What is Hashimoto’s?

Hashimoto’s thyroiditis, also called autoimmune thyroiditis, autoimmune thyroid disease or chronic lymphocytic thyroiditis, is a condition that was first discovered by the Japanese specialist Hashimoto Haruko in Germany in 1912.

In Hashimoto’s, the body produces antibodies to the enzyme thyroid peroxidase (TPO). These antibodies are called antithyroid peroxidase, or anti-TPO for short. In some cases there may be antibodies to the protein thyroglobulin; these are called antithyroglobulin, or TgAb. When these antibodies are present, it results in the invasion of the thyroid by cytotoxic T-cells, which attack the thyroid gland and result in inflammation and destruction of the gland. In many cases, the thyroid becomes enlarged and a goiter may develop. If left untreated, it can lead to hypothyroidism with intermittent bouts of hyperthyroidism.

While the American Association of Clinical Endocrinologists (AACE) estimates that 14 million people in this country have Hashimoto’s thyroiditis, many experts feel that the number is much higher because millions of people are suffering from symptoms but have yet to be diagnosed.3

As with most autoimmune diseases, women are about 20 times more likely than men to develop Hashimoto’s disease, and the typical patient is 30-50 years old; however, it can also affect children as well.

How is Hashimoto’s Thyroiditis Diagnosed?

As with Graves’ and most autoimmune diseases, it may take a few visits to your doctor before she suspects your thyroid is the cause of your symptoms. As you learned earlier, the thyroid affects literally every cell of your body, so when your thyroid hormones are low, the symptoms can mimic many other medical conditions. It’s no wonder that millions of people suffer needlessly for years, and millions more go undiagnosed. I suffered with the symptoms of Hashimoto’s for over four years before my thyroid was checked. When my doctor finally suspected that my thyroid was the problem, she tested my TSH and T4 levels, which were just out of range. She told me that she would retest in six months and handed me a prescription for an anti-anxiety medication. It took another two years and over a dozen doctors’ visits before I was tested for antibodies and given a diagnosis of Hashimoto’s.

What You Need to Know: Autoimmune thyroid conditions rarely exist alone. There are typically combinations of several conditions presenting at the same time. Hashimoto’s is a full body condition!

When the thyroid is under attack and makes too little thyroid hormone, a person can begin to experience a variety of uncomfortable and debilitating symptoms:

Physical Symptoms

•  Weight gain—even on a restricted calorie diet

• Hair loss on the head and the outer edges of the eyebrows

• Digestive problems—typically constipation—but it can alternate between constipation and diarrhea

• Other GI symptoms such as upset stomach and GERD

• Menstrual problems, such as heavy periods, cramping and raging PMS/PMSD

• Infertility and complicated pregnancies

• Sleep disorders—sleep apnea

• A feeling of fullness in the neck or problems swallowing because the gland is enlarged or a goiter, sore throat or hoarse voice

• Chest pain and tachycardia

• Chronic urinary infections (UTI’s)

• Chronic yeast infections of the GI and urogenital tract

• Chronic sinusitis—fungal

• Sensation of feeling cold all the time—especially hands and feet

• Migraine headaches

• Muscle weakness and pain

• Feeling “wired but tired”—exhaustion and fatigue that is not relieved by rest

• Bleeding gums, gum infections and periodontal disease

• Water retention, puffy face—especially around the eyes

• Low libido—in men and women

• Skin conditions, rashes, hives, itching

• Hay fever and food allergies

• Swollen lymph glands

• Anemia

• High blood sugar

• High cholesterol

• Brittle nails

• Dry skin

Emotional/Psychological Symptoms

• Depression

• Mood swings—from manic to depressed

• Anger and rage

• Anxiety and panic attacks

• Uncontrollable crying

• Memory problems

• Difficult concentration

• Trouble making decisions

• Feeling of giving up—what’s the use?

