Hashimoto’s Root Causes


Your thyroid gland is the master thermostat for your body, determining among many things, the rate of your metabolism, your energy levels, and how well you’re burning fat. So when your thyroid gland, which is a butterfly-shaped organ in the front part of your neck slows down, in a condition known as hypothyroidism, you feel tired, sluggish, cold, and sometimes achy, sometimes depressed or anxious, you start to gain weight now matter how disciplined you are about your diet, and your body starts to store fat – some of it in the form of harmful cholesterol!

In addition, you can start to have problems with your hormones including irregular or heavy periods, and even fertility troubles; you might become constipated because everything is slowing down including your digestion, you might develop dry skin, sleep problems, and even hair loss. YIKES!

Million of Americans, particularly women, are suffering with hypothyroidism, and about 50% of women who have this condition, don’t even know it. About 80% of all cases of hypothyroidism are due to an autoimmune response, leading to what is called Hashimoto’s thyroiditis. And many new moms develop this condition, too.

If you have any of the symptoms I’ve described above, it’s a good idea to talk with your integrative doctor, or have your primary care doctor (maybe one in the same!) run some thyroid labs. I talk about which tests are needed in my blog over here.

But what causes hypothyroidism? Are there things you might be able to do to lower your risks? These are the questions I answer for you in this article.

The Top 6 Hypothyroid Triggers

As a functional medicine doctor and herbalist, my approach is to look for the root – or underlying causes – of the conditions I treat. While this doesn’t mean that medications can always be avoided for treatment of your thyroid condition, it does mean that we know what can lead to the problem, thus helping you know what to avoid so you can reduce your risks of developing hypothyroidism and Hashimoto’s, and what you might in some cases be able to do to reverse it or prevent other conditions from developing.

#1 Celiac Disease and Leaky Gut Syndrome

My patient Karen started feeling sick and tired in her late 30s. After decades of struggling with constipation and other digestive problems, things took a turn for the worse and she developed severe fatigue, aching joints, depression, and much worse constipation than even her usual. Testing had revealed that Karen had Hashimoto’s thyroiditis. While it might have been tempting to stop there and just give her a medication for her thyroid problem, a deeper dive into why she developed the thyroid problem revealed a likely source: Karen had true celiac disease! Celiac disease is an autoimmune condition, a frequently missed diagnosis by conventional doctors, and is a common underlying cause of Hashimoto’s because the antibodies that get triggered as a reaction to gluten can start to attack the thyroid, as well as thyroid receptors on cells around your body, making your thyroid hormone production drop down low, or making your body unable to use thyroid hormone that you are producing. Going off of gluten for 3 months not only improved Karen’s digestion and mood, but also reversed her thyroid disease and she never became dependent on medication, and it might do the same for you!

How do you know if you have celiac disease? For starters, you can have your doctor check for gluten antibodies in your blood through some very standard lab tests, and you can also check for whether you carry the celiac genes, also easy to test for. Here’s the tricky part: if the gluten antibodies come back positive, you have celiac disease, but if they come back negative, that doesn’t mean you don’t have it – though that’s what most conventional doctors are taught. If you come back positive for the celiac genes, that doesn’t mean you have celiac disease, but it means you are more likely to develop it than people who don’t have the gene. In my practice, if patients have Hashimoto’s and come back positive for the gene, I instruct them to remove all gluten from the diet.

More advanced testing requires endoscopy, allowing a gastroenterologist to look for changes suggestive of celiac disease in a part of your small intestine called the duodenum. I don’t generally recommend this testing, which is mildly invasive and requires medical sedation. It’s a lot easier to take all gluten out for 3 months and see if you get improvement, and re-test to see if gluten and/or thyroid antibodies are going down, though this can take as long as 6-12 months to see on lab tests.

Which foods should you remove and for how long? If you have celiac disease you’ll have to be super strict about removing all gluten-containing foods, and foods that contain proteins that the body “reads” as if they have gluten. This includes wheat, rye, barley, corn, millet, oats, and coffee, which are the biggest culprits.

What if your tests come back negative, or you don’t have celiac disease but are gluten intolerant? Well, just being gluten intolerant can cause something called Leaky Gut Syndrome. Other causes of leaky gut include lactose or dairy intolerance, antibiotic use, taking ibuprofen, and other food intolerances. Also, if you have ulcerative colitis or Crohn’s disease, you have a leaky gut.

Leaky gut can cause proteins to get into your bloodstream and trigger the production of antibodies, which much like celiac disease can trigger an autoimmune reaction in your thyroid. To identify and treat a leaky gut, head over here.

#2 Demands on Your Adrenals

Your adrenals, like your thyroid, are glands – that means they produce hormones and chemicals your body needs to send out important information in the form of chemical signals to keep your body functioning properly. The adrenal glands sit one on top of each kidney and produce hormones and chemicals including cortisol, adrenaline, and aldosterone, to name a few, which control your blood sugar, insulin, fight or flight reaction, inflammation, and your blood pressure. Whereas your thyroid is your thermostat, the job of the adrenals is to regulate energy use. If you’re chronically exhausted, are calorie restricting, or if you have chronic inflammation or infections that your body is trying to fight, then your adrenal glands will tell your thyroid to go into energy conservation mode to save energy for important tasks like keeping inflammation at bay, and it will tell your thyroid to slow down and store fat so you have more energy to burn when needed. It’s like the adrenals are telling the body to cool it because it’s too hot in here.

