Tag Archives: diet

Hashimoto’s Thyroiditis Research

When diagnosed with an autoimmune disease such as Hashimoto’s Thyroiditis you will probably want to find out as much as possible to try and answer all the questions spinning around in your head. I’ll outline the questions that I had when I was diagnosed, together with the answers and their sources to save you a lot research.

What is Hashimoto’s Thyroiditis?

Hashimoto’s Thyroiditis is an autoimmune disease where the body’s own immune system attacks the thyroid gland. The thyroid is a butterfly shaped gland, located just below the Adam’s apple in the neck. It regulates a number of body functions, including those that can affect heart rate, protein production, energy consumption and sensitivity to other hormones by releasing two primary hormones T3 and T4. The regulation of the thyroid is controlled by the pituitary gland secreting thyroid-stimulating hormone (TSH).

Over time the destructive process of the autoimmune attack results in decreased thyroid function, producing symptoms that are similar to hypothyroidism (under active thyroid). However, when cells of the thyroid gland are destroyed it can release a surge of the stored thyroid hormones, temporarily producing symptoms of hyperthyroidism (over active thyroid).

What are the Symptoms of Hashimoto’s Thyroiditis?

Unfortunately the list of symptoms with Hashimoto’s Thyroiditis is long, with many symptoms common with other diseases. This results in patients being misdiagnosed with various other ailments when they actually have a thyroid condition. Fortunately, simple blood tests are available to check thyroid function and the presence of Hashimoto’s related antibodies.

At the early stages of Hashimoto’s it is quite possible that no symptoms present themselves, because the destruction of the thyroid has not progressed to the point where thyroid hormone production is inadequate.

The common hypothyroid related symptoms are:

  • Dry, sometimes itchy skin
  • Dry, thinning hair
  • Constipation
  • High cholesterol, especially LDL
  • Lower than normal heart rate
  • Temperature sensitivity, especially to the cold
  • Fatigue
  • Weight gain
  • Cognitive degeneration or brain fog (memory loss, inability to concentrate, slower thought processes)
  • Depression
  • Swelling of the thyroid gland or goitre
  • Heavy or extended menstrual bleeding
  • Fertility problems
  • Joint and muscle pain

With Hashimoto’s it is also likely that the patient can temporarily switch to having hyperthyroid symptoms, such as:

  • Weight loss
  • Rapid heat beat, to the point where you feel your heart is pounding
  • Increased appetite
  • Diarrhoea
  • Insomnia
  • Anxiety

What Causes Hashimoto’s Thyroiditis?

According to the official medical line, there is no conclusive evidence to point to any particular cause. A large number of people do believe that diet plays a huge role in triggering the disease, but that some environmental factors such as pesticides and heavy metals could also play a part. The latter can be consumed through our diet too, but some people do have direct exposure to specific toxins.

The strongest argument for the diet related angle as a cause for Hashimoto’s is with regards to Coeliac disease and general gluten intolerance. There is evidence of a reasonably strong correlation between people having coeliac disease and Hashimoto’s. Since both are autoimmune diseases it is definitely interesting to see this correlation. People who have adopted a “clean” diet without gluten, often based on a paleo diet, have had improvements in their symptoms and a small number of people report that they have stopped the progress of Hashimoto’s.

There is another theory on the cause of Hashimoto’s and other autoimmune diseases: bacterial pathogens. This field is new, but growing in recognition, with The Economist magazine even dedicating an edition’s cover story, Microbes Maketh Man, to the field. One researcher in particular, Professor Trevor Marshall and his Marshall Protocol, will likely come across your radar if you are researching this theory.

Excess iodine and radiation exposure can also trigger the disease.

It is most probable, like so many things health related, that a number of different triggers actually cause Hashimoto’s. Therefore, what can cause it in one population with near certainty may not affect another population. The most important thing is to try and determine what caused it for a particular individual and to minimise that factor.

Why did I get Hashimoto’s Thyroiditis?

Apart from the possible causes listed in the previous section there are a few other factors that can contribute to an increased risk of getting Hashimoto’s Thyroiditis.

