Thyroid health, Hashimoto's, what you need to know...

Hashimoto's thyroiditis, an autoimmune disorder, is a condition whereby the immune system mistakenly attacks the thyroid gland, leading to inflammation and impaired hormone production. In people with Hashimoto's, the immune system attacks the thyroid.
Located in the front of your neck, the thyroid gland is an organ that makes hormones that
control metabolism. So, thyroid hormones affect a lot of things, including your heart rate and how quickly your body uses calories from the foods you eat.
Hashimoto's can present in a variety of symptoms, which may develop gradually.
Some common symptoms include:

• Persistent tiredness or fatigue is one of the most prevalent symptoms of Hashimoto’s.
• Weight Gain, this can be unexplained weight gain or difficulty losing weight which can occur due to a slowed metabolism.
• Increased sensitivity to cold temperatures.
• Skin may become dry, and hair may become brittle and fall out.
• Digestive issues, including constipation and bloating are common.
• Mood swings, anxiety, or depression can occur due to hormonal imbalances.
• Weakness, particularly in the lower body, may be experienced.
• Aches and stiffness in joints can be a common complaint.
• Women may experience heavier or irregular menstrual cycles.

Many of these symptoms are similar to hypothyroidism, yet we see many cases where
Hashimoto's presents without hypothyroidism which includes increased TSH levels.

When it comes to the development of Hashimoto’s, there are several factors that can trigger and worsen Hashimoto's symptoms. We often see a link between family history of autoimmune diseases, this can be a risk factor in itself.
Exposure to certain chemicals, heavy metals and mycotoxins from mould have been linked as a trigger for the condition, this is due to their effects on the immune system. These are risk factors which we can test for and modulate in our clinical practice to optimise immune health. 
Viral or bacterial infections may play a role in the onset of Hashimoto's, for example the Epstein Barr virus and Shingles. 
Chronic stress can impact the immune system and exacerbate symptoms of Hashimoto's.
Due to the link between Hashimoto’s and the immune system, we often see links that can
impact the immune system, triggering or worsening symptoms..
Gluten has been shown to be a trigger for worsening symptoms of Hashimoto’s. Immune
cells form antibodies against the protein gliadin within gluten to quickly detect and neutralise it in future exposures. Due to very similar structures in gliadin (gluten) and an enzyme called transglutaminase, which is heavily concentrated in the thyroid gland, these sensitised gluten antibodies will mistakenly attack the thyroid gland at the same time it attacks gluten protein.
Studies show women with Hashimoto's Thyroiditis saw a reduction in thyroid antibody titers after following a strict gluten-free diet for six months.

So what does Gut health have to do with Hashimoto’s?

The microbiome can have a significant effect on Hashimoto's thyroiditis and overall thyroid health. The gut microbiome, which consists of trillions of microorganisms living in the digestive tract, plays a crucial role in regulating various bodily functions, including immune responses and inflammation.
A healthy gut microbiome helps to maintain a balanced immune system. Dysbiosis, or an
imbalance in gut bacteria, can lead to increased inflammation and autoimmune responses, potentially exacerbating conditions like Hashimoto's. The gut is a major component of the immune system, and an unhealthy microbiome can lead to a compromised gut barrier (often referred to as 'leaky gut' or intestinal permeability ). This allows toxins and undigested food particles to enter the bloodstream, which can trigger autoimmune responses.
Certain gut bacteria can produce short-chain fatty acids (SCFAs) that have anti-inflammatory properties. If the microbiome is imbalanced, this can reduce the production of SCFAs, increasing inflammation and can contribute to thyroid dysfunction.
The microbiome plays a vital role in the absorption of nutrients essential for thyroid health, such as iodine, selenium, and zinc. A disrupted microbiome may impair nutrient absorption, leading to deficiencies that can worsen Hashimoto's symptoms.
Some studies have even shown that gut bacteria can influence the metabolism of thyroid
hormones, potentially impacting their effectiveness and levels in the body.

