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All about Hashimoto's disease - Adapted from Clinical Nutritionist, Holly Hargreaves


What is Hashimoto’s disease ?


Hashimoto’s is an inflammatory autoimmune disease where the cells within the thyroid are attacked and destroyed by autoantibodies. This leads to disrupted thyroid hormone synthesis influencing every cell in the body.


Symptoms of Hashimoto’s disease can include but is not limited to:


⁃ Weight gain

⁃ Hair loss

⁃ Dry skin

⁃ Fatigue

⁃ Constipation

(Ragusa et al., 2019)





Some potential underlying triggers for Hashimotos include but are not limited to:


⁃ History of underactive thyroid (Hypothyroidism)

⁃ Infections both acute and chronic

⁃ Excessive exposure to environmental toxins these also include (household cleaning products, plastics, pesticides, hair dyes, make-ups and perfumes)

⁃ Poor digestive function, including digestion and elimination aswell as potential intestinal hyperpermeability

⁃ Stress and adrenal dysfunction

⁃ Nutrient deficiencies





How is it diagnosed ?


Hashimoto’s disease is diagnosed through a blood test for particular thyroid hormones and TSH (thyroid stimulating hormone) which secreted from the pituitary gland triggering the thyroid to release hormones. Aswell as thyroid autoantibody levels to assess whether hypothyroidism is a result of autoimmunity (i.e. Hashimoto’s thyroiditis).



As Nutritionists and Naturopaths we look into the unique root cause and combination of potential factors that may have contributed to Hashimoto’s disease, therefore informing where we begin with treatment.


Some key areas we address through treatment include the following.



Lifestyle modification



Particularly reducing stress levels and how we perceive stress to reduce cortisol levels. Increased cortisol levels within the body negatively impact the thyroid function. It can also drive autoantibodies due to its immunosuppressant effect on the immune system (Agha-Hosseini, 2016).


Some of Holly’s favourite tips for managing stress include


⁃ Yoga and meditation

⁃ Daily movement

⁃ Journalling

⁃ Being outdoors in nature

⁃ Vagus nerve stimulation (singing, darling, laughing, meditation, cold exposure (having a cold shower for 3-5 minutes)).



Dietary modification



Dependant on individual circumstances with a focus on eliminating triggers which may include :



Gluten


Gluten contains a protein called gliadin, which resembles that of transglutaminase which is present in the thyroid gland, aswell as the intestines. When gliadin enters the bloodstream, particularly if intestinal hyper permeability is present (which gliadin can contribute to), the immune system tags it for destruction and further destroys the thyroid gland 
(Hadizadeh Riseh et al., 2017). 

There are multiple good substitutes for your favourite gluten containing foods including :

Switching wheat bread for buckwheat, millet or nut bread 


Switching wheat pasta for brown rice, buckwheat, legumes pasta or zucchini noodles. 

Those with celiac disease are also more likely to be diagnosed with Hashimoto’s thyroiditis (Naiyer et al., 2008).









While working on ensuring nutrient status is optimal to support thyroid hormone synthesis and supporting immune function to protect the thyroid gland from further destruction. For example :


Selenium - An antioxidant found in large amounts within brazil nuts that plays an important role in protecting the thyroid gland from oxidative stress (Stuss et al., 2017).


Zinc - Found in foods such as oysters and shellfish aswell as nuts and seeds in smaller amounts. Zinc is essential for immune function but also critical for producing thyroid hormones.





Vitamin D - Get some sunshine! Vitamin D plays autoimmunity through decreasing certain autoimmune antibodies and also modulating the immune system as a whole (Chahardoli et al., 2019).Magnesium




Kaptured Nutrition






References


Agha-Hosseini, F., Shirzad, N., & Moosavi, M. S. (2016). The association of elevated plasma cortisol and Hashimoto's Thyroiditis, a neglected part of immune response. Acta clinica Belgica, 71(2), 81–85. https://doi.org/10.1080/17843286.2015.1116152


Chahardoli, R., Saboor-Yaraghi, A. A., Amouzegar, A., Khalili, D., Vakili, A. Z., & Azizi, F. (2019). Can Supplementation with Vitamin D Modify Thyroid Autoantibodies (Anti-TPO Ab, Anti-Tg Ab) and Thyroid Profile (T3, T4, TSH) in Hashimoto's Thyroiditis? A Double Blind, Randomized Clinical Trial. Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme, 51(5), 296–301. https://doi.org/10.1055/a-0856-1044


Hadizadeh Riseh, S., Abbasalizad Farhang, M., Mobasseri, M., & Asghari Jafarabadi, M. (2017). THE RELATIONSHIP BETWEEN THYROID HORMONES, ANTITHYROID ANTIBODIES, ANTI-TISSUE TRANSGLUTAMINASE AND ANTI-GLIADIN ANTIBODIES IN PATIENTS WITH HASHIMOTO'S THYROIDITIS. Acta endocrinologica (Bucharest, Romania : 2005), 13(2), 174–179. https://doi.org/10.4183/aeb.2017.174


Naiyer, A. J., Shah, J., Hernandez, L., Kim, S. Y., Ciaccio, E. J., Cheng, J., Manavalan, S., Bhagat, G., & Green, P. H. (2008). Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction. Thyroid : official journal of the American Thyroid Association, 18(11), 1171–1178. https://doi.org/10.1089/thy.2008.0110


Ragusa, F., Fallahi, P., Elia, G., Gonnella, D., Paparo, S. R., Giusti, C., Churilov, L. P., Ferrari, S. M., & Antonelli, A. (2019). Hashimotos' thyroiditis: Epidemiology, pathogenesis, clinic and therapy. Best practice & research. Clinical endocrinology & metabolism, 33(6), 101367. https://doi.org/10.1016/j.beem.2019.101367


Stuss, M., Michalska-Kasiczak, M., & Sewerynek, E. (2017). The role of selenium in thyroid gland pathophysiology. Endokrynologia Polska, 68(4), 440–465. https://doi.org/10.5603/EP.2017.0051

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