Saul Marcus, ND - Naturopathic Doctor

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7. Autoimmune Hypothyroidism (Hashimoto's thyroiditis)

An autoimmune disease is when the immune system attacks the body's cells.

When the immune system attacks the thyroid, causing decreased amounts of thyroid hormone this is called autoimmune hypothyroidism, or Hashimoto's thyroiditis.

Sometimes the immune system causes the thyroid to produce too much hormone (hyperthyroidism). This is called graves disease.

Tests for autoimmune thyroid disease

Antibody tests for autoimmune hypothyroidism are:

Generally anti-TPO is more likely to be elevated. Both tests should be run because it's possible that only anti-thyroglobulin is positive.

Often conventional doctors do not run antibody tests. From their perspective they are just going to prescribe thyroid hormone based upon TSH so it does not matter. From a holistic perspective these tests do matter. They show a possible cause of hypothyroidism, but also antibody levels may improve with proper treatment of the immune system.

Additional antibody tests:

Frequently Graves Disease patients will have the other antibodies elevated also. Therefore in hyperthyroidism all the antibodies should be tested. Patients often need to ask to have this tested as well.

Conventional treatment for autoimmune hypothyroidism

Conventional treatment for autoimmune thyroid disease (either hypo or hyper) is directed at symptoms only. There is no conventional treatment for the autoimmune disorder itself.

Often autoimmune disease indicates a body burdened with poor digestion and/or toxicity. If these are not resolved, then often another autoimmune disease develops. See the page on Autoimmune Polyendocrine Syndromes.

Molecular mimicry and leaky gut syndrome

The immune system has to tell the difference between cells of our own body (self), and anything else that doesn't belong (non-self). Bacteria, viruses or certain large food particles that pass through the GI system are recognized as non-self. Anything that is non-self and triggers an immune system response is called an antigen. Antibodies latch onto antigens and trigger the immune systems response.

antibodies tag onto antigens, and this allows the immune system to see the invader and attack

Sometimes antigens look a lot like some of our own cells (self). The immune looses the ability to tell self from non-self. It creates autoantibodies. Autoantibodies are antidbodies which are targeted against the individual's own proteins. This whole process is called molecular mimicry.

Molecular mimicry is a major cause of autoimmune disease in general. [35]

Autoimmune thyroid disease and "leaky gut" syndrome

In the gastrointestinal tract nutrients are absorbed from the outside world into the body. Along with needed nutrients, bacteria, toxins and large undigested food particles are also absorbed. These things really don't belong in our bodies. They become antigens, which the immune system recognizes as non-self.

The body makes various types of antibodies to target and eliminate antigens. Ones relevant to this autoimmune process are:

digestive system has a healthy immune response and elmiminates pathogens

As in the picture above, a small number of antigens cross the gastrointestinal mucosa in a health digestive system.

However, in an unhealthy digestive system people have what is called "leaky gut syndrome." This means that the mucosa border is too permeable. Large numbers of antigens leak across into the body. This causes an increase in IgG antibodies and over activates the immune system.

leaky gut leads to auto immune disease such as hashimoto's thyroiditis

This large stimulation of IgG antibodies deregulates the immune system. Through the process of molecular mimicry it starts to make antibodies against certain tissues of the body. [36]

Some antigens are more specific to certain auto-immune disease. For example, overgrowth of gut bacteria Yersinia enterocolitica lead to formation of antibodies found in autoimmune thyroid disease. [37]

Common causes of leaky gut and poor digestive health include:

The consequences of leaky gut:

Treatment of Leaky Gut Syndrome:

There are many programs and supplements that help restore function to the gastrointestinal tract. Among the most well known and used among holistic practitioners is the "Four R program"

Since emotional stress plays a huge role in digestive system function, a holistic assessment will consider it as well. Therapies such as calming supplements, herbs, homeopathy, or neuoemotional technique (go to netmindbody.com for more information) can help with this aspect.

Often it is just as essential to work on the emotional component besides the physical.