Hashimoto's is an autoimmune disease, so it cannot be fully cured. However, it can be put into remission. The body will then be brought into a relative balance, and the patient will be in a state in which he will not feel unpleasant symptoms related to the disease.
What is Hashimoto's disease?
Hashimoto's is a disease in which the body attacks its own tissues. It belongs to autoimmune diseases, just like:
- RZS,
- albinism,
- Sjorgen's band,
- Addison's disease,
- or type 1 diabetes.
For unknown reasons (the underlying cause is genetic predisposition), the immune system destroys the thyroid cells, leading to its reduction, "holes" or the formation of nodules.
Hashimoto's disease can be accompanied by an overactive or underactive thyroid, although it usually progresses quickly from hyperthyroidism to hypothyroidism.
It is worth noting, however, that Hashimoto's disease can exist without the accompanying hypothyroidism (many people bind them inextricably).
We talk about autoimmune thyroiditis when the test results show elevated anti-TPO and / or anti-TG antibodies and an ultrasound image of the thyroid gland (heterogeneous or reduced echogenicity of the thyroid parenchyma) or diagnosed disturbances in the functioning of the thyroid gland (usually it is is hypothyroidism).
The presence of two of the three factors mentioned above helps the physician determine whether or not Hashimoto's disease is present.
The road to Hashimoto's remission
Improving the functioning of the liver and intestines
For the thyroid to function properly, T4 must be converted to T3. Only then will the active triiodothyronine be able to reach our tissues and act on the appropriate cells.
The conversion of thyroxine into triiodothyronine occurs in various tissues of the body, including liver, intestines, kidneys. That is why it is so important to take care of each of these organs in the healing process of the thyroid gland.
Why is the conversion of T4 to T3 so important?
Because active triiodothyronine works up to 8 times stronger than T4. For this reason, thyroxine is also referred to as a prohormone. If we want the conversion process to go smoothly, we need to make it work betterliver. Especially it, because in addition to the process of transforming hormones, it also removes toxins from the body. And these additionally burden the body, which is already overloaded by the inflammation at Hashimoto's.
Healing the liver
So what should be done to support the functioning of the liver? First of all, give up processed food, alcohol and sweets, because these products burden your skin the most. They can also lead to non-alcoholic fatty liver disease, which will affect its performance and worsen its overall he alth.
In order to improve the detoxification phase of the liver, it is worth providing yourself with B vitamins, in particular:
- vitamin B3,
- vitamin B5,
- vitamin B6,
- vitamin B12,
- and glutathione,
- flavonoids
- and folic acid.
Due to the fact that many people have a mutation of the MTHFR gene (responsible for detoxification and the conversion of folic acid and vitamin B12 to their active forms), it is recommended that supplements with folic acid, vitamin B12 or vitamin B6 contain their methylated form.
With Hashimoto's combined with hypothyroidism, there is usually a weakened flow of bile, so supplements with milk thistle extract, artichoke, dandelion, L-methionine, taurine, inositol, choline will help here.
Better bowel condition
Good gut he alth is no less important to the recovery and regression of Hashimoto's symptoms than the liver. This is because as much as 20% of the T4 to T3 conversion occurs in the intestines.
Any dysfunction within the intestines, increased permeability of the intestinal barrier, dysbiosis or SIBO will lead to a weakening of the process of transformation of thyroid hormones.
The poor condition of the intestines will also reduce the absorption of L-thyroxine (a substance contained in the drug for hypothyroidism), which will result in the need to take larger doses.
In order to improve the tightness of the intestinal barrier, it is worth reaching for glutamine. It is also important to eliminate excess physical activity (practicing sports for many hours every day) and reduce the level of stress, as these two factors significantly contribute to increasing intestinal permeability.
In addition, it is worth taking care of the balance of the intestinal microbiome, where good bacteria will be more numerous than the bad ones. This harmony of the microbiome can be achieved, for example, by regular consumption of silage, appropriately selected by a doctor probiotic therapy and the consumption of varied, unprocessedfood.
