For many women, the onset of their hypothyroid symptoms began either during pregnancy or just after. Most of these women went on to be diagnosed with Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland. Pregnancy often triggers Hashimoto’s due to normal shifts in immunity that cause an already beleaguered immune system to tip out of control and begin attacking the thyroid gland.
Factors that can contribute to developing Hashimoto’s around pregnancy or childbirth include shifts in immune function during the third trimester, shifts in immune function postpartum, the dramatic shifts in hormone function, genetic tendency, and the exacerbation of existing disorders such as blood sugar imbalances, food intolerances, gut infections, and other autoimmune diseases (which may or may not be diagnosed).
How pregnancy can trigger Hashimoto’s hypothyroidism
Women make up the vast majority of people struggling with autoimmune diseases, about 75 percent. Researchers suggest this is because women have more complex hormonal systems that involve more fluctuations; hormone and immune function are closely tied. Hormone imbalances are a major contributor to chronic inflammation that can trigger autoimmunity.
Pregnancy simply exacerbates these fluctuations and underlying imbalances.
Shifts in immune function during and after pregnancy can trigger autoimmune disease
Women experience major immune shifts towards the end of pregnancy and then again immediately after birth. These are natural shifts designed to help protect the baby.
During the third trimester, a pregnant woman’s immune system becomes more heavily weighted toward what is called the TH-2 system. This arm of the immune system is the delayed immune reaction that produces antibodies that identify a foreign invader a short while after it enters the body. This response allows the body to recognize the invader in the future.
After the baby is born, a woman’s body then becomes more TH-1 dominant. This is the arm of the immune system that reacts immediately to a foreign invader, such as with swelling and pus around a splinter.
Most people who either already have an autoimmune disease or are at high risk of developing one are overly dominant in either the TH-1 or TH-2 arms of the immune system.
The immune swings that pregnancy and childbirth cause tip an already imbalanced immune system into full expression of an autoimmune disease such as Hashimoto’s hypothyroidism.
Although about 90 percent of hypothyroid cases are caused by Hashimoto’s, some cases are caused by chronic stress. As any mom can tell you, pregnancy and childbirth can bring inordinate amounts of stress.
Extreme or chronic stress depresses function of the pituitary gland. The pituitary gland is a small gland at the base of the brain that is like a control tower for the body’s hormones, telling the various glands throughout the body how much hormone to secrete in response to external and internal cues.
Chronic stress overwhelms the pituitary gland and depresses its function. As a result, the pituitary falters at its job of telling the body’s hormone glands to secrete hormones. In the case of the thyroid gland, this means it doesn’t tell it to release enough thyroid hormone.
This not only causes tiredness and other hypothyroid symptoms, but it can also explain postpartum depression in some women.
It’s important to understand that stress doesn’t just mean bad traffic or a demanding job. Many women enter into pregnancy already under enormous stressors they may not be aware of:
Leaky gut or gut infections
Blood sugar that is either too low (hypoglycemia) or too high (insulin resistance)
Undiagnosed food intolerances such as gluten sensitivity or celiac disease
Undiagnosed brain dysfunctions, such as from an old brain injury, brain inflammation caused by poor diet, or PTSD or CPTSD
Sensitivity to chemicals or over exposure to chemicals
Poor liver detoxification
Undiagnosed chronic bacterial, viral, parasitic, or fungal infections
Are you at risk? Check your TPO and TGB antibodies before pregnancy
It’s not a bad idea to screen for risk for Hashimoto’s before conceiving. You can do this by testing TPO and TGB antibodies. Many people have autoimmune mechanisms already in place that not advanced enough to cause symptoms. However, a big shock to the body such as pregnancy can be the tipping point to send you over the edge into autoimmune expression.
If you have Hashimoto’s in your family, other autoimmune diseases in your family, or you suffer from other inflammatory conditions, it pays to screen for your risk before pregnancy. This gives you an opportunity to use functional medicine strategies to slow down or send into remission your autoimmune condition.
Studies show that women with no thyroid symptoms but positive blood serum TPO antibodies have a 25 percent higher risk for developing an autoimmune response to their thyroid.
Reducing the risk of autism, allergies, eczema, and more in your baby
Using functional medicine to manage autoimmunity or heightened risk for autoimmunity is not only good for the mother’s health, but also for that of her child. Children born to mothers with autoimmunity such as Hashimoto’s show increased risk for varying health disorders, including autism spectrum disorder, eczema, asthma, food allergies, and food intolerances.
Researchers have increasingly found that autoimmune disorders underlie many cases of autism, which is caused by an autoimmune attack against the brain in these children. Whether it’s autism or other immune disorders, children born to mothers with imbalanced immune systems may be more vulnerable to environmental triggers that can tip them over into full blown autoimmunity.
