The Must Know Basics for Hashimoto's and Hypothyroidism

Start here and then focus on all the silver bullets and shiny objects.

Some of the common hypothyroid symptoms:

• Fatigue, muscle aches or weakness

• Difficulty losing weight

• Feeling cold

• Dry skin, increased shedding of hair

• Chronic constipation

• Heartburn

• Chronic bloating or gassiness

• Changes in cognitive functioning

• Feelings of sadness or apathy

• Irregular or absent menstrual cycles

Where is T4 converted to T3?

Between 80-90%+ of thyroid hormone produced is T4, and it must be converted to the active T3 form by other tissues.

These tissues are:

• Liver

• Kidneys

• Intestines

• Muscles

• Brain

This makes the health of these organs crucial to proper thyroid hormone circulation and efficacy.

2 hormones to be aware of that can affect thyroid hormone:

• Cortisol

• Estrogen

Both of these can reduce circulating T3 and induce hypothyroidism signs/symptoms.

We’ll talk more about them below.

Top Tips for Hashimoto’s Patients:

• Testing TSH is not enough. Ask for TSH, free T3, reverse T3, free T4, and TPO antibodies. Seeing where your vitamins & minerals land is also important (D, B’s, iron, zinc, Mg, selenium)

• The health of your microbiome is crucial. Artificial additives and gluten can contribute to leaky gut and therefore alert your immune system.

• Prolonged stress and sustained release of increased cortisol can contribute to the conversion of T3 to reverse T3 where the body can no longer use it. Low cortisol can also do this but much fewer people deal with that. Iron deficiency is also a cause of T3 —> rT3.

• Irregular or heavy periods may be an indication to test for estrogen dominance as this can contribute to hypothyroid symptoms or autoimmunity. One example is estrogen’s ability to increase thyroxine-binding globulin (TBG) levels, which binds to thyroid hormone and decreases free T3 levels.

  • Causes of estrogen dominance include:

    • Environmental Xenoestrogens: Compounds that mimic estrogen, such as BPA in plastics, pesticides, herbicides, and some cosmetics, load the body with excess estrogen.

    • Body Fat & Weight Gain: Fat cells contain an enzyme called aromatase that turns other hormones into estrogen. Being overweight can, therefore, cause estrogen levels to rise.

    • Chronic Stress: High cortisol levels from chronic stress can lead to a decrease in progesterone production, breaking the balance between the two hormones.

    • Poor Liver & Gut Health: The liver is responsible for detoxifying and flushing out excess estrogen. If the liver is overloaded (from alcohol, toxins, etc) or if the gut microbiome is imbalanced, estrogen cannot be properly eliminated and may recirculate.

    • Hormonal Changes: Perimenopause or menopause often brings a sharp decline in progesterone while estrogen fluctuates, sometimes leading to a relative dominance.

    • Medications: Hormone Replacement Therapy (HRT) and some birth control pills can elevate estrogen levels. Many medications contribute either directly or indirectly to reduced T3 hormone. Ask your doctor if you’re curious about how your meds are affecting your thyroid.

    • Diet: A low-fiber diet impairs the body’s ability to remove excess estrogen through waste, leading to higher levels in the body.

Which nutrients are crucial to optimize?

• Zinc—Needed to form TSH and too little can impair T4 to T3 conversion.

• Selenium—Acts as a catalyst to convert T4 to T3 and helps protect that body from oxidative damage.

• Magnesium—Proper thyroid function depends on a fine balance between calcium and magnesium. Magnesium is also used by the body in more than three hundred enzyme reactions.

• Iron—Adequate amounts of iron are necessary to transport T3 to the cells of your body. Being even “a little anemic” can have an effect.

• Iodine—Adequate amounts are needed to form T4 and T3.

• Glutathione— One of the most beneficial antioxidants in the body.

• Vitamin B’s— crucial for production and conversion of thyroid hormones.

• Glycine— needed for liver detoxification pathways and glutathione production.

The 5 Element view of thyroid disorders:

Source: The Tao of Chinese Medicine by Deke Kendal

1. Wood (Pineal) establishes proper timing

2. Fire (Pituitary) activates appropriate responses

3. Earth (Pancreas) provides stable nourishment

4. Metal (Thyroid) maintains consistent rhythm

5. Water (Adrenals/Reproductive) stores and provides reserves

How does TCM look at Hashimoto’s? What are some patterns we see?

1. Spleen Qi Deficiency

2. Spleen & Kidney Yang Deficiency

3. Liver Qi Stagnation with Phlegm Nodules - swollen gland or plum pit qi syndrome

4. Phlegm Stasis and Blood Stagnation - hard nodules that are irregularly shaped

With the autoimmunity component, there is usually a Kidney Deficiency of some sort, whether it’s Essence, Yin, or Yang.

Phlegm in this context can be attributed to inflammation.

What is the best treatment strategy for Hashimoto’s or hypothyroid patients?

Focusing on the immune, digestive, neuroadrenal, and circulatory systems one at a time. This process gives you the best chance at clearing what is not your body and nourishing what is.

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