Hashimoto’s thyroiditis: all you need to know at a glance

Hashimoto’s thyroiditis is a chronic autoimmune disease that initially leads to an overactive thyroid gland and later to an underactive one.

The immune system no longer works properly, attacks its own thyroid tissue due to misguided immune processes and almost completely decomposes it over time.

If there is not enough thyroid tissue available, the thyroid loses its ability to produce the vital thyroid hormones and the patient becomes hypoactive. An underactive thyroid comes with a variety of symptoms, but the autoimmune disease itself can also present a variety of symptoms.

However, the  symptoms of the autoimmune disease are  mostly not considered and perceived by the medical side, let alone treated. Thus, the following treatment usually refers to a pure symptom control on the part of the hypofunction.

The general course of Hashimoto’s disease is different for each patient, so that for example some of the patients do not have to accept any major limitations with this disease, but the other part has to struggle with the most massive symptoms and secondary diseases.

Often there is also no clear clinical picture tangible, since the symptoms sometimes change daily, since the lack of thyroid hormones is noticeable in almost all organs and thus brings with it multi-organ problems.

First, a few facts about Hashimoto’s thyroiditis

Hashimoto’s thyroiditis is now one of the most common autoimmune diseases in the western world and is unfortunately usually not recognized in time or simply downplayed by doctors as a harmless fashionable disease and definitely underestimated.

In addition, Hashimoto’s is usually not treated properly and is often not considered in the case of multi-organ diseases.

As one of the possible  causes for the Hashimoto  is still the forced iodization in Germany. Basically, there are hardly any foods that contain significant amounts of iodine. In 1993, Germany was declared an iodine deficiency area and since then people have not spilled anything, rather they have been paddling.

Whether mineral water, bread dough or even our salt…none of it is spared from iodization. And due to animal feed iodization, meat in Germany usually contains very high concentrations of iodine.

Germany is basically the last country in the EU that continues to practice forced iodization, which should perhaps open the eyes of our politicians. In this context, Germany is also the country in the EU that has the most thyroid diseases.

Iodine is responsible for converting free T4 into free T3. If there is an excess of iodine, on the one hand there is an oversupply of the active thyroid hormone, on the other hand the thyroid gland slowly but constantly becomes inflamed and, in the advanced stage, leads to a breakdown of the thyroid tissue, which in turn leads to an underactive thyroid gland over time.

If you already have Hashimoto’s disease, the inflammatory and autoimmune process is constantly fueled by the iodine intake, which leads to further problems and massive fluctuations in thyroid hormone utilization can occur. For this reason, the symptoms can also present themselves differently and fluctuate constantly.

In addition, other organs are affected by this back and forth. Above all, the adrenal glands suffer particularly from this hormonal stress and  adrenal fatigue  is often the result.

The Wickham study, one of the largest follow-up studies on Hashimoto, found that about 10% of the population had elevated levels of antibodies in their blood. In England, about 8% of women and 3% of men have an elevated basal TSH, which is always due to hypothyroidism or Hashimoto’s.

The study also found that 2% of the population had elevated TSH and reduced fT3 and fT4 levels.

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Who is affected?

Hashimoto’s thyroiditis mainly affects women over the age of 30. Most women get the disease after menopause. But even after pregnancy, when the hormonal balance gets messed up, the risk of an illness increases.

However, the number of sick men is also steadily increasing. A stressful lifestyle,  poor diet , a weak immune system, and chronic, untreated inflammation in the body are common conditions that often lead to disease.

In addition, heredity also plays a major role in Hashimoto’s. The  children  of parents who have Hashimoto’s disease usually develop Hashimoto’s disease about 25% more often than children of healthy parents.

Female children in particular are affected more frequently and should have their thyroid levels and antibodies checked from the age of 7 when taking a blood sample in order to be able to react early in the event of an illness.

Women with an unfulfilled desire to have children or who are unable to get pregnant should also   think about Hashimoto and get tested if necessary. During an underactive thyroid gland, the body goes into a kind of protection program and reduces many important bodily functions to minimum operation so that pregnancy is prevented so as not to harm the child.

What Causes Hashimoto’s Thyroiditis?