• Feeling that there is never enough time

• Feelings of “What about me?” “I never get what I want.” and “I never get to speak up.”

What a long list of symptoms! It takes real detective work to diagnose Hashimoto’s. The most common symptoms are depression and weight gain, so many people are given antidepressant medication and told to limit their calorie intake. Other common conditions include high blood sugar and high cholesterol so many times a person is simply told to cut down on sugar and fat and given a prescription for cholesterol-lowering drugs.

If your doctor does suspect that your thyroid is the cause of your symptoms she will usually test your levels of thyroid-stimulating hormone (TSH) and thyroxine (T4).

If your test comes back with an elevated TSH and a low level of thyroxine (T4) she may suggest a “wait and watch approach” before doing anything more. If she is well educated in thyroid health, and has taken the time to listen to your symptoms, she will suggest running more blood tests to investigate further.

Blood Tests

The diagnosis of Hashimoto’s involves measuring thyroid-stimulating hormone (TSH), Free T3 (triiodothyronine), and Free T4 (thyroxine) hormone levels, as well as antithyroid peroxidase antibodies (anti-TPO), and/or antithyroglobulin antibodies (TgAb). (Other acronyms are Tg and TGB).

In the case of Hashimoto’s, the body produces autoantibodies to thyroid peroxidase and sometimes to thyroglobulin, thus initiating a response from cytotoxic T-cells, which then attack thyroid tissue, causing swelling, inflammation and destruction of thyroid cells. When this happens, the traumatized thyroid slows its production of thyroid hormone. When blood thyroid hormone levels fall, TSH levels rise to stimulate the thyroid to make more hormones. A healthy thyroid will respond to TSH and make more thyroid hormone, but in the case of Hashimoto’s it cannot because it’s under attack—and so are the enzymes and molecules that are needed for thyroid production.

If a person has elevated TSH, a low T4 and T3 and a positive anti-TPO and/or TgAb, a diagnosis of Hashimoto’s is made.

Note: There are many variables with thyroid testing and not everyone with Hashimoto’s will test positive for antibodies. Conversely, not everyone with antibodies will have true Hashimoto’s. This is for two reasons:

  1. The immune system fluctuates, so there may be times when the antibodies will fall within the normal range, even though a person has a full-blown autoimmune thyroid condition and all of the accompanying symptoms.
  2. Even healthy people have some autoantibodies to thyroid cells, due to the normal activity of the thyroid gland, but they rarely are elevated too far out of the normal range.

I will talk about optimal versus suboptimal thyroid panel ranges and the different possible scenarios in Chapter 12 of The Thyroid Cure, Test—Don’t Guess!

Other Diagnostic Tests

Your doctor might order a fine needle aspiration (FNA) of the thyroid, which will show the activity of macrophages and T-cells. She may also suggest a radioactive iodine uptake test, which would show an enlarged thyroid gland with diffuse uptake of the radioactive iodine. In some cases, your doctor will do an ultrasound of your thyroid gland, which will show nodules and sometimes even assess how much destruction has taken place.

What is the Conventional Treatment of Hashimoto’s Thyroiditis?

I don’t mean to pick on conventional doctors, but please remember that they are not taught to question why your thyroid has become the target of your immune system. If your hormones fall within, or slightly below, the normal range, your doctor may suggest a “wait and watch approach” and send you home. If she detects a hormone deficiency, she will typically prescribe a synthetic (T4) thyroid hormone replacement called levothyroxine (brand names: Levothroid, Levoxyl, Synthroid) to bring your TSH and T4 back into the “normal” range. This treatment works moderately well for 50 percent of the people who take it. In some cases, it even helps to lower the antibody activity because it reduces inflammation by reducing the activity of TSH and “turning your thyroid off.”

Thyroid replacement does not address the reasons why the thyroid came under attack, and the underlying cause goes untreated and often leads to more autoimmune issues down the road!

