This autoimmune disorder is characterized as a malfunction of the immune system where the body produces antibodies that attack the body's own cells and tissues - the thyroid gland being the most commonly affected organ. Although the reasons for this dysfunction are complex, we understand that many environmental and endogenous factors are associated with autoimmunity of the thyroid.
Hashimoto's vs Graves’ disease:
Both Graves’ disease and Hashimoto's thyroiditis are autoimmune disorders of the thyroid. They are both conditions where the immune system (immune T and B cells specifically), infiltrate the thyroid gland and produce autoantibodies leading to abnormal function - underfunction or overstimulation of the thyroid gland in Hashimoto’s and Graves’ respectively.
Testing for these conditions involves looking at the presence of anti-TPO and anti-Tg antibodies in the blood. Usually easy to detect, these antibodies may precede diagnosis of clinical symptoms by 2-7 years. Usually the presence of anti-TG antibodies is not enough to make a definite diagnosis - as these antibodies can also be elevated in other conditions, including arthritis and type 1 diabetes. However, most patients with Hashimotos will have elevated anti-TG antibodies which is very characteristic of this disorder.
Possible risk factors/ contributors:
It is now believed that an interaction between genetic and environmental factors can lead to an autoimmune thyroiditis condition. Some risk factors include: recent or past infections, gender (females being more affected) and iodine intake. Environmental factors that can contribute to the development of these conditions include over-exposure to pesticides, heavy metals, halogens, polyhalogenated biphenols and various nutrient deficiencies or excesses. For example, although iodine is recognized as essential for thyroid functions, overconsumption can increase the risk of thyroid dysfunction in susceptible individuals, therefore levels should be monitored in at-risk and diagnosed individuals.
Once testing has confirmed a diagnosis of Hashimotos or Graves’, there are several options for treatment. First and foremost, thyroid replacement hormone (Levothyroxine) may be prescribed for Hashimoto's (hypothyroidism). For Graves’ (Hyperthyroidism) - anti-thyroid medications, radioactive iodine or surgical removal (partial or full) of the thyroid gland may be needed.
There are effective treatments which may be used to help treat autoimmune thyroid disorders. Addressing specific deficiencies such as vitamin D deficiency can help address some of the problem - with adequate levels having an immunomodulatory effect. In addition, botanical anti-inflammatory agents such a blue flag, selenium and rosmarinic acid which can target the thyroid - preventing an auto-immune reaction are used in specific doses. Knowing when to use the right botanical and at what dose is key to reducing damage to the thyroid gland, returning balance to the immune system and eliminating symptoms.
There are several compounds with varied mechanisms of action which can support thyroid function and prevent auto-immune damage. Some mechanisms involve T cell modulation and cytokine response. In addition to these therapies, it's also important to consider stress reduction options, improving digestion, and absorption through adequate nutrition and avoidance of triggering foods known to interfere with proper thyroid function. Finally, incorporating exercise helps induce 5'-deiodinase - an enzyme that helps stimulate production of thyroid hormones (T3 and T4). When treated multi-factorially, patients usually experience the best outcomes and can often significantly improve their thyroid health.
Hutfless S, Matos P, Talor MV, et al. Significance of prediagnostic thyroid antibodies in women with autoimmune thyroid disease. J Clin Endocrinol Metab. 2011;96:E1466-E1471.
Gallagher CM, Meliker JR. Mercury and thyroid autoantibodies in U.S. women, NHANES 2007-2008. Environ Int. 2012;40:39-43.
McLeod DS, Cooper DS. The incidence and prevalence of thyroid autoimmunity. Endocrine. 2012;42:252-265.
Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull 2011;99:39-51.