Hashimoto’s Thyroiditis | The course of the disease is different in each patient

Hashimoto’s thyroiditis is an autoimmune disease that is chronic and leads first to an overactive and subsequently to an underactive thyroid. In doing so, the immune system no longer functions properly and attacks its own thyroid tissue due to misguided immune processes and decomposes it almost completely over time.

When there is not enough thyroid tissue left, the thyroid gland loses its ability to produce the vital thyroid hormones and causes a hypofunction on the patient . The hypofunction of the thyroid gland also comes with a number of symptoms, but the autoimmune disease itself can also raise a wide range of symptoms.

However, the symptoms of the autoimmune disease are mostly ignored, perceived nor treated by physicians. Thus, the following treatment usually refers to a pure symptom control of the hypofunction.

The overall history of Hashimoto’s disease varies between patients, so that, for example, some patients may not face major health restrictions with the disease, while others are struggling with the most severe symptoms and sequelae.

Often, no clear clinical picture is palpable because the symptoms sometimes changes daily, as the lack of thyroid hormones is noticeable in almost all organs  and thus brings multi-organ problems.

First, a few facts about Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis now is one of the most common autoimmune diseases in the Western world and unfortunately is usually not recognized in time or simply downplayed by the doctors as a harmless fashion disease, and definitely underestimated. In addition, Hashimoto usually is not treated properly and often not considered in multi-organ diseases.

As one of the possible causes of the Hashimoto the forced iodization in Germany is still presumed. Basically, there are hardly any foods that does not contain insignificant amounts of iodine. In 1993, Germany was declared an iodine deficiency area and since then they like to do it the big way. Whether mineral water, bread dough or even our salt … none of this is spared from iodization. And by the animal feed iodization , in Germany also the meat usually contains very high concentrations of iodine.

Germany is basically the last EU country that continues compulsory iodisation, which should perhaps open our eyes to our politicians. In this context, Germany is also the country that has the most thyroid disease patients within the EU.

Iodine is responsible for converting the free T4 into the free T3. If an excess of iodine is present, on the one hand an over-supply of active thyroid hormone is produced, on the other hand the thyroid gland inflames slowly but continuously and leads in the advanced stage to a degradation of the thyroid tissue, which in turn leads to an underfunctioning of the thyroid gland over time.

If you are already suffering from Hashimoto, the inflammation and autoimmune process is constantly fueled by the iodine intake, which leads to further problems and can lead to massive fluctuations in thyroid hormone utilization. For this reason, the symptoms can constantly vary and permanently fluctuate. In addition, other organs are affected by this back and forth. Above all, the adrenal glands are particularly affected by this hormonal stress and adrenal fatigue often is the result.

The Wickham study, one of the largest studies on Hashimoto, found that approximately 10% of the population had elevated blood levels of antibodies. Also, that in England about 8% of women and 3% of men have an elevated basal TSH level, which is always due to hypothyroidism or Hashimoto. In addition, the study found that 2% of the population had elevated TSH and decreased fT3 and fT4 levels.

Who are those affected?

Of the Hashimoto’s thyroiditis especially women over 30 are affected. Most women fall ill after the menopause. But also after a pregnancy, when the hormone balance gets mixed up, the risk of illness increases.

However, the numbers of sick men are also rising steadily. A stressful lifestyle, poor nutrition, a weak immune system and chronic, untreated inflammation in the body are the usual conditions that often lead to a disease.

Moreover, inheritance also plays a major role in Hashimoto. The children of Hashimoto-affected parents usually get 25% more likely to have Hashimoto’s disease than children of healthy parents. In particular, the female children are affected more often and should already from the age of 7 do a blood draw,  to check the thyroid levels and antibodies to be able to react early in case of a disease.

Even women with an unfulfilled desire to have children or a non-existent pregnancy should think of Hashimoto and be tested if necessary. The body goes into a kind of protection program during hypothyroidism and keeps many important body functions to a minimum, so that pregnancy is prevented to not harm the child.

What causes Hashimoto’s thyroiditis?

Today’s literature refers to the following factors with regard to the triggers of Hashimoto’s thyroiditis:

  • Poor and thoughtless nutrition over longer periods
  • Any kind of stress (job, family, relationship, financial problems, etc.)
  • Genetic preload
  • Excessive consumption of iodine-containing foods and medications
  • Chronic infections and Inflammations that are not treated consistently
  • Viral infections such as glandular fever, EBV, rubella, mumps, herpes etc.
  • Personal crises such as the death of a loved one
  • Intestinal complaints and food intolerances
  • Hormonal shifts such as high estrogen levels and low progesterone levels

However, it requires a combination of the factors mentioned above to develop a Hashimoto.

