You’ve been told you have hypothyroidism. Maybe you’ve been experiencing symptoms like weight gain, cold hands and feet, fatigue, hair loss, anxiety or depression and brain fog for a while without knowing why.

1 in 4 women in or near perimenopause are diagnosed with hypothyroidism- if you’re one of them, know that you’re in plenty of good company.

The western standard of care for hypothyroidism is thyroid replacement hormone either synthetic, Synthroid (which happens to be the 4th highest selling drug in the US ) or bio- identical, Armour, Westhroid, Nature-Throid. The downside to medications is that they generally provide only partial relief of symptoms, and they fail to address the declining function of the thyroid, which continues to worsen overtime.

The other challenge in treating hypothyroidism solely with medication is that hypothyroidism is rarely the result of a problem with the thyroid itself. Now you may be wondering, if it’s not a problem with the thyroid, then why is my thyroid not working properly? Studies show that 90% of hypothyroid cases are caused by Hashimoto’s, an autoimmune disease where the immune system attacks the thyroid gland, causing a decline in thyroid hormone. Yes- Hashimoto’s can be diagnosed through a thyroid antibody lab test (TPOAb, TGAb) however since antibodies fluctuate constantly, it’s difficult to get an accurate reading, leaving many cases of Hashimoto’s undiagnosed.

In my prior article on hypothyroidism, I discussed why so many cases of hypothyroidism get missed and how to get a correct diagnosis if you’re symptomatic. In this article, we’ll be looking Hashimoto’s, the most common source of hypothyroidism and learning about its root causes.

Note: There are many potential causes of Hashimoto’s and for the majority of patients, multiple interlinking causes. This is a partial list. Please work with your appropriate health care provider to assess and treat your individual case.

Immune System Dysfunction/ Gut Inflammation

With autoimmune diseases the immune system has essentially gone haywire and is mistakenly attacking the body itself. As we learned in my blog post about gut function, approximately 70% of the immune system is found in the gut. So gut inflammation= immune system dysfunction. Gut inflammation is not the only cause of immune system dysfunction but it’s certainly a big one.

Chronic unexplained GI symptoms, anyone? The gut must heal in order for the immune system to function normally. In healing the gut, look for potential food intolerances (you’ll learn more about this below), dysbiosis (imbalanced good & bad bacteria in the colon) and leaky gut (abnormal permeability of the small intestine). Underlying infections and viruses may also be to blame for leaky gut and immune system dysfunction: H-Pylori (the same bacteria that causes ulcers), Borrelia burgdorferi (associated with Lyme disease), Epstein Barr and Herpes are some of the common infections and viruses found in Hashimoto’s patients in particular.

Stress and Cortisol

Stress plays a huge factor in Hashimoto’s. Many women even report symptoms beginning following a high stress time in their lives. The thyroid is directly linked to the adrenal glands, which produce cortisol aka the stress hormone. Adrenal fatigue, a condition of either high or low cortisol levels can result from stress and will negatively impact functioning of the thyroid and the endocrine system.

Gluten and Non-Gluten Grain Intolerance

Research shows a strong link between gluten intolerance and hypothyroidism. Interestingly enough, the molecular structure of gluten resembles that of thyroid hormone. Thus each time gluten is consumed, the thyroid produces less thyroid hormone, mistaking gluten for thyroid hormone. The end result? A tired and lazy thyroid that isn’t working properly.

Those who are sensitive to gluten may also have difficulty with gluten free grains. Non-gluten cereal grains like corn and rice contain a compound called lectins that contribute to leaky gut. In addition, consuming gluten and non-gluten grains causes low grade chronic inflammation, which is another contributing factor to Hashimotos.

Endocrine Disruptors – Environmental Toxins

They’re in your face wash, hair products, cleaning products bottled water, canned food and even your mattress. Environmental toxins wreak havoc on the thyroid, all of them: PCBs, BPA, phthlatates, flame retardants and perfluorinated chemicals.

Nutritional Deficiencies

Despite our accessibility to food and multivitamins, many of us are nutrient deprived. Stress also plays a factor as it causes the body to uptake large amounts of vitamins and minerals, leaving cells without their required nutrients. Nutrients required for proper thyroid function include selenium, zinc, iron, potassium iodine, vitamins a, c, d, e, and all the b vitamins.

Blood Sugar Problems

Do you skip meals sometimes? Are you a vegetarian who skims on protein or a carb-addict? All of these can result in hypoglycemia (low blood sugar) or dysglycemia (irregular blood sugar). When the pancreas is forced to pump out too much insulin due to chronic spikes in blood sugar, blood sugar levels can swing rapidly from high to low.

Overtime this cycle wears on the adrenals and the pituitary gland, making them sluggish, and potentially causing adrenal fatigue. To compensate, the adrenals and pituitary message the thyroid to produce more thyroid hormone. The thyroid then becomes fatigued as well.

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