Immune Disorders in Hashimoto's Thyroiditis: What Do We Know So Far?


(Meeping up the Science!) #1


This review of literature attempts to identify the factors that are involved in the pathogenesis of Hashimoto thyroiditis, an immune defect in an individual with genetic susceptibility accompanied with environmental factors. The frequency of Hashimoto’s disease is a growing trend and among Caucasians it is estimated at approximately 5%. The dysfunction of the gland may be clinically evident (0.1–2% of the population) or subclinical (10–15%). The pathology is diagnosed five to ten times more often in women than men and its incidence increases with the age (the peak of the number of cases is between 45 and 65); however, it can also be diagnosed in children. The pathogenesis of Hashimoto’s thyroiditis is still not fully comprehended. In the etiology of Hashimoto thyroiditis excessively stimulated T CD4+ cells are known to play the most important role. Recent research has demonstrated an increasing role of newly discovered cells such as Th17 (CD4+IL-17+) or T regulatory cells (CD4+CD25+highFoxP3+) in the induction of autoimmune disorders. The process of programmed cell death also plays an equally important role in the pathogenesis and the development of hypothyroidism.

Keto not working for me
(Jaz Hartley) #2

We actually know more. Autoimmune thyroid, whether hashi or Graves are both related to celiac disease or non-celiac gluten sensitivity.

We also know that certain pathogens in the gut a can trigger thyroid issues. This may be connectedto intestinal permeability

I also know that soy is toxic to thyroid hormones and anyone with autoimmune thyroid should avoid it.

Through Apex seminars I have data that most grains are “molecular mimics” to gluten which is a problem in celiac or non-celiac gluten sensitivity. And therefore grains should be avoided. Other molecular mimics for thyroid are spinach and tuna of all things

Chronic stress affects the HPA axis (hypothalamus pituitary adrenal axis) which can then affect the HPT axis (hypothalamus pituitary thyroid axis) according to classic physiology. Therefore chronic stress is detrimental to thyroid hormones. Chronic stress also impacts the cellular junctions of the intestinal lining which can then increase intestinal permeability leading to increase of celiac disease or non-celiac gluten sensitivity increasing autoimmune thyroid problems.

You can look up paleo autoimmune protocol for many foods to avoid that can also have an impact in intestinal permeability and autoimmunity reactions.

I hope that this list of potential factors helps. I am always happy to answer questions about this as autoimmune diseases are a focus of my practice

(Jaz Hartley) #3

I also know that many people with thyroid disorders have problems with the mthfr gene and taking methyl foliate can help

Methylation issues mean that folks with this problem also need to use the methylcobalamin form of B12 because the more common cyanocobalamin form is not processed in humans . Methylcobalamin is necessary to work with methyl folate for proper function.

I have found this to be very important in addressing autoimmune thyroid problems

(Kathryn) #4

I am wondering if there is a link to insulin resistance and Hashimoto? I have been doing selenium, and no longer do grains or dairy, or eggs. I read that many people with Hashimoto have an egg intolerance. But I struggle to loose weight!
Any one have your insulin resistance checked in combination with tyroid disease?
I am groping for answers.

(Jaz Hartley) #5

Yes insulin resistance goes along with Hashimotos

(Kathryn) #6

Oh I wonder if this is part of my issue. But I am not sure if it makes a difference to be tested, and what test to do. Any ideas? I know that sometime metformen is an rx that is helpful. But I have been Keto for almost a year. Would an insulin test be accurate? (And which tests do I ask my doctor to do?)
I have been testing my blood glouscose and it will average 100-107. Mid morning I can get a reading in the 80’s with just having my butter coffee till 10:30 or so.
I have gone dairy free and still this high of a reading. It can be discouraging after seeing how others are doing. Guess comparing is not helpful but still have some weight I would like to loose.

(Meeping up the Science!) #7

Kathryn, there is a link between T1 diabetes and Hashimoto’s, because T1 is an autoimmune disorder typically, and autoimmune disorders are like the world’s worst band groupies that travel together and mess up our lawns :wink:

Kidding aside, blood glucose imbalance and Hashimoto’s often occur together. Anything that impairs thyroid function impairs the metabolism. Insulin resistance is thought to sometimes trigger Hashimoto’s disease, as well, since it can cause inflammatory responses that trigger autoimmunity.

Metformin might help; some of us just have wonky metabolisms, period. It is very frustrating I know, but do not lose hope! @Richard might have more insight about that in particular. Search the forums here for metformin, there’s been quite a few posts. :slight_smile:


I have Hashimoto’s, and while there is a link to gluten intolerance/sensitivity, it is not known to be a causal relationship. In women, most cases are triggered at times of hormonal shifts–e.g., puberty, childbirth, menopause (which is why cases ‘peak’ at ages 45-65).

With one autoimmune disease, a person is susceptible to others.

Hashimoto’s diagnosis via blood tests are notoriously false negative–apparently unless the antibodies are attacking the thyroid at the time of the blood draw, the level will not be high enough for diagnosis. I personally was regularly checked, and my antibody level was low, but when I had a biopsy of one of my thyroid nodules, the pathologist diagnosed Hashi’s from the tissue extracted.