What comorbidities are possible?

Unfortunately, it is often the case, that the autoimmune diseases often occur in combination with other health problems. This unfortunately is also the case with me. Approximately 25% of Hashimoto sufferers additionally suffer from:

Conversely, patients with the above mentioned diseases should be also tested for Hashimoto’s Thyroiditis.

Symptoms of Hashimoto’s Thyroiditis

Some patients may not notice anything about their condition at first, others have the most severe problems and symptoms, and as thyroid hormones are active throughout the body, a deficiency can cause all sorts of symptoms, depending on which organ does not get enough hormones.

And this is exactly the problem, which is why doctors are so often overwhelmed with Hashimoto patients and why most of them have no other choice than to take care of the disease by themselves. Att the beginning of a Hashimoto thyroiditis it often happens that symptoms of hyperthyroidism appear at first, which are replaced then over time by the symptoms of hypothyroidism.

Hyperfunction symptoms

  • palpitations, rapid pulse
  • increased sweating
  • restlessness
  • irritability and nervousness
  • high blood pressure
  • accelerated hair growth
  • aggressive mood
  • weight loss
  • diarrhea
  • trembling of the hands
  • Menstrual disorders in Women

As the hormone production in the body decreases, because more and more hormone-producing thyroid tissue breaks down, the hyperfunction symptoms alternate with the symptoms of hypofunction.

Hypofunction symptoms

  • fatigue, lethargy and weakness
  • Depressed mood
  • Dry skin
  • constipation
  • freezing, low body temperature
  • high blood pressure, low pulse
  • dizziness, numb feeling in the head
  • confusion, problems with concentration
  • hair loss
  • muscle tightness and muscle weakness
  • blurred vision
  • anxiety, personality changes
  • insomnia
  • husky voice, feeling of a lump in the throat
  • Increased liver and cholesterol values
  • joint pain , rheumatic symptoms
  • Water retention in the face
  • reduced libido
  • weak immune system, constantly ill and catching cold
  • Menstrual disorders in women

These are the main symptoms, certainly further symptoms may be added the more the disease and hypofunction has progressed. In principle, it can be said that any organ that is undersupplied with thyroid hormones will cause problems over time and may present organ-specific symptoms.

How is Hashimoto’s thyroiditis diagnosed?

If you suspect a Hashimoto’s thyroiditis due to the above symptoms, you need a diagnosis first to confirm the suspicion. For this you first have to find a doctor who is well versed in thyroid disease and that usually is the problem.

Family doctors usually have frighteningly little knowledge of ​​the matter and the so-called endocrinology specialists know it a bit better, but mostly use the knowledge from their studies, which is usually completely outdated. Thus, the patient often has no other choice than to inform himself as well as possible about the disease and tell the doctor which examinations are desired. In this way you can prevent that the blood tests does not contain all relevant parameters and this shortens a possible physicians’ odyssey tremendously.

In order to be able to diagnose Hashimoto’s thyroiditis beyond any doubt, it is necessary to control various hormones and antibodies in the blood. Still, most doctors only test the TSH. If you’re lucky then the fT4. But usually nothing more because the doctors still think that it is sufficient to unmask a hypofunction with these parameters. But this definitely is not the case and a Hashimoto can not be detected with these two values ​​in any case.

In order to be able to get an idea of ​​the hormone status, at least the hormone values ​​in relation to TSH, fT3 and fT4 are required. And to clearly or unequivocally confirm or exclude Hashimoto, some antibody values ​​such as the MAK, TAK, and TRAK are needed.

In addition, the thyroid gland should be scanned and viewed more accurately in the ultrasound. A good doctor already can become suspicious after these two variants of examination and initiate a necessary blood test. Here once again the most important laboratory parameters, which should be examined in the blood:

Which laboratory values ​​are important for the diagnosis?

  • fT3 (free triiodothyronine)
  • FT4 (free levothyroxine)
  • TSH (Thyreoidea-stimulating hormone)
  • TPO-AK (anti-thyroid peroxidase antibodies)
  • TAK (thyroglobulin antibodies)
  • MAK (Microsomal antibody)
  • TRAK (TSH receptor autoantibodies)

Since in the Hashimoto’s thyroiditis causes the entire metabolism to slow down, it often comes to gastrointestinal discomfort, which disturbs the nutrient intake and lead to a micronutrient undersupply. This should be examined also if possible. Above all, the B vitamins, zinc, selenium, magnesium, calcium, ferritin in whole blood! But the sex-specific sexual hormones should also be determined in saliva or urine.

