What is Hashimoto’s disease?
Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, is an autoimmune disorder that causes the immune system to attack the thyroid gland. This leads to inflammation and damage to the thyroid tissue, resulting in hypothyroidism or underactive thyroid. In Hashimoto’s disease, the immune system produces antibodies that target thyroid peroxidase and thyroglobulin, two proteins involved in the production of thyroid hormones. Over time, the thyroid is no longer able to produce enough hormones for the body’s needs.
The most common symptoms of Hashimoto’s disease include fatigue, weight gain, dry skin, hair loss, feeling cold, muscle weakness, joint pain, depression, and constipation. Left untreated, hypothyroidism can increase the risk of cardiovascular disease, myxedema coma, mental impairment, infertility, and birth defects during pregnancy.
Hashimoto’s is the most common cause of hypothyroidism in the United States, affecting up to 2% of the population and 8 times more likely to occur in women than men. Although Hashimoto’s often occurs between the ages of 30 and 50, it can develop at any age. Some people are born with a genetic predisposition to Hashimoto’s, but environmental factors such as stress, poor diet, toxins, infections, and nutrient deficiencies are believed to trigger the onset and progression of the disease.
Is Hashimoto’s progressive?
Yes, Hashimoto’s disease is a progressive autoimmune disorder. This means that over time, more and more of the thyroid gland gets damaged and destroyed by the body’s own immune system. As a result, the thyroid produces less and less thyroid hormone, eventually leading to worsening hypothyroidism if untreated.
In the early stages, Hashimoto’s disease may cause subclinical hypothyroidism, where thyroid hormone levels fall within the normal lab reference range but are lower than optimal. There may be mild symptoms present or none at all. Without treatment, subclinical hypothyroidism tends to worsen over time.
Eventually, the declining thyroid function causes overt hypothyroidism, where thyroid labs fall below the normal range and symptoms become more pronounced. Thyroid hormone replacement medication is needed at this stage to correct the hormonal deficit.
Even with medication, the Hashimoto’s disease process continues to progress in most patients. Over months and years, more thyroid tissue is destroyed until very little fully functioning thyroid gland remains. The medication dose often needs to be increased gradually to account for this. Complete thyroid gland failure may occur, requiring full thyroid hormone replacement.
So in summary, Hashimoto’s thyroiditis is characterized by the slow development of worsening hypothyroidism over time due to ongoing autoimmune destruction of the thyroid gland itself. Progression can be slowed but not completely halted in most cases.
What causes Hashimoto’s thyroiditis to progress?
There are several factors that drive the progression of Hashimoto’s disease:
– Autoimmunity: Hashimoto’s is an autoimmune disorder. The immune system mistakenly attacks thyroid proteins and tissue. This autoimmune response persists and expands over time, leading to worsening thyroid damage.
– Genetic susceptibility: People with certain genetic markers are at increased risk of developing Hashimoto’s disease. These genes make someone more prone to autoimmune thyroid problems.
– Environmental triggers: Things like stress, pregnancy, infections, nutrient deficiencies, toxins, allergies, drugs, and radiation exposure can trigger or exacerbate the autoimmune thyroid response in those with a genetic predisposition.
– Epigenetic changes: Environmental influences cause epigenetic alterations, which are changes that affect how genes are expressed. This can make the immune system more likely to attack the thyroid.
– Faulty T cells: Disorder of the regulatory T lymphocytes allows cytotoxic T cells to attack thyroid proteins unchecked, perpetuating thyroid damage.
– Thyroid cell damage: Early thyroid cell injury by environmental triggers or other means releases proteins that cause more autoantibody formation and inflammation.
– Inflammation: Hashimoto’s disease causes chronic inflammation of the thyroid gland. This promotes scar tissue formation, impairing thyroid function.
– Immune system dysregulation: Imbalances in the immune system, like decreased Treg cells or impaired Fas-FasL apoptosis, reduce self-tolerance and allow more thyroid destruction over time.
