune system function. For supplementation, Vitamin D3 is a better option than D2 for improving your vitamin D level. The starting dose is generally in the range of 2000 to 5000 IU with adjustment as indicated by rechecking the level after three months.
  • Iron plays a key role in the process of thyroid hormone production. It is also required for the conversion of T4 to T3. In order to determine if you are truly iron deficient and require a supplement, you should have the following lab tests done: ferritin, serum iron, transferrin saturation, and total iron-binding capacity. Your healthcare provider can help you interpret the results and advise you on iron dosage.

When choosing an iron supplement, note that ferrous bis-glycinate is a form that tends to be more absorbable and less constipating than other iron pills. If you take thyroid medication, do not ingest an iron supplement within two hours of taking it, as iron may interfere with the absorption of the medication.

You can also boost your iron levels through dietary intake with foods like red meats, poultry, beans, and dark green, leafy vegetables. But keep in mind that iron from plant sources is not as absorbable as that from animals. Vitamin C can help increase the absorption of iron in that case.     

2. Reduce Intake Of Inflammatory Foods

Decreasing the amount of inflammation in the body is the goal of a Hashimoto’s treatment plan. So it makes sense to remove those foods from your diet that may be causing inflammation. The foods to which a person may be sensitive differs between individuals, but the following foods tend to be the most inflammatory:

  • Gluten
  • Sugar
  • Saturated fats
  • Artificial sweeteners or preservatives
  • Certain components of dairy (e.g. lactose or A1 beta-casein protein)
  • Soy, corn, sunflower, cottonseed, safflower, and mixed vegetable oils

Your healthcare provider can order a blood test for food allergies. You can use this information to steer away from foods for which you demonstrate a sensitivity. However, you may also choose to figure out your food sensitivities on your own by going through an elimination/provocation diet (EPD).

To perform an EPD, you eliminate one food category from your diet for three weeks. Then you add the food back into your diet for three days, assessing your reaction. Look for any symptoms of food sensitivity like bloating, fatigue, headache, joint pain, loose stools, constipation, insomnia, or skin changes.

Food categories you may want to test include:

  • Gluten
  • Corn
  • Other gluten-free grains
  • Dairy
  • Soy
  • Eggs
  • Nuts
  • Legumes
  • Shellfish
  • Nightshades (common nightshade vegetables include peppers, potatoes, tomatoes, and eggplants)

A faster method of implementing an EPD is to eliminate all of these food categories from your diet for three weeks. Then, re-introduce each category one at a time every 3 days. If no symptoms occur when you re-introduce a food, then you can leave it in your diet. If symptoms do appear, then remove the food again.

3. Improve Gut Health

About 70-80% of the cells of the immune system reside in the gut. So when you improve your gut function, you optimize your immune function as well.

Most Hashimoto’s patients have low levels of stomach acid. The gut does not absorb nutrients as well when stomach acid levels are low. Bacteria and other microbes are also able to survive more easily when they pass through the stomach in a less acidic environment. This allows them to take hold elsewhere in the body and cause an infection.

Betaine HCl (hydrochloride) is a supplement that can help boost stomach acid to optimal levels. It should be taken with the digestive enzyme pepsin at the end of a protein-rich meal. This assists the body in breaking down proteins more completely so that they don’t act as an immune trigger as well.

There is an imbalance of good and bad bacteria in the gut of many Hashimoto’s patients. This generally occurs because a deficiency of thyroid hormone causes decreased gut motility. By taking a quality probiotic, you can restore the good bacteria to a level that keeps the bad bacteria under control.

4. Consider Infections

There are two possible explanations for how an infection may cause the immune system to attack the thyroid:

  1. Molecular mimicry involves bacteria or other microbes looking very similar to thyroid cells. Then when the immune system produces antibodies to eliminate the infectious microbes, the antibodies also attack the similar-looking thyroid cells.
  2. Bystander effect describes the theory that microbes infiltrate the thyroid cells. In the process of killing the microbes, the immune system also attacks the cells that house them.

Infections most commonly linked with Hashimoto’s include candida, mycoplasma, and Epstein-Barr Virus. It is worthwhile to check for infections anywhere in the body and treat them appropriately.

5. Relieve Adrenal Stress

When you are under stress, your adrenal glands release cortisol, which signals a decrease in thyroid hormone production. So every treatment plan for Hashimoto’s disease should include stress management activities like yoga, meditation, or breathing exercises.

Adaptogens are natural substances that can also help you appropriately deal with stress. An adaptogen has the ability to boost a weakened immune system as well as calm down an overactive response. So it helps your body adapt to stress in whatever way is appropriate to normalize your body’s function. Examples of adaptogens include reishi, eleuthero, Schisandra, and ashwagandha.

6. Avoid Toxins

There are many toxic chemicals in the environment that can inflict damage on your body in so many ways – causing inflammation, disrupting your hormones, and increasing your risk for an autoimmune response. It’s difficult to avoid them all. But there are a few actions you can take to reduce their impact on your thyroid health:

  • Avoid chemicals that disrupt hormones. The Environmental Working Group (EWG) has put together a list of chemicals that can adversely impact your endocrine system. Avoid products that include these: lead, dioxin, atrazine, phthalates, perchlorate, fire retardants (polybrominated diphenyl ethers), arsenic, mercury, glycol ethers, perfluorinated chemicals (PFCs), organophosphate pesticides, bisphenol A (BPA, or BPA substitutes like BPF and BPS).
  • Use clean personal care products. Many facial and body products contain harmful chemicals that can disrupt your endocrine (hormonal) system. Look at the ingredients list and stick with products that are as natural as possible. Review the EWG list of chemicals to avoid.
  • Clean your air, especially if you live in an industrial area. Consider installing a HEPA (high-efficiency particulate air) filter in your home and office.
  • Avoid plastics for purposes that put them in contact with your food or drink. Plastic often contains BPA or BPA substitutes. Be careful with canned goods as well. The cans often contain BPA (though there are certain companies that specify their use of BPA-free cans).
  • Clean your water. Install a fluoride filter for your drinking water and your shower head.
  • Sweat! Sweating is one of your best detoxification mechanisms. Physical exercise or even a sauna can help you activate the sweating process. It’s always wise to seek the advice of your healthcare provider before changing your physical activity level or trying out a sauna, especially if you have a heart condition.

While there are some individuals who may not be able to fully wean off of their thyroid medication, there are certainly many natural ways to manage Hashimoto’s disease that can help you feel better, if not decrease your medication dose. Whenever possible, find a health practitioner with expertise in both natural treatment and conventional medicine for thyroid conditions. Always consult your healthcare provider before changing your medication dose or adding a supplement.