Genetics play a part with the disease often found in families with a history of Hashimoto’s and other autoimmune diseases. This means that is it very important to contact immediate and even extended family members to notify them of the disease and their increased risk profile. In my case my mother has a hypothyroid condition, but has not been tested for Hashimoto’s. Given my own diagnoses it is highly likely that my mother’s condition is the same as mine.

Women are far more susceptible (5-10 times) to Hashimoto’s than men. Perhaps I should purchase a lottery ticket since I am male and managed to get the disease!

Age is also a factor, with the disease often diagnosed in middle age, but it is still possible for teenagers to suffer from Hashimoto’s too.

How can I Treat Hashimoto’s Thyroiditis?

The conventional treatment plan provided by the majority of general practitioners and endocrinologists alike is to replace the thyroid hormone T4 with a synthetic version in the form of a pill to be taken every day for the remainder of the patient’s life. The only variant in this plan is the dosage of T4, which depends on a number of factors such as age, sex, weight and progression of the disease.

Given that the body takes time to react to the new source of T4 it can take months to fine tune the exact dosage an individual requires. Therefore patients are typically started on a fairly low dose of T4 with follow-up tests scheduled to check on TSH and Free T4 levels at regular levels until the correct dosage is determined.

While this approach can work for many people there is a large group who do not respond well to the standard treatment plan. Some patients find that they still suffer from hypothyroid symptoms even when their TSH and T4 numbers are within the acceptable range.

This has resulted in frustrated patients writing blogs, posting on forums, Facebook groups, and even the creation of a dedicated site called “Stop the Thyroid Madness” with an associated book.

Thankfully some doctors, endocrinologists, holistic/integrated medical practitioners and nutritionists are offering alternative treatment plans that do help these people. The plans often include the following:

  • Comprehensive thyroid tests that look at all aspects of TSH, T4 and T3
  • Dietary advice to avoid gluten, grains and eat whole foods, often using a paleo diet.
  • Lifestyle changes to increase exercise, improve sleep, reduce stress, etc.
  • Supplements for vitamin and mineral deficiencies, especially vitamin D which is typically very low in Hashimoto’s patients.

Another treatment option is the Marshal Protocol, based on the theory of bacterial pathogens as the cause for Hashimoto’s and other autoimmune diseases. People do claim to be having a great deal of success with this protocol, but there is not much official evidence to support the programme from what I have seen. Given that Professor Trevor Marshall’s theories go against conventional wisdom there are plenty of people who easily write him off as a crazy man.

I’m taking the middle ground on the Marshall Protocol. There is not enough evidence to disprove it, nor is there enough evidence to prove it. Therefore, if you have tried the recommended methods to regain your health and they have not worked then it may be worth giving the Marshall Protocol a try. It is an unconventional treatment plan, so it does seem that most people on the forum have followed a similar decision path, trying it as a last hope because they are long suffering many ailments. Do note though, that a key component of the Marshall Protocol is also diet related, so there is some commonality with other approaches too.

Can Hashimoto’s Thyroiditis be Cured?

While there are some people online who claim to have cured their Hashimoto’s Thyroiditis, I have not seen anyone who has demonstrated proof of sustained remission through documented medical records. When pushed most people say they have halted or controlled the disease, which is a very different outcome than a cure.

Based upon my own research, I’m going to stick to the official line that there is no available cure for Hashimoto’s Thyroiditis. I’ll happily be proved wrong if someone can show me that they have medical records proving their remission.

Conclusion

Like many other chronic autoimmune diseases, Hashimoto’s Thyroiditis is a complex and frustrating disease. Trying to understand the cause and the appropriate treatment plan can involve a lot of time and effort for patients who do not respond to the conventional “here is a pill to take every day” approach.

I hope that by putting this information together that you have understood more about Hashimoto’s Thyroiditis and have some new ideas on how to change your treatment plan if you are still suffering from the symptoms.

Given that I’m not a medical practitioner please do take the time to review the information on this page with your doctor. However, don’t be afraid to get a second opinion (or change doctors) if you think the information here reflects your situation, but your doctor doesn’t want to change your treatment plan. After all, you are the customer and the doctor is providing a service that you are paying for.

