Questions To Ask Your Doctor
- What is the likely cause of my Hashimotos disease?
- What are the results of my blood test? What do these results mean?
- What is the best treatment option? Will I need medicine?
- What are the side effects of the medicine? How long will I need to take it?
- When can I expect relief from my symptoms?
- Am I at risk for any long-term health problems?
A Complex Relationship: The Thyroid And The Immune System
Home A Complex Relationship: The Thyroid and the Immune System
The thyroid is the butterfly-shaped gland in our throat thatis an essential regulator in our body. It produces thyroid hormone , whichaffects virtually every one of our cells and is a contributor to metabolism andkeeping us energetic and active. When it is producing TH in appropriatequantities, it holds many organs and systems in equilibrium. We know that thereis close communication between the endocrine and immune systems and thatalteration in levels of TH can affect the function of the immune system.Thyroid hormones also have a role in inflammation, autoimmunity and clearingpathogens from the body. In what may seem like a strange occurrence, the immunesystem can also attack the thyroid, however.
Autoimmune Thyroid Disease
Autoimmune thyroid disease is not one disease, it refers toseveral different ways that the immune system can impact the thyroid.
You may have heard from someone you know that their thyroid is overactive or underactive. If its overactive, your body is producing too much TH, and you may be sweaty, anxious and lose weight without meaning to. A hypoactive or underactive thyroid is more common, especially in middle-aged women, and leads to the whole system slowing down and producing the following symptoms:
- Sensitivity to cold
- Brittle nails, hair loss, dry skin
- Muscle aches, weakness, joint issues
Stress, Thyroid Function, and Immunity
Hypothyroidism: Potential Symptoms And Causes Of An Underactive Thyroid Gland
Hypothyroidism is a thyroid disease that affects people globally. Two- to three-percent of Americans have hypothyroidism 10-15% mild hypothyroidism. Hypothyroidism affects women more than men. The thyroid gland is located in the neck and secretes hormones into the blood, which are then carried into the bodys tissues. The thyroid gland mainly produces a hormone called thyroxine , which is then converted by each of the bodys organs to the active form triiodothyronine . They both work to keep the bodys organs functioning properly. Thyroid hormone is important for regulation of body temperature, heart rate, blood pressure, and metabolism.
Underactive ThyroidHypothyroidism is a disease where the person affected has an under-functioning thyroid. When you have hypothyroidism, certain body functions slow down and may lead to fatigue, dry skin, and memory problems. Hypothyroidism is diagnosed with a blood test. You may experience a variety of symptomssome resembling other health issues. Some symptoms you might be aware of and some you may not notice at all.
The most common and noticeable symptoms may include:
- Loss of energy, fatigue
- Feeling pins and needles in hands and feet
- Heavier or worsening menstrual periods and cramps
- Growth delay
Some are considered severe, although the ranges of severity differ from person to person. The symptoms listed below can be caused by hypothyroidism and may affect other health problems .
Read Also: Is Armour Thyroid The Same As Np Thyroid
Hashimotos Thyroiditis And Hypothyroidism
Are people with autoimmune thyroid disease, such as Hashimotos thyroiditis or Graves disease, at more risk for acquiring COVID-19 or having a more serious COVID-19 infection?
The U.S. Centers for Disease Control advises that people who are immunocompromised are at higher-risk of severe illness from COVID-19. Immunocompromised people have a weaker immune system and have a harder time fighting infections. However, the immune system is complex, and having autoimmune thyroid disease does not mean that a person is immunocompromised or will be unable to fight off a viral infection.
Thus far, there is no indication that patients with autoimmune thyroid disease are at greater risk of getting COVID-19 or of being more severely affected should they acquire the COVID-19 infection.
Are there any shortages of levothyroxine?
Levothyroxine is one of the most widely used medications in the United States, and there are many brand and generic types available.
At this time, there are no identified shortages of any types of these thyroid hormone replacement medications.
However, in order to maintain social distancing and limit exposure to COVID-19, patients should consider obtaining a 90-day supply of prescriptions or receiving their thyroid medications through a mail-order service instead of picking them up at the local pharmacy.