Today’s literature refers to the following factors in relation to the triggers of Hashimoto’s thyroiditis:

  • Poor and thoughtless nutrition over long periods of time
  • Stress of any kind (job, family, relationship, financial problems etc.)
  • genetic predisposition
  • Excessive consumption of iodine-containing foods and medicines
  • Chronic infections and inflammation 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 problems and food intolerance
  • hormonal shifts such as too high estrogen levels and too low progesterone levels

However, it usually requires a combination of the above factors to develop Hashimoto’s disease.

Which comorbidities are possible?

Unfortunately, it is often the case that autoimmune diseases often occur in  combination with other health problems  . Unfortunately, this is also the case for me. Approximately 25% of those affected by Hashimoto also suffer from:

  • HPU / KPU
  • Adrenal Fatigue
  • Diabetes
  • Leaky-Gut
  • Celiac disease (gluten intolerance)
  • Crohn’s disease
  • Chronic Hepatitis
  • Vitiligo (white spot disease
  • Rheumatic diseases

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

What are the typical symptoms of Hashimoto’s thyroiditis?

Some patients often do not notice anything about their illness at first, while others have the most massive problems and symptoms. Because thyroid hormones are active throughout the body, a deficiency can cause any imaginable symptom, depending on the organ that isn’t getting enough hormones.

And this is exactly the problem, why doctors are so often overwhelmed with Hashimoto’s patients and why most of them have no choice but to take care of the disease themselves.

It is often the case that at the beginning of Hashimoto’s thyroiditis, symptoms of an overactive thyroid appear for the first time, which are then alternated over time by the symptoms of underactive.

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 cycle disorders in women

As soon as the hormone production in the body continues to decrease, as more and more hormone-producing thyroid tissue is broken down, the symptoms of hyperfunction alternate with the symptoms of hypofunction.

hypofunction symptoms

  • Tiredness, listlessness and weakness
  • Depressive mood
  • Dry skin
  • constipation and constipation
  • Cold, low body temperature
  • high blood pressure, low heart rate
  • Dizziness, feeling of cotton in the head
  • confusion, difficulty concentrating
  • hair loss
  • Muscle tightness and muscle weakness
  • visual disturbances
  • Anxiety, personality change
  • sleep disorders
  • hoarse voice, lump in throat
  • increased liver values ​​and cholesterol values
  • Joint pains, rheumatic symptoms
  • water retention in the face
  • decreased libido
  • weak immune system, constantly sick and cold
  • Menstrual cycle disorders in women

These are the main symptoms, but other  symptoms  may appear as the disease and hypofunction progresses. In principle, one can say that every organ that is undersupplied with thyroid hormones will cause problems over time and organ-specific symptoms can arise.

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How is Hashimoto’s thyroiditis diagnosed?

If one suspects Hashimoto’s thyroiditis based on the above symptoms, one needs a diagnosis that confirms the suspicion. For this you first have to find a doctor who is familiar with thyroid diseases and that is usually the problem.

General practitioners usually have a shockingly little idea of ​​​​the subject and the so-called specialists in the field of endocrinology know better, but mostly apply the knowledge from their studies, which is usually totally outdated.

This means that the patient often has no choice but to find out as much information as possible about the disease and tell the doctor what tests are required. This prevents blood tests from not containing all the relevant parameters and shortens a possible medical odyssey enormously.

In order  to be able to diagnose Hashimoto’s thyroiditis with certainty  , various hormones and antibodies in the blood must be checked. Most doctors still only test the TSH. If you’re lucky then the fT4.

You can’t usually count on more, because the doctors still think that these parameters are enough to unmask a hypofunction. However, this is definitely not the case and a Hashimoto can never be discovered with these two values.

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 in order to clearly confirm or rule out Hashimoto, you need some antibody values ​​​​such as the MAK, TAK and TRAK.

In addition, the thyroid should be scanned and examined more closely in the ultrasound. A good doctor can already become suspicious after these two types of examination and initiate a necessary blood test. Here are the most important laboratory parameters that should be examined in the blood:

Which laboratory values ​​are important for the diagnosis?

  • fT3 (free triiodothyronine)
  • fT4 (free levothyroxine)
  • TSH (Threoidea-Stimulierendes-Hormon)
  • TPO-AK (Anti-Thyreoperoxidase Antibody)
  • TAK (thyroglobulin antibodies)
  • MAK (Microsomal Antibodies)
  • TRAK (TSH receptor autoantibody)

Since the entire metabolism is slowed down in Hashimoto’s thyroiditis, gastrointestinal complaints often occur, which impede the absorption of nutrients and ensure a micronutrient deficiency.