Sources

 



Hashimoto’s Thyroiditis and the Endocrinologist

After receiving the news that I have an autoimmune disease called Hashimoto’s Thyroiditis I was in a bit of a daze, as I didn’t know anything about the condition. All the typical questions were going through my mind: Why did I get Hashimoto’s? What causes Hashimoto’s? How can I treat Hashimoto’s? Can Hashimoto’s be cured?

While I waited to see the endocrinologist I tried using my phone to google for information, but the phone reception at Mt. Elizabeth Hospital in Singapore is terrible and I could hardly load a page or two before I was called in to see the specialist. Now I was going to get some answers!

The doctor, who was pleasant enough, then started to tell me the bad news. They don’t really know what causes Hashimoto’s, but there seems to be a genetic disposition to it. Hashimoto’s tends to be more common in women, especially those over 50, so I was rare male case. All that he could offer is to monitor my thyroid stimulating hormone (TSH) and Free T4 levels to determine the correct dosage of T4 (Euthyrox in my case). There is no cure and I would have to take the pill every day, for the rest of my life.

Unfortunately, this is where I started to learn the hard lesson that for chronic diseases, such as diabetes, Hashimoto’s, and arthritis, western medicine doesn’t have a good answer, other than: “here, have a pill.” I’ll do a dedicated post on this problem at a later date, but suffice to say, I was quite frustrated after leaving the specialist.

I contacted my family to find out that my mum has hypothyroidism, but was never tested to see if the cause was Hashimoto’s. Given the genetic component, I’m guessing she probably has Hashimoto’s and I was predisposed to getting it from her wonderful genes. Thanks mum! 😉

I was determined to educate myself on this disease and find out if there were any different opinions on Hashimoto’s.

Anyone who has used the internet to research health conditions will have undoubtedly encountered the same problem that I then did. There is just so much information and plenty of it is written by people who make sweeping statements about a particular condition based on their own experience. Known in the scientific jargon as N=1 studies (a sample size of one), thus their opinion is hardly a great indication of validity. There is also the complication that Hashimoto’s and hypothyroidism tend to get lumped together which can cause confusion and poor recommendations. Finally, most of the information is more focused on women with Hashimoto’s than with men with Hashimoto’s.

After a  lot of reading articles and watching too many Youtube videos, the best cause of action seemed to be to fix my diet to remove all possible food related triggers that cause possible immune system responses. A paleo diet came up as one of the best options. Can you imagine how I felt when I read that? Here I was trying to make a positive lifestyle change and had already chosen a paleo based diet. Then I find out that it is the best diet for a condition that I didn’t even know I had when I made that choice!

Once the diet is started I needed to get the medication working to bring my TSH, T4 and T3 levels under control. After that there was not much that I could find on people who had actually managed to come off their medication and keep the disease at bay.

Given that sorting out the medication would take quite some time (months), I decided to dive into the paleo and primal world to learn as much as I could about my choice of lifestyle change. Then when I had my medication sorted I would return to focusing on how to possibly cure or at least control my Hashimoto’s.

For those that are interested here are my first test results for the Hashimoto’s indicators:

T4 Free    10.37  (10.00 - 23.00 pmol/L) 0.81 (0.78 - 1.79 ng/dL)
TSH        11.873 (0.450 - 4.500 mlU/L)
Tg Ab     122.40  (0.00 - 4.10 IU/mL)
TPO Ab   1300.32  (0.00 - 5.60 IU/mL)

There was no T3 test performed, as at the time of testing there was no known condition, thus it was unnecessary. The antibody tests were performed on the same blood sample to confirm Hashimoto’s, but only ordered after the doctor saw my TSH result.

In my next post I’ll go into more detail on the research I did during this time, including Youtube videos to watch, websites to visit and other, useful bits of information.



My Pre-Primal Health Status

I’d made the decision to try to improve my overall health by adopting a new lifestyle. As I described in my previous post, I believed that a paleo diet made the most sense from a scientific perspective and that an overall lifestyle outlined in Mark Sisson’s “The Primal Blueprint” seemed practical and most importantly maintainable. However, before I started this new phase of my life I wanted to perform some tests to make sure I had a record of my health markers going forward.