How To Think About Treating And Preventing Viral Infection
One of the biggest issues in dealing with the novel coronavirus is understanding how to think about it.
Most people are sufficiently freaked out that their response is to attempt to completely avoid the virus by hunkering down and staying away from every living creature or thing.
This is manifested as what we call social distancing.
But, for the purposes of this article, we are going to avoid talking about social distancing because the chances are very high that ultimately you will end up being exposed to the virus.
Social distancing, at least as it currently stands, is something that cannot last indefinitely and is unlikely to last until we have a vaccine.
This means you will have to prepare to be exposed to the virus and take every step in your power to improve the outcome if/when this does occur.
So the way that we are going to think about this is two fold:
#1. How can I ensure that if I am exposed to the virus that I am in the most healthy state as possible?
And #2. How can I reduce the impact that the virus has on my health to ensure that I can weather the storm ?
Also Check: Fasting Before Thyroid Test
Thyroid Nodules And Thyroid Cancer
Is it safe to delay a biopsy of my thyroid nodule?
Most thyroid nodules are benign , but some nodules of a certain size that also have suspicious features on ultrasound may be advised to undergo a biopsy. Even if the thyroid nodule is found to be cancerous, there is usually little risk in delaying surgery to have it removed. Thus, it would also be generally safe to delay biopsy of the nodule unless your clinician strongly advises that it be done urgently.
Are people with thyroid cancer at greater risk for COVID-19 infection because they are immunocompromised?
The U.S. Centers for Disease Control generally states that people who are undergoing cancer treatment meet the definition of being immunocompromised.
However, unlike many other types of cancer, the majority of thyroid cancer patients are not receiving chemotherapy or other treatment that would deplete the immune system and cause them to be immunocompromised. Having a previous diagnosis of thyroid cancer and receiving thyroid hormone medication is not a known risk factor for getting COVID-19 or being more severely affected by it.
For the rare thyroid cancer patients who are receiving chemotherapy medications for your thyroid cancer treatment, you would be considered at higher risk for severe illness due to COVID-19.
Is it safe to delay thyroid surgery because of the COVID 19 pandemic?
Is it safe to delay radioactive iodine treatment because of the current COVID-19 pandemic?
Potential Causes Of Hypothyroidism
Hypothyroidism, an under-performing thyroid, may have many different causesand some are more prevalent than others. The most common cause of hypothyroidism is an autoimmune disease.
About Autoimmune DiseaseOur bodies immune systems are charged with protecting us from bacterial and viral invaders. The immune system attacks invaders . People with autoimmune hypothyroidism are at a disadvantage because their immune system attacks the normal thyroid gland. These attacks cause the thyroid hormone producing cells to malfunction, and inhibit the thyroid glands ability to synthesize thyroid hormone. Eventually, there are not enough cells left to meet the bodys need for thyroid hormone. This is more common in women than menand can begin at any point in a persons life, but tends to become more common as people age.
Hashimotos DiseaseThe most prevalent type of autoimmune hypothyroidism is a disease that causes the thyroid to shrinkit is called Hashimotos disease and may cause.
Recommended Reading: What Are The Side Effects Of Np Thyroid
What Causes Hashimotos Disease
Researchers dont know why some people develop Hashimotos disease, but a family history of thyroid disease is common. Several factors may play a role, including2
Hypothyroidism can also be caused by
- some medicines used to treat bipolar disorder or other mental health problems
- iodine-containing medicines used to treat abnormal heart rhythm
- exposure to toxins, such as nuclear radiation
Is A Combination Of Hormones Needed
Levothyroxine is the synthetic form of the natural T-4. T-4 is converted into T-3 in the body. While most people are treated successfully with levothyroxine alone, some people don’t feel completely normal on levothyroxine.
Researchers have investigated whether adjusting standard hypothyroidism treatment to replace some T-4 with small amounts of T-3 may offer benefit. But, the majority of studies have determined that the addition of T-3 does not offer any advantage over treatment with T-4 alone.
