Hashimoto’s thyroiditis is the most common reason people develop hypothyroidism.
In Hashimoto’s, the immune system goes into overdrive and causes inflammation. This puts ongoing stress on the thyroid gland which can disrupt hormone levels and slowly damage the tissue over time. As time goes on, this ongoing immune response begins to disrupt how the thyroid works. Because of this interference the thyroid produces fewer hormones which can lead to hypothyroidism. This condition slows down the metabolism and impacts almost every system in the body.
Many people with Hashimoto’s disease often feel extremely tired, struggle with weight gain and experience brain fog. They might also find themselves feeling cold more often, notice their hair thinning and grapple with digestive problems. What’s surprising is that these symptoms can appear long before traditional lab tests show any major issues.
We view autoimmunity differently than conventional medicine, which frames it as the body unintentionally attacking itself. These responses can indicate that the body is having trouble healing under less than optimal circumstances rather than a mistake. The immune system may react violently—not in self-destruction, but rather as an effort to regain equilibrium—when it is overburdened by long-term stress, environmental pollutants, nutritional deficits, or hormone abnormalities.
The body is constantly striving for balance, but this process can become dysregulated and protracted when it is depleted of nutrition or energy or is overburdened with contaminants. Tissue damage results from the body becoming trapped in a cycle of immune activation rather than effectively reducing inflammation.
What can we do, then, to lessen the overactivation of the immune system and aid in its restoration?
Natural desiccated thyroid:
Hypothyroidism is a defining feature of Hashimoto’s, so thyroid hormone supplementation is often needed. We prefer a combination of T3 and T4 to ensure the body receives both the inactive storage form (T4) and the active, metabolically potent form (T3). Many people with Hashimoto’s struggle to convert T4 into T3 efficiently, making T4-only medications like levothyroxine insufficient. Natural Desiccated Thyroid (NDT) provides a more complete hormonal profile, including precursors T1 and T2. Supplementing with the right balance of thyroid hormones helps reduce stress on the thyroid gland, supports metabolism, and alleviates symptoms like fatigue, brain fog, and cold intolerance. NP Thyroid, Armour Thyroid, or OTC options like RaeNA’s NDT contain T3 and T4 and are great options.
Low dose naltrexone:
Low Dose Naltrexone (LDN) is an off-label use of naltrexone, traditionally prescribed at higher doses for opioid and alcohol dependence. Since the 1980s, medical providers have been prescribing LDN for autoimmune conditions. At doses typically ranging from 0.5 to 4.5 milligrams, LDN has potential immunomodulatory effects by temporarily blocking opioid receptors, leading to a rebound increase in endorphin production. Endorphins play a key role in regulating the immune system, reducing inflammation, and promoting T-regulatory (Treg) cell activity, which helps prevent excessive immune attacks on healthy tissues. LDN has also been shown to lower pro-inflammatory cytokines, such as TNF-a and IL-6, which are often elevated in autoimmune conditions.
Progesterone:
Women are up to 10 times more likely to develop Hashimoto’s than men. This is partly due to the influence of estrogen, which affects immune function and increases thyroid autoantibody production. The interaction between hormones and immune responses makes women more vulnerable to autoimmune diseases in general. “Estrogen blocks the release of hormone from the thyroid gland, and progesterone facilitates the release. Estrogen excess or progesterone deficiency tends to cause enlargement of the thyroid gland, in association with a hypothyroid state” (Dr. Ray Peat, PhD)
Supplementing with progesterone can help to:
- Counteract estrogen’s suppressive effects on the thyroid, allowing for better thyroid hormone release and utilization.
- Reduce thyroid autoimmunity, as progesterone helps modulate the immune system and lower inflammatory cytokines that contribute to Hashimoto’s.
- Improve T4-to-T3 conversion, since progesterone supports liver function, where much of this conversion takes place.
- Lower thyroid-binding globulin (TBG), increasing the amount of active thyroid hormone available to cells.
- Protect against cortisol and stress hormones, which can suppress thyroid function and contribute to autoimmunity.
- Support metabolic function, reducing common Hashimoto’s symptoms like fatigue, cold intolerance, and brain fog.