Triggers can include food intolerances, blood sugar imbalances, or toxic chemicals introduced into the bloodstream.
Of course, no one willingly or knowingly brings these hardships onto themselves or their children, but in today’s world the modern immune system faces significant burdens. Going into pregnancy knowing how to manage and minimize the impact of those burdens on the body can help minimize the risk. If you already developed Hashimoto’s during pregnancy or after childbirth, understanding why you did can help you better manage it.
Ask my office for help addressing the root cause of your Hashimoto’s hypothyroidism.
Numerous studies show a strong link between gluten intolerance and Hashimoto’s disease, an autoimmune disease that attacks the thyroid gland, causing hypothyroidism. This is because gluten has a molecular structure that closely resembles thyroid tissue — gluten sensitivity triggers an attack on the thyroid gland. Gluten (technically, the correct term is gliadin), is the protein found in wheat and wheat-like grains, such as spelt, kamut, rye, barley, triticale, and oats.
One of the immune system’s primary jobs is to protect the body from foreign invaders. Sometimes it may recognize a common food as a dangerous invader. When you eat that food throughout each day this can keep your immune system engaged in constant battle, making it hyper zealous, overly sensitive, and thus prone towards food sensitivities and autoimmunity.
Some people also have celiac disease, disease in which gluten triggers an autoimmune attack against the gut, the skin, or neurological tissue. Gluten sensitivity is more common than celiac disease, however, both show up in higher numbers in people with Hashimoto’s hypothyroidism.
If you have been diagnosed with hypothyroidism you should first test for Hashimoto’s by screening for TPO and TGB antibodies — the majority of hypothyroidism cases are caused by Hashimoto’s.
You should also screen for gluten intolerance or celiac disease given how common these conditions are in patients with Hashimoto’s. Likewise, people who discover they are gluten intolerant or have celiac disease should screen for Hashimoto’s.
It’s important to give up gluten completely if you have Hashimoto’s and gluten intolerance. Cheats and little bites are not ok as they trigger an immune response that ultimately destroys thyroid tissue. Also, it’s important to avoid foods that have been contaminated by gluten. Be careful when in a kitchen where gluten is used, with restaurant food, or with questionable packaged foods.
Cyrex Labs offers testing to identify gluten intolerance. However, sometimes the immune system can be so depleted that it produces too few antibodies to produce a positive test, even though you react to gluten. You can screen for this with a total immunoglobulin test.
However, given the evidence establishing a link between gluten intolerance and Hashimoto’s disease, you may be surprised how much better you feel by simply removing gluten from your diet as a start.
Many people have to remove other foods as well, such as dairy, eggs, or other grains. Following the autoimmune paleo diet for about a month and then reintroducing restricted foods one at a time every 72 hours can help you determine which foods trigger an inflammatory reaction in you.
Many people are able to put their hypothyroid symptoms into remission simply by following a diet that eliminates gluten and other trigger foods. Although autoimmune diseases such as Hashimoto’s can be successfully managed through diet and lifestyle strategies, it’s important to understand they can’t be cured. It’s just a matter of taming the immune system.
Ask my office for ways to manage your autoimmune Hashimoto’s hypothyroid condition.
When it comes to autoimmune Hashimoto’s hypothyroidism, dampening inflammation and immune attacks on the thyroid is the primary goal. One of the most powerful allies in this quest is to support your regulatory T cells (T reg cells). These are immune cells that do what their name implies — they help regulate the immune system. This means they play a role in either activating or dampening inflammation. The good news is that when it comes to Hashimoto’s, we can do many things to influence the T reg cells to dampen inflammation and quell Hashimoto’s flare ups and attacks so you can have more good days.
Ways to support T reg cells to manage Hashimoto’s
If you would like help understanding ways to support T Reg Cells to manage Hashimoto’s, you can schedule a FREE 15-MINUTE CONSULTATION with Dr. Celaya.
Following are some proven ways we can support our T reg cells to manage Hashimoto’s.
Vitamin D (cholecalciferol). Fat soluble vitamin D is a powerful supporter of the T reg cells, especially at therapeutic doses (around 10,000 IU a day).
Vitamin D is also important because studies show many people with Hashimoto’s have a genetic defect hindering their ability to process vitamin D. Therefore, they need higher amounts of vitamin D to maintain health. This can be the case even if a blood test shows sufficient levels of serum vitamin D. That’s because the defect is at the cellular receptor site, preventing vitamin D from getting into the cells.
Omega 3 fatty acids. The EPA and DHA in fish oil support T-reg cells. It’s important to make sure you take enough; it’s estimated 80 percent of the population are deficient in essential fatty acids.
Research shows a healthy dietary intake of supplemental omga-3 is 3,500 mg if you eat 2,000 calories per day.