There is some evidence that T-3 may offer benefit to certain subsets of people, such as people who have had their thyroid surgically removed . Research is ongoing.
T-3 can be given alone as liothyronine or in combination with T-4. Taking a combination T-4 and T-3 ends up producing higher than normal levels of T-3, especially soon after the medication is taken. This can cause a fast heart rate, anxiety and trouble sleeping.
But, for those who haven’t gotten enough relief from T-4 alone, adding liothyronine to standard levothyroxine treatment for a three- to six-month trial is a long enough period to see if the combination helps you.
Recommended Reading: Apple Cider Vinegar Thyroid Nodules
Strategy 3 Of Arms Manage And Mitigate Exposure To The Virus In The First Place
Im a huge fan of prevention rather than cure so if you can prevent a virus from entering into your body in the first place to me that is ideal.
Wash Your Hands and sing the Happy Birthday to You song so you wash for 20 seconds continuously, long enough to have an impact. As youre standing there at the basin lather the soap between your fingers, top & bottom, front & back of your hands and into your nail beds and remember to show your thumb some soapy love.
Cough/sneeze into a disposable tissue and throw it away before you touch anything. Then go wash your hands for 20 seconds continuously. Help others to do the same.
Stay up to date on the latest reputable information so you can respond quickly: Coronavirus health alert.
Causes Of Graves’ Disease
No one really knows what causes Graves’ disease because the causes of autoimmunity are not fully understood. Stress, both physical and emotional, is known to affect the responsiveness of the immune system and there appears to be some association between stress and the onset of autoimmune conditions – including Graves’ disease. Autoimmune conditions have a distinct genetic element, with some family lines having multiple cases of Graves’ disease and other autoimmune conditions. It is likely that some people’s genetic inheritance could predispose them to Graves’ disease. Another cause is excessive iodine intake. X-ray contrast mediums and a number of disinfectants contain a lot of iodine and can trigger Graves’ disease in susceptible people.
Read Also: What Does Negative Thyroid Antibodies Mean
Can Your Thyroid Cause Sleep Problems
Thyroid imbalances have been linked to sleep problems. Hyperthyroidism can cause difficulty sleeping due to arousals from nervousness or irritability, as well as muscle weakness and constant feelings of tiredness. An overactive thyroid may also lead to night sweats and frequent urges to urinate, both of which can disrupt sleep.
People with hypothyroidism , on the other hand, often experience trouble tolerating cold at night and joint or muscle pain that disrupts sleep. Some studies have linked an underactive thyroid to poor quality sleep, longer sleep onset or the time it takes to fall asleep and shorter sleep duration during the night. Younger people, individuals with a relatively low body mass index, and women are all considered at higher risk of developing sleep problems due to hypothyroidism.
Hypothyroidism can also cause hypersomnia, or the irrepressible need to sleep or lapses into sleep that occur on a daily basis. Hypersomnia can occur due to an underlying medical disorder, and hypothyroidism is considered the leading cause of hypersomnia due to a disorder in the endocrine system. Additionally, untreated hypothyroidism can be mistaken for sleep-related hypoventilation, or excessively slow or shallow breathing that occurs primarily during sleep.
What To Expect From Your Doctor
Your doctor is likely to ask you a number of questions, such as:
- What are your symptoms, and when did you first notice them?
- How have your symptoms changed over time?
- Have you noticed changes in your energy level or your mood?
- Has your appearance changed, including weight gain or skin dryness?
- Has your voice changed?
Recommended Reading: Medications That Affect Thyroid Function
The Simple Way To Arm Your Immune System
A diet rich in fruit and veggies, high-quality proteins yet low in sugar and processed foods hits all the nutritional high spots for arming your immune system. If your antibody count is high or you feel like you need a top up Ive listed in this article the nutrients Hashimotos and Graves should explore first.
Manage your stress and get lots of restorative sleep. Whilst these two almost seem like no-brainers you might be surprised to hear that most people struggle with them on a daily basis.
Whilst it might feel that all that matters is stockpiling enough toilet paper, make sure you wash your hands and eat your veggies )
Stay safe my thyroid brothers and sisters.
