Functional medicine has a lot to offer women suffering from chronic disease, including Hashimoto’s. By understanding each woman’s root causes, we can work to restore immune balance from the root of the issue. The result is often improvement of symptoms and a halt or reversal of the disease process. It isn’t always a single solution or quick fix, but often takes a variety of interventions and significant lifestyle change. 

In Part 1 of this series, I covered the basics of Hashimoto’s thyroiditis, including statistics and symptoms, as well as an introduction to the functional medicine perspective. Today’s article will dive deeper into addressing hypothyroid symptoms and effectively treating Hashimoto’s from a root cause approach. 

Keep reading to learn more about: 

• Can Hashimoto’s disease be reversed?
• What are the best lab tests for Hashimoto’s?  
• Functional medicine tools for Hashimoto’s disease treatment

Let’s get started! 

Can Hashimoto’s Disease Be Reversed?

The conventional medicine approach to Hashimoto’s is to manage thyroid hormone levels just as in other cases of hypothyroidism. Often, this means thyroid hormone replacement, where thyroid hormone is taken orally. While medication is helpful, and often necessary, this approach fails to address the root cause issues that are driving immune dysfunction and tissue damage. 

Many women come to me for another opinion, when they keep increasing their medication dosage, but continue to have symptoms of Hashimoto’s hypothyroidism. Reversal of Hashimoto’s might depend upon how much damage to the thyroid has already occurred, but in some cases reversal or remission is possible. In many cases, thyroid medication remains part of the overall treatment strategy, along with diet and lifestyle change to address root causes, halt disease progression and resolve symptoms. 

Thyroid Testing

Conventional doctors most likely test TSH (thyroid stimulating hormone) and sometimes TSH plus T4 thyroid hormone (thyroxine). It is possible to have these levels within the normal lab range, yet still experience symptoms. 

This is for two reasons. First, the lab ranges for thyroid hormone are quite wide and don’t represent optimal thyroid function. In functional medicine, we use a tighter lab range. Second, testing TSH (or TSH plus T4) alone doesn’t provide the full picture of thyroid health. 

Instead, it is important to request a full thyroid hormone panel for both initial screening as well as ongoing thyroid monitoring. A full panel includes at least the following:

• TSH
• Free T4
• Free T3 (T3 is active thyroid hormone)
• Thyroglobulin antibodies
• Thyroid peroxidase (TPO) antibodies

Remember that positive antibody tests are required for a Hashimoto’s diagnosis, yet most of the time aren’t tested, which may explain why Hashimoto’s is underdiagnosed. From a conventional perspective, the treatment for Hashimoto’s of thyroid hormone replacement is exactly the same as the treatment for hypothyroidism, so additional testing may not be justified from that perspective. 

However, from a functional perspective, we want to understand the complete picture of thyroid health. I’m also interested in other hormone imbalances, since all hormonal systems are connected. A thyroid imbalance may lead to an imbalance in sex hormones or an adrenal imbalance may contribute to thyroid imbalance, as examples. 

Diet, Nutrition And Hashimoto’s Disease Improvement

As you the correct diagnosis for your thyroid condition and uncover your unique root causes, we can put together a personalized treatment plan to help you feel better. Here are some places to focus on in order to dampen autoimmunity and address the root causes pieces:

• Eliminate gluten and other food sensitivities from the diet. A gluten-free trial is warranted for those with Hashimoto’s and other autoimmune disease. An elimination diet may be used as a jumping off point to discovery our personal Hashimoto’s disease diet. Find the details of the elimination process here. 

• Follow a nutrient-dense whole food diet. It is important to meet protein and micronutrient needs in order to support proper immune function. Functional testing for omega-3 fats, vitamins, minerals and amino acids may be warranted in order to personalize your diet and supplement protocol. 

• Balance the microbiome. Microbiome health is foundational. Functional stool testing is helpful to uncover any pathogenic infections, markers of permeability and imbalances. Targeted gut support is essential. 

• Learn to manage stress. Stress is a huge factor when it comes to autoimmunity and thyroid health. The thyroid and adrenals influence each other; when the body perceives stress, it will dial down thyroid function for protection. 

• Get rid of toxins. This means addressing environmental toxin exposures from all areas of life by choosing organic, using clean personal care and cleaning products, filtering drinking water, filtering indoor air and educating yourself about exposures. Support detoxification to help clear those exposures that you can’t control. 

As you can see, a functional approach to Hashimoto’s is a truly comprehensive one. It includes conventional treatments such as hormone replacement, but also utilizes the power of food lifestyle tools as root cause medicine.  

References

1. Biondi, B., Cappola, A. R., & Cooper, D. S. (2019). Subclinical Hypothyroidism: A Review. JAMA, 322(2), 153–160. Abstract: https://pubmed.ncbi.nlm.nih.gov/31287527/ 
2. Liontiris, M. I., & Mazokopakis, E. E. (2017). A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation. Hellenic journal of nuclear medicine, 20(1), 51–56. Full text: http://www.nuclmed.gr/wp/wp-content/uploads/2017/04/10.pdf 
3. Ihnatowicz, P., Drywień, M., Wątor, P., & Wojsiat, J. (2020). The importance of nutritional factors and dietary management of Hashimoto's thyroiditis. Annals of agricultural and environmental medicine : AAEM, 27(2), 184–193. Full text: http://www.aaem.pl/The-importance-of-nutritional-factors-and-dietary-management-of-Hashimoto-s-thyroiditis,112331,0,2.html