Diet can play a crucial role in managing Hashimoto's. While it may not cure the condition,
certain dietary choices can help alleviate symptoms and support overall thyroid function.
An anti-inflammatory diet can help reduce symptoms. Foods rich in antioxidants, such as
fruits and vegetables, can combat inflammation. Incorporate foods rich in omega-3 fatty
acids (like oily fish, flaxseeds, and walnuts), have also been shown to reduce inflammation.
Many individuals with Hashimoto's report improvement in symptoms when avoiding gluten, this is because gluten may trigger autoimmune responses.
Ensuring adequate intake of specific nutrients, such as selenium, zinc, vitamin D, and
omega-3 fatty acids, is important for thyroid health. Foods high in selenium, such as Brazil nuts, can support thyroid function.
Adequate vitamin D levels through sun exposure or supplements is vital in supporting
individuals with Hashimoto’s, this is because Vitamin D plays a role in reducing thyroid
antibodies, and we often see deficiencies are common in those with autoimmune conditions. 
Iron is also a key nutrient in the production of thyroid hormones and it is very much influenced  by  both dietary intake and gut health including SIBO. Without or without an autoimmune thyroid condition, iron will affect thyroid production. More in our blog on iron here.  
A balanced diet that stabilises blood sugar levels can help manage energy levels and reduce fatigue, a common symptom of Hashimoto's but this can also reduce stress on the body which can impact on immune function.
It is advised to be mindful of the consumption of raw cruciferous vegetables (like broccoli
and kale) and soy products, as they may interfere with thyroid function when consumed in large amounts, but it's important to include cruciferous vegetables in cooked form as they can help support hormonal balance and liver detoxification.
Try to limit processed and high-sugar foods which can potentially increase inflammation and disrupt gut health.

Lifestyle factors...

In addition to dietary changes, lifestyle also plays a role in supporting symptoms of
Hashimoto’s. Stress can significantly impact Hashimoto's thyroiditis and potentially trigger or exacerbate symptoms. Stress activates the body's 'fight or flight' response, leading to the release of stress hormones like cortisol. Chronically elevated cortisol levels can disrupt thyroid hormone production and metabolism, and may inhibit the hypothalamus and pituitary gland's ability to regulate thyroid hormone production, leading to lower levels of thyroid hormones.

Stress can alter immune function, potentially increasing inflammation and immune
responses. In autoimmune conditions like Hashimoto's, this can lead to heightened attacks on the thyroid gland.
Chronic stress may inhibit the hypothalamus and pituitary gland's ability to regulate thyroid hormone production, leading to lower levels of thyroid hormones.
Stress has the ability to negatively affect gut health, leading to issues like leaky gut
syndrome, which may worsen autoimmune responses and thyroid function.

We often see that stress can lead to unhealthy coping mechanisms, such as poor dietary
choices, lack of exercise, and disrupted sleep patterns. These factors can further exacerbate inflammation and Hashimoto's symptoms

Engage in moderate exercise, such as walking, swimming, or yoga, to help boost energy
levels, reduce stress, and promote overall well-being can help to reduce symptoms
associated with Hashimoto’s
It's important to prioritise good sleep hygiene to ensure restorative sleep, which is essential for hormone balance.

Hashimoto's thyroiditis can significantly impact daily life, but understanding its symptoms, triggers, and potential lifestyle and nutritional interventions can empower individuals to manage their health more effectively.

Diagnosis: this is done via blood testing but due to issues with poor testing and reference ranging, thyroid health can be suboptimal and can go unnoticed for years with sufferers being told they have depression, chronic fatigue, or are in perimenopause and menopause. Adding to the complexity and confusion, thyroid antibodies can be elevated for years before changes happen with TSH and T4 and so it assumed there isn't a problem when there is. It is also why in our clinic we always offer as standard practice a comprehensive thyroid screen. This is essential at all stages of life and gives us the full story. It can also be pivotal when dealing with infertility and miscarriage. 

Testing: As a clinic we can also offer relevant testing to support thyroid function including a comprehensive assessment with thyroid antibodies. We also offer a range of blood tests which assess sex hormones and cortisol as well as stool testing. To learn more you can book a free discovery call here and we would be delighted to answer any of your questions.