High dose thiamine:
Many people with Hashimoto’s experience chronic fatigue, brain fog, and sluggish metabolism, yet standard lab tests may not reveal a true thiamine deficiency. This is known as functional thiamine deficiency. Supplementing with high-dose thiamine helps restore energy by bypassing metabolic bottlenecks and supporting ATP production. It enhances GABA and dopamine activity, which may improve focus, memory, and mental clarity. Thiamine plays a role in reducing inflammation by lowering pro-inflammatory cytokines like TNF-a and IL-1ß, which are often elevated in Hashimoto’s and contribute to thyroid damage.
Case Reports
> J Altern Complement Med. 2014 Mar; 20(3):208-11.
doi: 10.1089/acm.2012.0612. Epub 2013 Sep 25.
Thiamine and Hashimoto’s thyroiditis: a report of three cases
Antonio Costantini 1, Maria Immacolata Pala
Results: Treatment with thiamine led to partial or complete regression of the fatigue within a few hours or days.
Removing dietary gluten:
Hashimoto’s is linked to celiac disease and gluten sensitivity. Research suggests that people with Hashimoto’s are significantly more likely to have gluten-related disorders due to molecular mimicry, where the immune system mistakenly attacks the thyroid because of similarities between gluten proteins and thyroid tissue. In addition to triggering an autoimmune response, gluten can also contribute to intestinal permeability (“leaky gut”), which allows undigested proteins, toxins, and inflammatory compounds to enter the bloodstream and further fuel immune system overactivation. Many with Hashimoto’s report symptom improvement when removing gluten, and some studies suggest that a gluten-free diet may help reduce thyroid antibodies and inflammation.
Meta-Analysis > Front Endocrinol (Lausanne). 2023 Jul 24:14:1200372.
doi: 10.3389/fendo.2023.1200372. eCollection 2023.
Effect of gluten-free diet on autoimmune thyroiditis progression in patients with no symptoms or histology of celiac disease: a meta-analysis
Lowering stress:
Almost every autoimmune condition is linked to stress and high cortisol. Chronic stress elevates cortisol, which suppresses thyroid hormone conversion (T4 to T3) and weakens the immune system’s ability to regulate itself.
High cortisol raises blood sugar, increases estrogen dominance, and depletes progesterone, all of which contribute to immune dysregulation. Elevated stress hormones can also increase intestinal permeability (“leaky gut”), allowing inflammatory compounds and toxins to further drive the autoimmune response. Lowering cortisol often requires significant lifestyle adjustments, but some effective strategies to help manage it include:
- Eat every 3-4 hours to keep blood sugar stable
- Avoid excessive fasting or low-carb diets
- Get morning sunlight
- Spend as much time in nature as you can
- Address emotional health and relationships
- Ensure adequate sodium, potassium, and magnesium intake help regulate cortisol
Lymphatic drainage and massage:
The original name for Hashimoto’s thyroiditis was “struma lymphomatosa,” a term given by Dr. Hakaru Hashimoto when he first described the condition in 1912. In Latin, “struma lymphomatosa” translates to “lymphoma-like swelling” or “swollen lymph gland mass.”
The lymphatic system is responsible for clearing cellular waste, toxins, and immune byproducts, so when it becomes sluggish, inflammation lingers, immune cells accumulate.
The thyroid can be affected, especially because there are so many lymph nodes and vessels surrounding the gland.
Lymphatic massage and drainage techniques around the neck may help:
- Reduce swelling and fluid retention in the thyroid area.
- Encourage the removal of inflammatory byproducts and immune cell waste.
- Support detoxification by improving circulation and lymph flow.
- Relieve pressure and discomfort associated with thyroid inflammation.
In closing
Many people think of Hashimoto’s as a condition that permanently damages the thyroid, but the thyroid has the ability to regenerate. Research suggests that thyroid function can improve when inflammation is reduced, metabolic function is restored, and the immune response is rebalanced. This means that healing is possible, even after years of thyroid dysfunction.
It’s always important to remember that with any chronic condition, lifestyle changes are necessary. Diet is usually one of the most important factors, as what we eat directly influences inflammation, immune function, and thyroid hormone production. Addressing stress, blood sugar balance, digestion, and nutrient deficiencies play a huge role in managing symptoms and supporting thyroid function.
There’s no one size fits all approach, but there are a lot of things we can do to help restore balance and improve how you feel.
Contact us today if you’d like to discuss your personalized treatment plan.