With love, Sonia x
Remember whilst I am a qualified naturopath, nutritionist and herbalist I am not your practitioner so any information provided here should only be used to arm you for a discussion with your qualified nutrition professional.
1. Wang H, Chen W, Li D, et al. . Vitamin D and Chronic Diseases. Aging Dis. 8, 346353.
2. Mitsuyoshi Urashima, Takaaki Segawa, Minoru Okazaki, Mana Kurihara, Yasuyuki Wada, Hiroyuki Ida, . Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren, The American Journal of Clinical Nutrition, 9,2551260.
3. Wang, J., Lv, S., Chen, G., Gao, C., He, J., Zhong, H., & Xu, Y. . Meta-analysis of the association between vitamin D and autoimmune thyroid disease. Nutrients, 7, 2485-2498
How Does Eating Diet And Nutrition Affect Hashimotos Disease
The thyroid uses iodine, a mineral in some foods, to make thyroid hormones. However, if you have Hashimotos disease or other types of autoimmune thyroid disorders, you may be sensitive to harmful side effects from iodine. Eating foods that have large amounts of iodinesuch as kelp, dulse, or other kinds of seaweed, and certain iodine-rich medicinesmay cause hypothyroidism or make it worse. Taking iodine supplements can have the same effect.
Talk with members of your health care team about
- what foods and beverages to limit or avoid
- whether you take iodine supplements
- any cough syrups you take that may contain iodine
However, if you are pregnant, you need to take enough iodine because the baby gets iodine from your diet. Too much iodine can cause problems as well, such as a goiter in the baby. If you are pregnant, talk with your doctor about how much iodine you need.
Don’t Miss: Do I Need To Fast For A Tsh Blood Test
Symptoms Of Hashimoto’s Thyroiditis
Hashimoto’s symptoms may be mild at first or take years to develop. The first sign of the disease is often an enlarged thyroid, called a goiter. The goiter may cause the front of your neck to look swollen. A large goiter may make swallowing difficult. Other symptoms of an underactive thyroid due to Hashimoto’s may include:
- Weight gain
Living With Hashimotos Disease
Hashimotos disease often stays stable for many years. If it does progress to hypothyroidism, it is easily treated.
If you are diagnosed with Hashimotos disease and plan to become pregnant, you should talk to your doctor. Hypothyroidism can affect both you and your baby if left untreated. Youll need to be careful and watch for symptoms of hypothyroidism throughout your pregnancy. Thyroid medicines are generally safe to take during pregnancy.
Also Check: Levothyroxine Dosage Guidelines
Does Birth Control Affect My Thyroid
When youre on birth control pills, the estrogen and progesterone inside of the pills can affect your thyroid-binding proteins. This increases your levels. If you have hypothyroidism, the dose of your medications will need to be increased while youre using birth control pills. Once you stop using birth control pills, the dosage will need to be lowered.
How Is Hypothyroidism Diagnosed
A blood test diagnoses an underactive thyroid gland . A normal blood test will also rule it out if symptoms suggest that it may be a possible diagnosis. One or both of the following may be measured:
- TSH. This hormone is made in the pituitary gland. It is released into the bloodstream. It stimulates the thyroid gland to make thyroxine. If the level of thyroxine in the blood is low, then the pituitary releases more TSH to try to stimulate the thyroid gland to make more thyroxine. Therefore, a raised level of TSH means the thyroid gland is underactive and is not making enough thyroxine.
- Thyroxine . A low level of thyroxine confirms hypothyroidism. Test results might be described as having ‘low thyroid levels’ or a ‘low thyroid’.
A test for thyroid antibodies may be done to confirm the diagnosis if the cause is thought to be autoimmune. Other tests are not usually necessary unless a rare cause of hypothyroidism is suspected. For example, tests of the pituitary gland may be done if both the TSH and thyroxine levels are low. If you have a swollen thyroid gland when the doctor examines you , you would usually have an ultrasound scan.
Read Also: Apple Cider Vinegar For Thyroid Problems