What is Autoimmune Thyroid Disease and How do you Live with It?
Updated: Jan 29
Often enough when discussing my condition, as a nutritionist I am approached by people that want to know one simple question, "What is autoimmune thyroid disease?" Another question also asked frequently is, "How does autoimmune thyroid disease relate to nutrition?" These questions can be overbearing to someone like me who has been asked them repeatedly over a lifetime. So, I'd prefer to just answer them and get them documented. This way, I can refer people here when the time comes.
To answer these questions, it is best to define the simplest terms about the condition itself. Autoimmune thyroid disease is a condition of the thyroid gland, in which the immune system of the body begins to attack its own cells or tissues, specifically, the thyroid. This attack cannot be controlled and results in either a hypothyroid state, which is considered Hashimoto's Thyroiditis, or a hyperthyroid state, which is considered Graves' disease. Graves' disease can also be known as thyrotoxicosis.
Unfortunately, conventional medicine claims that there is no cure for autoimmune thyroid disease. Conventional treatment options usually involve surgery, radioactive iodine, or taking medications that consist of synthetic or desiccated thyroid hormones that will either increase or decrease overall thyroid hormone production. Taking medication is usually a lifetime commitment and sometimes supportive interventions can be implemented alongside these medications.
Diagnosing Thyroid Disorders
So how do people find out that they even have this diagnosis? Most people that find out they have autoimmune thyroid disease, actually find out because their lab results come back with low or high levels of thyroid hormones; and it is their physician's responsibility to report these results to them. When looking at lab values, a reference range is used to measure how many units of hormones are flowing freely in the blood (unbound). Each person's hormone levels range differently depending on how the body uses the hormones for biological activities. By identifying certain hormones' antibodies, a person can easily monitor risk level or the current state of their condition.
The hormones tested for thyroid disease are normally T3, T4, and TSH. Most physicians usually, only try to level TSH, which is the most important hormone. However, other hormones are important as well. The hormones tested for an autoimmune thyroid condition are TSI, Tg, and TPO in addition to T3, T4, and TSH. TSI, Tg, and TPO are all proteins used to test for autoantibodies. When these proteins are attacked by autoantibodies, then it can be confirmed that there is actually autoimmunity.
T3 is triiodothyronine
T4 is thyroxine
TSH is thyroid stimulating hormone
TSI is thyroid stimulating immunoglobulin
Tg is thyroglobulin
TPO is thyroid peroxidase
What is the difference between Graves' disease and Hashimoto's Thyroiditis?
Since this post isn't actually about defining thyroid diseases and it's about defining the autoimmune aspect of the disease, we will focus on concepts that are not on most blog posts. For example, understanding the difference between Grave's disease and Hashimoto's Thyroiditis is important.
Graves' disease is a form of hyperthyroidism. This type of attack causes the body to over-produce thyroid hormones.
Hashimoto's Thyroiditis on the other hand, is a form of hypothyroidism. This particular attack of the thyroid causes the body to not produce enough thyroid hormones.
The symptoms are quite different, and I like to think of them in terms of a video cassette player, in fast forward or rewind. The difference in symptoms between thyroid conditions is, an individual with:
Graves' disease will suffer from:
Sweaty or clammy skin
Usually lose weight
Have increased heart rate
Have a sensitivity to heat
Have bulging eyes
Hashimoto's Thyroiditis will suffer from:
Have decreased heart rate
Have a sensitivity to the cold
Both conditions can cause similar signs and symptoms such as hair loss or coarse voice.
Being Diagnosed with both Grave's disease and Hashimoto's Thyroiditis
Unfortunately, people can have both Graves' disease and Hashimoto's Thyroiditis. More than often, if someone has been diagnosed with both conditions, it is because they have had one disease and it has eventually conformed into the other. A person will usually be diagnosed with Graves' disease first. Since, Graves' disease is a more serious condition, for the physician, the protocol is to try to get the thyroid back to a balanced state or even get the condition to a state so they can treat it long-term, such as hypothyroidism. If euthyroid fails in trying to reverse Graves' disease, physicians will use surgery or radioactive iodine treatments as an intervention. These two treatments will put the patient into a hypothyroid state. That's the goal anyway. Physicians will then try to treat this condition instead.
What is Hashitoxicosis?
The condition known as Hashitoxicosis is when the patient gets Graves' disease due to inflammation but thyroid cells are affected by autoantibodies of Hashimoto's Thyroiditis. It is sometimes known as a hyperthyroid type thyroid condition in addition to having thyroiditis, but the thyroiditis is what is causing the condition. The end result is a hyperthyroid state.
