If you have been diagnosed with hypothyroidism, chances are high it's caused by Hashimoto’s as Hashimoto's is responsible for more than 90 percent of hypothyroid cases. But most doctors don't test for Hashimoto's because it doesn't change how they treat low thyroid symptoms. However, it's vitally important to know this information because if you have Hashimoto's, it's just as important to treat the immune system as the thyroid.
Your thyroid symptoms are worse despite taking your thyroid medication
One of the most common things people experience is they still have symptoms despite taking their thyroid meds. Often, a doctor will prescribe ever increasing dosages as thyroid function declines. Some people find when they forget to take their meds they don't notice a difference in how they feel. This is because the meds don't address the immune system attacks destroying the thyroid gland even though your TSH may look normal.
You swing between low thyroid symptoms and high
Going back and forth between high and low thyroid symptoms is another common sign of Hashimoto’s. One week you are struggling with fatigue, headaches, constipation, depression, and low libido. The next week you're mind is racing and you have insomnia, heart palpitations, anxiety, and tremors. This happens because when your immune system flares up and attacks the thyroid, this causes excess thyroid hormone to spill into the bloodstream. Your doctor may mistakenly diagnose you with anxiety or even bipolar disorder. Blood tests during these swings will show TSH also peaks and dips. TSH may even test normal as it's moving through an up or down swing. This can lead to a misdiagnosis if you drew your blood during that time.
You have pernicious anemia, celiac disease, or other autoimmunities
Autoimmune diseases like Hashimoto’s low thyroid result from an imbalance in the immune system. Many people with one autoimmune disease will go on to develop one or more other autoimmune diseases. This is because the immune system becomes hyper sensitive and starts losing tolerance to other tissues in the body and attacking them too. If you have low thyroid function and other autoimmune diseases, it's likely you also have Hashimoto’s. Pernicious anemia (an autoimmune B12 deficiency), celiac disease, or a gluten intolerance are other autoimmune diseases commonly seen in people with Hashimoto’s. If you think you might have Hashimoto’s low thyroid, check if you also have any of these symptoms:
Low thyroid symptoms
- Feeling tired or sluggish
- Feeling cold — hands, feet, all over
- Require excessive amounts of sleep to function well
- Weight gain despite adhering to a low-calorie diet
- Gaining weight easily
- Difficult, infrequent bowel movements
- Depression and lack of motivation
- Morning headaches that wear off as the day progresses
- Outer third of eyebrow thins
- Thinning of hair on scalp, face, or genitals, or excessive hair loss
- Dryness of skin and/or scalp
- Mental sluggishness
High thyroid symptoms
- Heart palpitations
- Inward trembling
- Increased pulse rate, even at rest
- Feeling nervous and emotional
- Night sweats
- Difficulty gaining weight
Making sure it's Hashimoto’s
Symptoms are vital to asses but a blood test gives you the proof your doctor or even family members may need to understand you are struggling with an autoimmune disease. Look for these markers: Thyroid peroxidase antibodies (TPO Ab).
In most cases of Hashimoto’s the immune system attacks TPO, an enzyme that triggers thyroid hormone production. Thyroglobulin antibodies (TGB Ab).
Make sure and test for TGB antibodies too, which the thyroid uses to produce thyroid hormones. Thyroid stimulating hormone antibodies (TSH Ab).
This test can diagnose Graves’ disease (hyperthyroidism), although sometimes TSH antibodies may sometimes also be elevated in Hashimoto’s. This marker is often called thyroid stimulating immunoglobulin (TSI). In an advanced autoimmune thyroid condition, with multiple autoimmune diseases, and/or if you react to bioidentical thyroid meds but not synthetic, you may also have antibodies to T4 and T3.
When your Hashimoto's thyroid test comes back negative despite bad symptoms
Don’t worry if your test comes back negative even though you have all the symptoms; this is not uncommon. The immune system and inflammation flare and recede and when you do your test can reflect this. However, a positive test confirms Hashimoto’s low thyroid and that the immune system should be a target for management. Ask my office for more advice on managing Hashimoto’s low thyroid using functional medicine.
How to learn if you have Hashimoto’s low thyroid
Many patients are not diagnosed with hypothyroidism or Hashimoto’s until after several years and going through several doctors. It is a demoralizing journey richly illustrated in my book The Truth About Low Thyroid: Stories of Hope and Healing for Those Suffering With Hashimoto's Low Thyroid Disease
, through real-life stories from patients in my practice. Managing Hashimoto’s goes far beyond using thyroid medication as you must work to stop the immune system from attacking the thyroid. For more information on identifying and managing Hashimoto’s low thyroid, contact
About Dr. Josh Redd — Utah, Nevada, Arizona, Idaho, and New Mexico functional medicine
Dr. Joshua J. Redd, DC, MS, DABFM, DAAIM, author of The Truth About Low Thyroid: Stories of Hope and Healing for Those Suffering With Hashimoto's Low Thyroid Disease
, is a chiropractic physician and the founder of RedRiver Health and Wellness Center
with practices in Utah, Arizona, and New Mexico. He sees patients from around the world who suffer from challenging thyroid disorders, Hashimoto's disease, and other autoimmune conditions. In addition to his chiropractic degree, Dr. Redd has a BS in Health and Wellness, a BS in Anatomy, and a MS in Human Nutrition and Functional Medicine. He speaks across the nation, teaching physicians about functional blood chemistry, low thyroid, Hashimoto's, and autoimmunity. You can join his Facebook page here