Diagnosing & Healing Hashimoto’s with Functional Medicine

Hashimoto’s Disease is the medical name given to autoimmune hypothyroidism. It affects 1-2% of Americans, primarily women.  With this autoimmune condition, the body produces antibodies known as Thyroid Peroxidase antibodies or TPO antibodies, that attack the thyroid, rendering it less effective over time.

Hashimoto’s symptoms can include:

• Fatigue
• Weight gain
• Thinning or dry hair, nails, and skin
• Brittle nails
• Feeling cold all the time
• Irregular periods
• A slow gut
• Brain fog
• Depression
• Enlarged thyroid (Goiter)
• Thyroid nodules
• Loss of muscle strength and tone

Hashimoto’s is routinely underdiagnosed and misdiagnosed in traditional medicine

In traditional medicine, if your doctor suspects hypothyroidism, she will run a TSH (thyroid stimulating hormone) test after discussing your symptoms. However, a TSH test is not the sole indicator of thyroid health. If the TSH test comes back normal, Hashimoto’s is ruled out

Related Post: Why TSH is Not Enough to Detect Thyroid Problems

The lack of thyroid antibody testing can result in not recognizing ongoing autoimmunity, even in the face of normal thyroid function testing. Thyroid antibody testing is key for a Hashimoto’s diagnosis because the underlying cause of the disease is the autoimmune trigger. In addition to TPO antibodies being elevated, in Hashimoto’s Disease, thyroglobulin antibodies can also be elevated, although typically these antibodies are associated with Grave’s Disease, or autoimmune hyperthyroidism. Therefore, it is important to check both of these to confirm or exclude thyroid autoimmunity.

Functional medicine testing for Hashimoto’s

In functional medicine, a Hashimoto’s thyroiditis diagnosis isn’t ruled out just because TSH may appear normal.

A comprehensive thyroid lab panel would include some or all of  of these tests:

• TSH
• Free T4
• Free T3
• Reverse T3
• Thyroid antibodies (TPO, thyroglobulin)
• Thyroid supportive nutrients (selenium, magnesium, iron, ferritin)
• Urinary iodine

Additionally, many functional medicine physicians also evaluate adrenal (cortisol and DHEA) and sex hormone (estrogen, progesterone, testosterone) levels alongside thyroid testing to understand the full picture of your hormonal health.

It’s also key to have an in-depth assessment of your lifestyle. Sleep patterns, activity level, nutrition, and stress are all opportunities to intervene to improve thyroid–and overall–health.

Factors that affect thyroid function

Functional medicine doctors consider the factors that affect your thyroid when creating your treatment plan. Some of the key factors are environment and lifestyle-related, so your treatment will be personalized to you.

Some of the most common factors are:

• Vitamin and mineral deficiencies
• Stress
• Trauma
• Environmental factors such as lead and pesticides
• Fluoride
• Bromine (a leavening agent found in most baked goods)
• Activity level
• Kidney and liver disease
• Autoimmune diseases
• Genomics

Traditional medicine approach to Hashimoto’s disease treatment

The typical Hashimoto’s disease treatment begins with a TSH test and ends with a prescription for levothyroxine (Synthroid). Endocrinologists don’t usually explore other treatment options because they view Hashimoto’s as an irreversible condition. They may suggest eating a healthy diet and getting more exercise, but don’t often make recommendations specific to individual needs.

Functional medicine approach to Hashimoto’s disease treatment

Functional medicine treats Hashimoto’s as a potentially reversible condition. The holistic approach to Hashiomto’s disease treatment is focused on long-term healing and preservation of thyroid function. A functional medicine care plan for Hashimoto’s could include:

• Addressing stress and adrenal health
• Evaluating TSH, T3, T4, reverse T3, and thyroid antibodies
• Implementing an anti-inflammatory, gluten-free diet (to reduce TPO antibodies)
• The use of low dose naltrexone (LDN). The prescribed, compounded medication has an immunomodulating effect and can lower anti-thyroid antibodies.
• A repertoire of treatment choices, including traditional levothyroxine (T4), but also T3/T4 combination medications like Armour, and compounded, customized thyroid medication.

Healing thyroid inflammation with nutrition

With the heightened inflammation characteristic of any autoimmune disease, including Hashimoto’s, an anti-inflammatory diet is highly effective for improving or eliminating symptoms. The best thyroid-supporting nutrients include:

• Omega-3s
• Iodine in seaweed, kelp, eggs, and dairy
• Iron from lentils, legumes, and leafy greens
• Magnesium from pepitas, avocados, and leafy greens
• Selenium from Brazil nuts
• Tyrosine found in chicken, pork, seafood, and tofu
• Ginger and turmeric

Prescription medications for Hashimoto’s

Functional medicine doctors determine which medications will address your needs based on your level of thyroid function.

Synthetic thyroid hormones such as Synthroid (T4) and Cytomel (T3) are tolerated well by some Hashimoto’s patients.

Natural Dessicated Thyroid (NDT) is made from the thyroid glands of pigs. These medications include a combination of T3 and T4 and are a great option if you prefer natural treatment options.

A 2018 survey of hypothyroid patients found that NDT resulted in fewer memory, weight, and fatigue side effects than those taking synthetic thyroid hormones.

Common Natural Dessicated Thyroid Medications include:

• Armour
• NP-Thyroid
• West-throid
• Nature-throid

Low-dose Naltrexone (also known as LDN) at doses of 1-5mg may also be considered by your functional medicine provider because it is effective at decreasing TPO antibodies and preserving thyroid function.

Ready to start the natural approach to healing Hashimoto’s? Book an appointment with a functional medicine provider today.