These should also be examined if possible. Above all, the B vitamins,  zinc , selenium, magnesium, calcium, ferritin in whole blood! But the sex-specific sex hormones should also be determined in the saliva or urine.

How is Hashimoto’s thyroiditis treated?

Since Hashimoto is not curable, the symptoms are treated as far as possible. It is primarily about the progressive hypofunction of the thyroid gland, which is treated with mostly synthetic thyroid hormones. According to doctors, this should also work well and most of those affected should have no or hardly any symptoms.

In practice, however, it is usually very different and many patients are affected by a whole range of symptoms. And that even though the hormone levels in the blood seem to be looking good. This is usually due to the fact that too many doctors only look at the  TSH value and if this disappears in the direction of the no longer measurable range, hyperfunction is assumed directly. And this despite the fact that the patient clearly has symptoms of hypofunction.

In practice, it is usually the case that patients very often only feel well when the TSH is suppressed and the free thyroid hormones settle in the upper third. In addition, it is very important to start appropriate therapy as soon as possible after the diagnosis and to administer thyroid hormones orally. This relieves the overworked body and alleviates the suffering of the patient.

If treated with hormones in good time, the autoimmune process can be significantly dampened in the early stages and, if necessary, the progression of the disease can be delayed. Since Hashimoto’s thyroiditis usually progresses in phases, it is necessary to have blood values ​​determined more frequently during the adjustment phase and not just rely on one measurement. This is the only way to avoid dosing in the wrong direction.

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What could hormone adjustment look like?

When adjusting hormones, you should be very conscientious and careful and start with a low dosage. In the meantime, starting with 25 µg daily has proven itself. It shouldn’t be more than that at first, so that the body can adjust to the new hormone situation. It can often be observed that the condition improves for a short time at first and then deteriorates significantly again.

This is the so-called initial deterioration. The body notices that hormones are being supplied from outside and continues to stop producing them.

That’s why you have to keep adjusting the amount you take until you see a lasting improvement in the symptoms. Sensitive people increase by 6.25 µg every 4-6 weeks and then have their blood levels checked. Those who don’t have problems with the hormones can also increase in 12.5 µg increments. But this is very different from person to person.

The final setting is just as different. There are people who are comfortable with very low free values ​​and people who need to be set very high. As a rough guide, you can say that free values ​​in the middle or upper third should be aimed for and the TSH should be less than or equal to one.

What thyroid medications are there?

There is now a large selection of thyroid preparations that can be used to treat hypothyroidism. As in the past, most of the time, so-called monopreparations are used for therapy. These contain 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 200 µg are available here

If no significant improvement is in sight even after taking the monopreparation for a longer period of time and the fT3 is significantly lower in relation to the fT4, a combination preparation could help. From my personal point of view, after years of trying to adjust the drug, I am of the opinion that permanent adjustment with a mono-preparation is hardly possible, even if the doctors propagate it that way.

In addition to T4, combined preparations also contain the metabolically active T3. With these means one tries to raise the weakening fT3. However, you have to be more careful with combination preparations, as the active T3 often has a resounding effect and you can quickly become hyperactive.

Natural pig hormones – my personal salvation!

In addition to the synthetic thyroid hormones mentioned, there are also natural hormones that are mostly obtained from pig thyroids. There are many patients who report never having gotten well on synthetic hormones, but have achieved near-healthiness on natural hormones.

In addition to T4 and T3, pig hormones also contain T2 and T1, the effects of which have not yet been fully clarified.

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

The additional intake of Thybon (T3) could not help either. I also tried all conceivable variants of splitting.

In 2015 I switched to natural pig hormones and the first few days were incredible. I felt healthy for the first time in a long time! Unfortunately, this only lasted a few days, since the attitude naturally did not fit directly.

But today I can say that my thyroid function is almost perfect. This took a long time and I first had to find my dose and the right splitting. Currently I take the largest part at night (2 1/2 grains) and a part (1 grain) at noon between 12-1 p.m.

On the subject of natural thyroid hormones, I can only recommend the book “For the thyroid gland – against stubbornness”. There you can get all the information you need about thyroid adjustment with natural thyroid hormones, how to get the adrenal glands back in shape, what TSH is all about and much more.

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