By Dr. Lina Sakr 

Hashimoto’s disease is an autoimmune disorder that affects the thyroid. Located at the base of the neck below the Adam’s apple, this gland produces critical, body-regulating hormones.

So, what is an autoimmune disorder? It’s an illness caused by an overactive immune system that is unable to distinguish foreign invaders from the body’s own cells.

With Hashimoto’s, the body attacks its own thyroid gland. As the thyroid becomes more damaged, fewer thyroid hormones are produced, leading to hypothyroidism. At the same time, that hormonal imbalance can also lead to hyperthyroidism, or an excess of the hormones.

While anyone can develop Hashimoto’s disease, it’s most common among middle-aged women. Having another autoimmune disease – including rheumatoid arthritis, Type 1 diabetes or lupus – can also increase your risk. In some cases, too much iodine in the diet can be a trigger.

READ MORE: Friendly fire: How autoimmune disorders wreak havoc from within

What are symptoms of Hashimoto’s disease?

Thyroid hormones are essential for the healthy function of many body systems. A sustained decline in thyroid hormone production can lead to:

  • Fatigue and sluggishness
  • Increased cold sensitivity
  • Increased sleepiness
  • Swelling of the thyroid (goiter)
  • Dry skin
  • Constipation
  • Muscle weakness
  • Muscle aches, tenderness and stiffness
  • Joint pain and stiffness
  • Irregular or excessive menstrual bleeding
  • Problems with memory or concentration
  • A puffy face
  • Brittle nails
  • Hair loss
  • Enlargement of the tongue

A comprehensive blood panel can confirm a diagnosis of Hashimoto’s disease, including a thyroid-stimulating hormone (TSH) test. A high TSH level typically means your thyroid gland isn’t producing enough thyroxine (T4) hormone.

Antibody tests can provide further clarification, and in some cases, an ultrasound imaging test could determine the size of your thyroid and be used to check for any nodules.

Treating Hashimoto’s disease – A functional medicine approach

The conventional medicine approach to Hashimoto’s-triggered hypothyroidism is the medication levothyroxine, a synthetic form of the T4 hormone.

Such medications are often both helpful and necessary. But as we have often stated, treating autoimmune disorders through prescription drugs alone will typically only address the symptoms, not any underlying causes.

As author and Hashimoto’s patient, Izabella Wentz Pharm.D, writes, medication alone “wouldn’t actually help my thyroid produce the hormones on its own. It would replace the thyroid hormones my thyroid wasn’t producing… but it would not repair the thyroid damage. That’s because the conventional approach is much more one-size-fits-all,” she says. “Its goal is to get thyroid levels within ‘normal’ reference ranges and manage ‘being sick.’”

In functional medicine, we take a more holistic approach by considering the patient’s overall health, lifestyle and diet, including family history and environmental factors, in search of the root causes.

Ensuring proper gut health is an essential step in that process. That’s because the gastrointestinal tract serves as a barrier between the internal body and the external world, allowing nutrients to enter while preventing harmful substances from passing into the bloodstream. It houses the majority of the body’s immune system (80% of the body’s lymph nodes are around the GI tract) while helping protect against pathogens and regulate the immune function.

The gut also produces microbiomes. Those are a form of helpful gut bacteria that can aid in nutrient production, including Vitamins B and K. These organisms help maintain health and functional digestion and absorption, protecting against pathogens.

Gut bacteria and other microbiomes can impact cardiovascular health, obesity, diabetes, cancer and other chronic conditions. A leaky gut occurs when your small intestine’s lining becomes more permeable than normal, allowing toxins and bacteria to enter the bloodstream.

A leaky gut can adversely impact the immune, nervous and endocrine systems and create what’s known as dysbiosis, an imbalance of the GI bacteria.

READ MORE:  Functional medicine and diagnostic testing

Gut health: The 5R Framework

The functional medicine approach to gastrointestinal wellness relies on what is known as the 5R Framework:

  • Step 1: Remove any food or substance that might be causing dysbiosis which leads to thyroid inflammation. Potential triggers can cause oxidative damage, which triggers the thyroid to send out a stress response to the immune system.
  • Step 2: Replace missing nutrients or digestive enzymes. Depending on an individual patient’s test results.
  • Step 3: Reinoculate the gut with beneficial bacteria, by using proper probiotics and fermented food, if needed, the thyroid hormone,to restore the balance of the gut microbes and improve digestion and immunity.
  • Step 4: Repair any damage to the gut lining through L-glutamine, zinc and other supplements that help repair and maintain this essential protection. Glutamine is an amino acid that is the predominant fuel and nitrogen source for the gastrointestinal tract’s mucosal lining.
  • Step 5: Rebalance your adrenal and immune systems by embracing lifestyle choices, such as increased sleep and exercise and more effective stress management, all of which can affect gut health. Anatabine and curcumin supplements may be beneficial, as are alkaline-optimizing foods such as green juices and leafy vegetables.

READ MORE: Trust your gut: a functional medicine approach to gastrointestinal wellness

Healing Hashimoto’s: A case study

At Naples Center for Functional Medicine, we recently treated a patient diagnosed with autoimmune thyroiditis, with blood test results consistent with mild hypothyroidism and elevated antibodies.

The patient – who works overnights in a stressful health care job – followed the 5R protocol for several months, with subsequent lab work showing a decrease in thyroid antibodies and the patient reporting significant improvement.

 As always, consult with your physician prior to making any substantial lifestyle, health or nutritional changes. For questions, please contact our office at 239-649-7400.

About the Author

Dr. Lina Sakr is a board-certified internal medicine physician at Naples Center for Functional Medicine with nearly 40 years of experience. She specializes in metabolic and nutritional medicine, anti-aging medicine and women’s health.

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