How do you know if your adrenals have taken over thyroid mission control leading to hypothyroidism? Head over here to check out the symptoms of adrenal overdrive and adrenal fatigue, the two most likely scenarios, and learn what you can do to support and nourish these important glands to get your thyroid back in charge!

#3 Viral Infections

Clara came to see me all the way from Scotland because she wanted to get to the bottom of what suddenly caused her to develop painful swelling in her throat that was diagnosed as Hashimoto’s. She was also feeling extremely fatigued, was having joint pain, and was very anxious and depressed. Whenever patients come to me with these symptoms, I check for both Hashimoto’s disease and a couple of viral infections that not only cause the same symptoms as Hashimoto’s, but can be an underlying trigger for autoimmune hypothyroidism, so they commonly go hand in hand. Sure enough, Clara not only had worsening thyroid labs in spite of starting the thyroid medication her doctor had recommended, but she came back positive with active infection with Epstein-Barr virus (EBV), the same virus that causes mono, and which can be contracted at any age, or can become reactivated if you had mono before.

Other viral infections that have strong association with Hashimoto’s include Yersinia enterocolitica, an intestinal infection, Helicobacter pylori, a stomach bug, and in some cases, Cytomegalovirus (CMV). The best way to test for these viral infections is through blood testing; treatments can range from boosting immunity with herbal and nutritional support to medications, depending on the condition and the severity. Most importantly, it is important to note that EBV is more likely to be contracted or reactivated if you are under a lot of stress and aren’t getting enough rest and nutritious, immune supporting foods, and Yersinia and H. pylori are more likely to occur when your stomach’s immune defenses are down, often due to low stomach acid or B vitamins.

#4 Fluoride & Other Heavy Metals

The addition of fluoride to our drinking water was considered a major public health innovation, intended to drastically cut down on dental cavities in children, however, it turns out that fluoride is actually a major culprit in hypothyroidism. Simply put, the chemical structure of fluoride is very similar to that of iodine, which the thyroid depends on to produce thyroid hormones. Fluoride can bump that iodine right out of the way and take its place, but the thing is, while the key fits in the lock, it doesn’t turn on the ignition – instead, it blocks thyroid hormone from getting formed! Other heavy metals can do this too, including bromide which is found in many types of bread and baked goods made with bromated flour, and mercury which is high in many fish, including the tuna so many love in their sushi! One thing we can all do to reduce the risk of developing thyroid problems is reduce our heavy metal exposure, particularly to these avoidable triggers. Additionally, if you are having a thyroid problem, consider working with a functional medicine doctor to get tested for heavy metals and learn what to do to eliminate them, including foods and supplements that support detoxification including buffered vitamin C, alginate (from seaweeds), and glutathione. Detoxification should not be done during pregnancy or in the 3 months prior to conception.

#5 Pregnancy and Birth

Hormonal and immune system changes that naturally occur during and in the months after pregnancy predispose us as women to developing Hashimoto’s thyroiditis. Too often, in pregnant women and in new moms, fatigue, overwhelm, sleep problems, weight gain or difficulty losing weight, and even depression or anxiety, are dismissed as “normal pregnancy symptoms,” when in fact, these can also be due to Hashimoto’s. Further, difficulty getting pregnant, miscarriages, and challenges producing breast milk, which are often chalked up to simply being common problems, can also be due to Hashimoto’s. Untreated or under treated hypothyroidism in pregnancy can lead to serious problems for baby’s development and well-being, so it’s important for all women to have thyroid testing in pregnancy, to include thyroid antibody testing, because elevated antibodies in pregnancy are an important risk factor for developing thyroid problems after birth, and if you already have Hashimoto’s, it’s important to work with your midwife, family doctor, or OB to increase your medications appropriately. If you are a new mom struggling with any of the symptoms I mentioned in this article, get tested for Grave’s disease (an autoimmune form of thyroid disease in which the thyroid becomes overactive), and Hashimoto’s, and re-test every few months if symptoms persist, because some tricky aspects of these conditions in the months after birth make it easy to miss these diagnoses in new moms!

#6 Nutritional Deficiencies

The thyroid gland needs to be nourished with specific vitamins and minerals to function well. These include, to name the most common, iodine, zinc, and selenium, which many of us are getting in too marginal or insufficient amounts in our diets to support optimal thyroid functioning. I always recommend “food first” to optimize thyroid function – rich dietary sources of iodine include dulse and kelp (seaweeds), turkey breast, cod (fish), cranberries, yogurt (from animal dairy), and baked potatoes. Rich sources of zinc include oysters, red meat, poultry, seafood such as crab and lobsters, beans, nuts, whole grains, and dairy products, all of which provide some zinc. The rich dietary source of selenium is Brazil nuts – just 1-2 nuts/day provide all you need.

Nutritional supplements can also be helpful in boosting your level of these nutrients, but when it comes to iodine and Hashimoto’s, caution is required as in some people, supplementing with iodine can worsen the condition.

To learn more about Hashimoto’s  you can get my e-book Thyroid Insights and stay tuned for announcements about my new e-course For the Love of Thyroid by joining my community for FREE.

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