The average EFA capsule is 1,000 mg. Most people in the US eat between 2,000 to 3,000 calories a day and therefore should take 4 to 6 capsules of fish oil a day. Dietary sources of omega 3 include cold water fish, nuts, and seeds.
Glutathione. Glutathione, also known as the master antioxidant, supports T reg cells and is a powerful support in dampening inflammation and managing Hashimoto’s. Straight glutathione cannot be absorbed well but there are other ways to take it, including reduced glutathione, s-acetyl-glutathione, liposomal glutathione, and glutathione precursors.
Glutathione precursors make glutathione inside the cells and include n-acetyl cysteine, cordyceps, Gotu Kola, milk thistle, and alpha lipoic acid. Don’t be shy to take large amounts of glutathione support to dampen inflammation.
Short chain fatty acids (SCFAs). SCFAs are powerful signaling compounds that influence the health of the body and brain. They are produced by healthy gut bacteria that come from eating a diet abundant in a diverse array of vegetables. The more abundant and diverse your gut bacteria the better your SCFA production.
This helps many functions in your body, including proper T reg cell function and dampening of inflammation and managing Hashimoto’s. You can also take the SCFA butyrate to support your SCFA levels, however, you’ll need to make sure you’re eating plenty of vegetables throughout the day too for this strategy to be effective.
Endorphins. Saving the best for last, did you know a powerful way to support anti-inflammatory function of T reg cells is to experience joy, happiness, love, and playfulness? All of these things produce endorphins, feel good chemicals that reduce inflammation. Methods for increasing endorphins include:
Socializing regularly with healthy people
Meditation and breath work
Massage and other forms of body work
Doing something playful regularly
Daily expression of gratitude via a journal or verbal affirmation
Regular exercise that gives you a “natural high” but doesn’t wear you out
These are some of the ways you can manage your Hashimoto’s hypothyroidism. Ask my office for more information.
If you’re getting your TSH levels checked to monitor your thyroid health, it’s best to get that done in the morning. Otherwise, your results may come back normal even though you have hypothyroidism.
All the body’s hormones follow a daily rhythm, including thyroid hormone. This means there are times of the day when it naturally higher or lower. Researchers tested the blood of hypothyroid subjects both before 8 a.m. and again between 2 and 4 p.m.
In hypothyroid patients both untreated and on thyroid medication, TSH dropped was substantially lower during the afternoon test. This means an estimated 50 percent of people with hypothyroidism are not being diagnosed.
In the untreated group, TSH was 5.83 in the morning and 3.79 in the afternoon. In the treated group, TSH was 3.27 in the morning and 2.18 in the afternoon.
A 2004 study also showed late morning, non-fasting TSH was 26 percent lower compared to the early morning, fasting TSH. This means even a late morning blood draw could result in a failure to diagnose. Do you really want to know what is going on with your thyroid? Schedule a FREE 15-Minute Consultation with Dr. Celaya.
TSH blood test timing and functional medicine ranges
The timing of your blood draw plays an important role in reading a thyroid panel. However, there is more to it.
Even with an early morning blood draw, many doctors will still fail to diagnose hypothyroidism because they use lab ranges that are too wide and that do not reflect genuine thyroid health.
Many doctors still use a hypothyroidism TSH range of 0.5 to 5.0 even though the American Association of Clinical Endocrinologists recommends 0.3 to 3.0.
In functional medicine, we use an even narrower range of .25 to 1.25. We also know that only looking at TSH can miss hypothyroidism.
For example, TSH may be normal but other thyroid markers are off. That’s why it’s important to order a thyroid panel that includes total and free T4 and T3, reverse T3, free thyroxine index (FTI), T3 uptake, and thyroid binding globulins. Many conditions can cause poor thyroid function, including inflammation, hormonal imbalances, and chronic stress. Ordering these other thyroid markers provides more insight into such imbalances.
Always include a test for autoimmune Hashimoto’s hypothyroidism
In addition to these markers, anyone with symptoms of hypothyroidism should also test for Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland.
Why? About 90 percent of hypothyroidism cases in the US are caused by Hashimoto’s. To screen for Hashimoto’s, order TPO and TGB antibodies.
Thyroid medications may be necessary to support thyroid function, but they do not address the autoimmunity attacking the thyroid gland. Failing to manage Hashimoto’s increases the risk of developing other autoimmune diseases such as pernicious anemia, rheumatoid arthritis, vitiligo, and Type I diabetes. It will also make it more difficult to manage your symptoms.
Have you ever wanted to know everything there is to know about your thyroid? This 7-part video series will cover thyroid lab testing, nutrition and infections that affect the thyroid, toxins, thyroid hormone conversion, lifestyle, and adrenal interplay.