The condition of the gut is closely related to the immune system. If the intestinal barrier is leaky, endotoxins penetrate it and poison the body internally. This puts additional strain on the liver and is a source of inflammation.
In addition, food particles that pass through leaky gut are a factor that irritates the immune system and causes the development of numerous allergies. With Hashimoto's, which is an autoimmune disease, caring for your immune system is extremely important.
Energized - it will intensify the attack on its own tissues, silenced - it will allow to achieve remission. Keeping your intestines he althy with he althy food, sufficient hydration (helping to restore mucous membranes), and consuming anti-inflammatory omega-3 fatty acids is essential for the healing process.
Eliminate infection
Because one of the factors that can contribute to the onset or worsening of Hashimoto's disease are all sorts of infections, eradication of all kinds of pathogens is essential if we want to achieve remission of autoimmune thyroiditis.
The most common bacteria that cause Hashimoto's infections are:
- H. Pyroli,
- Borrelia burgdoferi,
- Yersinia enterocolitica.
In turn, the viruses responsible for the additional inflammation in the body are:
- Coxackie B virus,
- hepatitis C virus,
- EBV virus.
In addition, Hashimoto's development can be influenced by parasites such as Blastocystis hominis or yeast overgrowth.
The elimination of the infection consists in finding its source, e.g. by performing a stool test for Blastocytis hominis or a blood test for viruses, or undergoing gastroscopy in order to find the Helicobacter Pyrola in the stomach.
When pathogens are found, appropriate antibiotic, herbal or other treatment should be administered under the supervision of a doctor in order to get rid of microorganisms.
Toxin exclusion
Many artificial substances contained in food packaging or everyday objects can adversely affect the endocrine system, including thyroid hormones, or adversely affect the intestinal microflora. If a person with Hashimoto's wants their body to function efficiently, they should avoid them.
The following are especially dangerous:
- Xenoestrogens- are substances that mimic the effects of estrogens. Introduced from the outside, they disrupt the hormonal balancehuman. Their action is related either to fighting human estrogens, resembling them or disturbing the synthesis and metabolism of estrogens. Xenoestrogens, which include: parabens, UV filters, alkylphenols, pesticides, metalloestrogens, we can find, among others in cosmetics, detergents, paints, varnishes, dental materials, plastics.
- Bisphenol A (BPA)belongs to xenoestrogens that modulate the endocrine system. Due to its similarity to estrogen, it adversely affects the reproductive system and may also cause contact allergy or respiratory problems. It also inhibits the triiodothyronine receptors, causing them to turn off. Thus, it disrupts the functioning of the thyroid gland. Exposure to the toxic effects of bisphenol occurs both through the alimentary tract (when we eat food into which bisphenol has penetrated from plastic packaging), through the skin (when we use cosmetics packed in bottles with bisphenol, or through the respiratory tract (when we inhale air contaminated with dust containing this compound).
- Triclosan- it is a bactericidal and antifungal agent that is often found in: soaps, mouthwashes, tonics, toothpaste, deodorants, detergents cleanliness, toys, materials for making dishes. He is even present in clothes. The threat of its use in connection with the thyroid gland is that its structure resembles thyroid hormones, which can lead to disorders of its functioning (so far it has only been proven in studies on mice).
Taking medication correctly
Many people with Hashimoto's have hypothyroidism and take a daily dose of a drug designed to make up for their own thyroid hormones. It usually contains L-thyroxine (Euthyrox, Letrox, Eltroxin), which, in order to be absorbed well, must be taken on an empty stomach.
Patients usually take it in the morning, on an empty stomach, 30-60 minutes before the first meal. However, not all patients know that what they consume for the next 4 hours after swallowing the drug also affects the proper or not absorption of L-thyroxine.
Those who make dietary mistakes may later have the wrong idea that the drug is not working or that they need a higher dose. The truth is that the drug is simply not absorbed properly from the blood, e.g. patients ate breakfast too quickly (within 30 minutes).
