By Josh Redd, MS, DABFM, DAAIM, Chiropractic Physician
“I had several autoimmune diseases and was going to different doctors but couldn’t find anyone to help me feel like I used to before I got sick. I would have maybe four good days a month. Now I have 28 or more good days a month with functional medicine management.” — Anonymous, patient from RedRiver Health and Wellness Center
For 90 percent of people with hypothyroidism, their condition is caused by an autoimmune disease called Hashimoto’s, which damages the thyroid gland. Although most people who seek to manage their autoimmune Hashimoto’s simply want to feel better, there’s another reason you should address Hashimoto’s — it will lower your risk of developing other autoimmune diseases.
It’s not uncommon for people to have multiple autoimmune diseases. That’s because autoimmunity stems from an immune system that has become overzealous and imbalanced. Once you develop one autoimmune disease, you’re at increased risk for developing more. You may even already have another autoimmune reaction happening, it’s just not advanced enough to produce symptoms yet.
For example, at RedRiver we work primarily with Hashimoto’s patients. When we tested 100 Hashimoto’s patients for other autoimmune reactions, 50 percent of them came back positive for myelin basic protein antibodies, the marker for multiple sclerosis!
This is a powerful example we see in our own clinics on why it’s so important to manage your autoimmune Hashimoto’s in order to prevent the development of other autoimmune diseases.
Likewise, a 2012 study showed that about one in six people with Hashimoto’s have another autoimmune disease, the most common being:
- Atrophic gastritis, or chronic stomach inflammation, which causes pain, nausea, vomiting, and ulcers.
- Vitiligo, a loss of skin color and development of white patches across the body.
- Celiac disease, a reaction to the gluten in wheat that can cause severe gastric, brain, or skin reactions.
- Antiphospholipids syndrome, which can cause blood clots, miscarriages, or stillbirths.
- Multiple sclerosis, the gradual loss of the nerve sheaths that causes a wide variety of symptoms, including vision loss, pain, fatigue, and impaired coordination.
The patients in the study also exhibited chronic unexplained anemia and recurring pregnancy losses.
Functional medicine management of Hashimoto’s hypothyroidism can lower the risk of developing other autoimmune diseases.
It’s possible you have Hashimoto’s but haven’t been diagnosed because your conventional lab tests are normal. This makes it difficult to manage and prevent further autoimmune disorders. However, if you have symptoms that include weight gain, cold hands and feet, depression, fatigue, and hair loss, you may need a more thorough functional medicine evaluation to assess whether you have low thyroid.
First of all, you need to test more than just your thyroid stimulating hormone (TSH). If you have low thyroid symptoms you should also test for TPO and TGB antibodies. TPO stands for thyroid peroxidase and is an enzyme in the thyroid gland that plays an important role in the production of thyroid hormone.
TGB stands for thyroglobulin, which is a protein made by the thyroid gland. If your immune system attacks either one of these, you will produce antibodies that can be detected on a blood test to screen for Hashimoto’s.
When you produce antibodies to your own body tissue, this is a sign your immune system is dysregulated and that other body tissues are susceptible to the development of autoimmune diseases.
Fortunately, much research has been done in recent years that we can apply clinically to help slow down or stop the autoimmune attacks against your body. Autoimmunity is a multi-faceted disorder that depends on genetics, environmental factors, infections, brain health, other health disorders, and more, but both clinicians and researchers have found some common foundations to autoimmune management.
Most autoimmune patients respond very positively to a strict gluten-free diet. Gluten triggers a strong inflammatory reaction in many people, eventually causing a gluten intolerance. Because portions of the gluten protein have the same molecular structure as tissue in some parts of the body, this can trigger an immune attack against those tissues.
If you have undiagnosed gluten intolerance, eating gluten regularly keeps the immune system in a constant hyper vigilant state. This causes chronic inflammation, inflammatory health disorders, exacerbation of autoimmune symptoms, and an increased risk of developing additional autoimmune diseases.