It’s also important to note that not everyone does well on T4 replacement alone, so even though their lab tests look “normal,” their symptoms persist. It’s not uncommon for a person to suffer needlessly for months or years before finding the correct hormone replacement. I discuss the different hormone replacement options in Chapter 13 of The Thyroid Cure.

New Studies Show TSH as a Cause of Thyroiditis

In the case of Hashimoto’s, there may be another cause of inflammation that’s driving cytotoxic T-cells to destroy the thyroid gland. In his book, Hope for Hashimoto’s, Dr. Alexander Haskell explains how the condition of autoimmune thyroiditis or Hashimoto’s is caused by an iodide/iodine deficiency, which in turn causes low thyroid hormone levels. Low thyroid hormone levels then cause TSH levels to go up and hydrogen peroxide is produced in the cells of the thyroid, as it gets ready for the process of making thyroid hormones from iodine. In the case of chronic iodine deficiency, there is no iodine to uptake so the H2O2 just hangs around, causing oxidation of cells. He states that it’s the H2O2 that is causing inflammation of the thyroid, which in turn causes white blood cells (T-cells) to rush to the site to clean up the mess. If they have to stick around for a long time, say months or years, they may become overzealous and begin to attack some of the healthy tissue and cells, including thyroid peroxidase and thyroglobulin. This would explain why antibody levels go down in some people when they begin thyroid hormone replacement and lower their TSH.

Things You Can Do to Start Feeling Better Fast!

Healing involves restoring balance to the core systems of the body. While you work to get the proper thyroid tests to balance your thyroid hormones, you can begin to support your healing process by strengthening your body with good nutrition, supplementing deficiencies, and reducing your stress. I discuss just how to do that in The Thyroid Cure and on this website . If you need more help, please sign up for a tele series immersion program or make an appointment with me.

Remember, the body knows how to be healthy and will naturally move toward vibrant health if given what it needs: positive thoughts; sufficient rest; stress relief; vibrant food and proper nutrients; healthy GI and eliminatory systems; good detoxification pathways; and healthy environments!

If you have been diagnosed with Hashimoto’s or Graves’ you don’t have to suffer with this condition for the rest of your life. You can cure yourself! I wrote The Thyroid Cure so that you learn about how can uncover the roots of your condition and heal!

Buy The Book

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It’s not just about autoimmune thyroid disease. It’s about all autoimmune conditions.

It’s the only book on autoimmunity that is written for both the patient and their doctor.

In The Thyroid Cure, I outline the exact steps that anyone can take to reverse ANY kind of chronic, inflammatory autoimmune condition. I show you how to become empowered, navigate the broken medical system and get the right care, so that you can undercover the roots of your illness and heal for good.

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· 30-Day Meal Plan

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The Thyroid Cure is the roadmap you need for your path to healing!


Michelle Corey, C.N.W.C., F.M.C., is a Functional Medical Practitioner, Nutritionist and Author. She studied holistic nutrition at Clayton College of Natural Health and completed a comprehensive 2-year practical program at Academy of Functional Medicine and Genomics. Michelle is an advisor to the Academy of Functional Medicine and Genomics and the Functional Medical University, and a member of the Institute of Functional Medicine and the National Association of Healthcare Advocacy Consultants.

In her groundbreaking book The Thyroid Cure, The Functional Mind-Body Approach to Reversing Your Autoimmune Condition and Reclaiming Your Health, (Vibrant Way Press) Michelle presents readers with the keys to reversing the full spectrum of autoimmune conditions such as Hashimoto’s, Graves’ Disease, Lupus, Celiac, Rheumatoid Arthritis, Fibromyalgia and Chronic Fatigue.

Michelle offers Total Recovery Programs for patients who suffer from complex autoimmune and inflammatory conditions. These Functional Mind-Body programs are designed to guide people to recover wellness by balancing the core systems of the body through optimizing nutrition and detoxification, practices to release stress, let go of the past, and connect more fully to a life of spirit.