Failure to follow the appropriate rules of taking the drug will delay recovery and inhibit the remission process. That's whyif patients want to achieve remission, they must remember the following:
- Drinking coffee shortly after taking the drug (some people do not treat coffee as food, so they think a 30-minute interval does not apply to them), may result in the drug not being absorbed at all. It is best to postpone the consumption of coffee up to an hour after swallowing the medicine.
- Eating dairy products and products containing calcium (e.g. tahini paste, poppy seeds) is also not a good idea, because calcium weakens the absorption of L-thyroxine, which reduces its effectiveness. The same goes for calcium supplements / supplements. If we have to take them, let's do it at meals other than breakfast.
- supplements and foods containing iron (e.g. liver) are also not the best idea for a morning meal. Iron also inhibits the absorption of L-thyroxine.
- protein pump inhibitors used for heartburn, acid reflux and hyperacidity must not be taken shortly after L-thyroxine, because it needs an acidic environment to be absorbed, and under the influence of these inhibitors, the production of hydrochloric acid in the stomach is suppressed.
Sleep and regeneration
We can eat the he althiest food, take the best supplements, but if we do not take care of the proper quality and duration of sleep, we cannot count on our body to fully regenerate. Especially people who have Hashimoto's combined with hypothyroidism, where there is quite a lot of weakness and frequent feeling of fatigue, should rest.
Regeneration is also important because it leads to the equalization of the level of cortisol - a stress hormone that rises when threatened or when you need to act quickly.
While a briefly elevated cortisol level will not harm us, its long-lasting high concentration in the body (caused by chronic stress or too much physical activity) will lead to the feeling of exhaustion. A tired body will not get a signal that it is time to regenerate the thyroid gland, because it will simply not have the resources to do so.
In addition, any greater physical activity or stress will require energy, and this is created, among others, by thanks to thyroid hormones. An 8-hour sleep, preferably from 10 p.m., is a prerequisite for achieving remission.
Taking care not to overload the body with additional, exhausting physical exercise is also a necessary condition for the balance of thyroid hormones. Moderate exercise, such as walking, yoga, and cycling are recommended. Long hours of exercise at the gym or marathons are unfavorable.
Diet
Around the diet for people withHashimoto's have many myths. One of them is that it has to be very eliminative. The truth is that it should be a regular diet, where all the necessary nutrients are provided and where the proper caloric content is maintained (the thyroid malfunctions when slimming and with significant caloric restrictions).
The main emphasis in the diet of people with Hashimoto's is on anti-inflammatory products such as :
- omega-3 fatty acids,
- antioxidants contained e.g. in blueberries, blueberries, the appropriate dose of vitamin C and E.
It is a myth that gluten and dairy products must be excluded from the diet. So far, there are no scientific studies that would confirm the need to eliminate the above-mentioned products.
Only people with Hashimoto's who have celiac disease, gluten allergy or non-celiac gluten sensitivity should exclude cereal products such as wheat, oats from their diet.
Lactose intolerance, which would be the reason for excluding dairy products in Hashimoto's disease, or allergy to cow's milk proteins also does not occur so often that it would be necessary to exclude yoghurts or cheeses from the diet.
Only people with laboratory-confirmed results of tests for lactose intolerance or milk allergy can exclude dairy products under the supervision of a doctor and, under the supervision of a dietitian, apply a diet that will supplement calcium deficiencies caused by milk elimination.
Inability to eat vegetables such as: cauliflower, Brussels sprouts, cabbage, broccoli, radish is also a myth. The fact that they contain goitrogenic goitrogens does not eliminate them in the diet of people suffering from Hashimoto's. First of all, the harmfulness of goitrogens is greatest in raw vegetables, and most of these are rather cooked. In addition, you would have to eat a significant amount of them to adversely affect the functioning of the thyroid gland. Thus, the consumption of moderate amounts of vegetables containing goitrogens is perfectly acceptable and possible.
What should be avoided in the diet of people with Hashimoto's isexcess iodine . As more and more studies show, an excess of iodine can increase the inflammatory processes of the thyroid gland, increase the production of anti-thyroid antibodies and lead to the degradation of thyrocytes (hormonally active thyroid cells). It can also contribute to the emergence of Hashimoto's disease.