Since the treatment is for the subsequent hypothyroidism (as the antibodies destroy the thyroid), the Hashi’s diagnosis is not essential–but it’s helpful.

(Richard Morris) #9

I’m sorry I don’t know a lot about Hasimoto’s. Metformin specifically sensitizes our cells to insulin, specifically helps diabetics who are insulin resistant in their pancreas and unable to inhibit glucagon secretion with insulin - for those people it reduces liver output of glucose by roughly 30%.

(Kate) #10

I’m a Hashi and I can definitely say for me when my insulin is back up my thyroid function goes whacky. I am not sure which of them causes the initial flare but they usually happen at the same time. My father (who hasn’t had the antibody test so is just considered hypothyroid whereas I have Hashimoto’s as well as hypothyroidism) has a similar thing in that they are not sure if the thyroid caused the diabetes or the diabetes caused his thyroid problem.
My white cell count and neutriphils were always high up until about 6 months ago and may have been an indicator that something was going on long before I was diagnosed.

As for the gluten issue I had a gluten exposure after 7 months of being Keto (well not so much of a exposure more like I just ate pizza) and within 5 mins my lips were swollen and broke out in a rash down the side of my face and neck as well as my hands. My Dr said it looked like celiac rash (have been tested but it was negative though you had to have a large amount of gluten for a while before the test and I just wasn’t willing to make myself sicker or have the envitable eczema flare that came with it) . After having allergy testing it was deemed a wheat intolerance but that rash was painful enough that I will not be doing that again. Ever.

Interesting that it talks about the HPA axis as I went through Cushing’s testing for many issues to determine if it was the Hashi’s (cycling through Graves and Hashimoto’s) or something causing my symptoms (fat on my back of neck and above belly button) but wasn’t taken seriously by the hospital because I was losing weight (thanks to Keto). One thing I did find from testing was that I also had low growth hormone which apparently when insulin is high growth hormone is low.

I still struggle with insulin going up on occasion back into resistant levels. Worse thing at the moment is because I am not eating the carbs it brings my blood sugars low and I get thyroid symptoms of cold hands and feet when this happens.

I will stay Keto though because despite all my medical problems, Keto has help get rid of 80% of my symptoms (including reversing PCOS)like which more than I hoped for when I started my Keto journey.

(Jackson ) #11

If I only have hashimotos and not thyroid prob yet do u think is it ok to have ashwanghada supplement in trying to find in google smthg abt that but I found one article is saying is not good for hashimotos to have ashwaghada only for hypo they can have it anyone knw anthg abt this ?

(Kathryn) #12

Well I have been on the healing road this last year. I was struggling with weight gain while Keto. Since last Feb I was gaining 2 lbs a month. It was so distressing since I had gotten to my goal weight.
I did find out I had a high RT3 (reverse t3) which is like putting the brakes on your metabolism. Rats! Well getting that to go down has taken almost a year.
The weight gain has stopped finally (hallelujah!!) and I was up 15 pounds. Now I have reduced my T4 medication by 1/2 and the functional medicine doctor has me taking some T3 meds. This has helped with feeling better, more energy and not feeling so cold all the time. I am now able to see some weight loss and so grateful for that. With hypo and Hashis it can be so discouraging.
I am back in the gym and tracking my macros on occasion to see if I am getting enough fat.
So grateful for a doctor that knew what it was and does test using a full thyroid panel.
Keep asking the hard questions and seek to continue to educate yourself.
It can be a long process toward wellness.
But you are worth it!!

(Bunny) #13

Just a theory about Hashimoto’s et al. but it seems that estrogens when they inter-combine with bad exogenous estrogens or other chemical conversions from external environmental toxins can get lodged into the receptors (fits perfectly like a puzzle piece) of the thyroid glad possibly (blocking or interacting with thyroid secretions and further inhibiting binding abilities to other cells) causing the auto-immune (estrogen dominance) like response! (wish I could find a better illustration to demonstrate this!)


Estrogen Dominance as a Trigger for Hashimoto’s

We are not only exposed to estrogen from our internal hormone production but also through non-organic foods and through personal care products.

In 2015, I found a study that was performed in women with polycystic ovarian syndrome (PCOS), some of whom also had Hashimoto’s. Scientists wanted to figure out why some women with PCOS got Hashimoto’s and why some didn’t and ran hormonal tests on all of the women involved.

Lo and behold, they determined that excess estrogen – also known as estrogen dominance- can trigger Hashimoto’s.

So, how do you know if you have estrogen dominance? …More

5 Foods That Can Secretly Save Your Thyroid

(Jackson ) #14

Wht abt ashwagadha for hashimotos ? Not hypo still hashimotos ! Plz need an advice

(Bunny) #15

Is an alkaloid compound! Lowers cortisol too (not good if you have untreated Addison’s disease, damaged adrenal glands or low blood pressure)!

Ashwagandha: The Complete Herbal Guide

(Jackson ) #16


(Kate) #17

Interesting about the estrogen dominance. I noticed towards the end of my pregnancy as I became more insulin resistant that my arms got bigger.and my upper thighs. I was told this was probably due to estrogen by an Obs.

(Hala) #18

I just read an article saying ashwagadha not good for hashimotos Dessie only good for hypo or hyper but not for hashimotos it will rise the antibodies wht do u think ?