The Role of the Goiter in Autoimmune Thyroid Disease
Originally, I was suspected of having a goiter when I was 18 years old. A goiter or thyromegaly is the swelling of the neck where the thyroid is located. The gland swells immensely from all the inflammation in the thyroid. Usually, this will draw the attention of the physicians to test the blood for an imbalance of thyroid hormones. Goiters can be symptoms of both Graves' disease and Hashimoto's Thyroiditis.
Can Graves' Disease and Hashimoto's Thyroiditis be Reversed?
Yes, both Graves' disease and Hashimoto's Thyroiditis can be successfully reversed. There are actually many ways to go about reversing these conditions, but everyone uses a different combination of factors to succeed in it. Medications are usually the main conventional route, as well as radioactive iodine, or being scheduled for a thyroidectomy. However, there are other options often frowned upon such as supportive interventions that can aid in helping either the medication work more fluently, or help the person's body remit.
Other factors that can influence thyroid are toxins, hormone imbalance, lifestyle, and gut imbalance.
Nutrition plays a huge role in any disease state. In autoimmune thyroid disease, you can implement various nutritional techniques to achieve wellness and optimal health. For starters, getting a solid nutrition evaluation from a licensed nutritionist can help any person pinpoint malnourishment. This assessment can lead to supportive interventions that positively impact body composition, enhance bodily function, and improve quality of life.
Supportive interventions can be used to successfully manage thyroid conditions. Some of these interventions include dietary changes or lifestyle behavioral changes. Some health practitioners say through diet alone, the chances of euthyroid are high. Other practitioners say that a combination of diet and lifestyle techniques, along with medication is needed to be successful. Other interventions include regulating dysfunctional bio-systems like the detoxification system or the gut health systems; looking into psychological factors such as stress level, and mental and emotional wellness; or physical activity levels.
The most common interventions include using vitamins and minerals, and they are huge in today's emerging economy. Almost every person that eats the Standard American Diet (SAD) has some sort of deficiency or excess. Clinical studies have listed a variety of nutrients used in thyroid supportive interventions. These nutrients are iodine, selenium, zinc, vitamin A, vitamin D, and a variety of B vitamins. B vitamins often range differently with each individual. Also, tyrosine is an amino acid that can sometimes be used in the management of thyroid disease or symptoms.
How to Live with Autoimmune Thyroid Disease
Living with autoimmune thyroid disease isn't easy for anyone, especially when hearing the news from their physician. Physicians are trained in such a way to collect evidence in order to appropriately diagnose their patients. When they explain our disease to us and how there is no cure, many times what occurs when we hear this news is, we either doubt our physicians or believe them implicitly. We never stop to actually think about what the physician said. We never ask to look at this evidence or try and understand it. We just hear the news, ask for the best solution, take their suggestion and leave, and then try to reflect on it. As a result, we have put ourselves in a position of not really being able to understand our own condition.
Since we're all bio-individually unique, we all present with different intrapersonal feelings and emotional perspectives. First and foremost, no one person really wants to admit that they even have a thyroid condition. This is the first stage. People are so concerned with how they feel, the first thing they think of is how to try to get rid of the condition. This is especially true if they cannot perceive the impact the condition can have on their future lives.
The second stage is researching the condition. People become psychologically frantic. They find too much information everywhere that is meaningless and rarely stumble on the right information because it's scarce. We begin to build beliefs from the stories we hear about others online and form our own opinions. Yet, the information found still remains the same, and we can never get the information we need that may actually be found out-of-that-box.
The third stage is realizing that we may never get rid of this disease after all. People have realized that they have a chronic, slowly progressing, lifelong illness. Most of the time, but not always, people come to terms with their condition and this is when people tend to give up. Other times people are essentially tired of hearing just how incurable their disease is. There is also a desperate stage when people sometimes begin to seek alternative methods. However, the last thing people think of is what the root cause could be.
Living with autoimmune thyroid disease begins with finding the root cause to successfully manage the condition. To find the root cause, turn and look at habits, ways of living, and visit old physicians to collect records for a review of the evidence. Also, begin getting educated about your condition to learn how to implement the right interventions. If you're tired of living with autoimmune thyroid disease, then this is your opportunity to discover your greatest self.
Sriphrapradang, C. & Bhasipol, A. (2016). Differentiating Graves' disease from subacute thyroiditis using ratio of serum free triiodothyronine to free thyroxine. Annals of Medicine and Surgery, 10: 69-72. https://doi.org/10.1016/j.amsu.2016.07.024