Can Hashimoto’s be stopped from progressing?
Unfortunately, in most cases, the progression of Hashimoto’s cannot be completely stopped or reversed. The autoimmune-driven destruction of the thyroid gland tends to be relentless, albeit gradual in most patients. However, progression may potentially be slowed through a combination of proper treatment and lifestyle modifications.
Treatment approaches that may help slow progression:
– Thyroid hormone replacement medication – Levothyroxine or desiccated thyroid supplements help resolve hypothyroid symptoms and may reduce autoimmune activity against the thyroid.
– Immunomodulating medications – Low dose naltrexone, plasmapheresis, intravenous immunoglobulin therapy may modify the autoimmune attack in some cases. More research is needed.
– Supplements – Selenium, vitamin D, zinc, omega-3 fatty acids, curcumin, probiotics, NAC may reduce inflammation and autoimmunity. Effects are modest in most patients.
– Thyroid gland preservation – Radioactive iodine treatment accelerates loss of thyroid function. Antithyroid drugs may allow for retention of thyroid function longer.
– Regular monitoring – Frequent testing of thyroid levels allows early detection and treatment of declining function before symptoms worsen.
Lifestyle changes that may help:
– Stress reduction techniques – Chronic stress aggravates autoimmune conditions. Managing stress can be beneficial.
– Elimination diet – Removing inflammatory or autoimmune triggering foods like gluten, dairy, soy, eggs, corn, and nightshades.
– Gut health optimization – Correcting bacterial/fungal dysbiosis, leaky gut, and other gut issues can reduce inflammation.
– Nutrient optimization – Ensuring adequate intake of vitamins and minerals needed for proper immune regulation.
– Toxin avoidance – Reducing exposure to toxins, chemicals, mold, heavy metals, pollution, and cigarette smoke.
– Moderate activity – Regular moderate exercise helps manage stress and inflammation. Too intensive exercise may worsenautoimmunity.
– Adequate sleep – Getting enough quality sleep gives the immune system time to reset and heal.
What happens if Hashimoto’s is left untreated?
Leaving Hashimoto’s thyroiditis untreated allows progressive thyroid gland damage, eventually leading to full hypothyroidism and multiple associated complications:
– Worsening fatigue, brain fog, memory problems, depression
– Weight gain and inability to lose weight despite dieting
– Dry skin, brittle hair, hair loss
– Cold intolerance, low body temperature
– Muscle weakness, joint stiffness, carpal tunnel syndrome
– Constipation, fluid retention, puffy face
– Heavy periods, infertility, increased miscarriage risk
– Elevated cholesterol, atherosclerosis, heart disease
– Neuromuscular disorders, slowed reflexes
– Impaired immunity with frequent infections
– Hearing loss, vision problems, loss of taste/smell
– Peripheral neuropathy, tremors, seizures
– Myxedema coma – a rare but life-threatening complication
The longer hypothyroidism goes untreated, the higher the likelihood of irreversible complications. Thyroid hormone replacement is imperative to stop the progression of symptoms and reduce the many health risks associated with chronic low thyroid function.
With treatment, most people with Hashimoto’s thyroiditis can expect to have a normal life expectancy. However, they usually require lifelong thyroid hormone medication and monitoring.
The takeaway
While Hashimoto’s thyroiditis cannot be cured or its progression completely halted in most patients, proper treatment paired with a healthy lifestyle provides the best chance of slowing down its course. This allows for the retention of thyroid function for a longer time and reduced risk of complications from the disease.
Through medication, eliminating autoimmune triggers, reducing inflammation, supplementing appropriately, and practicing self-care, many people achieve excellent symptom management and are able to live full, vibrant lives in spite of Hashimoto’s. Though research continues to uncover new treatment possibilities, managing Hashimoto’s requires patience and perseverance. But most patients respond well to a multifaceted approach, preventing severe hypothyroidism for decades in many cases.