How is Hashimoto’s thyroiditis treated?

Since Hashimoto is not curable, the symptoms are treated as much as possible. It is primarily about the progressive hypofunction of the thyroid, which is treated with mostly synthetic thyroid hormones. According to doctors this also should work well and most sufferers should have little or no complaints.

In practice, however, most things look very different and many patients are affected by a whole range of symptoms. And although the hormone levels in the blood evidently look good. This is usually due to the fact that too many doctors only go to the TSH and if it disappears in the direction of the no longer measurable range, is directly assumed to be an hyperfunction. And although the patient clearly has hypofunction symptoms.

In practice, it is often the case that patients very often feel comfortable only when the TSH is suppressed and the free thyroid hormones settle in the upper third.

In addition, it is very important to start a suitable therapy as soon as possible after the diagnosis and to administer thyroid hormones orally. This relieves the overstressed body and relieves the suffering of the patient. If treated with hormones in time, the autoimmune process at the beginning of the stage can be significantly attenuated and, if necessary, a progression of the disease can be delayed.

Since Hashimoto’s thyroiditis mostly progresses in episodes, in the adjustment phase it is necessary to do blood tests more often ​​to determine the blood values and not rely on just one measurement. Only in this way it can be ruled out that you adjust your doses in the wrong direction.

How could a hormone adjustment look like?

In the hormone setting you should be very conscientious and careful and start with a low dosage. Meanwhile, getting started with 25μg daily has proven. It should not be more, so that the body can adapt to the new hormone situation. It often can be observed that the situation initially improves in the short term and then worsens significantly again. This is the so-called initial aggravation (Erstverschlechterung). The body notices that hormones are being supplied externally and is continuing to limit its own production more and more.

Therefore you must adjust the intake amount more and more, until a lasting improvement of the symptoms sets. Sensitive people increase by 6.25μg every 4-6 weeks and then have blood levels monitored. Those who have no problems with the hormones can also increase in steps of 12.5μg. But this is very different from person to person.

Equally different is the final setting. There are people who feel comfortable with very low free values ​​and people who have to be set very high. As a rough guideline you can say that free values ​​in the middle or upper third should be sought and the TSH should be less than or equal to one.

Which thyroid medications are there?

Meanwhile, there is a large selection of thyroid preparations that can be used to treat hypothyroidism. As before, therapy with the so-called mono-preparations is used mostly. These include the metabolically inactive thyroid hormone T4, which is converted to fT3 in the blood and organs. For example, L-Thyroxine, Euthyrox or Eferox with single doses of 25 to 200μg.

If even after a prolonged ingestion of the monopreparate no clear improvement is in sight and the fT3 in relation to the fT4 significantly lower, a combined preparation could help. However, from a personal point of view after years of adjustment tries, I am thinking that a permanent attitude with a single drug is hardly possible, even if the doctors propagandize it.

Combi-preparations contain not only the T4 but also the metabolically active T3. With these you try to raise the weakening fT3. However, you have to deal more cautiously with combination preparations, because the active T3 often has a resounding effect and you can get quickly into hyperfunction.

NDT (Natural Desiccated Thyroid) – My personal salvation!

In addition to the synthetic thyroid hormones I mentioned above, there are also natural hormones that are usually obtained from pigs thyroid glands. There are many patients who have never achieved a good state of health under the synthetic hormones, but have achieved a near-healthy state with natural hormones. In addition to T4 and T3, porcine hormones also contain T2 and T1, which effects have not been fully elucidated yet.

I tortured myself with pure L-thyroxine for 8 years. I tried from many different manufacturers. Neither Euthyrox, L-Thyroxine, L-Thyrox nor Lixin Liquid could help. Exactly the opposite was the case and my health was getting worse and worse. I tried all dosages from 25 to 225μg.

Also, the additional intake of Thybon (T3) could not help. I also tried all conceivable variants of splitting.

In 2015, I switched to Natural Desiccated Thyroid hormones and already the first few days were incredible. I felt healthy for the first time in many years! Unfortunately, this only lasted for a few days, because of course, the setting did not fit directly.

But today I can say that I have almost perfectly adjusted my dosage. Which took a long time and I first had to find my dose and the right Splitting. Currently, I take the main part for the night (2 1/2 grains) and a part (1 grain) at noon between 12-13:00h.

About the theme of natural thyroid hormones I can recommend the book “Stop the Thyroid Madness”. There you will get all the information you need to know about thyroid hormone replacement with natural thyroid hormones, how to get the adrenals back on track, what TSH is all about and much more.

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