I had a few existing health problems before starting on this journey, but nothing that I considered major. The most serious was related to Gastroesophageal reflux disease (GERD) or reflux as most people know it. I also had a large bump on my upper eyelid that was the result of a blocked oil gland. Other than that I felt a bit tired from lack of sleep after having our baby girl join our family at the start of Janurary, 2012.

GERD/Reflux

My GERD symptoms are not that typical. I would only feel some acid coming into my mouth once or twice a month and had no heart burn problem. However, I had one big symptom that would occur at random intervals; my sphincter would close and stop food from entering my stomach when I ate. Often It would just be a slight delay before I could feel the food or drink entering my stomach, but sometimes it could take minutes or even get to the stage where my saliva would build up in my oesophagus and I’d have to depart to the toilet for relief.

My gastroenterologist did an examination of my oesophagus and stomach by shoving a camera down my throat on a long tube. Thankfully I was not awake when this happened! The results confirmed the irritation of my oesophagus and that I have a hiatal hernia. Apparently the acid was coming up from my stomach and irritating my lower oesophageal sphincter. Then when food came down the hatch it would sometimes cause the irritated sphincter to spasm and close.

Treatment was to take a drug called Nexium daily to lower the acidity of my stomach, thus allowing things to calm down and the sphincter to heal. Then I could gradually come off the drug and hope that things would return to normal. However, that plan never worked! I was fine taking Nexium every other day, or even every couple of days, but as soon as I stopped the symptoms would return in 7-10 days.

At this stage I concluded that I would have to take Nexium for the rest of my life.

Eye Chalazion

Chalazion on my EyeI must admit, being male, I don’t spend as much time as my wife in front of the mirror cleaning my face and in particularly my eyes. This fact has obviously contributed to me getting an eye chalazion twice in as many years. This occurs when one of the many oil ducts on your eyelid becomes blocked, gets infected and inflamed. A sty is a bit different from a chalazion in that the sty is obviously infected and quite painful. My chalazion was just an annoying bump resulting from inflammation that would not go away after months and months.

I’d been my GP and to see two specialists about this problem. My wife wanted it removed as she had to look at it, but the specialists insisted on leaving it alone and let it go away naturally.

I went with the specialists, so it was still there before I started on my new lifestyle, much to my wife’s dismay.

Health Tests

My gastroenterologist ordered a barrage of blood tests. I honestly didn’t feel like standing up after the lady had finished taking out all the blood needed. I think it was around seven vials! I also had to do a urine test and stool test.

I’ve never had to do a stool test before. They gave me an appropriately coloured (brown) plastic container, similar in size and shape to the one for the urine test, but the lid included a built-in spoon/scraping device. Not being an expert in these matters I asked for advice on how best to take a sample. The women at the counter seemed as perplexed as me and said “just use the lid to scrape a sample.” Oh really? Wow, I would have never guessed. Thanks for the help! In the end I managed to do the deed without contaminating other body parts, a miracle!

Test Results

The following day I received a call from my doctor’s assistant that I needed to come in to discuss my test results and that I had to see another specialist! The assistant was not able to tell me why I needed to see another specialist, saying that that I needed to see my doctor to discuss the matter. I was then told to come to her office in a week’s time because the other specialist was only free then!

I was slightly nervous (to put it mildly). Was it cancer, an infectious disease, something that required surgery. My mind was a flurry of activity covering all the hideous possibilities, so I called back and asked to see my doctor as soon as possible.

I went the following day to find out that my cholesterol was quite high, but that was not the big problem. I was told that I have a chronic, autoimmune disease called Hashimoto’s thyroiditis, which is the result of my own body attacking my thyroid gland. With the thyroid under attack my levels of the thyroid hormones are often too low (hypothyroidism), but can spike to high levels (hyperthyroidism) when part of my thyroid breaks away because of the attack by my immune system.

I was relieved to hear that it is not life threatening and that the medication is quite cheap. Unfortunately, I was told I would have to take a pill every day for the rest of my life.

Luckily a free spot came up with the other specialist, so I was able to go and visit him later that day. In my next post I’ll talk about the visit to my endocrinologist, more about Hashimoto’s thyroiditis and the treatment options.