Thyroid Autoimmune Disorders!

 Dr. Claire Arcidiacono, ND 

Let us talk about Autoimmune and how it relates to the thyroid. This is important to talk about because thyroid health is much more complex than just under or overactive thyroid. It can be such a complex issue that I will be splitting it into 2 parts. This first part is a breakdown as to what autoimmune thyroid disorder is and the second part will focus on supplements. Let us get into it, shall we? What does autoimmune mean in this context? In this case autoimmune is a term referring to inflammation in the thyroid usually caused by the body’s immune system attacking the thyroid. The most common autoimmune system disorders of the thyroid are Hashimoto’s thyroiditis, Graves’ disease, postpartum thyroiditis, and silent thyroiditis. Sub-clinical thyroid disorders can be triggered by leaky gut, and other pro-inflammatory situations including other autoimmune disorders. (1)

Hashimoto’s disease results in a slow decline of hormones as the cells are damaged by the immune system. The symptoms of Hashimoto’s start slow but proceed to more severe hypothyroidism symptoms as they progress. What exactly are these symptoms? See the attached photo. (8)

As for blood tests TSH and T3/T4 will be typical for hypothyroidism but what is unique is the presence of specific antibodies called thyroid peroxidase or TPO. Please see the picture below for typical lab results for hypothyroidism. Hashimoto’s disease is treated in two main ways. The first is to work with the thyroid to help regulate its function. The second is more about the underlying cause. (2)

In contrast to Hashimoto’s, there is Graves’ disease, which results in the overproduction of hormones or in other words the symptoms of hyperthyroidism.(3)  Please see the attached photo for these symptoms. (9)

Lab results show typical TSH and T3/T4 for hyperthyroidism as well as antibodies to the thyroid. Please see below for typical hyperthyroidism labs. Radioactive iodine uptake can help determine Graves’ disease. The goal of treatment once again is to work on calming symptoms and address the underlying inflammation. (3) Now if you are wondering what I mean by “normal hypothyroid and hyperthyroid labs” I have included a chart right here so you can compare them! (10)

Postpartum thyroiditis is any thyroid dysfunction that occurs in the first 12 months after pregnancy. This may present as hyperthyroidism type symptoms or hypothyroidism type symptoms, or it may present as hyperthyroidism proceeding into hypothyroidism. Postpartum thyroiditis affects approximately 8% of pregnancies. Of those, one in five will develop permanent hypothyroidism that needs to be treated. Usual blood work will show antibodies to thyroglobulin, thyroid peroxidase, and TSH receptors. There is usually also a lymphocyte infiltration and T cell changes noted. In the initial phase there is usually a suppressed TSH. As time passes, this can shift to an increase in TSH, indicating that there is a shift from hyperthyroid to hypothyroidism. For most women there is no need to treat this condition as hormones will naturally regulate themselves. For others it is important to follow up with a health care provider to address the symptoms of thyroid dysfunction. (4)

Silent thyroiditis or sub-acute lymphocytic thyroiditis is a sub type of Hashimoto’s which features a goiter. In this condition, there are hyperthyroid symptoms followed by hypothyroidism symptoms. This can be diagnosed by a radioactive iodine uptake because in both hyperthyroid/hypothyroid you will have a decrease in iodine uptake. (5)

Goiter is a growth in the neck because of an enlarged thyroid, which is usually caused by iodine deficiency. A goiter or even a growth called a thyroid nodule may or may not be metabolically active. If it is active hyperthyroid symptoms can occur. If it is not active it can present as hypothyroid symptoms or in many cases, they are asymptomatic. Since these growths are most often associated with deficiencies of certain nutrients it is important to include those in any protocol. If they are caused by Hashimoto’s or Graves’ disease or pituitary disease or thyroiditis it is important to work on this underlying cause. Goiters and nodules are usually not treated independently but rather as part of a protocol to treat something like Graves or Hashimoto’s. (6)

Last but not least is sub-clinical thyroid disorders which are usually related to leaky gut and other auto-immune issues such as RA, SLE, and Diabetes. In this situation blood work is normal but is sub-optimum. Treating the symptoms can help with feeling better, but it is particularly important to target other underlying issues such as gut dysbiosis and leaky gut with healthy probiotics.(7)

In our next part of this 2-part mini-series I will be talking about just what supplements you can use to help with the symptoms of autoimmune thyroid disorders. I will be talking about supplements you might expect such as Turmeric, Omega 3s and something you may not expect such as Resveratrol!

Sources:

1. https://www.msmc.com/autoimmune-thyroid/#:~:text=The%20most%20common%20forms%20of,an%20overactive%20thyroid%20(hyperthyroidism).
2. https://www.mayoclinic.org/diseases-conditions/hashimotos-disease/diagnosis-treatment/drc-2035186
3. https://www.mayoclinic.org/diseases-conditions/graves-disease/diagnosis-treatment/drc-20356245
4. Keely, Erin Joanne (March 2011). “Postpartum thyroiditis: an autoimmune thyroid disorder which predicts future thyroid health”. Obstetric Medicine. 4 (1): 7–11. doi:10.1258/om.2010.100041. ISSN 1753-495X. PMC 4989649. PMID 27579088.
5. “Subacute lymphocytic thyroiditis” at Dorland’s Medical Dictionary
   Hörmann R (2005). Schilddrüsenkrankheiten Leitfaden für Praxis und Klinik (4., aktualisierte und erw. Aufl ed.). Berlin. pp. 15–37. ISBN 3-936072-27-2.
6. https://www.healthline.com/health/hypothyroidism/five-natural-remedies-for
7. hypothyroidism#natural-remedies
8. https://en.wikipedia.org/wiki/Hypothyroidism
9. https://www.emedihealth.com/glands-hormones/thyroid/treat-hyperthyroidism
10. https://www.amymyersmd.com/blogs/articles/thyroid-test-results