In turn,too little iodineleads to disturbances in the production of thyroid hormones, an increase in TSH levels and hypothyroidism. So moderation is important. WHO recommended dose of iodine for an adult (he althy) personis 150 µg per day (about 6.5 g of s alt).
However, it should be remembered that in addition to s alt, iodine contains products such as:
- fish,
- cheese,
- algae,
- brown rice
- or hazelnuts.
Therefore, when we consume these foods (and others containing iodine), we should limit s alting. Try not to take iodine supplementation with Hashimoto's disease.
A product to watch out for with Hashimoto's associated with hypothyroidism is soy. Due to the content of isoflavones, it causes worse absorption of L-thyroxine (a substance contained in the drug for hypothyroidism). Therefore, let's not eat it for breakfast.
Although soy yoghurts or tofu contain much less isoflavones than pure soybeans, however, if we can, give up serving them for morning meals.
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Supplementation
In the Hashimoto diet, there may be an increased demand for selenium and zinc, so it is worth supplementing them if we have the consent of an endocrinologist or other attending physician. In addition, it is worth taking omega-3 fatty acids and vitamin D regularly, as they will help us reduce inflammation.
- Selenium
Selenium plays an important role in restoring the proper functioning of the thyroid gland. This is evidenced by the results of studies conducted on groups of several dozen people with high levels of anti-TPO, incl. in Germany, Greece and Italy.
Patients who, in addition to the standard dose of L-thyroxine, took selenium in the form of selenomethionine or selenate at a dose of 200 µg Se per day for several months, recovered much faster (they had a greater decrease in anti-TPO antibodies, even up to values and it was done in a shorter time) than the placebo group.
In Italy, a study was also carried out in which patients in the early stages of autoimmune thyroiditis were given selenium before starting pharmacological treatment. The patients took this element for 12 months in a dose of 80 µg per day, which resulted in the improvement of the echogenicity of the gland.
Studies show that the use of selenium in Hashimoto's disease has a positive effect on the condition of the thyroid gland, regardless of the age of patients and whether they have a good level of this element in the body.
It is also worth noting that research in Greece showed that a positive side effect of taking selenium to repair the thyroid gland was also:
- mood improvement,
- better sleep quality,
- reducing the feeling of fatigue.
It is associated with a change in the metabolic turnover of such neurotransmitters as serotonin and dopamine, which are responsible for good mood, feeling greater happiness and motivation to act.
The usually recommended dose of selenium is 200 µg per day. However, the dosage of this element, due to the possibility of overdosing, which can be dangerous to he alth, should be determined by a doctor and adjusted to each patient individually.
- Zinc
Too low levels of zinc in the body can lead to:
- increase anti-thyroid antibodies,
- T3 receptor binding disorders,
- disturbance of said conversion
- whether the abnormal secretion of TRH by the hypothalamus and TSH by the pituitary gland (and without proper functioning of the hypothalamic-pituitary-thyroid axis, there can be no proper secretion of hormones).
Therefore, the recommended dose for he althy people, without zinc deficiency, is 10-15 mg per day. If we do not provide it with the diet, i.e. we do not eat pumpkin seeds, fish, shrimp, seafood, eggs or we have problems with absorption of nutrients, let's reach for the supplement. Before that, however, let's consult a doctor about the right dose of zinc for us. Typically, this is around 20 mg per day.
- Vitamin D
The need to take extra vitamin D is due to its immunomodulatory effect. It reduces the number of pro-inflammatory Th1 lymphocytes and increases the number of anti-inflammatory Th2 and Treg lymphocytes.
When there is a vitamin D deficiency (and it's not difficult to do that), then it comes to:
- increase the number of anti-thyroid antibodies,
- increase TSH and decrease thyroid hormones
- and to intensify inflammation.
This causes a vitamin D deficiency to significantly delay Hasimoto's remission. The standard prophylactic dose of vitamin D is 1,000 units, but people with Hashimoto's may need up to 5,000 units to maintain a state of balance in the body.
About the authorDominika Wilk