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Health Experts

The Thyroid Mistake: Understanding Hashimoto’s Disease

Hashimoto's thyroiditis, also known as chronic lymphocytic thyroiditis, is the most common cause of hypothyroidism in the United States. Here's what you need to know.

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Q: I was diagnosed with low thyroid, but the medication I’m taking isn’t helping. What am I doing wrong? — Becca R., Phoenix

A: Izabella Wentz was in the best of health and on top of the world. She earned a doctorate in pharmacy at the age of 23, became a Fellow of the American Society of Consultant Pharmacists, and met and married the man of her dreams.

Life was good. Until the symptoms started. Wentz suddenly started getting really tired, sometimes sleeping up to 14 hours in one day. She started experiencing unexpected panic attacks. Ditto with depression, which now was a regular—and unexplainable—visitor. She’d never had allergies, but was suddenly sensitive to foods. At various times and to varying degrees, she had all kinds of digestive issues.

Here’s the maddening part: Every doctor she went to said, “It’s all in your head.” They offered her antidepressants. One of them even told her, “You’re getting older.” (She was 25 at the time.)

Hashimoto’s Thyroiditis Diagnosis

What Wentz had was a condition called Hashimoto’s thyroiditis, an autoimmune disease in which your immune system goes rogue and attacks your thyroid gland. (Wentz went on to make the study of Hashimoto’s her life work and is now widely known as “the Thyroid Pharmacist.”) Hashimoto’s isn’t a rare or exotic condition—as many as 95% of hypothyroid cases are caused by it. But conventional doctors often miss Hashimoto’s because they routinely treat hypothyroidism with thyroid medication, regardless of what’s causing the problem.

And that’s why their patients frequently don’t get better. “When doctors treat Hashimoto’s, an immune disorder, with thyroid hormone medication, symptoms persist because the underlying problem—the gradual destruction of the thyroid gland—goes unchecked,” writes Datis Kharrazian, DHSc, DC, MS, author of Why Do I Still Have Thyroid Symptoms?.

With Hashimoto’s, the thyroid is producing less thyroid hormone because the thyroid gland is under attack by your immune system, which wrongly perceives your thyroid tissue as a foreign invader. It mounts an attack, ultimately leading to the destruction of thyroid tissue. The many symptoms that a person with Hashimoto’s can experience do not disappear with a dose of Synthroid.

Because thyroid tissue is being destroyed in Hashimoto’s, thyroid hormones can sometimes get dumped into the bloodstream causing jitteriness, anxiety, irritability, and even mania. Most of the time, though, you have too little thyroid hormone, which can cause depression and weight gain. And because there are thyroid receptors in every cell in the body, symptoms of Hashimoto’s are wide ranging, affecting everything from the emotions to the gut.

We don’t know exactly what causes autoimmune disease, but what we do know is that autoimmune diseases have triggers. And by identifying and eliminating those triggers, some autoimmune diseases—like Hashimoto’s—can go into remission, often staying there for long periods of time.

Common Thyroid Autoimmune Triggers

Factors that can bring about Hashimoto’s are pretty much the same as those for all autoimmune diseases—toxins, drugs, viruses, bacteria, environmental chemicals, and inflammatory foods.

The food connection is particularly interesting. Gluten molecules look suspiciously like thyroid tissue, and when gluten provokes your immune system, thyroid tissue can frequently be part of the collateral damage. If you’re at all sensitive to gluten, the immune system will get riled up when you ingest it, and will attack anything that resembles it (which happens to include thyroid tissue).

In gluten sensitive people, gluten also provokes an inflammatory response in the gut. This inflammation can lead to something called leaky gut syndrome, in which tiny undigested particles are able to get past the intestinal barrier and enter the bloodstream where they don’t belong—and where they trigger even more activity from the immune system. The more the immune system is firing on all cylinders, the more likely thyroid tissue will get caught in the crossfire.

Another trigger is stress. Stress does a lot of things to the immune system, and to Hashimoto’s in particular—none of it good. When you’re under constant, chronic stress, your levels of cortisol (the main stress hormone) are always elevated. Cortisol interferes with the body’s ability to convert the inactive thyroid hormone (T4) to the active kind (T3), the kind your body can actually use. Instead, cortisol directs some of that T4 to be converted to an inactive thyroid hormone called reverse T3. The result is that you have less active thyroid hormone in your bloodstream (and all the symptoms that go with low thyroid).

Did you know…
Stress is particularly harmful in cases of Hashimoto’s, so stress relief activities like yoga are key for recovery.

Hashimoto’s Natural Protocols

If you have low thyroid that you suspect is caused by Hashimoto’s, here are seven things you can do that will really make a difference in your health.

You can get your daily requirement of selenium by eating 4–8 Brazil nuts every day.

  1. See a functional medicine doctor. How do you know if you have Hashimoto’s? The first step is a test for thyroid antibodies. Any doctor trained in functional or naturopathic medicine will order this test for you and can recommend a holistic treatment strategy. You can find a practitioner at the Institute for Functional Medicine (
  2. Get off gluten. It’s inflammatory for many people and can provoke an immune system reaction that can wind up damaging thyroid tissue.
  3. Fix your gut. Look for hidden food sensitivities or intolerances that could provoke inflammation and immune system responses. The most common (besides gluten) are dairy, corn, eggs, nuts, and soy.
  4. Watch your blood sugar. Continuous insulin surges increase thyroid tissue destruction in those with autoimmune diseases. Healthy thyroid function depends on keeping your blood sugar in a normal range, and vice versa. For most people, this means cutting way back—or eliminating—processed carbohydrates.
  5. Try adrenal adaptogens. Adaptogenic herbs such as ashwagandha are like a metabolic thermostat—they help cool you off when you’re running too hot and heat you up when you’re running too cold. They can be very helpful at alleviating stress too.
  6. Take 200 mcg of selenium. This important mineral is necessary for the conversion of inactive thyroid (T4) to active thyroid (T3). You can also get your daily selenium by eating 4–8 Brazil nuts every day.
  7. Take probiotics. Keeping the gut healthy is critical with autoimmune diseases, so make sure there are plenty of “good guys” among the trillions of microbes in your gut.

Did you know…
You can get your daily requirement of selenium by eating 4–8 Brazil nuts every day.

Recommended Resources

In addition, has an excellent thyroid section run by the very knowledgeable Mary Shomon.