The autoimmune paleo (AIP) diet
Some people with autoimmune Hashimoto’s hypothyroidism feel great and improve their symptoms on a gluten-free diet.
Most, however, have to follow the autoimmune paleo (AIP) diet to figure out other foods that are triggering inflammation and thyroid symptoms.
A primary reason people develop multiple food sensitivities is because they also suffer from intestinal permeability, or leaky gut, a condition in which the gut walls become damaged and overly porous.
This allows undigested foods, bacteria, and other pathogens into the bloodstream, where they trigger inflammation, food sensitivities, and health disorders.
Addressing leaky gut is a foundation to most autoimmune Hashimoto’s protocols. One of the first steps is to follow the AIP diet, which eliminates foods that commonly provoke an immune reaction, for at least four to six weeks.
Many Hashimoto’s patients find they feel much better when they also eliminate foods such as dairy, corn, or other grains. In addition to following the diet, taking select nutritional and herbal compounds has been shown to help restore the gut lining.
Sometimes dietary changes alone can substantially reduce autoimmune flare-ups and stall the progression of thyroid damage from Hashimoto’s.
Managing the three-headed monster driving many cases of autoimmunity
In our practice, we see a number of triggers that drive this but we see three factors that often work together to substantially drive up inflammation and autoimmune flares.
Cortisol: This is an adrenal hormone that governs our stress responses. Autoimmune patients often have cortisol levels that are chronically high or low.
Insulin: Insulin is a hormone that helps regulate blood sugar. Many of our autoimmune patients have chronically high insulin, which is a precursor to diabetes. This creates a very inflammatory state in the body and brain.
Estrogen: The majority of patients with autoimmunity and Hashimoto’s are women, and estrogen imbalances are common in this population. That is because cortisol and insulin imbalances cause hormonal imbalances, particularly with estrogen. This drives up inflammation. It should be noted that men, too, can be affected by an estrogen imbalance that causes the development of female characteristics such as male breasts or feeling weepy.
Imbalances in cortisol, insulin, and estrogen work together to keep the body chronically inflamed and prevent its ability to restore and repair damaged tissue. This is especially apparent in the intestinal lining, which leads to a condition called intestinal permeability, or leaky gut.
A leaky gut allows undigested foods, bacteria, yeast, and other pathogens to escape through the intestinal wall into the sterile environment of the bloodstream. Once there, they begin triggering immune responses and inflammation throughout the body. This is a big factor in many cases of autoimmunity, and the “three-headed monster” of cortisol, insulin, and estrogen imbalances promote leaky gut.
By focusing on these three areas of dysfunction, we can help restore the health of the gut wall lining, lower inflammation throughout the body, and reduce autoimmune attacks against tissues.
This approach can also dramatically improve the health of the brain, which is extremely vulnerable to inflammation and imbalances of these three hormones. By improving the brain’s health, it is better able to communicate with the body’s organs and immune system for more optimal function.
Going beyond the autoimmune diet with functional medicine management
Sometimes, diet isn’t enough and more intensive therapy is warranted. Strategies include going after viral, bacterial, or fungal infections; addressing chemical sensitivities; restoring the gut microbiome (the important colonies of healthy bacteria that live in the digestive tract); addressing liver health, and/or looking for other factors that are triggering autoimmune attacks.
If you would like to manage your Hashimoto’s hypothyroidism and lower your risk of developing future autoimmune diseases, please contact my office.
About Dr. Redd
Josh Redd, MS, DABFM, DAAIM, is a chiropractic physician and author of the Amazon bestselling book The Truth About Low Thyroid. Dr. Redd owns seven functional medicine clinics in the western United States and sees patients from across the country and around the world who are suffering from challenging autoimmune, endocrine and neurological disorders. Dr. Redd also teaches thousands of health care practitioners about functional medicine and immunology, thyroid health, neurology, lab testing, and more.